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Publications

Journal Article Epublish

PubMed: 42850624 DOI: 10.1186/s13034-026-01188-0

Critical windows: timing of child maltreatment exposure and adult mental health.

Child Adolesc Psychiatry Ment Health 20(1)

Authors: Daniëlle Otten, Inga Schalinski, Jörg M Fegert, Andreas Jud, Elmar Brähler, Vera Clemens

Affiliations

  • Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Steinhövelstr. 5, 89075, Ulm, Germany. German Center for Mental Health (DZPG), Partner Site Ulm, Ulm, Germany. German Center for Child and Adolescent Health (DZKJ), Partner Site Ulm, Ulm, Germany.
  • Department of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany.
  • Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.
  • German Center for Mental Health (DZPG), Partner Site Ulm, Ulm, Germany.
  • German Center for Child and Adolescent Health (DZKJ), Partner Site Ulm, Ulm, Germany.
  • Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Ulm, Steinhövelstr. 5, 89075, Ulm, Germany. School of Social Work, ZHAW University of Applied Sciences Zürich, Pfingstweidstrasse 96, Zürich, 8005, Switzerland.
  • Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany.
  • Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany.

Abstract

BACKGROUND

Despite being recognized as the leading risk factor for mental disorders, child maltreatment (CM) remains insufficiently understood regarding type and timing of exposure. This study examines which developmental periods of exposure to CM subtypes are most strongly associated with adult mental disorders in women and men.

METHODS

Data from a German survey study from 2021 was used. The sample included N = 1,278 women [51.8%] (M age = 50.3; SD = 17.6) and N = 1,188 men [48.2%] (M age = 51.1; SD = 17.6). CM was assessed using the ISPCAN Child Abuse Screening Tools Retrospective version questionnaire. Conditioned Random Forest regression analyses were applied to examine the relevance of type and timing of CM for internalising [IMD] and externalising mental disorders [EMD] in adulthood. SHapley Additive exPlanations analyses were performed as post-hoc tests.

RESULTS

Timing of exposure to emotional abuse was most strongly associated with IMD; for women between ages 10-16 (variable importance [VI] ranging from 0.255 to 1.014), and for men ages 13 and 14 (VI: 0.349 and VI: 0.504). For men, EMD were most closely linked to emotional abuse between ages 10-16 (VI: 0.174-0.968), for women to exposure to sexual abuse between ages 13-15 (VI: 0.136-0.331) and neglect between ages 11-17 (VI: 0.098-0.331).

CONCLUSION

Distinct developmental windows of vulnerability to varying subtypes of CM shape adult mental health differently in women and men. Considering timing of subtypes of CM may enhance diagnosis and prevention strategies aimed at reducing lifetime mental health risks.

MeSH

Mental Disorders, Child Abuse, Mental Health, Child