Cathy Spatz Widom’s research while affiliated with John Jay College of Criminal Justice and other places

Previous studies have reported mixed findings regarding the relationship between childhood maltreatment and midlife mortality. To fill gaps in the literature, we examine the impact of childhood maltreatment on midlife mortality and test potential explanations for the relationship. Using a prospective cohort design, individuals with documented histories of childhood maltreatment (ages 0–11 years) during 1967–1971 and a demographically matched control group were followed into midlife. The National Death Index and Social Security Death Index were searched for all individuals ( N = 1575) to determine date and cause of death. Individuals who survived were interviewed in 1989–1995 (M age = 29). By 2023, 18% ( N = 283) had died. Contrary to expectations, there were no significant differences in midlife mortality between maltreated and control groups overall. Incidence rates for maltreated females were higher than for control females. Physically abused males were at decreased risk of midlife mortality. Among individuals interviewed in young adulthood, being female reduced risk, whereas lower SES and suicide attempt increased risk for midlife mortality. Childhood maltreatment, alcohol, drugs, anxiety, depression, smoking, and violent arrests did not. SES and problematic behaviors appear to play an important role in understanding midlife mortality and suggest targets for intervention.

Objective: Numerous studies have reported associations between child maltreatment and drug use and abuse. We ask whether internalizing and externalizing symptoms during young adulthood mediate the relationship between childhood maltreatment and illicit drug use and use of prescribed medications later in middle adulthood. Method: Utilizing a prospective cohort design, a large group of court-substantiated cases of childhood maltreatment (ages 0 -11) and demographically matched controls were followed into adulthood. Internalizing symptoms (depression and anxiety), externalizing symptoms (antisocial personality disorder), and drug abuse and dependence symptoms were assessed in young adulthood (Mage = 29) in interviews during 1989-1995 (N = 1,196). Information about the use of illicit drugs and prescribed medications was obtained in middle adulthood in interviews during 2003-2005 (N = 807, Mage = 41). Parallel mediation models were tested for depression and anxiety separately using path analysis. Results: Childhood maltreatment predicted more internalizing and externalizing symptoms during young adulthood. Internalizing symptoms during young adulthood mediated the effect of childhood maltreatment on prescription drug use in middle adulthood, whereas externalizing symptoms mediated the relationship between childhood maltreatment and illicit drug use in middle adulthood, despite controls for drug abuse/dependence symptoms in young adulthood. Conclusions: These new findings suggest that efforts should be directed at reducing internalizing symptoms of anxiety and depression and externalizing symptoms in maltreated children to reduce risk for drug use later in life. The unique mediating effects of internalizing versus externalizing symptoms on prescription drug and illicit drug use, respectively, suggest the need for tailored interventions for different kinds of drug use.

Objective: Homelessness is a serious and increasing public health concern. Childhood maltreatment and psychiatric problems have been associated with homelessness as risk factors; however, reliance on cross-sectional studies introduces ambiguity into interpreting previous findings. This study seeks to understand whether psychiatric symptoms in part explain the relationship between childhood maltreatment and homelessness. Methods: The authors used data from a prospective cohort design study in which individuals with documented histories of childhood maltreatment (ages 0-11 years) and a demographically matched group of children without those histories (N=1,196) were followed up into middle adulthood and interviewed. Psychiatric symptoms (anxiety, depression, post-traumatic stress disorder [PTSD], antisocial personality disorder [ASPD], and alcohol and drug use) were assessed at mean age 29. Homelessness was assessed at mean ages 29, 39, 41, and 47 years. Structural equation modeling was used to test mediation. Results: Twice as many individuals with histories of childhood maltreatment reported ever being homeless (25.6% vs. 12.3%, AOR=2.54, 95% CI= 1.86-3.50) and past year homelessness (5.5% vs. 2.5%, AOR=2.09, 95% CI=1.31-3.43) at age 29, compared to controls. Controlling for past homelessness, psychiatric symptoms predicted future homelessness at mean ages 41 and 47. Three significant paths from childhood maltreatment to future homelessness were identified through depression, PTSD, and ASPD. Conclusions: This longitudinal study with documented cases of childhood maltreatment found that psychiatric symptoms earlier in life predict homelessness. Depression, PTSD, and ASPD represent pathways through which childhood maltreatment increases homelessness risk and warrant greater attention.

