title: Patterns of Childhood Abuse and Neglect in a Representative German Population Sample.
abstract: BACKGROUND
  Different types of childhood maltreatment, like emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse are interrelated because of their co-occurrence. Different patterns of childhood abuse and neglect are associated with the degree of severity of mental disorders in adulthood. The purpose of this study was (a) to identify different patterns of childhood maltreatment in a representative German community sample, (b) to replicate the patterns of childhood neglect and abuse recently found in a clinical German sample, (c) to examine whether participants reporting exposure to specific patterns of child maltreatment would report different levels of psychological distress, and (d) to compare the results of the typological approach and the results of a cumulative risk model based on our data set.
  
  
  METHODS
  In a cross-sectional survey conducted in 2010, a representative random sample of 2504 German participants aged between 14 and 92 years completed the Childhood Trauma Questionnaire (CTQ). General anxiety and depression were assessed by standardized questionnaires (GAD-2, PHQ-2). Cluster analysis was conducted with the CTQ-subscales to identify different patterns of childhood maltreatment.
  
  
  RESULTS
  Three different patterns of childhood abuse and neglect could be identified by cluster analysis. Cluster one showed low values on all CTQ-scales. Cluster two showed high values in emotional and physical neglect. Only cluster three showed high values in physical and sexual abuse. The three patterns of childhood maltreatment showed different degrees of depression (PHQ-2) and anxiety (GAD-2). Cluster one showed lowest levels of psychological distress, cluster three showed highest levels of mental distress.
  
  
  CONCLUSIONS
  The results show that different types of childhood maltreatment are interrelated and can be grouped into specific patterns of childhood abuse and neglect, which are associated with differing severity of psychological distress in adulthood. The results correspond to those recently found in a German clinical sample and support a typological approach in the research of maltreatment. While cumulative risk models focus on the number of maltreatment types, the typological approach takes the number as well as the severity of the maltreatment types into account. Thus, specific patterns of maltreatment can be examined with regard to specific long-term psychological consequences.
authors.affiliation: Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schilling
authors.affiliation: Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weidner
authors.affiliation: Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Germany.|Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.affiliation: Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Germany.
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
authors.affiliation: Klinik für Innere Medizin I (Gastroenterologie, Hepatologie, Stoffwechsel- und Infektionskrankheiten, Psychosomatik, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany.|Klinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, München, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser
authors.affiliation: Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Pöhlmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000523:psychology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult