Cumulative Childhood Research Articles

Association of adverse childhood experiences with adult-onset cardiometabolic conditions and prescription medicine use

Abstract Association of adverse childhood experiences with adult-onset cardiometabolic conditions and prescription medicine use Background and importance Adverse childhood experiences are potentially preventable and traumatic events that occur during childhood. Childhood exposure to trauma is highly prevalent and adults who had adverse childhood experiences are at increased risk of developing physical conditions. However, effect of adverse childhood experiences on health outcomes remains underrecognized. Aim Here, we aimed to measure the association of cumulative adverse childhood experience with adult physical condition and use of prescription medicines in general population. Methods We conducted a cross-sectional analysis using the population-based health study including 21083 participants at age 40 years or older. Self-reported adverse childhood experiences before age at 18 years, present or previous cardiometabolic conditions, and present or previous use of medications prescribed for cardiometabolic conditions were used in our analysis. Cox proportional hazards regression was used to estimate age, sex, smoking, education, and income-adjusted risk of cardiometabolic condition and prescription medicine use after adverse childhood experiences. Association of multimorbidity and using multiple prescription medicines with adverse childhood experience was analyzed using generalized linear model with ordinal classification. Results We found that having a history of adverse childhood experience was associated with increased risk of subsequent cardiometabolic conditions; hazard ratios ranged from 1.117 (95% CI, 1.054 – 1.185) to 1.341 (95% CI, 1.181 – 1.522). Furthermore, adverse childhood experience was associated with multimorbidity of cardiometabolic conditions (odds ratio [OR], 1.195; 95% CI, 1.117 – 1.279) and increased risk of using multiple prescription medicines (OR, 1.131; 95% CI, 1.057 – 1.210). Notably, we observed the dose – effect relationships of cumulative adverse childhood experience to the increased risk of 5 among 6 cardiometabolic conditions and to the increased risk of using 4 among 6 prescription medicines. Furthermore, cumulative adverse childhood experience had the dose – effect associations with multimorbidity of cardiometabolic conditions (ORs ranged from 1.120 [95% CI, 1.033 – 1.214] to 1.526 [95% CI, 1.276 – 1.825]) and using multiple prescription medicines (ORs are 1.393 [95% CI, 1.195 – 1.624] and 1.572 [95% CI 1.315 1.879]). Conclusions and relevance: Our findings implicate cumulative adverse childhood experience as a risk factor for later cardiometabolic conditions and use of medicines prescribed for cardiometabolic conditions. Our results are significant by suggesting inquiry into adverse childhood experience exposure during clinical consultations, services to alleviate the burden and increasing resilience in addition to strategies aimed at prevention of cardiometabolic conditions might improve health outcomes.

Risk of Revictimization within Intimate Relationships among Women Survivors of Childhood Sexual Abuse: The Role of Cumulative Trauma and Self-Capacities Disturbances

Childhood sexual abuse, especially in the context of cumulative childhood interpersonal trauma (CCIT), is associated with an increased risk of revictimization by an intimate partner among women. The aim of the present study is to examine the role of self-capacities disturbances in the association between CCIT and revictimization by an intimate partner. The sample comprised of 247 adult women survivors consulting in sex therapy. Path analyses showed an indirect effect of self-capacities disturbances in the association between CCIT and revictimization (ORs = 1.49 and 1.62), demonstrating the importance of intervening in relational and affective difficulties among women survivors to prevent the risk of revictimization.

Stress of not being “man enough”: The role of masculine discrepancy stress and emotion dysregulation in the link between cumulative childhood trauma and perpetrated intimate partner violence in a clinical sample of men.

Stress of not being “man enough”: The role of masculine discrepancy stress and emotion dysregulation in the link between cumulative childhood trauma and perpetrated intimate partner violence in a clinical sample of men.

