Maltreatment Status Research Articles

Child Maltreatment Profiles among Children and Adolescents in the Spanish Child Welfare System

Maltreatment is a complex and multidimensional construct. Several types of maltreatment exist, but not all of them necessarily co-occur. In the last decades, researchers have tried to untangle the heterogeneity of maltreatment. However, few studies have been carried out outside the U. S. and none of the previous studies had considered all stages of maltreatment. In this study, we aimed at exploring latent profiles of maltreatment in a sample of 635 children and adolescents enrolled at different intervention plans within the Child Protective Services (CPS) in the Valencian Community, Spain. Latent Profile Analysis (LPA) was performed. Profiles were based on the five types of maltreatment (physical abuse, emotional abuse, sexual abuse, emotional neglect and physical neglect), as measured by the Chilhood Trauma Questionnaire-Short Form. Moreover, associations between the emerging profiles and sociodemographic, health- and school-related variables were also examined. Three profiles of maltreatment were found: “Relative low maltreatment” (58.58%), “Neglected” (35.92%), and “Severely abused and neglected” (5.5%). Then, profiles were contrasted with the reasons why court dictated maltreatment status of the child/adolescent to validate the maltreatment profiles. Results regarding the cumulative nature of maltreatment and its severity suggest tailoring public policies by level of risk of maltreatment. This study further proposes moving the focus of action from individuals themselves to the elements that characterize different maltreatment profiles, with the aim of protecting them. Future research ought to expand knowledge on maltreatment profiles in other European countries so as to promote generalization of results.

Investigating the associations between prenatal exposure to substances and intergenerational maltreatment and symptoms of psychopathology for adolescent girls from families with low income

BackgroundAdolescent girls whose families experience poverty are more vulnerable to psychopathology, and it is vital to investigate biopsychosocial factors contributing to mental health functioning. ObjectiveTo test associations between prenatal exposure to substances, intergenerational maltreatment, and adolescent mental health symptoms. Participants and settingBaseline data were used from a randomized controlled trial testing the efficacy of Interpersonal Psychotherapy (IPT-A) for depression among girls with and without maltreatment exposure. Adolescents (Aged 13–16; 63.5 % Black/African-American, 21.0 % White, 15.57 % other racial identity; 12.57 % Latina/x) were recruited from families experiencing financial adversity (income <200 % poverty threshold). MethodsAdolescent maltreatment status was determined by using multiple sources (child protective service records, parental report, and adolescent report). Mothers reported on prenatal substance exposure, experiences of maltreatment in their own childhood, and rated adolescent internalizing and externalizing symptoms. Latent Class Analysis was used to determine common patterns of prenatal substance exposure (tobacco, alcohol, marijuana, and cocaine). Structural Equation Modeling was used to evaluate associations between maltreatment in two generations, prenatal exposure to substances, and adolescent mental health symptoms. ResultsTwo profiles of prenatal substance exposure emerged: one typified by low substance exposure (92.8 %), and one with moderate to high substance exposure (7.2 %). Both prenatal substance exposure and maternal history of maltreatment were associated with adolescent maltreatment, which in turn, was associated with greater adolescent externalizing symptoms. Parental history of maltreatment was directly associated with greater adolescent internalizing symptoms. ConclusionPrenatal exposure to substances and intergenerational maltreatment each confer risk for mental health symptoms in adolescent girls.

Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife.

