Adult Resilience among Maltreated Children: A Prospective Investigation of Main Effect and Mediating Models

Childhood maltreatment associated suicidal risk in Chinese children and adolescents: a mediation of resilience

BACKGROUND

Existing evidence suggests that children and adolescents who had experienced childhood maltreatment (CM) are at higher suicidal risk. However, the mediation role of resilience in this association remains unclear. We aim to investigate the mediation via resilience in the associations between CM and three suicidal risk indicators (suicidal ideation, SI; suicidal plan, SP; suicidal attempt, SA) among a large sample of Chinese children and adolescents.

METHODS

A population-based cross-sectional survey was conducted in southwestern China Yunnan province. A total of 9723 children and adolescents were included and analyzed by using a multi-stage stratified cluster sampling design. Univariate and multivariate logistic regression models were fitted to explore the associations between CM, resilience, and the three suicidal risk indicators, dose-response trends further elucidated by using the restricted cubic splines. Path models were adopted to estimate the mediation of resilience.

RESULTS

The estimated prevalence rates for one-year SI, SP and SA were 32.86% (95% CI: 31.93-33.80%), 19.36% (95% CI: 18.57-20.16%) and 9.07% (95% CI: 8.51-9.66%). After adjustment, CM significantly associated with all 3 suicidal risk indicators, and the odds ratios (ORs) were 2.13 (95% CI: 1.91-2.37), 2.45 (95% CI: 2.13-2.81), and 3.61 (95% CI: 2.90-4.52) for one-year SI, SP, and SA, respectively. Path models revealed that resilience significantly mediated the associations between CM and the three suicidal risk indicators, and among all dimensions of resilience, family support presented the strongest mediation consistently.

CONCLUSIONS

Our study results suggest that intervention measures which focusing on improving psychological resilience might be effective in reducing suicidal risk for children and adolescents who had experienced maltreatment. Prospective studies should be done to corroborate our findings.

The experience of childhood sexual abuse: An exploratory description of psychological and adaptive functioning in Canadian men

BACKGROUND

Childhood sexual abuse (CSA) affects a number of men yet knowledge gaps remain around comprehensively describing psychological and adaptive outcomes for this population.

OBJECTIVE

Examine how a Canadian sample of men with and without CSA histories compares on broader areas of psychological and adaptive functioning.

PARTICIPANTS AND SETTING

This exploratory study included 109 adult men aged 25-60 years who were grouped according to whether they experienced CSA (n = 69) or not (n = 40). Participants were recruited from Ottawa, Ontario, Canada.

METHOD

Using a multi-method approach, we conducted an exploratory and comprehensive examination of how CSA contributes to various areas of psychological (e.g., depression, anxiety, stress, dissociation, anger, PTSD) and adaptive functioning (e.g., friendship quality, employment) using self-report and clinician-administered measures.

RESULTS

CSA men were an average of 8.5 years old at abuse onset. Most (62.3 %) had disclosed their CSA experience, waiting an average of 13.6 years before disclosure. After controlling for covariates (i.e., other types of maltreatment, non-maltreatment adversities, education, income), results indicated a significant association between CSA and men's psychological functioning, but not their adaptive functioning.

CONCLUSIONS

Findings highlight the importance of broadening our understanding of how the experience of CSA, controlling for important covariates, can contribute to the well-being of men in order to better respond to their psychological needs.

Childhood Maltreatment and Life Satisfaction in Chinese Student Preschool Teachers: The Roles of Resilience and Social Support

Although some studies have explored the relationships between childhood maltreatment and life satisfaction, few studies have explored the pathways between those two variables in a sample of student preschool teachers. The current study, thus, attempts to explore the relationships between childhood maltreatment and life satisfaction in Chinese student preschool teachers and to examine the roles of resilience and social support in those relationships. A total of 1218 students majoring in early childhood education were recruited from three Chinese universities to attend this study. Self-reported questionnaires were used to collect data, and structural equation modeling was used to perform data analysis. Results showed that childhood maltreatment was negatively associated with life satisfaction in Chinese student preschool teachers; resilience and social support mediated those relationships. The findings suggest that childhood maltreatment not only has a direct relationship with life satisfaction, but also has an indirect relationship with life satisfaction via resilience and social support. Childhood maltreatment should be considered when enrolling student preschool teachers, and increasing levels of resilience and social support should be meaningful approaches when cultivating student preschool teachers who have experienced childhood maltreatment.

