Abstract
Childhood maltreatment may have an influence on anxiety symptoms and coping styles. This longitudinal study aimed to estimate the prospective associations between different types of childhood maltreatment and anxiety symptoms among Chinese adolescents, with a particular focus on investigating whether these associations vary by the tendency of coping styles. Data were from the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research. The baseline sample included 1957 participants (response rate: 99.03%) and followed up at 1-year later (n = 1836, retention rate: 93.8%). Anxiety symptoms, childhood maltreatment, the tendency of coping styles, morning cortisol level, depressive symptoms, self-esteem, and other demographics were measured. Overall, the mean age of the baseline students was 13.6 (SD: 1.5) years. The final results showed that childhood emotional abuse (unstandardized β-estimate = 0.13, 95% CI = 0.07–0.18), physical abuse (unstandardized β-estimate = 0.08, 95% CI = 0.01–0.16), and sexual abuse (unstandardized β-estimate = 0.17, 95% CI = 0.04–0.29) were positively associated with anxiety symptoms at follow-up after adjusting for significant covariates at baseline. Additionally, the stratified analyses demonstrated that only among students with negative coping styles, childhood emotional abuse, physical abuse, and sexual abuse were associated with subsequent anxiety symptoms; the differences between the positive and negative coping style strata were significant (P < 0.05). Childhood maltreatment appears to be a predictor of anxiety symptoms among adolescents, and the tendency of coping styles may have a moderating role in these longitudinal associations. The efforts to prevent anxiety symptoms are recommended to be focused on adolescents with the experience of childhood maltreatment and negative coping styles.
Highlights
Childhood maltreatment, defined as any form of physical, emotional, or sexual abuse and neglect that occurs to those under 18 years of age, is thought to affect one in three children globally[1]
Baseline Generalized Anxiety Disorder Scale-7 (GAD-7) scores were related to anxiety symptoms at follow-up
In post hoc sensitivity analyses, we reran all models using the overall CTQ-SF score and found similar results. To our knowledge, this is the first longitudinal study to test the associations between specific types of childhood maltreatment, coping styles, and anxiety symptoms among Chinese adolescents
Summary
Childhood maltreatment, defined as any form of physical, emotional, or sexual abuse and neglect that occurs to those under 18 years of age, is thought to affect one in three children globally[1]. It is well described that childhood maltreatment can have long-term effects on health through the lifespan and is associated with the development of mental and physical well-being in adolescence[2]. 20.0% of Chinese adolescents had suffered childhood physical abuse, 30% had suffered emotional abuse, 12% had suffered sexual abuse, 47% had suffered physical neglect, and 44% had suffered emotional neglect, respectively[3]; indicating that childhood maltreatment has been a major public health problem among Chinese adolescents. Adolescence is a transitional and developmental period characterized by tremendous physical maturation, social role changes, and psychological development[4]. Exposure to childhood maltreatment may make adolescents especially susceptible to internalizing
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