Gender differences in the association between emotional maltreatment with mental,emotional, and behavioral problems in Swedish adolescents

Emotional maltreatment is a common form of child abuse with a powerful negative impact on mental health. The aim of this study was to examine the effect of emotional maltreatment on mental health and mental well-being in a general population of Swedish 12- to 13-year old girls and boys. Data was collected via self-report questionnaires in classroom settings from 1134 students. Emotional maltreatment had significant effects on mental health and mental well-being for both girls and boys. Moreover, there were significant interaction effects between gender and levels of emotional maltreatment. Girls reported decreased mental health and mental well-being at lower degrees of emotional maltreatment compared to boys. Furthermore, girls reported larger decreases in mental health in response to exposure of emotional maltreatment. For internalizing symptoms, mental well-being and psychosomatic symptoms, exposure level of emotional maltreatment seemed to magnify the gender differences. For externalizing symptoms, there were no differences between girls and boys in the group reporting no emotional maltreatment and the increase in externalizing symptoms were of equal magnitude for both genders. Given the impact of emotional maltreatment on mental health in the general population, results from this study implies that a trauma-informed perspective is necessary in understanding gender differences in mental health in early adolescence. Further research is needed in order to understand the underlying processes generating the differences in girls and boys responses to emotional maltreatment.     

Psychological maltreatment,coping strategies,and mental health problems: A brief and effective measure of psychological maltreatment in adolescents

Psychological maltreatment is an important social and public health problem and associated with a wide range of short and long-term outcomes in childhood to adulthood. Given the importance of investigating mitigating factors on its effect, the purpose of the present study is to investigate the mediating effect of active and avoidant coping strategies on the association between psychological maltreatment and mental health– internalizing and externalizing– problems in adolescents. Participants of the study consisted of 783 adolescents, ranging in age from 14 to 18 years (M = 15.57, SD = 0.88), with 52.9% female and 47.1% male. Several structural equation models were conducted to investigate the mediating role of coping strategies on the effect of psychological maltreatment on adolescents’ internalizing and externalizing problems. Findings from mediation analyses demonstrated the mediating effect of active and avoidant coping strategies on the association between psychological maltreatment and mental health problems. The outcomes support adolescents use more avoidant coping strategies and fewer active coping strategies in the face of psychological maltreatment experiences, and this affects their mental health. Taken together, these results should contribute to the design of prevention and intervention services in order to promote mental health.     

The role of attachment in the relationship between child maltreatment and later emotional and behavioral functioning

The experience of childhood maltreatment is an important predictor of unfavorable emotional and behavioral outcomes. Because little research examined explanatory variables in the relationship between childhood maltreatment experiences and later outcomes, this study examined the role that attachment serves in this relationship. Four hundred twenty-four participants completed questionnaires assessing the variables of interest for this study. Results indicated that both childhood maltreatment experiences (particularly emotional abuse) and attachment (particularly to mothers and peers) are significant predictors of later emotional and behavioral outcomes. Further, attachment contributed unique and significant variance to the relationship between childhood maltreatment experiences and later outcomes. Such findings suggested that secure attachment may serve as a protective factor against maladaptive emotional and behavioral outcomes as children reach emerging adulthood, even in the context of childhood maltreatment experiences. The importance of studying the relationships among these variables is discussed.     

Childhood maltreatment,psychopathology and well-being: The mediator role of global self-esteem,attachment difficulties and substance use

Childhood maltreatment is known to be associated with a broad variety of psychopathology and deteriorated well-being in adolescent populations. In the present nationwide study, we aimed to explore global self-esteem, attachment difficulties and substance use as possible mediators of these associations in a high-risk adolescent population. We included 400 adolescents (aged 12–20 years) living in residential youth care in Norway (response rate 67%). The participants completed a semistructured psychiatric interview (Child and Adolescent Psychiatric Assessment (CAPA)), a study-specific questionnaire, a revised version of the Self-Perception Profile for Adolescents (SPPA) and the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). Information was also provided by the adolescent’s primary contact at the institution. Two models were tested using structural equation modelling; one assessed the association between childhood maltreatment and psychopathology, and one assessed the association between childhood maltreatment and well-being. Childhood maltreatment, psychopathology, well-being, global self-esteem and attachment difficulties were treated as latent variables, and substance use was added as an observed variable. The results of this study showed that global self-esteem was a mediator of paths in both models, whereas attachment difficulties and substance use were not. Preventing decline in health and well-being in high-risk adolescents is a main goal, and this study suggests that improving self-esteem, in addition to providing psychiatric health services, could be an important tool for achieving this goal.     

An empirical analysis of behavioral and emotional problems of foster children as related to re-placement in care

Foster care is seen as a temporary service. However, for many children, foster care involves years of long term care. Most professionals feel that if a child must remain in care, the number of foster homes or re-placements the child experiences should be minimized. Evidence suggests that this lack of stability has a detrimental effect on the child's psychosocial development. Even though the research evidence supports the negative impact of re-placement on the foster child, little empirical research has dealt with identification of factors associated with children likely to be re-placed. This article focuses on foster children with behavioral and emotional problems and analyzes the association of these problems with placement stability and continuity. The findings report that children with behavioral and emotional problems are replaced in foster care more often than those children without similar problems.     

Childhood maltreatment: A predictor of mental health problems among adolescents and young adults

Child maltreatment is a risk factor for detrimental effects on mental health that may extend to adulthood. This study aimed to examine the association between exposure to childhood maltreatment, socio-demographic factors, and students’ mental health status and self-esteem. A cross-sectional study enrolled a representative sample of 1270 students from Kuwait University. An anonymous self-administered questionnaire included students’ socio-demographic characteristics, history of exposure to childhood physical and/or emotional maltreatment, DASS-21 to assess mental health status, and Rosenberg self-esteem scale was used. Chi-square test and binary logistic regression models were applied. The study found that among participants, 49.6%(95% CI: 64.8%–52.4%), 63.0%(95% CI: 60.3%–65.7%), and 43.8%(95% CI: 41.1%–46.6%) reported having depression, anxiety, and stress respectively. Moreover, 22.5%(95% CI: 20.1%–24.8%) and 18.6%(95% CI:16.5%–20.9%) reported childhood physical and emotional maltreatment, respectively; while 12.7% reported both. Multivariate analysis revealed that experiencing childhood physical and emotional maltreatment were independent contributors to reporting depression and anxiety; while exposure to only emotional maltreatment contributed to reporting stress. Gender, GPA, childhood enrollment in private/public schools, number of close friends, were other contributors to mental health problems. Participants’ median score of self-esteem was 17/30, and only childhood emotional maltreatment was a significant predictor to low self-esteem after adjustment for other confounders. Mental health problems, and experiencing childhood physical and emotional maltreatment were prevalent relatively high among university students. Childhood corporal and emotional maltreatment were independent predictors to adolescents and young adults’ mental health problems. Experiencing childhood emotional maltreatment predicted low self-esteem. Further research to assess culture factors associated with childhood maltreatment is recommended.     

Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States

Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders.     

Mediating effects of teacher and peer relationships between parental abuse/neglect and emotional/behavioral problems

The current study examined the mediating effects of the teacher and peer relationships between parental abuse/neglect and a child’s emotional/behavioral problems. A total of 2070 student surveys from the panel of the Korean Child Youth Panel Study (KCYPS) were analyzed by path analysis. The key findings of this study are outlined below. Firstly, parental physical and emotional abuse and neglect had significant effects on children’s problems. The direct effect of parental abuse on emotional/behavioral problems was higher than the direct effect of parental neglect on emotional/behavioral problems. Secondly, the teacher relationship partially mediated the effects of the parental abuse/neglect on emotional/behavioral problems. Thirdly, the peer relationship also partially mediated the effects of parental abuse/neglect on children’s emotional/behavioral problems. The indirect effect of parental neglect via teacher relationships and peer relationships was stronger than the indirect effect of parental abuse. This study is significant in that it identified that parental abuse/neglect was mediated by the teacher and peer relationship, thereby suggesting an implication for effective intervention with children who have suffered abuse and neglect. In terms of the teacher and peer relationship, understanding the influence of parental abuse and neglect on children’s problems was discussed, and the limitations and recommendations for future study were suggested.     