Association of child maltreatment and bullying victimization among Chinese adolescents: The mediating role of family function, resilience, and anxiety

BACKGROUND

Among adolescents, child maltreatment is linked to being bullied at school. Nevertheless, little is known about the mediating mechanisms underlying this association. Therefore, our research aimed to explore and evaluate the potential mediators of the relationship between child maltreatment and bullying victimization among Chinese adolescents.

METHODS

From October to December 2020, a population-based cross-sectional survey was conducted among 6247 adolescents (3401 males, 2846 females) in Anhui Province, China. The subjects of the survey were elementary and middle school students from grades 4 to 9. The data were collected through self-report questionnaires. Pearson correlation and linear regression were used to examine the relationships among child maltreatment, bullying victimization, family function, resilience, and anxiety. Structural equation modeling (SEM) was employed to conduct mediation analyses.

RESULTS

The results indicated that child maltreatment positively predicted the later bullying victimization of adolescents. Resilience and anxiety were each shown to separately mediate this relationship. Moreover, the sequential mediating effects of family function, resilience, and anxiety also mediated the predictive effect of child maltreatment on bullying victimization.

CONCLUSIONS

Resilience and anxiety were both shown to be important independent mediators for the relationship between child maltreatment and bullying victimization. Furthermore, the combined mediating effects of family function, resilience, and anxiety were also of great significance. These findings provide additional evidence that family and individual factors are critical to understanding bullying victimization. Effective prevention and intervention strategies for school bullying should target family and individual vulnerabilities in adolescents.

Adverse childhood experiences and resilience among adult women: A population-based study

Background

Adverse childhood experiences (ACEs) have consistently been associated with elevated risk of multiple adverse health outcomes, yet their contribution to coping ability and psychiatric resilience in adulthood is unclear.

Methods

Cross-sectional data were derived from the ongoing Stress-And-Gene-Analysis cohort, representing 30% of the Icelandic nationwide female population, 18-69 years. Participants in the current study were 26,198 women with data on 13 ACEs measured with the ACE-International Questionnaire. Self-reported coping ability was measured with the Connor-Davidson Resilience Scale and psychiatric resilience was operationalized as absence of psychiatric morbidity. Generalized linear regression assuming normal or Poisson distribution were used to assess the associations of ACEs with coping ability and psychiatric resilience controlling for multiple confounders.

Results

Number of ACEs was inversely associated with adult resilience in a dose-dependent manner; every 1SD unit increase in ACE scores was associated with both lower levels of coping ability (β = -0.14; 95% CI-0.15,-0.13) and lower psychiatric resilience (β = -0.28; 95% CI-0.29,-0.27) in adulthood. Compared to women with 0 ACEs, women with ≥5 ACEs had 36% lower prevalence of high coping ability (PR = 0.64, 95% CI 0.59,0.70) and 58% lower prevalence of high psychiatric resilience (PR = 0.42; 95% CI 0.39,0.45). Specific ACEs including emotional neglect, bullying, sexual abuse and mental illness of household member were consistently associated with reduced adult resilience. We observed only slightly attenuated associations after controlling for adult socioeconomic factors and social support in adulthood.

Conclusions

Cumulative ACE exposure is associated with lower adult resilience among women, independent of adult socioeconomic factors and social support, indicating that adult resilience may be largely determined in childhood.

Funding

This work was supported by the European Research Council (Consolidator grant; UAV, grant number 726413), and the Icelandic Center for Research (Grant of excellence; UAV, grant number 163362-051). HBD was supported by a doctoral grant from the University of Iceland Research Fund.

