Objective and subjective experiences of child maltreatment and their relationships with psychopathology
Open accessAbstract
Does psychopathology develop as a function of the objective or subjective experience of childhood maltreatment? To address this question, we studied a unique cohort of 1,196 children with both objective, court-documented evidence of maltreatment and subjective reports of their childhood maltreatment histories made once they reached adulthood, along with extensive psychiatric assessment. We found that, even for severe cases of childhood maltreatment identified through court records, risk of psychopathology linked to objective measures was minimal in the absence of subjective reports. In contrast, risk of psychopathology linked to subjective reports of childhood maltreatment was high, whether or not the reports were consistent with objective measures. These findings have important implications for how we study the mechanisms through which child maltreatment affects mental health and how we prevent or treat maltreatment-related psychopathology. Interventions for psychopathology associated with childhood maltreatment can benefit from deeper understanding of the subjective experience.
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Environmental factors are strongly associated with the risk of developing MDD and other stress-related disorders.
“Epidemiological studies indicate that environmental factors are strongly associated with the risk of developing MDD and other stress-related disorders.18–22”
From Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential (2023) · cites this paper as [20]
The Results (section ‘Agreement between objective and subjective measures of child maltreatment’; page unavailable) associate retrospectively reported childhood maltreatment with elevated lifetime risk of a group of disorders that includes depression and PTSD. But the paper examines childhood maltreatment specifically, not environmental factors generally; it also finds no elevated risk for participants identified only through official maltreatment records. The citation therefore supports a narrower, qualified version of the claim. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSubjective methods yielded much higher rates of psychopathology compared with sole reliance on objective records.
“Moreover, subjective methods yielded much higher rates of psychopathology compared with sole reliance on objective records (Danese & Widom 2020).”
From Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms (2021) · cites this paper as Danese & Widom 2020
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“prospectively recorded ACEs are not recalled or because prospective records are absent for ACEs that are recalled (Danese and Widom, 2020; Reuben et al., 2016).”
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“Recent evidence suggests that it is the perceived, rather than objective (i.e., actual) experience of childhood adversity which is associated with psychopathology (Danese & Widom, 2020).”
BackgroundResultInfluential(2024) · doi:10.7554/elife.92700 · Cited by 29 · see citing works
“…a wealth of research suggests that the effects of experiences of early life adversity are cumulative, non-specific and rather unlikely to be tied to specific types of adverse events ( Danese et al., 2009 ; Danese and Widom, 2020 ; Gehred et al., 2021 ; Smith and Pollak, 2022 ; Young et al., 2019 ).”
BackgroundDanese, A., & Widom, C. (2024) · Lancet psychiatry · doi:10.1016/s2215-0366(24)00224-4 · Cited by 28 · see citing works
Self-citationOncioiu, S. I., Boivin, M., Geoffroy, M., Arseneault, L., Galéra, C., Navarro, M. C., Brendgen, M. R., Vitaro, F., Tremblay, R. E., Côté, S. M., et al. (2021) · Psychological Medicine · doi:10.1017/s0033291721003822 · Cited by 33 · see citing works
Childhood Maltreatment and Narcissism: The Mediating Role of Dissociation
Bertele, N., Talmon, A., & Gross, J. J. (2022) · Journal of Interpersonal Violence · doi:10.1177/0886260520984404 · Cited by 27 · see citing works
“Although recent research highlights the importance of subjective evaluation in the field of childhood maltreatment (Danese & Widom, 2020), report or response biases are possible.”
BackgroundBürgin, D., Witt, A., Seker, S., d'Huart, D., Meier, M., Jenkel, N., Boonmann, C., Schmeck, K., Fegert, J., & Schmid, M. (2023) · Development and Psychopathology · doi:10.1017/s0954579423001426 · Cited by 26 · see citing works
“…debated considering certain biases (e.g., recall biases) with new studies reporting only poor overlap between maltreatment exposure assessed in prospective versus retrospective research designs (Baldwin et al., 2019; Bürgin et al., 2020; Danese & Widom, 2020; Danese, 2020; Hardt & Rutter, 2004).”
