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Early verbal abuse results in more adult depression

Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011. Dr. Dombeck received his Ph.D. in Clinical Psychology in 1995 ...Read More

A tantalizing study note – one definitely worth commenting on – was posted yesterday. Unfortunately, only subscribers to the Journal of Affective Disorders are able to access the full details. We know this much: A Florida State University psychology researcher, Dr. Natalie Sachs-Ericsson, and colleagues, have done a study looking at the relationship between childhood incidence of verbal abuse (by parents to their children), and proneness to self-critical thinking habits, and incidence of anxiety and/or depressive disorders as adults. As you might suspect, there appears to be a relationship. Adults who were verbally abused as children have "1.6 times as many symptoms of depression and anxiety as those not verbally abused, and were twice as likely to have suffered a mood or anxiety disorder during their lifetime" (quote taken from the UPI story as reported on PsychPort.

This sort of finding makes intuitive and theoretical sense, I think, but exactly why this should be the case is maybe not entirely clear so I’ll try to spell it out. The enormous success of cognitive behavioral therapy as a treatment for depressive and anxiety disorders has made it quite clear that the way people think about themselves – the way they silently talk to themselves and make explanations for the things that happen to them – has an enormous bearing on how vulnerable or resistant to depressions and anxiety disorders. People who habitually tend to blame themselves when things go wrong, or who tend to focus on the negative aspects of events rather than on the positive events are far more likely to become depressed or to suffer from anxiety problems than are people with more positive thought habits. Cognitive therapy derives all of its healing power from this observation. It is nothing more and nothing less than a set of techniques to help people with negative thought habits to become aware of those habits, and to correct their negatively biased thought conclusions and appraisals. Depressive patients who are able to learn how to correct their excessively negative interpretations of events are generally able to substantially lessen their depressive or anxious symptoms. Symptom reduction is robust as well. Cognitive therapy works about as well or slightly better than antidepressant medication in the short term (for treatment of depression), and better than antidepressant medication in the long term (when all treatments are stopped).

All of this begs the question, "how do people develop negative thought habits in the first place?". There are probably many pathways, including genetic predispositions inherited from parents to children (e.g., Neuroticism, see my essay on Temperament), but one important pathway definitely has to do with the quality of the early relationships children form with caregivers (usually parents). We know from developmental psychology research that identity forms from the outside in, which is to say that children’s sense of self is based on actual early relationships with caregivers. When caregivers are harsh and judgmental towards children, children learn to internalize that dialog, and become harsh and judgmental towards themselves. Early relationships are all that children know to base an identity upon, and so they form the crystal around which other later relationships form. Children who are raised in a judgmental environment where little they accomplished was good enough are, of course, likely to internalize that ethic into their sense of self as they grow, so much so that the resulting perfectionism they will exhibit will appear second nature to them. It will never occur to them (without outside prompting) that other patterns of thought are possible.

Given the importance of early relationship quality on identity formation, and of identity formation on habits of thought and self-judgment, it is not at all surprising that being raised in an abusive environment (where the messages sent to the developing children all take the form of "you are inadequate") will be prone to emotional problems.

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