Childhood Maltreatment, Automatic Negative Thoughts, and Resilience: The Protective Roles of Culture and Genes

Resilience, a psychological trait conceptualized as the ability to recover from setbacks, can be weakened by childhood maltreatment, which comprises childhood abuse and childhood neglect. The current study aimed to investigate whether childhood maltreatment could increase automatic negative thoughts (ANT), thus weakening resilience. Furthermore, as psychological characteristics are commonly subject to the moderating effects of cultural context and biology, the study also explored whether and how cultural and genetic factors separately interact with childhood maltreatment to predict resilience. In study 1, the participants comprised 237 American and 347 Chinese individuals; study 2 included 428 genotyped Chinese individuals. We combined regression, mediation, moderation, and machine learning methods to test the mediating effect of ANT on the link between childhood maltreatment and resilience as well as the moderating roles of culture and genetics. Study 1 found that both childhood abuse and childhood neglect increased ANT and thus weakened resilience. In addition, the ANT-mediating effects of childhood neglect were stronger in American than Chinese participants. In Study 2, using the leave-one-out approach, we constructed two separate prediction models based on 22 and 16 important single nucleotide polymorphisms (SNPs), and we found that the interaction between childhood abuse/neglect and polygenic scores based on important SNPs could predict ANT. The mediating effects of ANT on the relationship between childhood abuse/neglect and resilience were significant for participants with low polygenic scores but not for those with high polygenic scores. In conclusion, both the cultural environment and individual genetic makeup moderated the mediating effects of ANT on the association between childhood maltreatment and resilience. These findings indicated the roles of culture and genetics in protecting against the adverse effects of childhood maltreatment on resilience.

The importance of child abuse and neglect in adult medicine

The risk for adverse consequences and disease due to the trauma of child abuse or neglect is easily assessed using the self-administered modified ACEs questionnaire. Exposure to child maltreatment is endemic and common. At least one out of every ten USA adults has a significant history of childhood maltreatment. This is a review of the literature documenting that a past history of childhood abuse and neglect (CAN) makes substantial contributions to physical disease in adults, including asthma, chronic obstructive pulmonary disease, lung cancer, hypertension, stroke, kidney disease, hepatitis, obesity, diabetes, coronary artery disease, pelvic pain, endometriosis, chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia, and auto immune diseases. Adults who have experienced child maltreatment have a shortened life expectancy. The contribution of CAN trauma to these many pathologies remains largely underappreciated and neglected compared to the attention given to the array of mental illnesses associated with child maltreatment. Specific pathophysiolologic pathways have yet to be defined. Clinical recognition of the impact of past CAN trauma will contribute to the healing process in any disease but identifying specific effective therapies based on this insight remains to be accomplished. Recommendations are made for managing these patients in the clinic. It is important to incorporate screening for CAN throughout adult medical practice now.

Resilience Following Child Maltreatment: Definitional Considerations and Developmental Variations

Resilience following childhood maltreatment has received substantial empirical attention, with the number of studies on this construct growing exponentially in the past decade. While there is ample interest, inconsistencies remain about how to conceptualize and assess resilience. Further, there is a lack of consensus on how developmental stage influences resilience and how protective factors affect its expression. The current systematic review uses a developmental lens to synthesize findings on resilience following child maltreatment. Specifically, this article consolidates the body of empirical literature in a developmentally oriented review, with the intention of inclusively assessing three key areas-the conceptualization of resilience, assessment of resilience, and factors associated with resilience in maltreatment research. A total of 67 peer-reviewed, quantitative empirical articles that examined child maltreatment and resilience were included in this review. Results indicate that some inconsistencies in the literature may be addressed by utilizing a developmental lens and considering the individual's life stage when selecting a definition of resilience and associated measurement tool. The findings also support developmental variations in factors associated with resilience, with different individual, relational, and community protective factors emerging based on life stage. Implications for practice, policy, and research are incorporated throughout this review.

Caregiver and divine support: Associations with resilience among adolescents following disclosure of sexual abuse

BACKGROUND

Social support is believed to be important for fostering adolescent resilience following sexual abuse. Caregiver support is often examined as a source of support for adolescents, but divine support (support from God or a higher power) has received scant research attention.

OBJECTIVE

This study examines relations of caregiver support and divine support with resilience following adolescent sexual abuse.

PARTICIPANTS AND SETTING

Participants were 548 adolescents aged 11-17 (M_age = 13.78; 91% female) and their non-offending caregivers (M_age = 39.68; 79% mothers). Families were recruited from a children's advocacy center located in the southern United States following a disclosure of sexual abuse.