War‐related trauma linked to increased sustained attention to threat in children
Michalek, J. E., Lisi, M., Binetti, N., Özkaya, S., Hadfield, K., Dajani, R., & Mareschal, I. (2022) · Child Development · doi:10.1111/cdev.13739 · Cited by 26 · see citing works
Ugarte, E., & Hastings, P. (2022) · Development and Psychopathology · doi:10.31234/osf.io/pwe4x · Cited by 26 · see citing works
“…who display “truly” (observed and statistically demonstrated) unpredictable behaviors might enlighten several questions about the developmental biobehavioral implications of experiences and/or cognitions of unpredictability (Baldwin & Esposti, 2021; Danese & Widom, 2020; Rivenbark et al., 2020).”
BackgroundJavakhishvili, M., & Widom, C. S. (2021) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2021.101351 · Cited by 25 · see citing works
Self-citationDanese, A., McLaughlin, K., Samara, M., & Stover, C. (2020) · British medical journal · doi:10.1136/bmj.m3073 · Cited by 26 · see citing works
Self-citationPerini, I., Mayo, L., Capusan, A., Paul, E. R., Yngve, A., Kämpe, R., Gauffin, E., Mazurka, R., Ghafouri, B., Stensson, N., et al. (2023) · Molecular Psychiatry · doi:10.1038/s41380-023-02033-y · Cited by 25 · see citing works
Childhood Maltreatment and Eating Disorders: A Prospective Investigation
Talmon, A., & Widom, C. S. (2021) · Child Maltreatment · doi:10.1177/1077559520988786 · Cited by 31 · see citing works
“Danese and Widom (2020) reported that without the person’s subjective reporting of the experience, the risk of psychopathology in individuals with objectively defined maltreatment (based on court records) was minimal.”
BackgroundResultInfluentialSelf-citationGee, D. G., & Cohodes, E. M. (2023) · Development and Psychopathology · doi:10.1017/s0954579423001128 · Cited by 25 · see citing works
“…the context of early adversity necessitates consideration of distinct ways of experiencing and understanding these adversities (Biel & Coates, 2021; Danese & Widom, 2020; Pollak & Smith, 2021), as well as an emphasis on eradicating harmful societal forces such as structural racism that perpetually…”
BackgroundAlnassar, J. S., Juruena, M., Macare, C., Perkins, A., & Young, A. H. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.040 · Cited by 24 · see citing works
Conley, M. I., Hernandez, J., Salvati, J. M., Gee, D. G., & Baskin-Sommers, A. (2022) · Development and Psychopathology · doi:10.1017/s095457942100184x · Cited by 26 · see citing works
“…although perceptions of threat in the neighborhood, school, and family have been shown to be distinct risk factors and influences on development (Danese & Widom, 2020; ElSheikh & Harger, 2001; Goldman-Mellor et al., 2016; HadleyIves et al., 2000), there are contexts and indicators of threat…”
BackgroundRiem, M., Lotz, A., Horstman, L., Cima, M., Verhees, M., Dijk, K. A.-V., van IJzendoorn, M. H., & Bakermans-Kranenburg, M. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105380 · Cited by 24 · see citing works
“It should be noted that retrospectively measured subjective experience of child abuse is a more important predictor of developmental outcomes compared to prospective or objectives measures of the actual event (Danese and Widom, 2020; Latham et al., 2020).”
