A pernicious cycle: Finding the pathways from child maltreatment to adolescent peer victimization

The purpose of this study was to identify the pathways from childhood physical and sexual abuse to adolescent physical and sexual victimization by assessing behavior symptoms (both internalizing and externalizing) and peer popularity as potential mediating variables. The data derive from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which tracks the consequences of child abuse and neglect using five study sites across the US. Child physical and sexual abuse was measured at age 12 using self-reports of life-time maltreatment experiences. Internalizing and externalizing symptoms were assessed at age 12 using the Child Behavior Checklist (CBCL). Peer popularity was assessed at age 14 by teachers. Peer victimization was assessed at age 16 using the modified version of the Juvenile Victimization Questionnaire. The results indicated that physical abuse had no direct effect on either physical or sexual peer victimization, whereas sexual abuse had significant direct effect on both physical and sexual victimization. Assessed at age 12, children who had been physically or sexually maltreated were found to have higher levels of internalizing and externalizing symptoms. These increased symptoms are associated with lower peer popularity at age 14, which in turn is associated with greater physical and sexual peer victimization at age 16. The findings suggest that multiple points for interventions may exist to disrupt the cycle of victimization. Early assessment and treatment for externalizing symptoms and for low peer popularity may be helpful in preventing physical peer victimization among adolescents who have been physically and/or sexually abused.     

Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model

Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999–2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n = 280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.     

Abusive parents' reports of child behavior problems: relationship to observed parent-child interactions

PURPOSE: We evaluated the hypothesis that abusive parents' reports may exaggerate rates of child behavior problems in a clinical sample. METHOD: The association between parental ratings of behavior problems and independent observations of child behaviors was examined in a sample of 205 clinic-referred families, 58 of which had a reported history of physical abuse. RESULTS: Relative to the comparison group, parents in the abuse group reported more externalizing problems in their children after controlling for parental psychopathology, and displayed more emotionally controlling and less supportive behavior during parent-child interactions. However, there was no association between abuse history and observed child behaviors during the interaction tasks. Abuse status significantly moderated the association between parent-reported externalizing behaviors and observed demanding behavior by the child; the association was significant among comparison families, but not in the abuse group families. CONCLUSIONS: Results indicate that abusive parents may over-report externalizing behavior problems in their children.     

Mutual Relations Between Mothers' Depressive Symptoms and Hostile-Controlling Behavior and Young Children's Externalizing and Internalizing Behavior Problems

Objective. This study considered the role of mothers' depressive symptoms and hostile-controlling behavior in young children's externalizing and internalizing behavior problems. Pathways of influence between mothers' depressive symptoms and hostile-controlling behavior and children's externalizing and internalizing behavior problems also were examined. Design. Data were collected at child ages 4 and 6 years from a nonclinical, community sample of 51 mothers and their children. At both assessments, mothers' behavior was observed during a structured mother - child play activity, and mothers completed questionnaires to assess their depressive symptoms and children's externalizing and internalizing symptoms. Results. Hierarchical regression analyses revealed different patterns of findings across the 2 assessments as well as different patterns of findings for children's externalizing versus internalizing behaviors. At age 4, mothers' depressive symptoms and hostile-controlling behavior predicted children's externalizing behaviors; at age 6, only mothers' hostile-controlling behavior predicted children's externalizing behaviors. Regarding children's internalizing behaviors, mothers' depressive symptoms were significant predictors at child age 4; however, by age 6, mothers' depressive symptoms were no longer significant predictors. When longitudinal modeling was applied to the data, some support for both maternal and child effects was found. Conclusions. Findings highlight the importance of considering mothers' depressive symptoms and hostile-controlling behavior in predicting children's externalizing and internalizing behavior problems and suggest different etiological pathways for externalizing versus internalizing expressions of dysfunction.     

