What Haunts Child Abuse Victims? Memory, study discover

For generations, our society has oscillated over how best to treat people who experienced horrible things in childhood.

Should these memories be discovered, allowing their destructive power to dissipate? Should it be gently shaped into something less painful? Or should they be left untouched?

Researchers from King’s College London and City University of New York have examined this mystery by conducting an unusual experiment.

Researchers interviewed a group of 1,196 American adults repeatedly over a 15-year period about their levels of anxiety and depression. Unbeknownst to the subjects, 665 of them were chosen because court records showed they had suffered abuse such as physical abuse, sexual abuse or neglect before the age of 12.

Not all of them told the researchers they had been abused—and that was associated with a significant difference.

The study showed that 492 adults who reported experiencing abuse and were in court records proving abuse had significantly higher levels of depression and anxiety than a control group with no documented history of abuse. Posted last week In JAMA Psychiatry. The 252 people who reported abuse without court records reflecting it also had higher levels.

But the 173 people who did not report being abused, despite court records showing it happening, had no more distress than the general population.

Dr Andrea Danes, professor of child and adolescent psychiatry at King’s College London and one of the study’s co-authors, says the findings suggest how people frame events in their early childhood and interpret them powerfully for their mental health as they become adults.

“It almost goes back to the sober message,” he said, “and it’s what you make of experience.” “If you can change how you interpret the experience, if you feel more in control in the moment, that’s something that can improve mental health in the long run.”

in Meta-analysis Among 16 studies of child abuse published in 2019, Dr. Danes and his colleagues found that 52 percent of people with records of childhood abuse did not report it in interviews with researchers, and 56 percent of those who did report no history. Documented abuse.

This discrepancy may be due in part to problems with measurement—court records may not contain a history of abuse—and may also reflect that self-reporting of abuse is influenced by a person’s levels of anxiety and depression, Dr. Danes said.

“There are many reasons why people may, in some ways, forget those experiences, and other reasons why others may misinterpret some experiences as neglect or abuse,” he said.

Even given these warnings, he said, it was notable that adults who had a documented history of abuse but did not report it — because they had no memory of the events, interpreted them differently or chose not to share those memories with interviewers. – seemed more correct.

He said, “If the meaning you give to these experiences is not central to how you remember your childhood, so you don’t feel like you need to report on it, you are more likely to have better mental health over time.”

Traumatic childhood experiences have been the subject of some of psychiatry’s most intense battles. Sigmund Freud assumed early in his career that many of his patients’ behaviors indicated a history of childhood sexual abuse but later recanted, attributing them to unconscious desires.

In the 1980s and 1990s, therapists used techniques such as hypnosis and age regression to help clients discover memories of child abuse. These methods have fallen under a barrage of criticism from mainstream psychiatry.

Recently, many Americans have embraced therapies designed to manage traumatic memories, which have proven effective in treating PTSD. Experts are increasingly calling for screening patients for adverse childhood experiences as an important step in providing physical and mental health treatment.

New findings in JAMA Psychiatry suggest that treatment that seeks to relieve depression and anxiety by trying to unearth repressed memories is ineffective, said Dr. Danes, who works in the Institute of Psychiatry, Psychology and Neuroscience at King’s College.

But he cautioned that the study’s findings should not be interpreted as an endorsement of avoiding traumatic memories, which can make them “terrifying” in the long run. Instead, they point to the promise of treatments that seek to “reorganize” and ease memories.

He said, “It’s not about deleting the memory, but having the memory and having more control over it so that the memory becomes less terrifying.”

Memory has always been a challenge in the field of child protection because many cases of abuse involve children under the age of 3, when lasting memories begin to form, David Finkelhour, director of the University of New Hampshire’s Crimes Against Children Research Center, who was not involved in the study.

In treating people with a history of abuse, he said, clinicians must rely on superficial, incomplete, and variable accounts. “All we have are their memories, so we don’t have a choice,” he said.

He cautioned against the conclusion that forgotten abuse has no lasting effect. Early abuse may manifest through what he described as a “hangover”—difficulty adjusting emotions, feelings of worthlessness, or, in the case of sexual assault victims, a desire to provide sexual gratification for others.

Elizabeth Loftus, a psychologist at the University of California, Irvine, and a prominent skeptic about the reliability of memories of abuse, pointed out that the study did not reach another conclusion that the data could support: Forgetting abuse may be a healthy response.

“They could have said, people who don’t remember in some ways are better off, and you probably don’t want to mess with them,” she said. “They don’t say that, and that, to me, is very important.”