Trauma History in a Medium-Secure Adult Male Forensic Mental Health Setting

Forensic services have shifted their focus to the importance of forensic practice becoming more trauma informed. Trauma exposure is pervasive in forensic mental health populations and has been found to negatively impact the course of severe mental illness (SMI) and increase risk of violence. This study aimed to explore the trauma histories of adult male inpatients in a medium-secure psychiatric hospital, and examine childhood and adulthood trauma as predictors of diagnoses, self-harm, suicidality, hospital re-admissions, substance use, and nature of offense. The case files of 85 male patients in a medium secure unit in the UK were reviewed. Eighty-seven percent of patients had a schizophrenia diagnosis and 86% had extensive trauma histories, the most common trauma type being physical violence in childhood (44.7%). One patient had a PTSD diagnosis. Logistic regressions demonstrated that cumulative childhood and adulthood trauma significantly increased the odds of self-harm. Cumulative childhood trauma exposure was found to decrease the likelihood of having a schizophrenia diagnosis. There is a serious under-recognition of the extent and consequences of trauma exposure; trauma histories are likely greater than the findings of this study and existing literature suggests. Implications for clinical practice, trauma-informed care (TiC), and future research are proposed.

Adverse Childhood Experiences, Protective Factors, and Childhood Obesity: Comparing the Effectiveness of Three Resilience Frameworks

Abstract While rates of childhood obesity continue to rise in the United States, multiple studies have linked childhood obesity to adverse childhood experiences (ACEs). ACEs researchers have begun to develop frameworks that identify protective factors that build resilience against ACEs. However, these frameworks have a limited evidence base. Utilizing data from the 2018–2020 National Survey of Children’s Health, this study compared the effectiveness of the National Scientific Council on the Developing Child (NSCDC), Health Outcomes from Positive Experiences (HOPE), and cumulative positive childhood experiences (PCEs) frameworks in mitigating the impact of ACEs on childhood obesity. Based on hierarchical logistic regression conducted on data from 46,672 children between the ages of 10 and 17 years old, this study found that both the NSCDC and HOPE frameworks were associated with childhood obesity, with each framework explaining a similar amount of variance in childhood obesity across analyses. The cumulative PCEs framework did not strengthen the association between either framework and childhood obesity. Across analyses, strong self-regulation, mastery/after-school activities, and living in a supportive neighborhood had the strongest association with childhood obesity. The findings suggest that the most salient protective factors may be those most closely associated with the direct causes of childhood obesity, with the need to identify factors across ecological levels. Future research is needed to validate these frameworks further and explore these frameworks with other outcomes. The findings have important implications for future ACEs research and ACEs interventions. Public Relevance By understanding which resilience frameworks and protective factors have the strongest relationship with childhood obesity among children who experienced ACEs, interventions can potentially be developed using these findings to mitigate the harmful impact of ACEs on childhood obesity. Key Findings This study found that the National Scientific Council on the Developing Child (NSCDC) and Health Outcomes from Positive Experiences (HOPE) frameworks were associated with childhood obesity after controlling for adverse childhood experiences (ACEs) in a sample of children between the ages of 10 and 17 years old. The strongest protective factors against childhood obesity were strong self-regulation, mastery/after-school activities, and living in a supportive neighborhood. Given the relationship between these protective factors along with several covariates in the study with childhood obesity, future ACEs interventions should potentially target these protective factors and other social determinants of health to reduce the negative impact of ACEs on childhood obesity.

A - 56 Cumulative Childhood Adversity Is Linked with Reduced Cognitive Performance during Late Childhood to Adolescence

