Cumulative Childhood Maltreatment Research Articles

Investigating the role of alexithymia in the association between cumulative childhood maltreatment and teen dating violence victimization

BackgroundChildhood maltreatment is increasingly recognized as an important risk factor for teen dating violence (TDV) victimization. However, far too little research has studied the mechanisms that could explain this higher risk of revictimization. The present study investigated the role of alexithymia in the association between cumulative childhood maltreatment, TDV victimization occurrence and chronicity, and TDV-related post-traumatic stress disorder (PTSD) symptoms. MethodsA total of 2780 adolescents, aged 13 to 19, completed measures of childhood maltreatment and alexithymia at Time 1 and TDV victimization and TDV-related PTSD symptoms at Time 2 (6 months later). Two mediational models were tested to examine the role of alexithymia as a risk factor for revictimization. One model assessed TDV occurrence as an outcome, while the other explored TDV chronicity and TDV-related PTSD symptoms as outcomes. ResultsFindings suggest that cumulative childhood maltreatment is associated with an increased probability of TDV occurrence through alexithymia. Cumulative childhood maltreatment and alexithymia are also associated with TDV chronicity and TDV-related PTSD symptoms. Notably, cumulative childhood maltreatment is associated with higher levels of alexithymia among adolescent victims of TDV, which, in turn, predicts higher TDV chronicity and TDV-related PTSD symptoms. LimitationsThis study relied on abbreviated measures and did not include all forms of child maltreatment (e.g., emotional and physical neglect). ConclusionsPromoting emotional awareness and identification among youth victims of child maltreatment could reduce the risk of TDV occurrence, TDV chronicity, and TDV-related PTSD symptoms.

Attachment as an intermediary variable between childhood maltreatment and perceived partner responsiveness in adolescents and young adults.

Cumulative childhood maltreatment (CCM) is associated with relationship difficulties including lower perceived partner responsiveness (PPR)-the degree of feeling cared for, understood, and validated by a person's partner. Attachment theory is understood via its representations of self and others and could offer a better understanding of how CCM effects continue into adulthood and affect PPR. We examined whether CCM is related to PPR via attachment in French-speaking adolescents and young adults. A sample of 427 individuals in a romantic relationship and another sample of 159 couples completed self-report measures. In both samples, a person's CCM was associated with their own lower PPR via their higher attachment anxiety and avoidance. In the dyadic sample, a person's CCM was associated with their partner's lower PPR via their own higher attachment anxiety. Attachment insecurities help understand the associations between CCM and PPR and may represent an important intervention target.

Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review.

Despite the growing body of literature on posttraumatic stress disorder (PTSD) and chronic pain comorbidity, studies taking into account the role of childhood exposure to traumatic and adverse events remains minimal. Additionally, it has been well established that survivors of childhood trauma may develop more complex reactions that extend beyond those observed in PTSD, typically categorized as complex trauma or CPTSD. Given the recent introduction of CPTSD within diagnostic nomenclature, the aim of the present study is to describe associations between childhood trauma in relation to PTSD/CPTSD and pain outcomes in adults with chronic pain. Following PRSIMA guidelines, a systematic review was performed using the databases Pubmed, PsychInfo, Psychology and Behavioral Sciences Collection, and Web of Science. Articles in English or French that reported on childhood trauma, PTSD/CPTSD and pain outcomes in individuals with chronic pain were included. Titles and abstracts were screened by two authors independently and full texts were consequently evaluated and assessed on methodological quality using JBI checklist tools. Study design and sample characteristics, childhood trauma, PTSD/CPTSD, pain outcomes as well as author's recommendations for scientific research and clinical practice were extracted for analyses. Of the initial 295 search records, 13 studies were included in this review. Only four studies explicitly assessed links between trauma factors and pain symptoms in individuals with chronic pain. Findings highlight the long-term and complex impact of cumulative childhood maltreatment (e.g., abuse and neglect) on both PTSD/CPTSD and chronic pain outcomes in adulthood. This review contributes to current conceptual models of PTSD and chronic pain comorbidity, while adding to the role of childhood trauma and CPTSD. The need for clinical and translational pain research is emphasized to further support specialized PTSD/CPTSD treatment as well as trauma-informed pain management in routine care.