Although childhood maltreatment is associated with a host of poor health and social outcomes in adulthood, many individuals manifest resilience. We tested competing predictions about whether achieving positive psychosocial outcomes in young adulthood would be differentially predictive of allostatic load at midlife for those with and without a childhood history of maltreatment. The sample included 808 individuals, 57% of whom had court-documented records of childhood abuse or neglect between 1967 and 1971, and demographically matched controls without those histories. Participants provided information on socioeconomic, mental health, and behavioral outcomes in interviews conducted between 1989 and 1995 (mean age = 29.2 years). Indicators of allostatic load were measured between 2003 and 2005 (mean age = 41.2 years). The relationship between positive life outcomes in young adulthood and allostatic load in middle adulthood varied depending on childhood maltreatment status (b = .16, 95% CI: .03; .28); for adults who did not experience childhood maltreatment, more positive life outcomes predicted lower allostatic load (b = -.12, 95% CI: -.23; -.01), whereas the relationship was not significant for adults with a childhood history of maltreatment (b = .04, 95% CI: -.06; .13). There were no differences in the results predicting allostatic load for African-American and White respondents. Childhood maltreatment may have enduring effects on physiological functioning that are manifest in elevated allostatic load scores in middle age. Alternatively, resilience to maltreatment-as manifest in positive functioning in socioeconomic and behavioral domains-may not be sufficiently stable over adulthood to buffer individuals from the physiological consequences of stressful environments.

Patterns and trajectories of children's maltreatment experiences in Taiwan: Latent transition analysis of a nationally representative longitudinal study

BackgroundLittle is known about the patterns of child maltreatment change over time and vary according to gender and child protective services (CPS) experience in Taiwan. ObjectiveTo examine the latent status and the trajectories of child maltreatment and to identify effects that gender and CPS have on these statuses and trajectories in Taiwan. Participants and settingA national proportionately stratified sample of 6233 4th-grade students were recruited from 314 elementary schools in Taiwan, and followed up at 6th and 8th graders. A total of 1908 students completed valid data at all three time points was analyzed. MethodsLatent class analysis and latent transition analysis were used to identify the number of latent variables and the patterns of child maltreatment. Multiple-group model was used to test with gender difference. ResultsFour latent maltreatment statuses were identified: high all maltreatment, high psychological maltreatment, high neglect, and no/low maltreatment. A reduction in maltreatment severity occurred over time was found. The percentage of students in the “high all maltreatment” and “high neglect” groups decreased whereas those in the “high psychological maltreatment” and “no/low maltreatment” groups increased. Differences in the transition probabilities of latent maltreatment status by gender was revealed. The percentage of CPS recipients in the “high all maltreatment” decreased over time. ConclusionsThis study highlighted the dynamic nature of child maltreatment and described the timing, continuity, and change that characterizes children's exposure to maltreatment in Taiwan. Policies and interventions geared toward early detection, mitigation, and prevention of child maltreatment are needed.

Bidirectional associations between family conflict and child behavior problems in families at risk for maltreatment

BackgroundChildren's exposure to family conflict is associated with the development of behavior problems. However, it remains unclear whether this association (1) functions bidirectionally and (2) exists independent of more severe forms of violent victimization. ObjectiveThe present study aimed to examine bidirectional and transactional associations between family conflict and children's behavioral problems, controlling for time-varying violent victimization experiences. Invariance testing examined whether these models differed by gender and by maltreatment status prior to initial recruitment. Participants and settingParticipants were caregiver-child dyads identified prospectively as being at risk for maltreatment and family violence exposure prior to age four (N = 1281; 51.4 % female; 74.6 % persons of color). MethodsCaregivers were interviewed prospectively about family conflict, children's aggressive and delinquent behavior, and children's victimization experiences at child ages 6, 8, and 10. ResultsAfter controlling for prior victimization, significant cross-lagged bidirectional associations were identified between family conflict and child behavior problems. Indirect effects from age 6 to age 10 externalizing problems through age 8 family conflict were not supported. Several bidirectional paths were stronger among boys than girls. Results revealed little evidence for moderation by prerecruitment maltreatment status. ConclusionsFindings support a conceptualization of the family-child relationship that is reciprocal in nature and highlight the importance of non-violent, everyday negative family processes. Interventions aiming to improve child behavior problems by targeting severely dysfunctional family processes should also address non-violent, lower-level patterns of negative family interactions, such as everyday instances of blame, criticism, nonacceptance, and favoritism.