Abstract Objective History of adverse childhood experiences (ACEs) has been linked with poorer cognitive performance in young adulthood and cognitive decline in older adults; however, few studies have examined these relationships during childhood and adolescence, which are key periods for neurocognitive development. The current study investigated the longitudinal relationships between ACEs and cognitive performance during late childhood/adolescence. Method 10,827 participants (ages = 9–15.5 years old; 48% female) were included from the Adolescent Brain Cognitive Development Study. Cumulative ACE scores were created using annual parent and child reports of youth’s exposure to ACEs from baseline (ages 9–10) to Year 4 follow-up (ages 13–15). Cognitive performance was assessed using the NIH Toolbox (completed at baseline, Year 2, and Year 4). Separate linear mixed-effects models examined associations between ACEs and cognitive performance while accounting for time, age, sex assigned at birth, caregiver education, household income, pubertal status, internalizing and externalizing symptoms, and random effects of subject and family/twin status. Additional analyses tested for interactions with time. Results Greater ACEs were associated with poorer cognitive performance on tasks measuring verbal (p’s < 0.001) and visual (p < 0.001) memory, working memory (p = 0.01), cognitive flexibility (p = 0.004), processing speed (p < 0.001), and language (p’s < 0.001), above and beyond covariates. ACEs were not associated with attention (p = 0.09). Cognitive performance improved over time; however, compared to baseline, youth with greater ACE history at Year 4 demonstrated poorer attentional performance (p = 0.008). Conclusions Findings suggest that ACEs influence cognitive performance during key neurodevelopmental periods, and future work should assess clinical utility of targeted cognitive remediation in youth with adversity history.

A Safe Haven Through Attachment: A Dyadic Perspective on the Association Between Cumulative Childhood Trauma and Relationship Satisfaction.

Cumulative childhood trauma (CCT) increases the risk of experiencing interpersonal problems and relationship distress in adulthood. However, not all CCT survivors experience such difficulties, and little research has investigated protective factors against relationship dissatisfaction in CCT survivors and their partners. Romantic attachment might be one such factor that could reduce the harmful effects of a CCT history on relationship satisfaction for both survivors and their partners. Using a dyadic perspective, this study aimed to examine the association between CCT and relationship satisfaction and to test the moderating effect of attachment avoidance and anxiety on this association. A sample of 501 couples was recruited through a Canadian survey firm. Canadian couples who had provided their telephone number were randomly selected to complete the short form of the Dyadic Adjustment Scale, the Experiences in Close Relationships Scale, and the Childhood Cumulative Trauma Questionnaire. The actor-partner interdependence moderation model was used to guide the analyses. Results showed that individuals' and partners' higher CCT was correlated with both partners' lower relationship satisfaction. The analyses revealed a moderating effect of lower attachment avoidance on the link between individuals' CCT and their own relationship satisfaction. Specifically, individuals' CCT was significantly and negatively associated with relationship satisfaction at high levels of attachment avoidance, but unrelated to relationship satisfaction at low levels of attachment avoidance. The final model explained 31.4% of the variance in relationship satisfaction. Overall, the findings support the relevance of couple interventions that focus on romantic attachment to improve relationship well-being in couples where one or both partners have experienced CCT.

Longitudinal association of adverse childhood experiences with cognitive function trajectories among middle-aged and older adults: group-based trajectory modeling.

Adverse childhood experiences (ACEs) impact cognitive function, but the relationship remains unclear. We aim to identify cognitive function trajectories and scrutinize the correlation between ACEs and cognitive function. To identify cognitive trajectories, we employed a group-based trajectory model, and influential factors were determined using multinomial unordered logistic regression analysis. Three cognitive decline subgroups emerged: low-start decline, high-start stability, and mid-start decline. There is no dose-response relationship between cumulative adverse childhood experiences and cognitive function. The high-start stability group had specific residence and education traits, while sibling death affected them. The mid-start decline group was vulnerable to parental death, physical abuse, and domestic violence. The low-start decline group should consider age structure and childhood friendships. No dose-response association between cumulative ACEs and cognitive decline. Still, specific ACE metrics are correlated with cognitive trajectories. We can incorporate patients' ACEs into cognitive function assessments for early risk factor identification and tailored interventions. Moreover, recognizing the influence of early-life experiences on cognitive function, we can advocate for nurturing positive family and societal environments to optimize cognitive function.

