Longitudinal growth of post-traumatic stress and depressive symptoms following a child maltreatment allegation: An examination of violence exposure,family risk and placement type

Few longitudinal studies have analyzed how traumatic experiences (e.g. home removal, violence exposure) influence both depressive and Post-Traumatic Stress (PTS) symptoms in children involved with Child Protective Services (CPS). This study investigated the change trajectories of both depressive and PTS symptomatology as well as their associations over time, focusing on the effect of complex trauma. Data were obtained from the National Survey of Child and Adolescent Well-Being (1999–2007), a nationally representative study of children and adolescents who were referred to child protective services for alleged maltreatment. The Children's Depression Inventory (CDI) scale measured depressive symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model. The participants' initial levels of depressive and PTS symptomatology were significantly and positively related; furthermore, any changes in these two outcomes were also correlated longitudinally. The initial assessment of PTS symptoms significantly contributed to the advancement of more severe depressive symptoms over time. No significant differences were found between youth who remained in the home and those removed from the home. However, violence exposure, sexual abuse, gender and age were significant predictors of level and rate of change in both PTS and depressive symptoms. PTS growth factors mediated the longitudinal relationship between witnessing severe violence and depressive symptoms. The findings suggest a complex developmental association between depressive and PTS symptomatology among CPS-involved youth that is rooted in early childhood experiences with complex trauma.     

The role of disclosing child sexual abuse on adolescent adjustment and revictimization

The role of disclosing child sexual abuse on adolescent survivors' symptomatology and the presence of additional unwanted sexual experiences was investigated in a subsample of 111 adolescents from the National Survey of Adolescents who reported child sexual abuse. Results indicated that prompt disclosure of sexual abuse to an adult moderated the influence of penetration during the abuse on the number of symptoms at assessment. Thus, prompt disclosure buffered the influence of more severe abuse. Disclosure also had a main effect on the likelihood of further victimization. Participants who told an adult promptly after the abuse were less likely to report additional unwanted sexual experiences.     

Maternal victimization and child trauma: The mediating role of mothers' affect

This study examined the effects of maternal childhood and adult victimization on child trauma symptomatology both directly and indirectly via three types of maternal affective problems as mediators (depression, anxiety, and hostility). A high proportion of mothers in the sample reported a history of childhood or adulthood physical and sexual abuse and findings showed that these experiences impacted how victimized women may function as parents. Mothers' adult victimization had a stronger effect on children compared to maternal childhood victimization. The relationship between maternal adult victimization and child trauma symptoms was mediated by maternal depression. Maternal anxiety mediated the relationship between both maternal childhood and adulthood victimization and child trauma symptoms, but anxiety played a buffering role. Maternal hostility was associated with both childhood and adulthood victimization, but did not serve as a mediator. Implications for practice with victimized mothers and their children are discussed.     

Coping with parental loss because of termination of parental rights

This article addresses the process by which children and adolescents cope with severe acute stress of parental loss from causes other than divorce or death. Participants were 60 children and adolescents from a residential treatment facility. Most had experienced neglect, physical abuse, and sexual abuse, and their parents had their parential rights terminated. Measures of symptomatology indicated that children reported low levels of depressive symptoms, whereas caregivers reported the children were experiencing significant psychological problems. Children used avoidant coping strategies more often than emotion-focused coping strategies, which, in turn, were used more than problem-focused coping strategies. Results are discussed in terms of helping children cope with parental loss.     

Ethnicity and child sexual abuse experiences of female college students

This research examines the understudied issue of race/ethnicity in relation to child sexual abuse experiences (CSA) in a cross-sectional convenience sample of 461 female college students completing a survey. Comparisons of students' abuse experiences revealed ethnic differences in sexual abuse prevalence, severity of abuse, the victim- offender relationship and post-abuse coping. Black students reported more sexual abuse than other ethnic groups, followed by Hispanics, Whites, and Asians. Although timing and extent of disclosure of sexual abuse did not vary by ethnicity, negative social reactions to disclosure were more common for certain ethnic groups than others. No ethnic differences emerged for depressive or PTSD symptoms. Implications are drawn for future research on the issue of ethnic differences in the aftermath of CSA experiences.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

The Association of Maternal Depressive Symptoms with Child Externalizing Problems: The Role of Maternal Support Following Child Sexual Abuse

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother–child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found to partially operate through abuse-specific maternal support, which was assessed via parent report. Implications of the findings for parenting programs are discussed, and future research directions are considered.     