Effects of the child–perpetrator relationship on mental health outcomes of child abuse: It's (not) all relative

The present study was conducted to better understand the influence of the child–perpetrator relationship on responses to child sexual and physical trauma for a relatively large, ethnically diverse sample of children and youth presenting for clinical evaluation and treatment at child mental health centers across the United States. This referred sample includes 2,133 youth with sexual or physical trauma as their primary treatment focus. Analyses were conducted to ascertain whether outcomes were dependent on the perpetrator's status as a caregiver vs. non-caregiver. Outcome measures included psychiatric symptom and behavior problem rating scales. For sexual trauma, victimization by a non-caregiver was associated with higher posttraumatic stress, internalizing and externalizing behavior problems, depression, and dissociation compared to youth victimized by a caregiver. For physical trauma, victimization by a non-caregiver was also associated with higher posttraumatic symptoms and internalizing behavior problems. The total number of trauma types experienced and age of physical or sexual trauma onset also predicted several outcomes for both groups, although in disparate ways. These findings are consistent with other recent studies demonstrating that perpetration of abuse by caregivers results in fewer symptoms and problems than abuse perpetrated by a non-caregiving relative. Thus, clinicians should not make a priori assumptions that children and adolescents who are traumatized by a parent/caregiver would have more severe symptoms than youth who are traumatized by a non-caregiver. Further exploration of the role of the perpetrator and other trauma characteristics associated with the perpetrator role is needed to advance our understanding of these findings and their implications for clinical practice.     

Callous unemotional traits and the relationship between aggressive parenting practices and conduct problems in Singaporean families

Research into parenting influences on child conduct problems in Asian countries has been limited compared to that conducted in Western countries, especially with regard to interplay between parenting and callous unemotional (CU) traits (e.g., lack of guilt and empathy). This study examined associations between dimensions of aggressive parenting practices (psychological aggression, mild and severe physical aggression), dimensions of child aggression (proactive, reactive), and child CU traits, in Singapore. Participants were children and adolescents with clinic-referred externalizing problems (N = 282; 87.6% boys), aged 7–16 years. Mild and severe parental physical aggression was found to be uniquely associated with children’s proactive aggression, whereas parental psychological aggression was uniquely associated with both proactive and reactive aggression. Consistent with previous evidence regarding CU traits as moderators of the relationship between negative parenting and child conduct problems, physically aggressive parenting was found to be more strongly associated with children’s proactive aggression among children with low levels of CU traits, than those with high CU traits. These findings support the need for ongoing research into CU traits in Asian cultures, focused on heterogeneous risk pathways to antisocial behavior and individual differences in response to family-based interventions.     

Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms

The present study examined the relationship of child maltreatment to both emotion dysregulation and subsequent eating pathology. In an effort to extend previous research, the authors examined the unique impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modeling was utilized to simultaneously examine the effects of all three abuse types on multiple dependent variables as well as examine whether deficits in emotion regulation mediated the relationship between abuse and eating pathology. Results from a survey of 1,254 female college students revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Additionally, emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. Findings support previous research on the enduring effects of emotional abuse as well as highlight the importance of the assessment of CEA in the treatment of ED symptoms.     

The unique relation of childhood emotional maltreatment with mental health problems among detained male and female adolescents

Mounting evidence indicates that emotional maltreatment is at least as harmful as physical and sexual abuse. Notwithstanding their high occurrence among detained adolescents, the link between emotional maltreatment and mental health problems in these youths is not well researched. This study, therefore, was designed to examine the unique link between emotional maltreatment and mental health problems, with particular attention to gender differences. Well validated self-report measures of maltreatment experiences (Childhood Trauma Questionnaire) and mental health problems (Youth Self Report) were completed by 341 detained adolescents (156 boys, 185 girls) aged 12 to 18 years. As expected, girls reported higher levels of maltreatment experiences and internalizing and externalizing mental health problems than boys. Blockwise multiple linear regression analyses indicated that in both genders emotional abuse was uniquely and positively associated with internalizing and externalizing mental health problems, over and above the influence of other types of maltreatment. Furthermore, sexual abuse was uniquely related with internalizing problems in girls only, whereas only in boys this type of abuse was uniquely related with externalizing problems. Detained adolescents who have been the victim of emotional abuse in combination with another type of maltreatment may be the worst subgroup in terms of mental health problems. Therefore, emotional maltreatment experiences in adolescents who offend should receive more research and clinical attention.     