Cumulative Adverse Childhood Experiences (ACEs) and Recidivism: A Meta-Analysis

This meta-analysis quantitatively synthesizes existing literature to investigate the relationship between aggregations of adverse childhood experiences (ACEs) and recidivism among court-involved youth and adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and moderation analyses were conducted. Sixteen studies (published n = 12), encompassing 101,778 unique participants (girls/women = 21.1%; adults n = 1,204), met the inclusion criteria. A small overall effect size revealed that an accumulation of ACEs increased the odds of reoffending. The relationship between ACEs and recidivism was only statistically significant for the subgroup of studies using youth samples. In addition, ACEs only predicted recidivism in the subgroup of published studies (compared to dissertations). Other moderators (gender, study location, recidivism time frame) were not significant. Our results suggest that courts, particularly youth courts, would benefit from screening for cumulative ACEs to help identify those most at risk for reoffending and in need of intervention.

Reduced hippocampal volume unmasks distinct impacts of cumulative adverse childhood events (ACEs) on psychotic-like experiences in late childhood and early adolescence

Stress is associated with increased vulnerability to psychosis, yet the mechanisms that contribute to these effects are poorly understood. Substantial literature has linked reduced hippocampal volume to both psychosis risk and early life stress. However, less work has explored the direct and indirect effects of stress on psychosis through the hippocampus in preclinical samples- when vulnerability for psychosis is accumulating. The current paper leverages the Adolescent Brain Cognitive Development (ABCD) Study sample to examine whether objective psychosocial stressors, specifically adverse childhood experiences (ACE), are linked to vulnerability for psychosis, measured by psychotic-like experiences (PLE) severity, in late childhood and early adolescence, both directly and indirectly through the deleterious effects of stress on the hippocampus. Baseline data from 11,728 individuals included previously examined and validated items to assess ACE exposure, hippocampal volume, and PLE severity – a developmentally appropriate metric of risk for psychosis. Objective psychosocial stress exposure in childhood was associated with elevated PLE severity during the transition from childhood to adolescence. Hippocampal volume was significantly reduced in individuals with greater PLE severity and greater childhood stress exposure compared to peers with low symptoms or low stress exposure. These findings are consistent with a hippocampal vulnerability model of psychosis risk. Stress exposure may cumulatively impact hippocampal volume and may also reflect a direct pathway of psychosis risk. Objective psychosocial stress should be considered as a treatment target that may impact neurodevelopment and psychosis risk.

Specific effects of cumulative childhood trauma on suicidality among youths

BackgroundSuicidality was very high among individuals who suffered from childhood trauma. The distribution of cumulative childhood trauma among youths remains unclear, as well as the specific effects of cumulative childhood trauma on suicidality. This study attempted to explore the distribution of cumulative childhood trauma and examine the specific effects of cumulative childhood trauma on suicidality. MethodsA cross-sectional design was employed in this study, with 117,769 college students recruited from 63 universities in Jilin Province, China. All variables were measured by corresponding self-report questionnaires. The Venn diagram was used to represent the distribution of single and cumulative childhood trauma. ANOVA and chi-square tests were conducted to identify the high-risk suicide groups. Multiple linear regression analysis was performed to examine risk factors for suicidality for overlapping subtypes. Results27,671 (23.5%) participants reported suffering from childhood trauma, of which 49.5% were male (Mage = 19.59, SD = 1.76). The “physical neglect” group accounted for the largest proportion (31.5%). Suicidality was the highest in the “overlap of childhood neglect, emotional abuse, and physical abuse” group (2.0%). Depression, obsessive-compulsive disorder, and post-traumatic stress disorder were common risk factors for suicidality. LimitationsThis study was limited by cross-sectional studies and self-report bias. ConclusionsThe childhood trauma subtype group with the largest proportion was not necessarily the highest suicidality. Both the largest group and the highest-risk suicide group require special attention to their respective risk factors.