ResultGenetic and early environmental predictors of adulthood self-reports of trauma
Peel, A., Purves, K., Baldwin, J., Breen, G., Coleman, J., Pingault, J.-B., Skelton, M., ter Kuile, A. T., Danese, A., & Eley, T. (2021) · British Journal of Psychiatry · doi:10.1192/bjp.2021.207 · Cited by 24 · see citing works
“As the nature of rGE effects vary across development, environmental adversities in pre-school (age 1-4), middle childhood (7-10) and early adolescence (12-16) were summed to create five composite scores of parent- and self-reported”
MethodSelf-citationBürgin, D., Clemens, V., Witt, A., Sachser, C., Jud, A., Brähler, E., Strauss, B., Petrowski, K., Schmid, M., & Fegert, J. (2023) · International Journal of Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106382 · Cited by 23 · see citing works
Lippard, E., & Nemeroff, C. B. (2022) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2022.173361 · Cited by 26 · see citing works
Breaking the Cycle of Intergenerational Childhood Maltreatment: Effects on Offspring Mental Health
Islam, S., Jaffee, S. R., & Widom, C. S. (2022) · Child Maltreatment · doi:10.1177/10775595211067205 · Cited by 25 · see citing works
“Danese and Widom (2020) found that subjective self-report measures of maltreatment are more predictive of psychopathology outcomes than court-substantiated records, which is consistent with our findings.”
ResultSelf-citationRodriguez, A. M., Hogg, B., Gardoki-Souto, I., Valiente-Gómez, A., Trabsa, A., Mosquera, D., García-Estela, A., Colom, F., Pérez, V., Padberg, F., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.681876 · Cited by 23 · see citing works
Early adversity as the prototype gene × environment interaction in mental disorders?
Martins, J., Yusupov, N., Binder, E. B., Brückl, T. M., & Czamara, D. (2022) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2022.173371 · Cited by 22 · see citing works
Li, S.-Q., Wang, R., Thomas, E. M., Jiang, Z.-C., Jin, Z., Li, R., Qian, Y., Song, X.-B., Sun, Y., Zhang, S.-C., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.918092 · Cited by 22 · see citing works
“purposes cannot rule out the possibility of recall bias, which may influence the strength of the observed relationships but recent work suggests that recall bias does not explain associations between retrospective reports of childhood adversity and psychopathology (59).”
BackgroundScheuplein, M., & van Harmelen, A. (2021) · Current Opinion in Psychology · doi:10.31234/osf.io/tz4an · Cited by 22 · see citing works
Mental health of children and young people in the WHO Europe region
Tarasenko, A., Josy, G., Minnis, H., Hall, J., Danese, A., Lau, J. Y. F., Cortese, S., Stringaris, A., Redlich, C., & Ougrin, D. (2025) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2025.101459 · Cited by 21 · see citing works
“The impact of maltreatment on psychopathology appears to be explained by an individual’s appraisal and memories of such events, 44–46 and trauma-focused cognitive behavioural therapy is effective for treating post-traumatic stress disorder and comorbid symptoms following sexual abuse, 47…”
Self-citationO’Shields, J., Graves, B. D., & Mowbray, O. P. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100611 · Cited by 18 · see citing works
“who have an objective history of CM without subjective recall of CM were less likely to experience a mental health problem (Danese and Widom, 2020).”
BackgroundPereira, S. M. P., Rogers, N. T., & Power, C. (2021) · BMC Medicine · doi:10.1186/s12916-021-02164-5 · Cited by 20 · see citing works
“Our finding for adult retrospective report is particularly relevant given that prospective measures such as court substantiated sexual abuse have high rates of false negatives [45].”
BackgroundResultOlsavsky, A. K., Stoddard, J., Erhart, A., Tribble, R. C., & Kim, P. (2021) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsab005 · Cited by 21 · see citing works
Uy, J., & Gotlib, I. (2023) · Journal of Child Psychology and Psychiatry and Allied Disciplines · doi:10.1111/jcpp.13942 · Cited by 20 · see citing works
“…we also explored possible differences between the subjective and objective severity ratings of early adversity, given research demonstrating differential associations between participants’ subjective and objective experience of maltreatment and psychopathology (e.g., Danese & Widom, 2020).”
Plomin, R., Gidziela, A., Malanchini, M., & von Stumm, S. (2022) · Development and Psychopathology · doi:10.1017/s0954579422000931 · Cited by 20 · see citing works
“Supporting this perspective is a recent study showing that subjective rather than objective mal-treatment in childhood predicted psychopathology later in life (Danese & Widom, 2020).”