Cumulative Childhood Maltreatment and Non-Suicidal Self-Injury: the Mediating and Moderating Role of Perceived Social Support in a Sample of University Students

Cumulative Childhood Maltreatment and Non-Suicidal Self-Injury: the Mediating and Moderating Role of Perceived Social Support in a Sample of University Students

Dispositional optimism mediates relations between childhood maltreatment and PTSD symptom severity among trauma-exposed adults

BackgroundExperiences of maltreatment in childhood, such as abuse and neglect, have been associated with poorer psychological well-being in adulthood, including elevated risk of revictimization and increased likelihood of developing posttraumatic stress disorder (PTSD) symptoms. Maltreatment has also been associated with reduced resources related to resilience, such as optimism, which may act as a protective factor for mental health. ObjectivesIn this study, we examined the mediating role of dispositional optimism in the relationship between childhood maltreatment and PTSD symptom severity from recent trauma in a sample of adults (n = 108) who presented to their local emergency department following trauma. MethodsWe analyzed six models to account for cumulative childhood maltreatment as well as five primary subtypes of maltreatment: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. ResultsGreater dispositional optimism mediated relations between total maltreatment and decreased PTSD severity (Bab = .056, SE = .029, 95 % CI [.009, .121]). Optimism also mediated relations between all maltreatment subtypes and PTSD severity, except sexual abuse. ConclusionsThese results may suggest optimism and positive psychology interventions as effective techniques in reducing the likelihood of PTSD development and severity in trauma-exposed individuals.

Predictors and correlates of lifetime and persistent non-suicidal self-injury and suicide attempts among adult survivors of childhood sexual abuse

ABSTRACT Background: Childhood sexual abuse (CSA) is a well-established risk factor for non-suicidal self-injury (NSSI) and suicide attempts (SA); still few studies have examined predictors of individual differences in NSSI/SA amongst CSA survivors. Objective: To examine predictors of NSSI and SA among adult CSA-survivors. Methods: In a sample of 516, primarily female adult CSA-survivors recruited from support centres for sexual abuse survivors in Norway, we examined the role of abuse/perpetrator characteristics, and the degree/severity of exposure to other types of childhood maltreatment (cumulative childhood maltreatment; CCM), as predictors of lifetime NSSI and SA. In a subsample of 138 individuals responding to follow-up waves two- and four years later, these same distal factors, as well as previous NSSI and proximal factors in the form of symptoms of mental health disorders (posttraumatic stress, anxiety, depression, sleep disturbances, and eating disorders), relational problems, and perceived social support, were examined as predictors of persistent NSSI. Finally, those attempting new SA during the follow-up period were compared to those who did not on these variables. Results: Higher CCM scores and having had an unknown perpetrator positively predicted lifetime NSSI scores. Higher CCM scores, violent abuse, and having had an unknown perpetrator predicted lifetime SA. Higher CCM scores, previous NSSI, having had a known perpetrator, as well as higher depression-, anxiety- and eating disorder scores, positively predicted persistent NSSI during the four-year follow-up period. Compared to those with no new SA, those reporting new SA during the follow-up period had higher CCM, lifetime NSSI, mental health symptoms and relational problem scores, lower perceived social support scores, and were more likely to have done a past SA and to have experienced abuse involving physical violence. Conclusions: A broad range of both distal and proximal factors should be assessed as potential predictors of NSSI and SA among adult CSA-survivors.

Cumulative Childhood Maltreatment and Executive Functioning in Adulthood

ABSTRACT Maltreatment during childhood has detrimental consequences for survivors. Among children, maltreatment predicts deficits in cognition and impairment in academic and emotional functioning. Although studied extensively in children, the extent to which cognitive deficits are evident in adulthood has been examined to a lesser extent. Executive functioning (EF) is a set of cognitive processes that help to guide behavior toward goals and is characterized by a prolonged maturational time course. As such, it is particularly vulnerable to the effects of early stress, which confers risk for psychopathology. Thus, it is critical to assess the potential impact of childhood trauma on adult EF. The present study sought to assess the impact of a history of childhood maltreatment on EF during adulthood using both self-reported and task-based measures of EF processes. Higher levels of cumulative childhood maltreatment predicted poorer EF. Furthermore, deficits were not accounted for by current symptoms of depression and anxiety, indicating that the impact of childhood maltreatment on cognitive functioning in adulthood is not the result of current internalizing psychopathology.

Unraveling the Consequences of Childhood Maltreatment: Deviations From Typical Functional Neurodevelopment Mediate the Relationship Between Maltreatment History and Depressive Symptoms