Ecological momentary assessment of contextual variables,satisfaction, and emotional and behavioral states of adolescents by level of victimization

The harmful effects of victimization on mental health have been demonstrated in several age groups, cultures, and populations, but there is wide variability in the resulting psychopathology. Ecological momentary assessment (EMA) allows the expression of an emotional state to be recorded at any given time and linked to a situation or context.This study aimed to analyze the contextual variables (where, with whom, and what), momentary satisfaction, and perception of momentary emotional and behavioral symptoms in a cohort of adolescents by the level of victimization, using EMA. We explored the everyday symptom profiles and the contexts in which events took place among 100 adolescents over a one-week period. Sociodemographic data were collected and assessment was done using the EMA (as a smartphone application) and the Juvenile Victimization Questionnaire (to assess childhood and adolescent victimization). In this study, regarding contextual variables, the group with the highest level of victimization (top 10%) showed a significant relationship with being away from home and being with friends other than classmates, and not being with parents or relatives. There was also an unexpectedly higher frequency of sporting engagement in this group. A relationship existed between emotional and behavioral problems and higher levels of victimization. In conclusion, the different groups of victimized subjects present a relatively high level of satisfaction in relation to the daily contexts and show low levels of emotional and behavioral symptomatology.     

Developmental trajectories and longitudinal mediation effects of self-esteem,peer attachment,child maltreatment and depression on early adolescents

ObjectivesThe purpose of this study is to identify the developmental trajectories of peer attachment, self-esteem, depression, and child maltreatment, and to understand the longitudinal mediation effects that peer attachment and self-esteem have on the influence of perceived abuse on early adolescent depression.MethodsThis study uses Year 1 to Year 5 data of the 4th grader panel of the Korea Youth Panel Survey (KYPS) and utilizes a multivariate latent growth model to analyze the main variables in the applicable data between 5th (i.e., Year 2) and 8th (i.e., Year 5) grades.ResultsThe results indicate that from the 5th to the 8th grade, the degree of abuse and depression increases while self-esteem gradually decreases with slowly lowering peer attachment. A significant distribution of the initial values and the rate of change were present for all main variables of the study, confirming individual differences in time wise changes. Further, more exposure to abuse correlated with a decrease in self-esteem, while an increase in self-esteem greatly reduced depression. The initial value of self-esteem showed a partial mediation effect, whereas the rate of change indicated a full mediation effect with a significant longitudinal mediation effect. More experience of abuse during early adolescence indicated a lower degree of peer attachment, and a higher peer attachment was related to decreased depression. A significant partial mediation effect was present for both the initial value and the rate of change of peer attachment, and a longitudinal mediation effect was present.Practice implicationsThis study confirmed that self-esteem in early adolescents is an important protective factor that can greatly reduce the degree of depression, and suggests continuous interventions conducted to increase self-esteem in adolescence. Furthermore, by determining that peer attachment decreases the degree of depression in children at risk, the study emphasizes the healing aspect of adolescent peer attachment.     

Shifting definitions of emotional maltreatment: an analysis child welfare investigation laws and practices in Canada

Objective

Although there is growing evidence that the emotional dimensions of child maltreatment are particularly damaging, the feasibility and appropriateness of including emotional maltreatment (EM) in child welfare statutes continues to be questioned. Unlike physical and sexual abuse where investigations focus on discreet incidents of maltreatment, EM is not as easily defined and delimited. Through a review of legislation and child welfare investigation practices in Canada, this paper examines (1) whether Canadian child welfare services respond to EM with the same level of perseverance as with other forms of maltreatment and (2) the extent to which the introduction in 2008 of a more specific EM taxonomy distinguishes between EM and family problems that could lead to EM.

Method

Following an analysis of the legislative framework for EM across Canada, investigations practices in Canada are examined using data from the 1998, 2003 and 2008 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS). Using data from the 2008 cycle, EM investigations are compared to other maltreatment investigations for all of Canada (N = 15,980). Changes in EM investigations over time are then compared using data from the three cycles of the study, excluding Québec because of limited data availability in 2003 (N = 5,360 in 1998, 11,562 in 2003 and 14,050 in 2008).