Anger Expression Mode,Depressive Symptoms,Hopelessness, and Decision Coping among African American Adolescents

This study examined the relationship between anger expression mode, depressive symptoms, hopelessness, and decision coping patterns among a non-clinical community sample of 276 low-income African American adolescents (mean age = 14.47). Participants were students in sixth through tenth grades enrolled in health and wellness classes in two public schools in West Tennessee. They were asked to complete a battery of instruments including the Anger Style Inventory, Children's Depression Inventory, Hopelessness Scale for Children, and Flinders Adolescent Decision Making Questionnaire. Findings indicate a significant association between anger expression mode, depressive symptomatology, hopelessness, and decision coping pattern among study participants. Gender and screening positive for depressive symptoms predicted participant's anger response mode. Using multiple assessment scales may provide useful information toward preventing the onset of clinically significant emotional disorders among adolescents.     

The association of maternal depressive symptoms with child externalizing problems: the role of maternal support following child sexual abuse

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother-child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found to partially operate through abuse-specific maternal support, which was assessed via parent report. Implications of the findings for parenting programs are discussed, and future research directions are considered.     

Parental Discipline and Abuse Potential Affects on Child Depression,Anxiety, and Attributions

The current study investigated differences in children's emotional functioning as a product of their parents' reported disciplinary practices and child abuse potential. Families with no known history of abuse were recruited to ascertain whether depressogenic attributional style and depressive or anxious symptomatology was evident in children of parents who used harsher physical punishment and who had higher abuse potential. Forty‐two New Zealand children ages 8–12 participated with their parents. Child‐report measures of depression, anxiety, and attributional style were compared with parents' responses on physical discipline scenarios and child abuse potential. Children's anxiety symptoms were higher in those children whose parents obtained higher abuse potential scores and had harsher discipline practices. Children's depressive symptoms and some components of maladaptive attributional style were also found in families with higher abuse potential. Results suggest emotional difficulties similar to those of maltreated children even without identifiable abuse.     

Marital Conflict Trajectories and Associations With Children's Disruptive Behavior

We seek to identify heterogeneous trajectories of marital conflict during the early childhood period, identify predictors associated with these trajectories, and examine associations between trajectory group membership and children's disruptive behavior. Participants were 469 families examined 4 times when the children were 2 to 54 months of age. Maternal reports of marital conflict, adverse childhood experiences, depressive symptoms, and sociodemographic characteristics were collected, and averaged maternal and paternal reports of child disruptive problems were used. Using growth mixture modeling, 3 trajectories of marital conflict were identified: high increasing (21.8%), high decreasing (7%), and low stable (71.2%). Maternal adverse childhood experiences predicted increased risk of belonging in the high‐increasing group, whereas depressive symptoms predicted increased risk of belonging in the high‐decreasing group. Importantly, children of mothers in the high‐increasing group exhibited higher levels of disruptive behavior at 54 months when compared with children of mothers in the high‐decreasing and low‐stable groups.     

Maternal Positive and Negative Interaction Behaviors and Early Adolescents' Depressive Symptoms: Adolescent Emotion Regulation as a Mediator

This study examined the relation between mothers' positive and negative interaction behaviors during mother–child interactions and the emotion regulation (ER) and depressive symptoms of their adolescent offspring. Event‐planning (EPI) and problem‐solving interactions (PSI) were observed in 163 mother–adolescent dyads, and adolescents also provided a self‐report of ER responses and depressive symptoms. Sequential analyses of mother–adolescent behaviors during the interaction tasks indicated that adolescents with more depressive symptoms were more likely to reciprocate their mothers' negative affective behaviors. Adolescents whose mothers displayed less positivity and more negativity (i.e., less frequent positive and more frequent negative behaviors) during the EPI displayed more emotionally dysregulated behaviors in the PSI and reported more frequent maladaptive ER responses. Adolescents whose mothers behaved negatively toward them more frequently during mother–adolescent interactions also reported more depressive symptoms. The frequency with which adolescents engage in maladaptive ER responses mediated the association between maternal negativity and adolescents' concurrent depressive symptoms.     