BackgroundChildhood maltreatment is associated with lifelong psychiatric sequelae. However, our understanding of neurobiological mechanisms responsible for this association is limited. Childhood maltreatment may confer risk for psychopathology by altering neurodevelopmental trajectories during childhood and adolescence. Longitudinal research, which is essential for examining this question, has been limited. MethodsWe investigated maltreatment-associated alterations in the development of neural circuitry. Associations between cumulative childhood maltreatment (assessed using a dimensional measure of abuse and neglect via the Childhood Trauma Questionnaire) and the longitudinal development of resting-state functional connectivity (rsFC) were examined in 130 community-residing adolescents. Functional magnetic resonance imaging data were acquired at age 16 (T1; mean ± SD age, 16.46 ± 0.52 years; 66 females) and age 19 (T2; mean follow-up period, 2.35 years; n = 90 with functional magnetic resonance imaging data at both time points). ResultsWe found maltreatment to be associated with widespread longitudinal increases in rsFC, primarily between default mode, dorsal attention, and frontoparietal systems. We also found sex-dependent increased maltreatment-associated rsFC in male participants in salience and limbic circuits. Cross-sectional analyses revealed a shift in maltreatment-related rsFC alterations, which were localized to subcortical and sensory circuits at T1 and to frontal circuits at T2. Finally, longitudinal increases in rsFC connectivity mediated the relationship between childhood maltreatment and increased depressive symptoms. ConclusionsTo our knowledge, this is the first study to examine longitudinal maltreatment-related alterations in rsFC in adolescents. Our findings shed light on the neurodevelopmental consequences of childhood maltreatment and provide evidence for their role in risk for depression.

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents

BackgroundTo explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences. MethodsA cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively. ResultsThe prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21–1.24), emotional abuse (aOR=1.15, 95% CI=1.14–1.15), sexual abuse (aOR=1.16, 95% CI=1.15–1.18), physical neglect (aOR=1.04, 95% CI=1.03–1.05), and emotional neglect (aOR=1.03, 95% CI=1.02–1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys. LimitationsThe study only included school students, and the cross-sectional design limited our ability to make causal inferences. ConclusionsThe study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.

68 Psychosocial predictors of pubertal timing: A systematic review

The psychosocial predictors of pubertal timing include a variety of variables that can be grouped into four large categories: SES, family environment, race, and childhood maltreatment. However, much of the research regarding predictors of pubertal timing examines these categories of predictors separately, which is problematic as many of these factors are closely related. As such, it is important to examine multiple psychosocial predictors of pubertal timing simultaneously. This review aimed to examine all predictors in a systematic way, in order to allow a comprehensive review of each predictor and how they are related to one another. We examined all empirical articles published since Belsky, Draper, & Steinberg (1991) examining psychosocial predictors of pubertal timing. Data was collected using predetermined keywords applied to four different databases: PsychINFO (n= 433), Medline (n= 543), CINHAL (n= 484), & Scopus (n= 564). After duplicates were removed, a total of 1905 articles were identified. Articles underwent three separate reviews by two blind reviewers. The review process revealed a total of 126 articles suitable for inclusion in the review. Each psychosocial predictor was examined in a systematic way in order to draw connections between all types of predictors and their implications. Within this review, predictors were divided into four major categories of variables: race, socioeconomic status, family environment and childhood maltreatment. Findings indicated a complex picture of psychosocial predictors and how they are all connected. In sum, variables related to cumulative childhood maltreatment tended to remain significant above the other predictors such as, father absence, socioeconomic status, and race. These findings imply that youth, particularly girls, who have cumulative stress experience puberty earlier than those with fewer stressors. This review provides a more comprehensive profile of youth at-risk for later negative health outcomes associated with precocious puberty. Particularly, this review will be the first of its kind to include all articles examining psychosocial predictors of pubertal timing in both boys and girls. The present findings have implications for the refinement of models explaining the psychosocial predictors of precocious puberty. More specifically, if practitioners could better identify early psychosocial signs of precocious puberty they may be in a better position to provide appropriate treatment.

Distinguishing Complex PTSD from Borderline Personality Disorder among individuals with a history of sexual trauma: A latent class analysis

IntroductionThere has been debate regarding whether Complex PTSD (CPTSD) is conceptually distinct from Borderline Personality Disorder (BPD). ObjectiveTo assess whether ICD-11 CPTSD was distinguishable from BPD in a sample of sexual assault survivors. MethodA subsample of individuals (n=956), that selected sexual assault as an index trauma, were selected from a U.S. general population survey dataset. The distribution of PTSD, CPTSD and BPD symptomology was evaluated using latent class analysis (LCA). Multinomial logistic regression analyses were performed to evaluate whether various forms of child maltreatment and cumulative child maltreatment could discriminate between classes. ResultsCPTSD emerged as a distinct symptom profile within the sample. Conversely, BPD symptomology was evident in two classes but was accompanied by PTSD/CPTSD symptomology in each. Overall, five classes were identified that differed both quantitatively and qualitatively. Cumulative childhood maltreatment and physical neglect predicted CPTSD class membership. ConclusionThe findings suggest that CPTSD is distinct from BPD among a sample of individuals who have been shown to be at significant risk for both diagnoses. Further research is required to identify factors that distinguish CPTSD from BPD.

