Association of childhood adversities with the first onset of mental disorders in Japan: Results from the World Mental Health Japan, 2002–2004
Introduction
It is widely known that childhood adversities (CAs), such as parental death or child abuse, are significant risk factors for the onset of mental disorders during childhood or later life (Comijs et al., 2007, Fristad et al., 1993, Mullen et al., 1996). However, most of these studies were performed in Western countries, and it is uncertain whether a similar association between CAs and mental disorders can be found in Japan (Matsuura et al., 2009). Unlike in Western culture, Japanese culture is more likely to accept physical punishment of children as a form of discipline (Chang et al., 2006, Ellis and Petersen, 1992, Hayashida, 1986). In addition, since extended family or community ties are stronger in Japan (Fukuyama, 1995, Kitaoji, 1971), the impact of parental loss on the mental health of children might be relatively lesser. Therefore, the impact of CAs on the mental health of Japanese children might be different from those reported in children from Western countries. The effect of CAs on the onset of mental disorder among Japanese children needs to be analyzed.
Recent studies have shown that CAs are often comorbid (Dong et al., 2004, Ney et al., 1994), requiring simultaneous assessment of multiple CAs to avoid overestimation of the effect of particular CAs (Finkelhor et al., 2007, Kessler et al., 1997). Further, each CA often has a different effect on specific mental disorders (Kessler et al., 1997), suggesting that it is not plausible to use a cumulative score of the effects exerted by different CAs, such as the Adverse Childhood Experience Score (Dube et al., 2001, Edwards et al., 2003), which assumes that each CA has the same effect as the others and that the cumulative effects of multiple CAs are additive (Green et al., 2010). The purpose of this study is to elucidate the effects of CAs on the onset of mental disorders in the general population of Japan using a plausible statistical model that takes into account both additive and multiple CA effects.
Section snippets
Sample
The data from the World Mental Health Japan (WMH-J) was used. The WMH-J conducted an epidemiological survey of Japanese people aged 20 years and older as a part of the World Health Organization’s World Mental Health Survey Initiative (Kessler and Ustun, 2004). Details of the WMH-J survey design, sampling, and field procedures have been described previously (Kawakami et al., 2008). Seven community populations in Japan (from 2 urban cities and 5 rural municipalities) were selected as study sites
Results
The weighted distribution of demographic variables were as follows: female, 49.4%; mean age, 50.8 (standard deviation: 0.6) years; graduate high school or less, 59.5%; current workers, 65.8%; unemployed, 2.1%; and retired or homemaker, 26.1%.
Among the study sample, 32% reported of having experienced at least one of the CAs during childhood (Table 1). The prevalence of CAs was not statistically different between males (34%) and females (30%). More specifically, parental death, parental divorce,
Discussion
This study confirmed the relatively high prevalence of CAs and strong interrelationship among CAs in Japan. In addition, CAs showed a dose-response-like association with mental disorders. Among CAs, parental mental illness and family violence were stronger predictors of mental disorders. CAs were more vulnerable to the development of mental disorder among females than in males. Interestingly, specific CAs showed association with particular mental disorders (e.g., physical abuse was associated
Role of funding source
The World Mental Health Japan (WMH-J) Survey is supported by a Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013) from the Japan Ministry of Health, Labour, and Welfare. These activities were also supported by the United States National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558
Contributors
World Mental Health Japan Survey Group designed the study and wrote the protocol. Author Takeo Fujiwara managed the literature searches and analyses, and both author Takeo Fujiwara and Norito Kawakami wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.
Conflict of interest
None.
Acknowledgement
We would like to thank the staff members and other field coordinators in the WMH-J 2002–2004 Survey. The WMH-J 2002–2004 Survey was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We also thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis.
References (57)
- et al.
The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample
Child Abuse Negl
(2009) - et al.
Child-specific and family-wide risk factors using the retrospective childhood experience of care & abuse (CECA) instrument: a life-course study of adult chronic depression – 3
J Affect Disord
(2007) - et al.
Bullying, depression, and suicidality in adolescents
J Am Acad Child Adolesc Psychiatry
(2007) - et al.
Childhood adversity, recent life events and depression in late life
J Affect Disord
(2007) - et al.
The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction
Child Abuse Negl
(2004) - et al.
Poly-victimization: a neglected component in child victimization
Child Abuse Negl
(2007) - et al.
Psychosocial and endocrine features of chronic first-episode major depression in 8–16 year olds
Biol Psychiatry
(2001) - et al.
Criminal behaviour and violent crimes in former inpatients with affective disorder
J Affect Disord
(2009) - et al.
The corticotropin-releasing hormone challenge in depressed abused, depressed nonabused, and normal control children
Biol Psychiatry
(1997) - et al.
Child psychiatry in Japan
J Am Acad Child Adolesc Psychiatry
(1989)
The long-term impact of the physical, emotional, and sexual abuse of children: a community study
Child Abuse Negl
Salivary cortisol and dehydroepiandrosterone in relation to puberty and gender
Psychoneuroendocrinology
The worst combinations of child abuse and neglect
Child Abuse Negl
Family discord, parental depression, and psychopathology in offspring: 20-year follow-up
J Am Acad Child Adolesc Psychiatry
The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations
Soc Sci Med
Child maltreatment in Missouri: combining data for public health surveillance
Am J Prev Med
The genetics of major depression: moving beyond the monoamine hypothesis
Psychiatr Clin North Am
Does bullying cause emotional problems? A prospective study of young teenagers
BMJ
Development and preliminary psychometric properties of an instrument for the measurement of childhood trauma: the early trauma inventory
Depress Anxiety
Where and when to spank: a comparison between U.S. and Japanese college students
Journal of Family Violence
A longitudinal study of maternal depression and child maltreatment in a national sample of families investigated by child protective services
Arch Pediatr Adolesc Med
Foster youth transitions to adulthood: a longitudinal view of youth leaving care
Hypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls
J Clin Endocrinol Metab
Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys
JAMA
Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the adverse childhood experiences study
JAMA
Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study
Am J Psychiatry
Socialization values and parental control techniques: a cross-cultural analysis of child-rearing
Journal of Comparative Family Studies
Family history research diagnostic criteria
Cited by (55)
Association of severe maternal morbidity with bonding impairment and self-harm ideation: A multicenter prospective cohort study
2023, Journal of Affective DisordersPathways to recovery among survivors of childhood physical abuse: What is important to promote complete mental health
2023, Children and Youth Services ReviewAssociation between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population
2021, Journal of Psychiatric ResearchCitation Excerpt :Sexual and physical abuse had an interesting behavior in the likelihood of mental disorders. While sexual abuse predicted anxiety and mood disorders (essentially, internalizing disorders related to rumination), physical abuse predicted impulse-control and substance use disorders (externalizing disorders) depicting, again, the different roles of each ECA in the developmental pathways of psychopathology (Fujiwara et al., 2011). Violence, especially in developing countries as Mexico (Benjet et al., 2010), plays an important role in being associated with all classes of disorders except mood disorders, as in an adolescent sample in the USA (McLaughlin et al., 2012b).
Association between maternal adverse childhood experiences and mental health problems in offspring: An intergenerational study
2021, Development and Psychopathology