Results

EM is included as a form of reportable maltreatment in all provincial and territorial statutes in Canada. Over 11,000 cases of EM were substantiated in Canada in 2008, at a rate of 1.86 cases per 1,000 children. While EM investigations were substantiated at a lower rate as other forms of maltreatment, a higher proportion of EM cases were referred for specialized services, kept open for on-going child welfare services, lead to an out of home placement, and lead to an application to child welfare court. Using a broad definition of EM the number of investigations classified as EM in Canada, excluding Québec, nearly tripled from 1998 to 2003. In 2008, using more specific definitions focusing on caregiver definitions, the number of investigations classified as EM nearly returned to their 1998 level, with nearly twice as many cases being classified as risk of future maltreatment.

Conclusion

EM is a well established category for child welfare intervention in Canada, however, more emphasis should be given to distinguishing between EM and family problems that place children at risk of EM.     

Predictors of variation in sate reported rates of psychological maltreatment: A survey of statutes and a call for change

BackgroundPsychological maltreatment (PM) is equivalent in harm to other forms of child maltreatment and yet it is not included in all US State child abuse statutes and past research using the National Child Abuse and Neglect Data System (NCANDS, 1998, 2007, 2008) identified 300-480-fold differences in substantiated cases across US States. This variation is inconsistent with the significance of the problem and the availability of reliable operational definitions.Participants and SettingUS State statutes were coded and compared with reported rates of four different forms of child maltreatment in the 2014 and 1998 NCANDS data sets.MethodsData were extracted from NCCANDS and State statutes were coded independently by the authors (kappa = .96).ResultsFor 2014, the difference in reported rates of PM between the State with the lowest rate and the State with the highest rate was 523-fold which was much higher than for physical (30-fold) and sexual abuse (20-fold) but not neglect (524-fold). Statutes still use the term “mental injury” from the original Child Abuse Prevention and Treatment Act (Child Abuse Prevention & Treatment Act, 1974) and two thirds did not define it. Reported rates of PM in NCANDS were not correlated with whether PM was defined in the statute but when a harm standard was present, reported rates were statistically lower. Almost 70% of statutes mentioned a current trend (e.g., sexual/human trafficking) demonstrating a willingness by States to amend statutes.ConclusionsA common, reliable definition of PM (and other forms of maltreatment) in CAPTA, NCANDS, and US State statutes is necessary for the US to have a surveillance system that allows for the assessment of the effects of policies on reported rates of all forms of maltreatment.     

Reflective function mediates the relationship between emotional maltreatment and borderline pathology in adolescents: A preliminary investigation

Deficits in mentalizing, particularly within the context of attachment relationships i.e., reflective function (RF), are posited to result from childhood maltreatment and to influence the development of borderline personality disorder (BPD). Whilst a mentalization-based model of BPD provides a theoretical explanation, direct empirical support for this model, in linking childhood maltreatment to borderline pathology remains limited. This study examined the interrrelationships between childhood maltreatment, RF, and borderline pathology in a mixed adolescent sample, consisting of adolescents with BPD (n = 26) and a group of non-clinical adolescents (n = 25). With the aim of directly testing the mentalization-based model of BPD, we additionally investigated the influence of each form of childhood maltreatment within this developmental pathway. Self-report data supported the hypothesized indirect effect of childhood maltreatment on elevated borderline pathology through lowered RF in adolescents. Both emotional abuse and emotional neglect were found to indirectly influence borderline pathology through adolescent RF, however, only emotional abuse indirectly influenced borderline pathology through RF, after all other maltreatment types were controlled for. Findings support the promotion of mentalization, within attachment-related contexts, as an intervention target for adolescents with borderline pathology and as a potential target of prevention for at-risk children and adolescents with histories of childhood maltreatment, especially emotional abuse. Future research should delineate other underlying mechanisms, independent of RF, which may also link the influence of childhood maltreatment, and in particular, emotional abuse, to BPD.     

Intergenerational transmission of child maltreatment: Predictors of child emotional maltreatment among 11 to 17 years old children residing in communities of Karachi,Pakistan