Cumulative Childhood Maltreatment and Subsequent Psychological Violence in Intimate Relationships: The Role of Emotion Dysregulation

Cumulative maltreatment or exposure to multiple types of child abuse or neglect increases the risk of perpetrating and sustaining intimate partner violence (IPV) in adulthood and is associated with deficits in emotion regulation, which are considered as robust determinants of psychological IPV. Yet, no research has evaluated this relationship by distinguishing the cognitive and behavioral components of emotion dysregulation. Thus, the goal of the present study was to examine the mediating role of cognitive and behavioral emotion dysregulation in the relationship uniting cumulative childhood maltreatment and psychological IPV. A total of 162 adults consulting in sexology completed self-report questionnaires assessing their experiences of cumulative trauma, emotion dysregulation, and psychological IPV. The majority (86%) of participants experienced more than one type of childhood maltreatment, whereas half of them reported having perpetrated (51%) and sustained (54%) psychological IPV. Path analyses confirmed the mediational role of emotion dysregulation in the relationship between cumulative maltreatment experiences and psychological IPV. The hypothesized model was also invariant across gender. Results highlight the necessity to assess child maltreatment and IPV experiences thoroughly in individuals consulting for sexual or relational problems.

Childhood Maltreatment and Child Protective Services Involvement Among the Commercially Sexually Exploited: A Comparison of Women Who Enter as Juveniles or as Adults

A risk for commercial sexual exploitation is childhood maltreatment. It’s unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics, t tests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation.

Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse

In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N=278, 95.3% women, mean age at first abusive incident=6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way.

Childhood Maltreatment and Unprotected Sex among Female Juvenile Offenders: Evidence of Mediation by Substance Abuse and Psychological Distress

PurposeResearch has shown that childhood maltreatment is associated with sexual risk taking among female juvenile offenders; however, the mechanisms by which maltreatment influences sexual risk remain poorly understood. We assessed whether substance abuse, psychological distress, and dating violence mediate the relationship between childhood maltreatment and unprotected sex. MethodsSexually active female juvenile offenders (13–17 years of age) completed audio computer-assisted self-interviews (n = 232). Logistic regression with a risk decrement approach, the Sobel test, and the Goodman I test were used to evaluate mediation. ResultsMaltreatment before sixth grade was common in our sample, including physical abuse (48.7%), sexual abuse (14.7%), supervision neglect (57.3%), and physical neglect (18.5%). Cumulative childhood maltreatment was also high with 42.2% reporting two or more types. In the fully adjusted model, cumulative childhood maltreatment remained associated with unprotected sex (odds ratio, 2.43; 95% confidence interval, 1.27, 4.65). The percent of the total effect in the relationship between childhood maltreatment and unprotected sex that was mediated by substance abuse was 16.4% (Sobel = 2.54 [p = .01]; Goodman I = 2.49 [p = .01]) and psychological distress accounted for 23.7% (Sobel = 2.55 [p = .01]; Goodman I = 2.51 [p = .01]). Dating violence was not a significant mediator in our analyses. ConclusionWe found a strong relationship between childhood maltreatment and unprotected sex among female juvenile offenders that was partially mediated through substance abuse and psychological distress. These findings can be used to develop public health strategies to increase condom use among female juvenile offenders. Trauma-informed approaches to sexual health promotion that address substance abuse and psychological distress are warranted.

Altering Risk Following Child Maltreatment: Family and Friend Support as Protective Factors

Although the long-term effects of cumulative childhood maltreatment (CCM) include a variety of adverse consequences, many individuals are resilient following such experiences. This study explored the role of social support from family and friends in buffering long-term outcome following CCM, examining both main and moderating effects. Participants included 344 college aged men and women. Findings revealed strong promotive (main) effects of social support from family and friends that were associated with a reduction in symptoms of depression/anxiety and anger/hostility, regardless of the severity of abuse experienced. Support generally acted as a buffer (moderator) against negative outcomes for individuals with lower, and not higher, levels of CCM. The role of family support in moderating outcome was complex, particularly with respect to women’s later dating victimization; here family support functioned as a protective factor at low CCM, but as a vulnerability factor at high CCM.

Cumulative Childhood Maltreatment and Depression Among Incarcerated Youth

Youth involved in the juvenile justice system are at high risk for mental health problems, particularly depression. Furthermore, these youth often present with a history of childhood maltreatment. Despite research consistently demonstrating a link between childhood maltreatment and depression, our understanding of intervening factors of this relationship remains limited. This study examined impulsivity, hopelessness, and substance use as potential explanatory variables in the relationship between cumulative childhood maltreatment and depression severity among 110 incarcerated youth. The data were analyzed using path analysis. As hypothesized, cumulative maltreatment maintained a strong direct relation with depression severity in the context of the additional variables in the final model. Cumulative maltreatment also had an indirect relation with depression severity through both impulsivity and hopelessness. Contrary to expectation, substance use was not an explanatory variable in the model. These findings suggest that impulsivity and hopelessness might be important factors to consider in future studies on the relation between childhood maltreatment and depression symptoms among incarcerated youth.