METHODS

Adolescents completed measures of caregiver and divine support and their social and academic functioning; caregivers and adolescents reported on adolescent psychological functioning. Resilience was operationalized as the absence of clinical levels of psychological symptoms together with the presence of adaptive levels of social and academic functioning.

RESULTS

Both caregiver support (r = .19, p < .001) and divine support (r = .14, p = .001) were positively associated with resilience. Considered together in regression analyses, caregiver support (OR = 1.02, p = .001) and divine support (OR = 1.06, p = .04) were both associated with resilience.

CONCLUSION

Clinicians and researchers should consider the potential contribution of caregiver and divine support to adolescent resilience following sexual abuse.

Physical and sexual abuse in childhood and adolescence and leukocyte telomere length: A pooled analysis of the study on psychosocial stress, spirituality, and health

Introduction

We examined whether abuse in childhood and/or adolescence was associated with shorter telomere length in a pooled analysis of 3,232 participants from five diverse cohorts. We also assessed whether religion or spirituality (R/S) could buffer deleterious effects of abuse.

Methods

Physical and sexual abuse in childhood (age <12) and adolescence (age 12–18) was assessed using the Revised Conflict Tactics Scale and questions from a 1995 Gallup survey. We measured relative leukocyte telomere lengths (RTL) using quantitative real time polymerase chain reaction. We used generalized estimating equations to assess associations of physical and sexual abuse with log-transformed RTL z-scores. Analyses were conducted in each cohort, overall, and stratified by extent of religiosity or spirituality and religious coping in adulthood. We pooled study‐specific estimates using random‐effects models and assessed between-study heterogeneity.

Results

Compared to no abuse, severe sexual abuse was associated with lower RTL z-scores, in childhood: -15.6%, 95% CI: -25.9, -4.9; p-trend = 0.04; p-heterogeneity = 0.58 and in adolescence: -16.5%, 95% CI: -28.1, -3.0; p-trend = 0.08; p-heterogeneity = 0.68. Sexual abuse experienced in both childhood and adolescence was associated with 11.3% lower RTL z-scores after adjustment for childhood and demographic covariates (95% CI: -20.5%, -2.0%; p-trend = 0.03; p-heterogeneity = 0.62). There was no evidence of effect modification by R/S. Physical abuse was not associated with telomere length.

Conclusions

Sexual abuse in childhood or adolescence was associated with a marker of accelerated biological aging, decreased telomere length. The lack of moderation by R/S may be due to inability to capture the appropriate time period for those beliefs and practices.

What Do Adults Think About Their Adverse Childhood Experiences (ACEs), and Does It Matter?

We examined the self-reported adulthood impact of adverse childhood experiences (ACE's), including both the amount (magnitude) and type (valence positive or negative) of impact reported, in order to characterize variability in impact ratings, as well as to quantify their predictive ability with respect to health outcomes. We descriptively characterized impact by type of event and analyzed associations between impact ratings and demographic characteristics of respondents to explore resilience. We also analyzed the relationships between impact ratings and health outcomes. We found that, while there was wide variability in impact ratings, emotional abuse was rated as the most impactful in magnitude, and sexual and emotional abuse were rated as the most negatively impactful in terms of valence. We further found that impact ratings are predictive of adult health outcomes above and beyond the experience of the events alone. We conclude that perceived impact is a potentially important variable to include when self-reported ACEs are assessed.

Child maltreatment and the risk of antisocial behaviour: A population-based cohort study spanning 50 years

BACKGROUND

Child maltreatment is associated with an increased risk of antisocial behaviour; however, whether this risk persists and remains stable across the life-course is undetermined.

OBJECTIVE

To examine associations between chid maltreatment and antisocial behaviour across the life-course.

PARTICIPANTS AND SETTING

The study used 50 years of longitudinal data from the 1958 British birth cohort (n = 8088) measuring child neglect (prospectively) and abuse (retrospectively) and antisocial behaviour from childhood-to-adulthood.

METHODS

Latent growth curve models analysed the longitudinal course of antisocial behaviour across childhood (7-16years) and adulthood (23-50years) as a function of child maltreatment. We used directed acyclic graphs to identify, and adjust for, potential confounders (biological, family, social).

