Complex childhood trauma, gender and depression: Patterns and correlates of help-seeking and maladaptive coping

Abstract

Background: Little is known about access to treatment or maladaptive coping amongst those with a history of childhood trauma and subsequent depressive disorder, which is often complicated by post traumatic stress disorder (PTSD).

Aims: To (1) identify profiles of complex childhood trauma amongst men and women with major depression, (2) examine patterns of service access and treatment or maladaptive coping (drug misuse, alcohol abuse or suicidality), and (3) associations with socio-economic/demographic characteristics, comorbid PTSD, anxiety/mood disorders and perceived social support.

Method: Analysis of Wave 3 of the national epidemiologic survey on alcohol and related conditions (NESARC) (2012-2013). We use the Latent Class Analysis 3-step approach in Mplus to examine individual differences in childhood experiences and coping behaviour. We examined both (a) the inter-relationship of this patterning, and (b) the extent to which proactive and maladaptive coping are associated with socio-economic/demographic characteristics, comorbid PTSD, anxiety disorders and perceived social support.

Results: a diagnosis of Major Depression was recorded for 7432 people, two thirds of whom reported a history of complex childhood trauma. Maladaptive coping is associated with the most severe trauma groups, comorbid PTSD, dysthymia, and anxiety disorders.

Conclusion: Given the evidence of the current study, suggesting a poorer treatment course for depression in adults with complex childhood trauma, early screening for a trauma history will facilitate preventive efforts before onset of depression, possibly mitigating a poorer treatment course.