Childhood maltreatment is associated with a range of negative social and psychological outcomes at different developmental stages. Using data from a prospective longitudinal study of the consequences of childhood maltreatment, we examine whether childhood maltreatment predicts lower levels of social connectedness and more depression symptoms over a 30-year time period and examine the directionality of the trajectories from childhood into middle adulthood. Children (ages 0–11 years) with documented histories of maltreatment and demographically matched controls were followed into adulthood across four waves: 1989–1995 (n = 1,196; Mage = 29.2 years, SD = 3.9), 2000–2002 (n = 896; Mage = 39.5 years, SD = 3.6), 2003–2005 (n = 808; Mage = 41.2 years, SD = 3.6), and 2009–2010 (n = 649; Mage = 47.0 years, SD = 3.5). Social connectedness and depressive symptoms were measured at all four time points. Random intercept cross-lagged panel models were used to estimate bidirectional relationships between social connectedness and depression symptoms and the extent to which the trajectories differed for the maltreated and control groups. Individuals with documented histories of childhood maltreatment generally had significantly lower levels of social connectedness and higher levels of depression compared to matched controls. Depression was associated with lower levels of social connectedness concurrently at ages 39, 41, and 47. Depression predicted lower social connectedness, and social connectedness predicted lower depression in middle adulthood, but not young adulthood. Better understanding of the long-term impact of childhood maltreatment on social connectedness and depression has implications for designing effective interventions.

Existing research suggests that prior victimizations during a person’s lifetime, particularly childhood traumas and maltreatment, are risk factors for abuse and revictimization in adulthood, although longitudinal evidence is sparse. Using data from a 30-year ongoing longitudinal study of the long-term consequences of childhood maltreatment, this paper describes the extent to which childhood maltreatment predicts subsequent victimization and partner violence victimization at two time points in adulthood. Data were obtained from a prospective cohort design study in which children with court-substantiated cases of maltreatment (ages 0–11 years) and demographically matched controls were followed into adulthood and interviewed over several waves. Childhood maltreatment was assessed through juvenile and adult court records from 1967 to 1971 in a midwestern county area in the United States. Victimization experiences were assessed from 2000 to 2002 (Mage = 39.5 years) and 2009 to 2010 (Mage = 47.5) and included two types based on information from the lifetime trauma and victimization history instrument and questions about past year partner violence victimization. Individuals with histories of childhood maltreatment were more likely to report physical and sexual assaults and kidnapping and stalking victimization than controls through age 39.5. In contrast, the two groups did not differ at the later assessment at age 47.5, except maltreated individuals reported greater risk for sexual assault/abuse than controls. For intimate partner violence victimization at age 39.5, maltreated and control groups differed only in terms of victimization involving injury. Later in adulthood, more individuals with histories of childhood maltreatment reported partner physical violence victimization compared to controls. Although these longitudinal findings showed a general decline in victimization experiences over the two time points, these results demonstrate that childhood maltreatment increases risk for subsequent revictimization in middle adulthood, specifically for sexual assault/abuse and intimate partner physical violence victimization. These findings have implications for prevention and intervention efforts targeting maltreated children.

Background: Cognitive deficits might contribute to the elevated risk of life-course psychopathology observed in maltreated children. Leading theories about the links between childhood maltreatment and cognitive deficits focus on documented exposures (objective experience), but empirical research has largely relied on retrospective self-reports of these experiences (subjective experience), and the two measures identify largely non-overlapping groups. We aimed to test the associations of objective and subjective measures of maltreatment with cognitive abilities within the same individuals. Methods: We studied a cohort of individuals from the US Midwest with both objective, court-documented evidence of childhood maltreatment and subjective self-reports of individuals' histories at age 29 years. Between the ages of 29 years and 41 years, participants were assessed with a comprehensive set of cognitive tests, including tests of general verbal intelligence (Quick Test and Wide Range Achievement Test-Revised [WRAT]), non-verbal intelligence (Matrix Reasoning Test [MRT]), executive function (Stroop Test and Trail Making Test Part B [TMT-B]), and processing speed (Trail Making Test Part A [TMT-A]). Participants were also assessed for psychopathology (Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory). We tested the associations between objective or subjective measures of childhood maltreatment with cognitive functions using ordinary least squares regression. To test whether cognitive deficits could explain previously described associations between different measures of maltreatment and subsequent psychopathology, we re-ran the analyses accounting for group differences in the Quick Test. People with lived experience were not involved in the research or writing process. Findings: The cohort included 1196 individuals (582 [48·7%] female, 614 [51·3%] male; 752 [62·9%] White, 417 [34·9%] Black, 36 [3·8%] Hispanic) who were assessed between 1989 and 2005. Of the 1179 participants with available data, 173 had objective-only measures of childhood maltreatment, 492 had objective and subjective measures, 252 had subjective-only measures, and 262 had no measures of childhood maltreatment. Participants with objective measures of childhood maltreatment showed pervasive cognitive deficits compared with those without objective measures (Quick Test: β=-7·97 [95% CI -9·63 to -6·30]; WRAT: β=-7·41 [-9·09 to -5·74]; MRT: β=-3·86 [-5·86 to -1·87]; Stroop Test: β=-1·69 [-3·57 to 0·20]; TMT-B: β=3·66 [1·67 to 5·66]; TMT-A: β=2·92 [0·86 to 4·98]). The associations with cognitive deficits were specific to objective measures of neglect. In contrast, participants with subjective measures of childhood maltreatment did not differ from those without subjective measures (Quick Test: β=1·73 [95% CI -0·05 to 3·50]; WRAT: β=1·62 [-0·17 to 3·40]; MRT: β=0·19 [-1·87 to 2·24]; Stroop Test: β=-1·41 [-3·35 to 0·52]; TMT-B: β=-0·57 [-2·69 to 1·55]; TMT-A: β=-0·36 [-2·38 to 1·67]). Furthermore, cognitive deficits did not explain associations between different measures of maltreatment and subsequent psychopathology. Interpretation: Previous studies based on retrospective reports of childhood maltreatment have probably grossly underestimated the extent of cognitive deficits in individuals with documented experiences of childhood maltreatment, particularly neglect. Psychopathology associated with maltreatment is unlikely to emerge because of cognitive deficits, but might instead be driven by individual appraisals, autobiographical memories, and associated schemas. Funding: National Institute of Justice, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, Doris Duke Charitable Foundation, and National Institute for Health and Care Research.

