title: Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study.
abstract: BACKGROUND
  Childhood maltreatment and maladaptive personality are both cross-sectionally associated with psychological distress. It is unknown whether childhood maltreatment affects the level and longitudinal course of psychological distress in adults and to what extent this effect is mediated by maladaptive personality.
  
  
  METHODS
  A sample of 2947 adults aged 18-65, consisting of healthy controls, persons with a prior history or current episode of depressive and/or anxiety disorders according to the Composite Interview Diagnostic Instrument were assessed in six waves at baseline (T0) and 1 (T1), 2 (T2), 4 (T4) and 6 years (T6) later. At each wave psychological distress was measured with the Inventory of Depressive Symptomatology, Beck Anxiety Inventory, and Fear Questionnaire. At T0 childhood maltreatment types were measured with a semi-structured interview (Childhood Trauma Interview) and personality traits with the NEO-Five Factor Inventory.
  
  
  RESULTS
  Using latent variable analyses, we found that severity of childhood maltreatment (emotional neglect and abuse in particular) predicted higher initial levels of psychological distress and that this effect was mediated by maladaptive personality types. Differences in trajectories of distress between persons with varying levels of childhood maltreatment remained significant and stable over time.
  
  
  CONCLUSIONS
  Childhood maltreatment was assessed retrospectively and maladaptive personality types and level of psychological distress at study entry were assessed concurrently.
  
  
  CONCLUSIONS
  Routine assessment of maladaptive personality types and possible childhood emotional maltreatment in persons with severe and prolonged psychological distress seems warranted to identify persons who may need a different or more intensive treatment.
authors.affiliation: Section of Clinical Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: Spinhoven@FSW.LeidenUniv.NL.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Section of Clinical Psychology, Leiden University, Leiden, The Netherlands.
authors.forename: Bernet M
authors.initials: BM
authors.lastname: Elzinga
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Albert M
authors.initials: AM
authors.lastname: Van Hemert
authors.affiliation: Section of Methods and Statistics, Leiden University, Leiden, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: de Rooij
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology* / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D005239:Fear; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010551:Personality; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Anxiety; Avoidance; Childhood trauma; Depression; Personality traits