Childhood maltreatment and later stressful life events as predictors of depression: A test of the stress sensitization hypothesis.

Abstract

Long-term negative effects of child maltreatment, including risk for depression, are well established. The role of acute stressors in the relationship between maltreatment and depression is not as clear. We used data from a prospective study to test a stress sensitization hypothesis; whether child maltreatment lowered the threshold at which adult household stressors impacted adult depression. We hypothesized that maltreatment would positively moderate the relationship between acute stressors and adult depressive symptoms. Participants (n = 457) were majority White (~ 80%) and from low-income families (63%), and the sample was gender balanced (54% male) at the start of a 40-year longitudinal study examining the causes and consequences of child maltreatment. Regression analyses tested a main effects model for adult depression, modeled as a function of proximal adult household stressors and officially recorded child maltreatment, and controlled for measures of prior depression, household stress, and sociodemographic factors. A second model added the interaction between maltreatment and stressors to test the stress sensitization hypothesis. Maltreatment had a positive overall association with adult depression. This association was not significant after taking into account adult stressors and other controls. Adult stressors had a unique, positive association with depression. The association between adult stressors and depression was stronger for participants with histories of child maltreatment. Child maltreatment increases sensitivity to later stressors, adding to the risk for depression. Findings are generally consistent with prior studies linking child maltreatment, stress, and later depression and provide support for stress sensitization extending into adulthood.