One overlooked result in a 1989 Science paper on the “cycle of violence” was a race-specific increase in risk for arrest for violence among Black maltreated children, but not White maltreated children. We examine whether race differences in the cycle of violence are explained by risk factors traditionally associated with violence. Using a prospective design, maltreated and non-maltreated children were matched on age, sex, race, and approximate family social class and interviewed at mean age 28.7 years ( N = 1196). Arrest histories were obtained through age 50.5. Regression analyses included maltreatment, race, self-reported violent behavior, and risk factors (e.g., family, school, neighborhood variables). For arrests for violent crime, race was a significant predictor, whereas childhood maltreatment was not significant. For violent arrests, there was a significant race × maltreatment interaction when the total number of risk factors were included controlling for self-reported violent behaviors. For self-reported violent behaviors, childhood maltreatment remained significant for some risk factors. However, race did not predict self-reported violent behaviors. Offending behavior and traditional risk factors did not explain the disproportionate arrests among Black maltreated children. This disparity in the cycle of violence may reflect complex processes influenced by racial bias or structural racism.

Background Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped. Methods In this review, we draw on multi‐disciplinary research and present an integrated framework to explain maltreatment measurement disagreement. Results We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment. Conclusions A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment‐related psychopathology and targets for novel interventions.

Background: Adult appraisals of their childhood sexual experiences as abusive are associated with increased risk for long-term psychological problems. Factors that underlie whether adults appraise their childhood sexual experiences as abusive remain unknown. Objective: To determine factors associated with adult cognitive appraisals of childhood sexual abuse. Participants and setting: Participants were 1196 adults ages 19-41 (M = 29.23, SD = 3.84) with documented cases of childhood maltreatment (sexual abuse, physical abuse, and neglect) during the years 1967-1971 and demographically matched controls who were followed up and interviewed in adulthood. Methods: Using a prospective cohort design, participants were asked to recall whether they had any sexual experiences in childhood, and if so, the frequency of abuse, age at the onset of abuse, relationship to perpetrator, and whether they appraised the experiences as sexually abusive. Results: Over half of the sample (52%) reported childhood sexual experiences, yet only 44% considered those experiences sexually abusive. Participants with documented cases of child sexual abuse and neglect were more likely to appraise their childhood sexual experiences as abusive compared to controls. Participants who reported more severe abuse, more frequent abuse, younger age at the onset of abuse, and intrafamilial and both intra-and extrafamilial abuse (vs. extrafamilial abuse) were more likely to consider their experiences abusive. Compared to males and Black participants, females and White participants were more likely to appraise their experiences as abusive. Conclusions: Understanding factors that determine adult cognitive appraisals of childhood sexual experiences as abusive can inform clinical interventions for maltreated populations.

Background: Childhood maltreatment and psychiatric morbidity have each been associated with accelerated biological aging primarily through cross-sectional studies. Using data from a prospective longitudinal study of individuals with histories of childhood maltreatment and controls followed up into midlife, we test two hypotheses examining whether (1) psychiatric symptoms mediate the relationship between childhood maltreatment and biological aging and (2) psychiatric symptoms of anxiety, depression, or post-traumatic stress disorder act in conjunction with childhood maltreatment to exacerbate the association of child maltreatment to aging. Methods: Children (ages 0-11y) with documented histories of maltreatment and demographically matched controls were followed into adulthood (N = 607) and interviewed over several waves of the study. Depression, anxiety, and post-traumatic stress disorder symptoms were assessed at mean ages 29 (interview 1) and 40 (interview 2). Biological age was measured from blood-chemistries collected later (Mage= 41y) using the Klemera-Doubal method. Hypotheses were tested using linear regressions and path analyses. Results: Adults with documented histories of childhood maltreatment showed more symptoms of depression, PTSD, and anxiety at both interviews and more advanced biological aging, compared to controls. PTSD symptoms at both interviews and depression and anxiety symptoms only at interview 2 predicted accelerated biological aging. There was no evidence of mediation; however, anxiety and depression moderated the relationship between childhood maltreatment and biological aging. Conclusion: These new findings reveal the shorter and longer-term longitudinal impact of PTSD on biological aging and the amplifying effect of anxiety and depression on the relationship between child maltreatment and biological aging.