Post-traumatic stress as a pathway to psychopathology among adolescents at high-risk for victimization

ObjectiveVictimization by violence elevates adolescents’ risk for developing internalizing and externalizing psychopathology. Recent findings suggest that disruptions in developmental processes associated with post-traumatic stress (PTS) reactions may partially account for the relationship between victimization and the subsequent development of psychopathology during adolescence. The present study tested the temporal sequencing of these associations using multi-informant measurements in a large, diverse sample of adolescents at high-risk for victimization.MethodData were collected from a multi-site consortium of prospective studies, the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about 833 youth’s victimization experiences (i.e., direct, indirect, familial, and non-familial violence), PTS, and affective, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms were gathered from youth and their caregivers during biannual face-to-face interviews when youth were between the ages of 4 and 14 years, and continuously from official child protective services records.ResultsStructural equation modeling revealed that cumulative victimization contributed to elevations in youth and caregiver reported late childhood and early adolescent psychopathology. While PTS mediated the association between victimization and youth reported ADHD, ODD, CD, major depressive, and generalized anxiety symptoms during adolescence, it only mediated the association between victimization and caregiver reported affective symptoms.ConclusionsPTS reactions following childhood victimization partially accounted for escalations in psychopathology during the transition to adolescence. These findings underscore the importance of integrating trauma-informed assessment and intervention approaches with at-risk adolescents. Researchers should determine whether trauma-focused interventions sufficiently ameliorate other psychopathology among victimized adolescents or if additional interventions components are necessary.     

Child abuse history in teen mothers and parent–child risk processes for offspring externalizing problems

This study examined whether child abuse history in teen mothers impacts offspring externalizing problems indirectly, through its influence on attachment and maternal hostility. In a longitudinal sample of 112 teen mother–child dyads, mothers reported on their own abuse experiences, attachment and maternal hostility were assessed via direct observations, and externalizing problems were measured using maternal reports. Compared with mothers with no abuse history, mothers with a history of sexual and physical abuse were more likely to have an insecurely attached infant, which predicted higher externalizing problems in preschool, which in turn predicted subsequent increases in externalizing problems in Grade 3. Furthermore, relative to the no abuse history group, mothers with a history of sexual and physical abuse showed more hostility toward their child at preschool, which in turn predicted elevated externalizing problems in Grade 3. Mothers’ history of either sexual or physical abuse alone did not have significant indirect effects on externalizing problems. Fostering secure attachment and reducing risk for maternal hostility might be important intervention goals for prevention programs involving at-risk mothers with abuse histories.     

Effortful Control Moderates Bidirectional Effects Between Children's Externalizing Behavior and Their Mothers' Depressive Symptoms

This study examined bidirectional associations between mothers' depressive symptoms and children's externalizing behavior and whether they were moderated by preschool‐age effortful control and gender. Mothers and teachers reported on 224 primarily White, middle‐class children at ages 3, 5, and 10. Effortful control was assessed via behavioral battery and mother ratings. Structural equation modeling indicated that maternal depressive symptoms at child age 3 predicted more externalizing behavior at age 10 among children with low effortful control and among boys. Externalizing behavior at age 3 predicted fewer depressive symptoms at the age 10 assessments among mothers of children with high effortful control. Boys with suboptimal self‐regulation exposed to high levels of maternal depressive symptoms were at greatest risk for school‐age behavioral problems.     

