Coping with conflict as pathogenetic link between psychosocial adversitiesin childhood and psychic disorders in adulthood

Objectives: The present study explores the connection between neurotic or i mmature strategies for coping with conflict in the presence of specific psy chosocial adversities during childhood and their cumulative effect. Here we test the hypothesis as to whether certain coping strategies can be viewed as a pathogenetic link between psychic illness in adulthood and adversities during childhood. Methods: 407 consecutive patients referred to the outpatient unit of a psyc hosomatic university hospital were included in the study. The strategies fo r coping with conflict were assessed by means of two psychometric methods ( FKBS, Hentschel et al., 1996; SBAK, Ehlers u. Peter, 1989), and the childho od adversities were assessed using the Mainz Structured Biographic Intervie w (Egle, 1993). Results: Patients with sexual abuse and/or physical maltreatment during the first 14 years of life showed significantly higher values for immature cop ing mechanisms than patients without such traumatisation. Childhood adversi ties correlated negatively with mature coping strategies and positively wit h immature strategies. Significant differences also arise when patients wit h low risk are compared to those with a higher amount of childhood adversit ies. The latter group exhibits significantly higher scores for immature neu rotic coping strategies, while the former exhibits mature ones. By means of a multivariate logistic regression analysis, 7 and 10% respectively of the variance of the predominant coping strategies within each group occurring in adulthood could be accounted for. Conclusions: The results suggest that in patients exposed to psychosocial s tress during childhood an increased vulnerability for psychic disorders in adulthood is, in part, caused by the use of immature strategies for coping with conflict.