Impact of childhood maltreatment on adult mental health trajectories during the COVID-19 pandemic

The relationship between changes in mental health during the severe and sustained stresses of the COVID-19 pandemic and exposure to childhood maltreatment is not well-characterized despite the recognition of early life adversity as a pervasive risk factor for adverse mental health outcomes throughout the lifespan. To determine whether a history of childhood maltreatment was associated with vulnerable mental health trajectories during the pandemic, we analyzed data from the CovSocial study, a longitudinal online study that assessed 3,522 adult respondents from Berlin, Germany at seven time points during the pandemic, including two lockdowns. Exposure to childhood maltreatment was assessed with the Childhood Trauma Questionnaire. The main outcome was membership in one of four latent mental health profile classes identified in a previous study from dynamic changes of resilience-vulnerability factor scores that captured variance in longitudinal measures of vulnerability (depression, anxiety, stress, burdens) and resilience (coping, optimism, social support). Exposure to childhood maltreatment significantly increased the odds of belonging to the most vulnerable compared to the most resilient latent class (OR, 4.66 [95 % CI, 3.57, 5.98]). On average, individuals with exposure had a greater mental health burden at baseline compared to non-exposed individuals (p < 0.001, Cohen's d = 0.24) and increasing mental health problems during the second sustained lockdown (p = 0.003, Cohen's d = 0.18). Our results suggest that individuals who experienced childhood maltreatment are at increased risk for mental health problems during the pandemic, emphasizing the need for detection of cases and targeted interventions during future crises.