An event-based analysis of maternal physiological reactivity following aversive child behaviors.

Research investigating the association between parents' physiological reactivity and their ability to self-regulate in parenting contexts typically examines the average physiological response across the duration of a dyadic task, conflating reactivity across a multitude of parent and child behaviors. The present study utilized a moving-window analytical technique to generate a continuous, second × second time series of mothers' high-frequency heart rate variability (HF-HRV) to conduct an event-based analysis of maternal reactivity in the 10s following an aversive child event. Analyses examined whether maternal reactivity related to parenting behaviors similarly among maltreating (n=48) and non-maltreating (n=29) mother-preschooler dyads. Results indicate that maternal behavior was not associated with average HF-HRV reactivity, but mothers who demonstrated an increase in HF-HRV immediately following a negative child event were more likely to engage in behaviors to return the dyad to a positive state. Findings were specific to incidents of negative child behavior, and results were not moderated by maltreatment status. These results highlight the value of using an event-based design to isolate reactivity in response to targeted events to understand how physiological reactivity supports parenting.

The Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y): Adaptation and Validation Across a Varied Sample of Children and Adolescents.

Flexible self-regulation has been shown to be an adaptive ability. This study adapted and validated the adult Flexible Regulation of Emotional Expression (FREE) Scale for use with youth (FREE-Y) in community and maltreatment samples. The FREE-Y measures the ability to flexibly enhance and suppress emotion expression across an array of hypothetical social scenarios. Participants (N = 654, 8-19 years) were included from three studies. Confirmatory factor analysis (CFA) confirmed a theoretically appropriate higher order factor structure. Using multiple-group CFAs, measurement invariance was achieved across maltreatment status, age, and gender. Reliabilities were adequate and construct validity was demonstrated through associations with measures of emotion regulation, psychopathology, IQ, and executive functioning. Group comparisons indicated lower Suppression and Flexibility scores for maltreated versus comparison participants. Findings suggest that the FREE-Y is a valid measure of expressive regulation ability in youth that can be applied across a range of populations.

Ego Control Mediates the Effect of Maltreatment on Child Depression.

Maltreatment among school-aged children is associated with negative impacts on development and can contribute to the onset of psychological difficulties, including early depressive symptoms. Maltreatment can have devasting consequences, thus it is important to better understand the mechanisms contributing to children's psychological outcomes. Purpose: The objective of this study was to examine children's personality functioning (ego control and ego resiliency) as mediators of the association between substantiated maltreatment and depression. Methods: A total of 300 school-aged children were followed over the course of 3years in the context of a summer camp (168 maltreated children; 132 non-maltreated children). Maltreatment status was determined through cases referred by the Monroe County Department of Social Services, New York. Ego control and ego resiliency at year 2 (T2), as measured by camp counselors using the California Child Q-Set, were tested as mediators. Children's depressive symptoms were self-reported using the Childhood Depression Inventory at year 3 (T3). A parallel mediation model was tested using Mplus. Results: Maltreatment was not directly associated with depression at either time point, but significantly predicted both mediators. Ego undercontrol significantly predicted increased depressive symptoms at T3, while there was no significant prediction by ego resiliency. Conclusions: These findings point to the longitudinal paths to early depressive symptoms in maltreated children and the mediating effect of children's ego control which could be a target for intervention.

Children’s concealment of a minor transgression: The role of age, maltreatment, and executive functioning

This study examined the role of age, maltreatment status, and executive functioning on 752 4- to 9-year-old maltreated and nonmaltreated children’s recall disclosure of a transgression in which the children appeared to have broken toys while playing with a stranger. Interviewers used narrative practice rapport building and then questioned children with free recall and cued recall questions. Younger and maltreated children were more likely to disclose during rapport building, whereas older and nonmaltreated children were more likely to disclose in response to recall questions. Working memory deficits appeared to mediate the relation between children’s characteristics and disclosure during rapport but not during recall. The results demonstrate that how children are questioned affects the relations between deception and age, maltreatment, and executive functioning.