Behavior problems in elementary school among low-income boys: The role of teacher–child relationships

The authors identified trajectories of teacher–child relationship conflict and closeness from Grades 1 to 6, and associations between these trajectories and externalizing and internalizing behaviors at 11 years old among low-income, urban boys (N = 262). There were three main findings. Nagin cluster analyses indicated five trajectories for conflict with all children evidencing increases in conflict, and four trajectories for closeness with all children demonstrating decreases in closeness. Trajectories with higher levels of conflict and lower levels of closeness were associated with higher levels of externalizing and internalizing behavior problems at 11 years old. Moreover, conflictual teacher–child relationships exacerbated the effects of externalizing and internalizing behavior problems in early childhood; children with conflictual teacher–child relationships had higher levels of behavior problems in middle childhood relative to children with low conflictual teacher–child relationships. Implications of targeting teacher–child relationships as interventions to help prevent behavior problems are discussed.     

Parents who hit and scream: Interactive effects of verbal and severe physical aggression on clinic-referred adolescents’ adjustment

The goals of this study were first, to delineate the co-occurrence of parental severe physical aggression and verbal aggression toward clinic-referred adolescents, and second, to examine the interactive effects of parental severe physical aggression and verbal aggression on adolescent externalizing and internalizing behavior problems. This research involved 239 referrals of 11- to 18-year-old youth and their dual-parent families to a non-profit, private community mental health center in a semi-rural Midwest community. Multiple informants (i.e., adolescents and mothers) were used to assess parental aggression and adolescent behavior problems. More than half of clinic-referred adolescents (51%) experienced severe physical aggression and/or high verbal aggression from one or both parents. A pattern of interactive effects of mother-to-adolescent severe physical aggression and verbal aggression on adolescent behavior problems emerged, indicating that when severe physical aggression was present, mother-to-adolescent verbal aggression was positively associated with greater adolescent behavior problems whereas when severe physical aggression was not present, the links between verbal aggression and behavior problems was no longer significant. No interactive effects were found for father-to-adolescent severe physical aggression and verbal aggression on adolescent adjustment; however, higher father-to-adolescent verbal aggression was consistently linked to behavior problems above and beyond the influence of severe physical aggression. The results of this study should promote the practice of routinely assessing clinic-referred adolescents and their parents about their experiences of verbal aggression in addition to severe physical aggression and other forms of abuse.     

Prevalence and risk factors of child maltreatment among migrant families in China

Although cases of child abuse among migrant families are often reported by social media, the issue of child maltreatment among migrant families in China has received little empirical attention. This study investigated both the prevalence of child maltreatment by parents among migrant families, and the individual, family and community-level risk factors associated with child abuse in this context. A survey was conducted with 667 migrant and 496 local adolescents in Shenzhen, South China, with a stratified two-stage cluster sampling design. Logistic regression analysis was conducted to compare the prevalence of maltreatment between migrant and local adolescents, and also to explore risk factors associated with the psychological and physical maltreatment in both groups. The results showed that parent-to-child abuse was more prevalent among migrant than local adolescents, with migrant adolescents 1.490 and 1.425 times more likely to be psychologically and physically abused by their parents than their local counterparts. Low academic performance, delinquent behavior, family economic adversity and low parent attachment put migrant adolescents at increased risk of both psychological and physical maltreatment, and neighborhood disorganization was significantly related to psychological aggression among migrant adolescents. The findings confirm that child abuse perpetuated by parents is a serious problem in Mainland China, especially among migrant families, and implications for policy and practice are discussed.     

Externalizing behaviors of Ukrainian children: The role of parenting

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9–16 years of age (50% males) in 11 communities in Eastern, Southern, and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors such as aggression, delinquency, and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogs about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and nongovernmental organizations, and mass media that work with child abuse prevention in Ukraine.     

Developmental trajectories of disruptive behavior problems in preschool children of adolescent mothers

Using hierarchical linear modeling (HLM), we analyzed individual developmental trajectories of disruptive behavior problems between ages 3.5 to 6.0 years for 183 children of adolescent mothers. We examined how the level of problem behavior (intercept) and the rate of change over time (slope) are influenced by child's sex, mother's depression/anxiety symptoms, and mother's use of negative control for regulating child behavior. On average, disruptive behavior decreased from age 3.5 to 6.0. Child sex and maternal depression/anxiety related to the level of behavior problems but not to the rate of change. Boys and children of more depressed/anxious mothers exhibited higher levels of disruptive behavior. Maternal negative control was associated with both level of disruptive behavior and rate of change, and negative control mediated the effects of maternal depression/anxiety. Greater negative control corresponded to higher levels of behavior problems and no reduction in their display over time. Child race moderated effects of negative control.     