BackgroundThe Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers
Czepiel, D., Hoek, H., van der Markt, A., Rutten, B., Veling, W., Schirmbeck, F., Mascayano, F., Susser, E., & van der Ven, E. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.896843 · Cited by 20 · see citing works
“The current findings also coincide with a wider body of literature highlighting the subjective appraisal of crises and traumatic life events as drivers of negative outcomes (53).”
ResultSamaey, C., Lecei, A., Achterhof, R., Hagemann, N., Hermans, K. S. F. M., Hiekkaranta, A. P., Kirtley, O. J., Reininghaus, U., Boets, B., Myin‐Germeys, I., et al. (2023) · Journal of Adolescence · doi:10.1002/jad.12145 · Cited by 20 · see citing works
Positive parenting moderates associations between childhood stress and corticolimbic structure
Kahhalé, I., Barry, K. R., & Hanson, J. (2023) · PNAS Nexus · doi:10.1093/pnasnexus/pgad145 · Cited by 19 · see citing works
“…elevated rates of adult psychopathology only when considering self-report experiences of maltreatment and not when relying on court-documented records alone ( 21); a similar pattern has been replicated for other early life experiences such as peer victimization and neighborhood violence (22, 23).”
Testing the specificity of environmental risk factors for developmental outcomes.
Bignardi, G., Dalmaijer, E., & Astle, D. (2021) · Child Development · doi:10.31219/osf.io/v2pca · Cited by 19
Predicting disclosure latency in substantiated cases of child sexual abuse
Gewehr, E., Hensel, B., & Volbert, R. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105346 · Cited by 27 · see citing works
Bali, P., Sonuga‐Barke, E., Mohr‐Jensen, C., Demontis, D., & Minnis, H. (2023) · JCPP Advances · doi:10.1002/jcv2.12169 · Cited by 18 · see citing works
“Prospective longitudinal studies are therefore regarded as essential in teasing apart direction (s) of causality as they avoid the potential biases inherent in retrospective assessments of CM and ADHD (Baldwin et al., 2019; Danese & Widom, 2020).”
BackgroundScorza, P., Duarte, C. S., Lee, S., Wu, H., Posner, J., Baccarelli, A., & Monk, C. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2023.02.018 · Cited by 18 · see citing works
Prevalence of child maltreatment in a nationwide sample of 18 to 31 year-olds in Germany
Kasinger, C., Schlack, R., Brähler, E., Fegert, J., & Clemens, V. (2024) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-024-00795-z · Cited by 18 · see citing works
“…individuals who report CM retrospectively constitute a distinct group from those who report CM prospectively [42], Nevertheless, subjective reports of childhood maltreatment have been shown to be associated with adverse consequences for later health, making themhighly relevant for adulthood [43].”
BackgroundColeman, O., Baldwin, J. R., Dalgleish, T., Rose‐Clarke, K., Widom, C. S., & Danese, A. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14048 · Cited by 39 · see citing works
Self-citation
- Authors
- Danese, A., & Widom, C. S.
- Affiliations
- King's College London (GB)
- The Graduate Center, CUNY (US)
- Corresponding author
- Danese, Andrea
- Widom, Cathy Spatz
- Venue
- Nature Human Behaviour
- Published
- 2020-05-18
- Volume
- 4
- Issue
- 8
- Pages
- 811-818
- ISSN
- 2397-3374 (ISSN-L)
- OpenAlex
- W3024217604
- Cited by
- 414
- References
- 0
- Citations by year
- 2026: 50 · 2025: 68 · 2024: 72 · 2023: 72 · 2022: 68 · 2021: 66 · 2020: 18
- FWCI
- 22.42
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Nature Human Behaviour (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- RCUK | Medical Research Council (P005918)
- U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (MH49467, MH58386)
- U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD40774)
- U.S. Department of Health & Human Services | NIH | National Institute on Aging (AG058683)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Sociology and Political Science › Military, Security, and Education Studies
- Keywords
- child abuse, psychopathology, subjective experience, objective measures, court records, retrospective recall, childhood trauma, mental health
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Humans, Interviews as Topic, Male, Psychopathology, Case-Control Studies, Adult Survivors of Child Abuse, Young Adult
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