Coping Strategies and Depression Among College Students Following Child Sexual Abuse in Turkey

The objective of this study was to investigate the relationship between type of coping style and depression in college students with child sexual abuse experience. A total of 1,055 college students completed self-report measures to assess depressive symptoms, coping strategies, and child sexual abuse history. This study was conducted with a subset of 125 college students who reported that they had been sexually abused in childhood. They were divided into depressive and nondepressive groups according to their depressive symptoms. Data was collected with the Childhood Sexual Abuse Measurement, the Beck Depression Inventory, and the Coping Styles of Stress Scale. Family characteristics were measured with a demographic questionnaire. Analyses involved multiple regression to test for predictive effects. Among college students with child sexual abuse histories, parental education level and both problem-focused and emotion-focused strategies significantly explained depression scores.     

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.     

Child Sexual Abuse and Adult Mental Health,Sexual Risk Behaviors,and Drinking Patterns Among Latino Men Who Have Sex With Men

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals’ likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.     

Exposure to child abuse and risk for mental health problems in women

Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.     

Early Age of First Sexual Intercourse and Depressive Symptomatology among Adolescents

Past literature has provided conflicting evidence for the association between adolescent sexual intercourse and depressive symptomatology. Whereas some studies conclude that sexually active youth may be at risk for depression, others provide contrary results. Thus, it is unclear as to whether depression results directly from coitus or if this relationship is explained by other factors—that is, there may be biological, psychological, or sociological predictors of both depressive symptomatology and early sexual intercourse. Using the National Longitudinal Study of Adolescent Health dataset, depressive symptomatology in adolescents over a seven-year time period was analyzed. The final sample (n = 6,510) was comprised of 49.35% male (n = 3,213) and 50.65% female (n = 3,297) participants. Although an earlier age of first coitus was predictive of future depressive symptoms, both variables appear to be concomitant outcomes of the biopsychosocial process. Thus, although one may be able to use early coitus as a marker for subsequent depressive symptomatology, it does not appear to occur because of early sexual intercourse. Furthermore, the reverse relationship was not found to be significant in this study—that is, higher levels of previous depressive symptomatology did not predict an earlier age of first sexual intercourse in adolescents.     

Resilience in parenting among young mothers: Family and ecological risks and opportunities

The present study used a person-centered approach to examine resilience in parenting among a sample of young mothers (under age 21 at childbirth). Resilient functioning as a parent was defined as the lack of perpetration of child maltreatment (substantiated reports of child abuse and neglect) in the context of risk. Risk factors were assessed at multiple levels, including family (e.g., negative childhood histories in family of origin) and ecological (e.g., neighborhood poverty, mother's financial stress) levels. Analyses revealed a group of mothers who demonstrated resilience in parenting despite a context of substantial risks from their childhood histories (e.g., negative family relationships) and current ecologies (e.g., economic and neighborhood conditions). Mothers in the resilient group were less likely to a) live with their families of origin, and b) to rely on their own mothers as sources of emotional or caregiving support. Data also indicated that young mothers' resilient functioning as parents was associated with higher rates of depressive symptoms among these mothers, perhaps suggesting a “cost” or limit to resilient parenting functioning in young mothers. Results are discussed in a resilience framework.     

Perpetration,Revictimization, and Self-Injury: Traumatic Reenactments of Child Sexual Abuse in a Nonclinical Sample of South African Adolescents

Risk factors for traumatic reenactments of child sexual abuse experiences (perpetration, revictimization, and self-injury) were examined in a sample of 718 South African secondary school adolescents. Logistic regression analyses indicated that the most consistent predictors of reenactments were a history of child sexual abuse (rape and/or indecent assault) and respondents’ gender, with males being significantly more likely than females to report perpetration (OR = 13.5) and females being more likely to report revictimization (OR = 3.2) and self-injury (OR = 2.5). An analysis restricted to respondents with a history of child sexual abuse indicated that negative abuse-related cognitions were the most consistent predictor of all forms of traumatic reenactment.     

Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong

The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents’ psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers’ sexual eroticism and externalizing behavioral symptoms. Disclosers’ cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.