The social foundations of racial inequalities in arrest over the life course and in changing times

AbstractAlthough racial disparities in criminal justice contact are long‐standing and the subject of continuing public debate, few studies have linked early‐life social conditions to racial disparities in arrest over the life course and in changing times. In this article, we advance and test a theoretical model of racial inequality in long‐term arrest histories on a representative sample of nearly 1,000 individuals from multiple birth cohorts in the Project on Human Development in Chicago Neighborhoods. Large Black–White disparities in arrests from ages 10 to 40 arise from racial inequalities in exposure to cumulative childhood advantages and disadvantages rather than from race‐specific effects. Smaller but meaningful Hispanic–White gaps follow a similar pattern, and the same explanations of racial disparities hold across different offense types and across birth cohorts who came of age at different times during 1995 to 2021. These findings indicate that inequalities in early‐life structural factors, which themselves are historically shaped, trigger processes of cumulative advantage and disadvantage that produce racial disparities in arrests over the life course and that persist across different points in contemporary history.

The role of social support in reducing the long-term burden of cumulative childhood adversity on adulthood internalising disorder

PurposePrevious research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood.MethodsThe Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members’ birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support.ResultsResults indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0 .98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) = .98 (0.97, 0.99), p < 001).ConclusionThe findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA.

Editorial perspective: protective factors following cumulative childhood adversity.

Adverse childhood experiences can have a significant impact on adult psychosocial outcomes. However, negative outcomes are not inevitable, and protective factors can interrupt the realisation of negative developmental trajectories and result in positive adaptation in spite of childhood adversity. Interventions that promote social support, encourage education and academic achievement, and address specific personality and dispositional factors are likely to beneficial for those with experience of childhood adversity. Holistic assessment that considers both neurodevelopmental conditions and trauma symptoms is also important for promoting resilience and avoiding assumptions that mental and behavioural problems in children with cumulative adversity are purely 'social'.

Cumulative childhood interpersonal trauma and parental stress: The role of partner support.

Parents who have experienced cumulative childhood interpersonal trauma (CCIT, i.e., an accumulation of different types of abuse) tend to experience higher parental stress following the birth of a child. As CCIT is associated with lower levels of partner support, which is linked to increased parental stress, partner support could explain the link between CCIT and parental stress. Yet, these variables have never been studied using a dyadic approach. This study examined the role of received and provided partner support in the association between CCIT and parental stress. A randomly selected sample of 1119 couples with infants completed online questionnaires assessing CCIT, partner support, and parental stress. An actor-partner interdependence model path analysis showed that both parents' CCIT were associated with increased paternal stress through fathers' lower received and provided support, and with increased maternal stress through mothers' received and provided support. Overall, the findings highlight the significance of examining the interdependence between both parents' experience and the role of partner support as a key factor explaining the link between CCIT and parental stress, thereby emphasizing its importance as an intervention target.

Heterogeneous neighbourhood effects on the educational attainments of native Norwegian and immigrant-descendant female and male young adults

Using longitudinal register data from Oslo, Norway, this article examines how cumulative childhood exposure to family and neighbourhood contexts influences the educational attainments of young adults, paying special attention to how these determinants vary by gender and immigrant status. Specifically, we examine how neighbourhood socioeconomic and immigrant context experienced during childhood affects the completion of secondary school and university enrolment during young adulthood. We assess the extent of effect heterogeneity for three immigrant status groups stratified by gender. We control for geographical selection using a recently developed technique that first models parental selection of neighbourhood attributes and then uses the resulting predicted probabilities of selection as instruments in the neighbourhood-effects-on-education model. We find that neighbourhood affluence, educational levels and non-Western immigrant composition have important impacts on young adult educational outcomes, though results differ sharply by gender and immigrant status.

Maternal childhood trauma and observed maternal care behaviors with 4-month-old infants.

