Review of “Hurtful Words: Association of Exposure to Peer Verbal Abuse with Elevated Psychiatric Symptom Scores and Corpus Callosum Abnormalities”

Review of “Hurtful Words: Association of Exposure to Peer Verbal Abuse with Elevated Psychiatric Symptom Scores and Corpus Callosum Abnormalities”

Jessica Lyles

This study by Teicher and his colleagues (2010) was designed to examine the effects that verbal abuse from peers had on brain structures (particularly the corpus callosum) and psychological symptoms (depression, anxiety, substance use, etc.). Previous research the authors had conducted showed that parental verbal abuse had a significant impact on children’s symptoms ratings in areas such as depression and anger-hostility (Teicher et al., 2006; Anderson et al., 2009). They also cite the fact that research shows that children who are victims of abuse from peer have decreased rates of psychological symptoms and maladaptive behaviors such as increase chances of engaging in fights. While the first purpose of this study is to examine whether there are elevations in psychiatric symptoms due to verbal abuse, it is also to examine diffusion tensor imagining to determine if the verbal effects white matter since they had seen this in previous research with parental verbal abuse (Choi et al., 2009).

Teicher, Samson, Sheu, Polcari, and McGreenery (2010) obtained their sample from a multi-study database of young adults (N = 1,662) who responded to an advertisement for childhood memories. The participants were divided into different groups. The first group (n = 848) involved individuals who were not exposed to any sexual abuse, physical abuse (both parental and peer), or domestic violence in their childhood. A another group (n = 707) included participants who also did not experience verbal abuse from their parents in addition to what the first group did not experience. The final group (n = 63) was created for the purpose of performing the diffusion tensor imaging. These individuals did not have exposure to abuse and physical violence similar to the other groups and they also had not reported history of axis I or axis II disorders. The participants all differed on the level of exposure they have to peer verbal abuse.

The participants were given self-report measures to obtain information on past abuse and trauma, as well as psychological symptoms including depression, anxiety, somatic complaints, dissociative experiences and others. Demographic information was gathered as well as information on family income or perceived financial security in childhood as possible contributors to symptom ratings. The group who had the diffusion tensor imaging performed on them also completed the questionnaires and given the imagining afterwards. A structural equations model was performed on the subset of 707 participants to examine the relationship between experiencing peer verbal abuse and demographic information as well as symptoms ratings on the questionnaires. Multiple regressions were also conducted on the 848 group to look at the impact of peer versus parental verbal abuse. Multiple regression analysis was also performed on the data from the diffusion tensor group to examine how areas of neural activity correlated with exposure to peer verbal abuse.

Results from the study were extensive. First, the results showed that gender played a role; specifically that males not only reported a larger degree of exposure to verbal abuse by other males than females, they also reported significantly more exposure to peer verbal abuse than females. The authors also found that a significant amount of exposure correlated with a greater chance of scoring clinically significant symptom ratings. The scores on the symptom rating questionnaires were also effected by gender differences. Specifically, females scored higher on the Dissociative Experiences Scale and Limbic System Checklist-33 than males while males reported higher scores on drug use. The results from the study also showed that timing of peer verbal abuse experience resulted in higher symptom ratings; specifically, symptom ratings were higher when exposed to the abuse in middle school though exposure in elementary and high school did have some impact. The results from the diffusion tensor imaging indicated that there were relationships between level of exposure to peer verbal abuse and mean diffusivity in the splenium of the corpus callosum. Specifically, radial diffusivity showed a positive correlation between exposure to verbal abuse and the splenium of the corpus callosum. Fractional anisotropy numbers also showed a negative correlation with exposure to peer verbal abuse in the right posterior corona radiata, though this correlation was not significant. It should be noted that there were no differences in gender or axial diffusivity in the neuroimaging group. The results showed the impact that peer verbal abuse can have on symptom ratings and neural activity. The authors hoped that this study would help people pay more attention to what children are exposed to and provide preventative measures to keep children from developing psychological problems later in life.

One of the greatest strengths of this article is the importance the results have on the future direction of clinical work. This article shows that exposure to peer verbal abuse in childhood not only increases the chances of experiencing psychological issues later in life, but it also effects neural functioning in these individuals. It means that it is critical to provide services to children exposed to abuse at an early age to prevent later psychological problems or to prevent the abuse from occurring in the first place. However, there are some flaws that need to be addressed that could impact the way that consumers view this article. One issue that may impact the significance of the results is the population that they used in the study. Instead of using children, they used young adults who responded to an advertisement on childhood memories. This could pose a problem because previous research has shown that as we age people may not remember childhood events as accurately as we think we do. We also know that individuals who are highly susceptible may believe they had been a victim of abuse based off the questionnaires that they are responding to. Even the authors state that these analyses were “retrospective and correlative and hence are subject to problems associated with faulty recall and spurious associations” (Teicher et al., 2010, p. 1470). Therefore it is important to use caution when examining these results because they may not be an accurate portrayal of what happens to individuals exposed to peer verbal abuse and other factors may be in play.

Another significant flaw in this study is the waste of potential use of data that was collected during the study; specifically, using only one group for neuroimaging purposes. While this study was unique in the fact that it controlled for other forms of abuse in obtained a “pure” sample of individuals who experienced just verbal peer abuse, they missed the opportunity to look at the other groups as well. There may be relationships or neural activity in the other two groups that may contribute to those individuals having psychological problems. Including the other groups may also to have helped confirm that the neural activity shown in the diffusion tensor group was due to peer verbal abuse and not another fact. Also another issue with the neuroimaging group is that they were classified as the “healthy control” group because they did not have axis I or axis II disorders. For the purposes of this study, a “true” control group should have been established with participants who were similar to the neuroimaging group, but did not suffer from peer verbal abuse. Once again, this group would have been helpful in ruling out neural activity that was not due to peer verbal abuse.

Statistically, the authors were wise to use a structural equations model to show to map out the relationship between peer verbal abuse and psychological and demographic information. The only flaw with this section of the statistical analysis is that they did not also include structural models for all the groups and only did it for the 707 participants. It would have been nice if the authors had done it for the other groups as well to visually display the results, which can be complicated to read and understand. Another statistical flaw is that they only ran multiple regressions, mainly because this allowed them to leave exposure as a continuous variable. However, it may have been advantageous to run analysis with the exposure to peer verbal abuse as some form of categorical input so that it could be known at what level of exposure does this become a problem. This information could be important in a clinical setting because you may not need to focus on every child who experiences peer verbal abuse, but only those who are significantly exposed. In general this was a well done study and the results from it should be taken into consideration in future clinical work with children exposed to abuse.


Article Referenced:

Teicher, M. H., Samson, J. A., Sheu, Y. S., Polcari, A., & McGreenery, C. E. (2014). Hurtful words: association of exposure to peer verbal abuse with elevated psychiatric symptom scores and corpus callosum abnormalities. American Journal of Psychiatry.



Anderson, C. M., Rabi, K., Lukas, S. E., & Teicher, M. H. (2010). Cerebellar lingula size and experiential risk factors associated with high levels of alcohol and drug use in young adults. The Cerebellum9(2), 198-209.

Choi, J., Jeong, B., Rohan, M. L., Polcari, A. M., & Teicher, M. H. (2009). Preliminary evidence for white matter tract abnormalities in young adults exposed to parental verbal abuse. Biological Psychiatry65(3), 227-234.

Teicher, M. H., Samson, J. A., Polcari, A., & McGreenery, C. E. (2006). Sticks, stones, and hurtful words: relative effects of various forms of childhood maltreatment. American Journal of Psychiatry163(6), 993-1000.