Not much new information in this article, but it does serve as a stark reminder that child abuse has significant implications for many victims. Childrens' cognitive processing skills are more rudimentary than that of adults, and so when significant events impact them, they are more vulnerable to developing rigid schemas with respect to themselves, other people, and the world around them. In general, rigid thinking isn't all that healthy, and child abuse certainly contributes to the development of rigid thinking patterns - thus the ongoing impact, even later in life. One point to remember is that individuals with histories of child abuse will experience mental health issues more strongly than if they hadn't been abused. From the article:
The impact of child abuse already is known to increase the risk of suicide, however the literature about other characteristics of depressed victims of child abuse is scarce. Although the findings of the Mayo study do not confirm causality, the information stresses the importance of more aggressive approaches from the public health perspective to prevent child abuse. "A history of child abuse makes most psychiatric illnesses worse," according to Magdalena Romanowicz, M.D., lead author of the study. "We found that it significantly impacts the wide range of characteristics of depressed inpatients including increased risk of suicide attempt, substance abuse, as well as earlier onset of mental illness and more psychiatric hospitalizations. This new information serves as a reminder of the importance of child abuse prevention from a public health perspective.
Clinicians need to factor this information into their assessments, and consider the ramifications of a client's childhood history. Very often individuals who present as "resistant to therapy" are simply having a more difficult time with treatment due to issues like a history of child abuse, which complicates the therapeutic process. In addition, many clinicians do not adequately assess for trauma histories (to include child abuse, but also other traumatic incidents as well), due to 1) discomfort with the topic (this stuff can be a bear to talk about in therapy); 2) inadequate questioning (many individuals will not disclose this information when only one or two vague questions are asked about "trauma"); and 3) a lack of recognition of the importance of this issue to treatment. If a person does "get stuck" in therapy due to undisclosed issues related to an abuse history, this often reinforces negative self-perceptions the individual has of him or herself (i.e. "I can't do anything right"), which is not the case, but appears so to the individual. Bottom line - many people do figure out ways to cope or recover from an abuse history; however, if a person is struggling as a result of an abuse history, and is in treatment as a result, the issues present as a result of that history need to be addressed.