Body appreciation and body dissatisfaction between maltreated and comparison adolescents

Body image, both positive and negative, is a salient issue in adolescence and can affect mental health as well as mental health can affect body image. Although maltreated youth are known to have serious mental health problems, very little research has explored body image problems in this population. This study explored the association between maltreatment and both body appreciation and body dissatisfaction as well as the relationship between BMI percentile and both body appreciation and body dissatisfaction. Data came from a study on the effects of maltreatment on adolescent development, and participants included child welfare-affiliated maltreated youth (N = 299) and comparison youth (N = 148) ages of 9–13 years. Linear regression was used to evaluate if BMI percentile and maltreatment status were related to body appreciation and body dissatisfaction, while also evaluating the influence of age, race, pubertal development, and depressive symptoms. The analyses were stratified by sex. Maltreated boys reported lower body appreciation than the comparison boys. Latina girls reported lower body appreciation compared to White, Black, or biracial/multiethnic girls. As depressive symptoms increased, body appreciation decreased and body dissatisfaction increased for both boys and girls. BMI was not associated with body appreciation or body dissatisfaction. Interventions that address body image should not only focus on decreasing body dissatisfaction but should also work to promote positive body image or body appreciation. These interventions should target boys and girls and all ethnicities/races, especially maltreated boys and Latinas, as well as address depression symptoms along body image problems.

Emotion Socialization and Developmental Risk: Interactive Effects of Receptive Language and Maltreatment on Reminiscing.

Emotional reminiscing, or mother-child discussion of past emotional experiences, is a critical aspect of emotion socialization that predicts a range of child outcomes and is central to parent-child interventions. Thus, understanding individual differences in emotional reminiscing will advance our ability to identify families at-risk for poor emotion dialogues and to adapt interventions for diverse populations, such as families affected by maltreatment and mothers and children with low language abilities. The present study examined associations among maternal and child receptive language with emotional reminiscing and the moderating role of maltreatment. Two hundred and twenty three underserved, racially diverse mothers (144 maltreating) and their preschool aged children completed measures of receptive language (PPVT-4). Emotional reminiscing was comprehensively measured using maternal report and observations of emotion dialogues, including ratings of elaborations, maternal sensitive guidance, and child cooperative exploration. Child language was positively associated with all observed aspects of child reminiscing, and the association between child language and maternal reminiscing was moderated by maltreatment. For non-maltreating families, child language was positively associated with maternal factual elaborations and sensitive guidance. For the maltreating families, these associations were not significant, demonstrating that maltreatment disrupted the association between child language and reminiscing. Maternal language was significantly associated with maternal report of emotion dismissing behaviors, regardless of maltreatment status. Results highlight that language is an essential individual difference factor contributing to variance in emotion dialogues, and that maltreatment influences how child language relates to reminiscing. Future directions and clinical implications for families affected by developmental risk are considered.

Heightened amygdala reactivity and increased stress generation predict internalizing symptoms in adults following childhood maltreatment.

Childhood maltreatment is one of the most potent predictors of future psychopathology, including internalizing disorders. It remains unclear whether heightened amygdala reactivity to threat and elevated stress exposure may be implicated in the pathogenesis and maintenance of internalizing disorders among individuals with a history of childhood maltreatment. Using data from a sample of 1,144 young adults, we investigated the contribution of baseline threat-related amygdala reactivity and prospective major stressful life events to internalizing symptoms severity 1year later (on average) in individuals with a history of maltreatment (n=100) and propensity score matched nonmaltreated peers (n=96). Even after stringently matching for several potentially confounding variables - including baseline internalizing symptoms, socioeconomic status and IQ - childhood maltreatment status predicted increased amygdala reactivity at baseline, elevated post-baseline exposure to major stressful life events and internalizing symptoms at follow-up. We also showed, for the first time, that amygdala reactivity at baseline and also post-baseline exposure to major stressful life events mediated the association between a history of maltreatment and future internalizing symptoms. These findings provide support for the view that maltreatment is a potent developmental insult leading to long-lasting neurocognitive recalibrations of the threat processing system. It is possible that such alterations, over time, may impact mental health functioning by compromising the ability to effectively negotiate everyday challenges (stress susceptibility). These alterations were not, however, found to sensitize an individual to the impact of major stressful life events. The results of this study also lend compelling support to the view that increased psychiatric risk, in the context of childhood maltreatment, follows from an increased propensity to experience major stressful life events (stress generation).

The Influence of Online-Only Friends on the Substance Use of Young Adults with a History of Childhood Maltreatment

Background: Existing research shows that having offline friends that use substances increases risk for individual substance use in adolescence. However, there is little research examining the influence of online social networks on substance use in young adulthood. Objectives: This study examined the number of online-only Facebook friends (i.e. those with no in-person contact) that were substance users in relation to the participants’ alcohol and marijuana use in the past year. Methods: The sample (n = 114) were selected from participants enrolled in a longitudinal study on childhood maltreatment in an urban city within the United States. The mean age of the sample was 21.84 (SD = 1.43), 61% female. With participant permission, data were downloaded from Facebook to obtain the list of online friends. A self-report questionnaire recorded the substance use of each participant. Path analysis and logistic regression were used to examine (a) the number of online-only friends who drink as a predictor of participants’ problem drinking, (b) the number of online-only friends who smoke marijuana as a predictor of participants’ marijuana use, and (c) moderation by maltreatment status. Results: The results showed a significant effect of the number of online-only friends who smoke marijuana on the participant’s marijuana use. However, after including offline friends this significant effect was no longer present, but offline friends predicted individual marijuana use. Conclusions/Importance: These findings demonstrate that substance use in online social networks may be associated with individual use in young adulthood, but that offline influence is stronger.

Caregiver ratings and performance-based indices of executive function among preschoolers with and without maltreatment experience

ABSTRACTDespite the well-documented impact of early maltreatment on children’s executive function (EF), there has been limited consensus about how to best assess this neurocognitive domain in high-risk, vulnerable preschool-aged children. Relevant studies have generally utilized either performance-based tests or caregiver ratings of EF, yet multi-method research has been rare. This study examined the EF profiles of preschoolers exposed to maltreatment, as indexed by the Behavior Rating Inventory of Executive function – Preschool Version (BRIEF-P), and investigated associations between caregiver ratings and performance-based measures (Happy–Sad Stroop, Tapping Test, and Dimensional Change Card Sort – DCCS) of EF in this population. Maltreatment status was further tested as a moderator of associations between these measures. Participants were (n = 107) children aged 4–5 years (M = 4.75; SD = 0.57; 39% female), with various levels of exposure to maltreatment. Children exposed to maltreatment were found to exhibit significantly more caregiver-rated deficits in EF than non-maltreated children, with greater fluctuations apparent across all scales of the BRIEF-P. Consistent with previous research in neurologically impaired children, there were only limited and weak to moderate correlations between BRIEF-P scales and performance-based measures of EF. Furthermore, maltreatment status was found to moderate the association between scores on the BRIEF-P Inhibit Scale and the DCCS, such that the association between these indices was weaker among children exposed to higher levels of maltreatment.

Longitudinal Relationship Between Mental Health Symptoms and Sleep Disturbances and Duration in Maltreated and Comparison Adolescents

PurposeTo examine the longitudinal relationships between mental health symptoms and sleep for male and female maltreated and comparison adolescents. MethodsParticipants were from a longitudinal study of child maltreatment (maltreated n = 247; comparison n = 138). The current analyses used data from Time 3 (T3; average age 13.7 years) and Time 4 (T4; average age 18.2 years). Path models tested cross-lagged effects between mental health symptoms (depression and Post Traumatic Stress Disorder [PTSD]) and sleep (disturbances and duration) and main effects of maltreatment on Time 4 variables, stratified by sex. ResultsReciprocal relationships between depressive and PTSD symptoms and sleep disturbances were found only for females. Specifically, depressive and PTSD symptoms at T3 predicted sleep disturbances at T4 and sleep disturbances at T3 also predicted depressive and PTSD symptoms at T4. Regarding sleep duration, PTSD symptoms at T3 predicted shorter sleep duration at T4 among females but not for males. There was no effect of maltreatment status on mental health symptoms or sleep disturbance, but maltreated adolescents reported longer sleep duration at T4 than comparison adolescents. ConclusionsThe reciprocal nature of the relationship between mental health symptoms and sleep disturbances in females highlights the need to treat both mental health symptoms as well as sleep problems in female adolescents to improve mental and physical health. The absence of a negative effect of maltreatment on sleep may be due to the fact that the maltreated youth and comparison youth lived in the same low-income urban communities and were exposed to the same nocturnal environmental irritants.

Unpacking the Associations Among Maltreatment, Disengagement Coping, and Behavioral Functioning in High-Risk Youth.

Given the association between child maltreatment and a host of negative behavioral consequences, there remains a need to continue to identify mechanisms underlying this association as a means of improving intervention efforts. The present study examined one potential mechanism, namely, disengagement coping. We asked 6- to 17-year-old maltreated ( n = 249) and comparison ( n = 133) youth questions about emotional experiences that induced sadness and anger, strategies they used to cope with those emotions, and behavioral functioning (i.e., behavioral problems and aggression). Maltreated adolescents reported higher levels of behavioral problems and aggression relative to comparison adolescents, and adolescents who disengaged from emotional situations reported more behavioral problems relative to those who did not disengage. Tests of mediation suggested that, for adolescent-age youth, part of the association between maltreatment status and behavioral problems was explained by disengagement. In children, maltreatment was not associated with disengagement or behavioral problems. Results have implications for understanding age-related differences in the emotional and behavioral consequences of maltreatment.

Linking Patterns of Substance Use With Sexual Risk-Taking Among Female Adolescents With and Without Histories of Maltreatment

PurposeThis study aimed to determine the associations between patterns of substance use and sexual risk-taking among female adolescents with and without histories of maltreatment. MethodsData are from a prospective cohort study examining the impact of maltreatment on subsequent female adolescent sexual health (N = 504). Participants averaged 18.24 years in age (SD = 1.12), and approximately 63% had substantiated incidences of maltreatment filed with Child Protective Services prior to age 18. The present study used latent class analysis to examine patterns in adolescent substance use, and negative binomial regression models to examine the links between patterns of substance use and sexual risk-taking and to determine whether these associations were moderated by adolescents' maltreatment status. ResultsSix classes emerged from latent class analysis labeled as follows: abstainers (25% of sample); polysubstance users—early initiators (13%); polysubstance users—late initiators (23%); alcohol and cannabis users—late initiators (9%); alcohol users—late initiators (18%); and tobacco users (12%). Patterns of adolescent polysubstance use were associated with the highest levels of sexual risk-taking, and patterns of late-initiated polysubstance use, late-initiated alcohol use, and tobacco use were more strongly related to sexual risk-taking for female adolescents with histories of maltreatment. ConclusionsThis study is the first to determine the specific patterns of substance use that are more strongly related to sexual risk-taking for maltreated female adolescents. By doing so, this study demonstrates how a person-centered approach can facilitate our understanding of how to best leverage sexual risk-taking prevention efforts.

Maltreated Children Use More Grammatical Negations

Many studies reveal a strong impact of childhood maltreatment on language development, mainly resulting in shorter utterances, less rich vocabulary, or a delay in grammatical complexity. However, different theories suggest the possibility for resilience—a positive adaptation to an otherwise adverse environment—in children who experienced childhood maltreatment. Here, we investigated different measures for language development in spontaneous speech, examining whether childhood maltreatment leads to a language deficit only or whether it can also result in differences in language use due to a possible adaptation to a toxic environment. We compared spontaneous speech during therapeutic peer-play sessions of 32 maltreated and 32 non-maltreated children from the same preschool and equivalent in gender, age (2 to 5 years), home neighborhood, ethnicity, and family income. Maltreatment status was reported by formal child protection reports, and corroborated by independent social service reports. We investigated general language sophistication (i.e., vocabulary, talkativeness, mean length of utterance), as well as grammatical development (i.e., use of plurals, tense, grammatical negations). We found that maltreated and non-maltreated children showed similar sophistication across all linguistic measures, except for the use of grammatical negations. Maltreated children used twice as many grammatical negations as non-maltreated children. The use of this highly complex grammatical structure shows an advanced linguistic skill, which shows that childhood maltreatment does not necessarily lead to a language deficit. The result might indicate the development of a negativity bias in the structure of spontaneous language due to an adaptation to their experiences.

Maltreatment and diurnal cortisol regulation: A meta-analysis

Childhood maltreatment leads to a host of negative physical and mental health outcomes, with cortisol dysregulation implicated as a possible mechanism. Given inconsistencies across in the literature regarding the direction and magnitude of the association between maltreatment and diurnal cortisol regulation, the current meta-analysis of 27 studies aimed to examine the association between maltreatment and at least one of 3 indicators of diurnal cortisol regulation: wake-up cortisol levels, the cortisol awakening response (CAR), and/or the diurnal cortisol slope. Effect sizes were calculated using Hedges’ g formula and were pooled using a random effects model. For the association between maltreatment and wake-up cortisol level, the aggregate effect size was g=0.08, p=0.26. Notably, effect sizes between maltreatment and wake-up cortisol were significantly larger (Qbetween=5.18, p=0.02) for studies of agency-referred samples, g=0.24, p=0.006, than studies for which maltreatment status was based on self-report, g=0.00, p=0.97, with maltreatment associated with reduced wake-up cortisol levels. For the association between maltreatment and the CAR and diurnal cortisol slope, the aggregate effect sizes were non-significant and none of the moderator variables were significant. Although results did not indicate a large and robust association between maltreatment and various indicators of diurnal cortisol, studies with more rigorous designs (i.e., agency-referred samples) showed a small, significant association between maltreatment and blunted wake-up cortisol levels, suggesting a pattern of hypocortisolism.

Maltreated and comparison adolescents' recollections of lifetime residences: Relationship to delinquency and marijuana use.

Both childhood maltreatment and frequent childhood residence changes are associated with poor behavioral outcomes including drug use and delinquency. It is not clear whether a higher number of residences results in poorer outcomes for maltreated adolescents compared to adolescents living in the same community but without child welfare-documented maltreatment. Our study of child welfare-affiliated maltreated youth (n=216) and comparison youth (n=128) from the same community (age M = 18.21, SD = 1.42) examined: 1. whether child/caregiver characteristics and maltreatment status were associated with lifetime number of residences and 2. whether child/caregiver characteristics, residences, and maltreatment status were associated with delinquency and marijuana use. The outcomes of this study, number of residences, delinquency, and marijuana use, were all skewed, and consequently negative binomial regressions were used. Maltreatment status, ever living with a non-parent caregiver, and being older are associated with more residence changes during childhood. More residences and male sex are associated with person offense delinquency and marijuana use. In lower income neighborhoods, such as where the adolescents in this study lived, residence changes are not unusual, but in this study maltreated youth moved more often than youth from the same community. It is important to help caregivers who live in disadvantaged neighborhoods, especially families with child welfare involvement, understand the behavioral consequences of residence changes and provide support for stable long-term housing.