ObjectiveFamilies where parents had childhood history of victimization may likely to abuse their children; hence contributing as an important predictor of child emotional maltreatment (CEM). This study aimed to determine the relationship of intergenerational abuse with CEM among 11–17 years old children residing in peri-urban and urban communities of Karachi, Pakistan.MethodStructured interviews were conducted with 800 children and parents-pair using validated questionnaire “International Child Abuse Screening Tool for Child (ICAST-C)” comprised of 4 domains. Domain of child emotional maltreatment was considered as outcome (CEM-score). The relationship between Parental history of childhood victimization and CEM-Score was measured using linear regression.ResultsThe average CEM-score was came to be 19+5.2 among children whom parental history of childhood victimization was present (P < 0.001). The estimated mean CEM-score increased by 5.59 units (95% CI= {2.61, 8.51}) among children whom parents had a history of childhood victimization (Intergenerational abuse) with severe physical familial abuse.ConclusionThe current study provided evidence on intergenerational transmission of maltreatment suggesting early prevention to break the cycle of child maltreatment through generations. Preventive measures can be taken, once a parental history of childhood victimization has been identified, by providing appropriate services to those families who belong to lower socioeconomic status, where mothers are young, presence of siblings’ rivalry/ bullying and/or violence among family members. However, these factors do not explain a complete causality of the intergenerational transmission therefore additional factors, for instance parenting styles must be taken into consideration.     

From childhood emotional maltreatment to depressive symptoms in adulthood: The roles of self-compassion and shame

BackgroundEmotional abuse is a form of maltreatment that most strongly predicts adult depressive symptoms in community samples. Introject theories suggest that some depressive symptoms stem from survivors having learned to treat themselves the way they were treated by their perpetrators.ObjectiveMalevolent introjects may undermine self-compassion, which may subsequently maintain feelings of shame. Thus, we hypothesized that self-compassion and shame would mediate the path from retrospective reports of maltreatment to concurrent depressive symptoms in adulthood.Participants and SettingParticipants were 244 adult community members and college students living in a Southwestern American metroplex.MethodWe ran a multiple mediator path model with emotional abuse as the independent variable. We specified four covariates: physical abuse, sexual abuse, physical neglect, and emotional neglect, and held constant the variance they explained in self-compassion, shame, and depression.ResultsOur final model accounted for 53.1% of the variance in adult depressive symptoms. A significant indirect effect from emotional abuse passed through both mediators and ended in adult depressive symptoms. We also found an indirect path from emotional neglect to depression passing through both mediators.ConclusionsIt appears emotional abuse and emotional neglect can undermine the formation of self-compassion. Low self-compassion predicts greater shame and depressive symptoms. Our model suggests self-compassion may be a particularly effective intervention point for survivors of emotional maltreatment.     

The past is present: The role of maltreatment history in perceptual,behavioral and autonomic responses to infant emotional signals

In the current study associations between parents’ experiences of childhood maltreatment and their perceptual, behavioral and autonomic responses to infant emotional signals were examined in a sample of 160 parents. Experienced maltreatment (both physical and emotional abuse and neglect) was reported by the participants and, in approximately half of the cases, also by their parents. During a standardized infant vocalization paradigm, participants were asked to squeeze a handgrip dynamometer at maximal and at half strength while listening to infant crying and laughter sounds and to rate their perception of the sounds. In addition, their heart rate (HR), pre-ejection period (PEP), and vagal tone (RSA) were measured as indicators of underlying sympathetic and parasympathetic reactivity. Results indicated that participants did not differ in their perceptions of the infant vocalizations signals according to their maltreatment experiences. However, maltreatment experiences were associated with the modulation of behavioral responses. Experiences of neglect during childhood were related to more handgrip force during infant crying and to less handgrip force during infant laughter. Moreover, a history of neglect was associated with a higher HR and a shorter PEP during the entire infant vocalization paradigm, which may indicate chronic cardiovascular arousal. The findings imply that a history of childhood neglect negatively influences parents’ capacities to regulate their emotions and behavior, which would be problematic when reacting to children’s emotional expressions.     

Childhood emotional maltreatment,anxiety, attachment,and mindfulness: Associations with facial emotion recognition

The current study investigated factors thought to contribute to facial emotion processing. Female university students (N = 126) completed self-report measures of childhood emotional maltreatment, anxiety symptoms, attachment anxiety and avoidance, and trait mindfulness before completing a facial emotion recognition task, where they viewed sequences of faces that incorporated progressively more emotional content until they were able to correctly identify the emotion. They completed the task under low and high cognitive load conditions to distinguish between relatively effortful versus automatic processing abilities. Regression analyses revealed that under low cognitive load, attachment avoidance and mindfulness predicted quicker identification of fear (i.e., with less perceptual information), whereas anxiety predicted slower identification of fear (i.e., with more perceptual information). In the high cognitive load condition, emotional maltreatment and mindfulness predicted quicker identification of fear, and anxiety and mindfulness predicted faster identification of emotions overall. Although current findings are correlational, most of these effects were specific to fearful faces, suggesting that experiences of childhood emotional maltreatment and associated socio-emotional sequelae are related to heightened processing of threat-related information.     