Child sexual abuse as reported by Israeli adolescents: Social and health related correlates

The objectives of the study were to assess the prevalence of child sexual abuse (CSA) in a nation-wide representative sample of 14–17 year old Israeli adolescents, and to examine the associations between CSA, socio-demographic correlates and various measures of physical and mental health. The study population consisted of 906 mother–adolescent dyads, belonging to a community based, representative sample of Israeli 14–17 year olds, interviewed in 2004–5. Response rate was 68%. Subjects provided demographic data, and information about CSA, physical symptoms, body image, well-being and use of mental health services. DAWBA was used to obtain information regarding mental disorders and suicidality. SDQ was used to obtain data on bullying. Statistical analyses were conducted using an SPSS-17 complex sample analysis module and multivariate analyses were conducted to assess the associations between CSA and risk factors and social and health related correlates. Findings show that CSA was reported by 3.3% of adolescents. Higher risk of exposure to CSA was found among girls, among adolescents living in a one-parent household and among adolescents with a chronic disability. In multivariate models adjusting for gender, learning disabilities and depression, CSA was associated with suicidal attempts, stomach ache, dizziness, sleep problems, well being at home and bullying behaviors. No association was found with suicidal ideation or other physical symptoms. Our findings confirm that the associations between CSA and different outcomes vary depending on the socio-psychological context, and underline the importance of addressing the complexity of variables associated with CSA.     

Externalizing Problems in Head Start Children: An Ecological Exploration

The increased familial and environmental stressors affecting Head Start families over the last two decades have precipitated an escalation of mental health difficulties among participant children (Yoshikawa & Knitzer, 1997). Using an ecological framework (Bronfenbrenner, 1979). this study explored externalizing behavior problems among a group of Head Start children in a suburban county. Children were assessed for externalizing behavior problems in the home and classroom. Additionally, parents participated in interviews about a variety of ecological factors related to children's behavior problems. Almost one-quarter of the children were identified by their parents as having externalizing behavioral problems in the borderline or clinical range. Twice as many girls as boys had borderline or clinical levels of behavioral problems. Child externalizing behavior was positively associated with child internalizing behavior, parent psychological symptomatology, child temperament, family environment, and exposure to community violence. Children with parent-identified externalizing behavior did have specific social problem-solving skills deficits. Additionally, they were observed to have high levels of specific inappropriate behavior, but did not exhibit high levels of teacher-rated behavior problems. The implications of these findings for Head Start program planning are discussed.     

Externalizing Problems in Head Start Children: An Ecological Exploration

The increased familial and environmental stressors affecting Head Start families over the last two decades have precipitated an escalation of mental health difficulties among participant children (Yoshikawa & Knitzer, 1997). Using an ecological framework (Bronfenbrenner, 1979). this study explored externalizing behavior problems among a group of Head Start children in a suburban county. Children were assessed for externalizing behavior problems in the home and classroom. Additionally, parents participated in interviews about a variety of ecological factors related to children's behavior problems. Almost one-quarter of the children were identified by their parents as having externalizing behavioral problems in the borderline or clinical range. Twice as many girls as boys had borderline or clinical levels of behavioral problems. Child externalizing behavior was positively associated with child internalizing behavior, parent psychological symptomatology, child temperament, family environment, and exposure to community violence. Children with parent-identified externalizing behavior did have specific social problem-solving skills deficits. Additionally, they were observed to have high levels of specific inappropriate behavior, but did not exhibit high levels of teacher-rated behavior problems. The implications of these findings for Head Start program planning are discussed.     

Early life stress and behavior problems in early childhood: Investigating the contributions of child temperament and executive functions to resilience

This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population-based cohort (n = 2803), parents reported on multiple stressors (age 0–6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously.