Citation

Dunn EC, Nishimi K, Neumann A, Renaud A, Cecil CAM, Susser ES, Tiemeier H. J. Am. Acad. Child Adolesc. Psychiatry 2019; ePub(ePub): ePub.

Affiliation

Erasmus University Medical Center, Rotterdam, The Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA.

Copyright

(Copyright © 2019, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2019.02.022

PMID

31078631

Abstract

OBJECTIVE: Exposure to interpersonal violence is a known risk factor for psychopathology. However, it is unclear whether there are sensitive periods when exposure is most deleterious. We aimed to determine if there were time-periods when physical or sexual violence exposure was associated with greater child psychopathology.

METHOD: This study (N=4,580) was embedded in Generation R, a population-based prospective birth-cohort. Timing of violence exposure, reported through maternal reports (child age=10 years) was categorized by age at first exposure, defined as: very early (0-3 years), early (4-5 years), middle (6-7 years), and late childhood (8+ years). Using Poisson regression, we assessed the association between timing of first exposure and levels of internalizing and externalizing symptoms, using the Child Behavior Checklist at age 10.

RESULTS: Violence exposure at any age was associated with higher internalizing (physical violence: RR=1.46, p<0.0001; sexual violence: RR=1.30, p<.0001) and externalizing symptoms (physical violence: RR=1.52, p<0.0001; sexual violence: RR=1.31, p=0.0005). However, the effects of violence were time-dependent: compared to children exposed at older ages, children first exposed during very early childhood had greater externalizing symptoms. Sensitivity analyses suggested that these time-based differences emerged slowly across ages 1.5, 3, 6 and 10, showing a latency between onset of violence exposure and emergence of symptoms, and were unlikely explained by co-occurring adversities.

CONCLUSION: Interpersonal violence is harmful to childhood mental health regardless of when it occurs. However, very early childhood may be a particularly sensitive period when exposure results in worse psychopathology outcomes.

RESULTS should be replicated in fully prospective designs.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

children; interpersonal violence; latency; psychopathology; sensitive periods