Early childhood maltreatment and trajectories of behavioral problems: Exploring gender and racial differences

The current study aimed to examine the trajectory of child behavior problems over time as a function of early maltreatment. We anticipated that early alleged maltreatment would have a substantial impact on both internalizing and externalizing behaviors. The impact of gender and racial differences in the trajectories were also examined. Using the LONGSCAN archived data, a total of 484 children were selected for the study from varying sites. Two groups were formed: children with early allegations of maltreatment from birth to age 4 and children without any report. Children included did not have further allegations of maltreatment from ages 4 to 12. Additionally, they must have completed a behavioral assessment using the Child Behavior Checklist at the age 4 baseline interview. Multilevel modeling using the SAS PROC MIXED procedure was used to examine the effects of early allegations of maltreatment on the trajectories of both internalizing and externalizing problems. Although race was not significant, gender was found to differ in trajectory of behavioral problems among children with early allegations of maltreatment. For boys, the impact of early maltreatment was strongest at the most proximal assessment of behavioral outcomes and then decreased gradually over the course of subsequent periods. For girls, although no significant impact was observed at each measurement point, the impact of early maltreatment increased and became pronounced over time. Findings support the importance of early intervention/prevention to decrease the likelihood of presenting behavioral problems in later childhood years with consideration to gender.     

Measurement of emotional/psychological child maltreatment: a review

Background

Emotional/psychological child maltreatment (ECM) is a major public health problem with serious consequences including emotional and behavioral problems. Nevertheless, ECM is an understudied area.

Objectives

The aims of this review are to identify measures of ECM and to evaluate their psychometric properties and utilities. We provide a summary of ECM measures that have been tested for their reliability and validity, evaluate the quality of these assessments and suggest directions for future research.

Methods

We searched PsycINFO and Medline databases from 2000 to 2010 in addition to a hand search of retrieved references; 2344 were identified and the abstracts reviewed independently by two authors to identify relevant articles. Using pre-established criteria, 144 of those articles were selected and reviewed in full to assess whether the instruments included a separate measure of ECM and its psychometric properties.

Results

Forty-five articles examining 33 measures met the inclusion criteria and were selected for further review. The majority of measures demonstrated acceptable reliability; fewer measures had evaluated one or more types of validity.

Conclusion

Both reliability and validity testing are required in order to establish more accurate measures of ECM.

Practice implications

Reliable and valid measures are necessary to enhance our limited knowledge about the distribution, determinants and consequences of ECM.     

The impact of maltreatment characteristics and revicitimization on functioning trajectories in children and adolescents: A growth mixture model analysis

Person-centered approaches are considered promising methods for a deeper understanding of the causes and consequences of maltreatment. So far, only few studies have employed such approaches in the study of maltreatment. The aim of the present study was to examine the impact of maltreatment-related variables on trajectories after maltreatment. Growth mixture modelling (GMM) was used to examine different trajectories of functioning in 206 children and adolescents (M = 9.8 years) with a history of child maltreatment. Trajectories were analyzed in regards to maltreatment characteristics and revictimization using multinomial logistic regression. The participants were followed up over a 12 months period including three assessments. Four trajectories were identified: resilient (22.9%), worsening (15.1%), recovering (32.2%), chronic (29.8%). Revictimization (OR: 2.6–5.5), a longer period between first and last reported incident of maltreatment (OR: 0.033 – 0.038) and consequently the age at first (OR: 0.039 – 0.054) and age at last reported incident (OR: 20.3–26.9) were significant predictors of a worsening functioning trajectory. Having experienced neglect predicted a worsening trajectory in contrast to a chronic and resilient trajectory (OR = 4.8–5.2). Findings suggest that a clinical follow-up of children with a history of maltreatment is crucial as this population represents a high risk sample. A worsening trajectory was closely associated with revictimization. Functioning trajectories seem to be directly linked to chronicity and timing of maltreatment. Implications are discussed.