To examine the relationship between maternal childhood trauma and early maternal caregiving behaviors (MCB). Participants included 74 mother-infant dyads (maternal age 20-45 years; ethnicity 64.9% Latina) from a longitudinal pregnancy cohort study. Maternal childhood trauma was assessed during pregnancy with the childhood trauma questionnaire (CTQ). Observed mother-infant interactions at infant age 4 months were coded utilizing modified Ainsworth's MCB rating scales that assessed a range of behaviors (e.g., acceptance, soothing, and delight) which we analyze grouped together and will summarize using the term "maternal sensitivity." Linear regressions tested the associations between maternal childhood trauma and MCB. Primary analyses examined the relationships of MCB with (a) any maternal childhood trauma (moderate or greater exposure to physical abuse, sexual abuse, emotional abuse, physical neglect, and/or emotional neglect) and (b) cumulative childhood trauma. Secondary analyses examined the relationships between each type of childhood trauma and MCB. Exposure to childhood trauma was not associated with MCB (p = .88). Cumulative childhood trauma score was associated with lower scores on MCB (β = -1.88, p < .05). Emotional abuse and emotional neglect were individually associated with lower scores on MCB (β = -1.78, p = .04; β = -1.55, p = .04, respectively). Physical abuse, sexual abuse, and physical neglect were not associated with MCB. Many mothers exposed to childhood trauma may be resilient to negative effects on parenting behaviors, while specific experiences of childhood trauma (emotional abuse, emotional neglect, and cumulative childhood trauma) may predict less sensitive early parenting behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Collective trauma: Childhood abuse, perceived discrimination, and COVID-19.

Few studies have examined the interplay between collective trauma (e.g., the COVID-19 pandemic) and personal trauma (e.g., child abuse and discrimination). In a longitudinal child maltreatment study, with a community sample added, negative COVID impact (e.g., financial and mental health difficulties due to COVID) was examined in relation to childhood abuse exposure and perceived discrimination. Adults (N = 135) completed an online survey about trauma- and pandemic-related experiences. Regressions examined predictors of negative COVID impact and posttraumatic stress disorder (PTSD) symptoms during the pandemic. Although cumulative maltreatment contributed to negative COVID impact, when high levels of cumulative maltreatment had been experienced in childhood, greater negative COVID impact did not significantly relate to PTSD symptoms: For these participants, PTSD symptoms were relatively high (but not at ceiling) in adulthood overall. Negative COVID impact predicted PTSD symptoms only at low levels of cumulative child abuse. Perceived discrimination was associated with negative COVID impact and PTSD symptomatology. Cumulative childhood abuse at high levels likely set the stage for PTSD symptoms in adulthood, regardless of negative COVID impact. Individuals with lower levels of cumulative childhood abuse had fewer PTSD symptoms unless COVID had a stronger negative impact on their lives. Discrimination contributed to lower pandemic-related well-being. Insight is provided into special vulnerabilities associated with maltreatment backgrounds and discrimination at times of collective challenges. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-concept mediates the relationships between childhood traumatic experiences and adolescent depression in both clinical and community samples

BackgroundChildhood trauma is a pivotal risk factor for adolescent depression. While the association between childhood trauma and depression is well-established, the mediating role of self-concept has not been acknowledged. Specifically, limited attention has been paid to how childhood maltreatment impacts adolescent depression through physical and social self-concept, both in clinical and community samples. This study aims to investigate how distinct and cumulative childhood trauma affects adolescent depression, as well as the potential mediating role of self-concept in their relationships.MethodsWe recruited 227 depressed adolescents (dataset 1, 45 males, age = 15.34 ± 1.96) and 574 community adolescents (dataset 2, 107 males, age = 16.79 ± 0.65). Each participant was assessed on five subtypes of childhood trauma severity, cumulative trauma index, physical and social self-concept, and depression. Mediation models were tested separately in the clinical and community samples.ResultsClinically depressed adolescents experienced a higher level of trauma severity, a greater number of trauma subtypes, and had lower levels of physical and social self-concept compared to community adolescents. Analyses on childhood trauma severity and cumulative trauma index jointly indicated that physical and social self-concept played mediation roles in the relationships between childhood trauma experiences and depression. Moreover, the mediating effects of self-concept were stronger in depressed adolescents when compared to community samples.ConclusionsOur findings suggest that physical and social self-concept play mediating roles in the pathway linking childhood trauma and adolescent depression, particularly in clinically depressed individuals.

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.