RESULTS

Child maltreatment was associated with higher levels of antisocial behaviour at all seven timepoints across the life-course (7-50years). Antisocial behaviour was elevated during childhood and adulthood in individuals who were maltreated, independently of confounding factors. Individuals who experienced multiple types of maltreatment were at the greatest risk of antisocial behaviour. Each additional maltreatment type was associated with an increased risk during both childhood (B = 0.173; SE = 0.024; p < .001) and adulthood (B = 0.137; SE = 0.014; p < .001). There was limited evidence that child maltreatment was associated with within-person rates of change, indicating that the increased risk of antisocial behaviour did not change over time.

CONCLUSIONS

Child maltreatment is associated with an increased risk of antisocial behaviour, with a persistent and stable association remaining up to age 50. Our results highlight the burden of child maltreatment and the importance of providing long-term support for individuals who experience child maltreatment.

The Cycle of Violence Revisited: Childhood Victimization, Resilience, and Future Violence

The individual and social protective factors that help break the cycle of violence are examined. Specifically, this study investigates (a) the individual and social protective factors that reduce violent offending among previously victimized children, and (b) whether certain protective factors are more or less important depending on the type and frequency of childhood victimization experienced. Data on young adults from Wave III of the National Longitudinal Study of Adolescent to Adult Health are used (N = 13,116). Negative binomial regression models are estimated to examine the protective factors that promote resiliency to violent offending among individuals who reported being physically and sexually victimized as children. Results indicate that a number of individual and social protective factors reduce violent offending in young adulthood. With a few exceptions, these factors are specific to the type, frequency, and comorbidity of abuse experienced. The results suggest a number of promising approaches to break the cycle of violence among previously victimized children. Future research should move beyond explaining the cycle of violence to examine how the cycle may be broken.

Childhood adversity, social support networks and well-being among youth aging out of care: An exploratory study of mediation

The goals of the present study are to examine the relationship between childhood adversity and adult well-being among vulnerable young adults formerly placed in substitute care, and to investigate how characteristics of their social support networks mediate this association. A sample of 345 Israeli young adults (ages 18-25), who had aged out of foster or residential care, responded to standardized self-report questionnaires tapping their social support network characteristics (e.g., network size or adequacy) vis-à-vis several types of social support (emotional, practical, information and guidance), experiences of childhood adversity, and measures of well-being (psychological distress, loneliness, and life satisfaction). Structural equation modelling (SEM) provided support for the mediating role of social support in the relationship between early adversity and adult well-being. Although network size, frequency of contact with its members, satisfaction with support, and network adequacy, were all negatively related to early adversity, only network adequacy showed a major and consistent contribution to the various measures of well-being. While patterns were similar across the types of support, the effects of practical and guidance support were most substantial. The findings suggest that the detrimental long-term consequences of early adversity on adult well-being are related not only to impaired structural aspects of support (e.g., network size), but also to a decreased ability to recognize available support and mobilize it. Practical and guidance support, more than emotional support, seem to be of critical importance.

Relationship and community factors related to better mental health following child maltreatment among adolescents

Research on factors associated with good mental health following child maltreatment is often based on unrepresentative samples and focuses on individual-level factors. To address these gaps, the present study examined the association between relationship- and community-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. Data were drawn from the National Comorbidity Survey of Adolescents (NCS-A; n=10,148; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. Having supportive parent and family relationships were significantly associated with good mental health (AOR ranging from 2.1 to 7.1). Positive community and school experiences were also significantly associated with good mental health (AOR ranging from 2.0 to 9.8). In most models, support from friends and siblings was not related to better mental health. Factors to be tested for efficacy in interventions targeted to adolescents with a history of child maltreatment include encouraging supportive parent and family relationships, and fostering positive community and school experiences.

Violent Victimization Among Disadvantaged Young Adults Exposed to Early Family Conflict and Abuse: A 24-Year Prospective Study of the Victimization Cycle Across Gender

Significant associations between childhood victimization and later revictimization have materialized in previous literature; yet, the victimization cycle has been primarily explored with indicators of sexual assault, although insight into linkages between other forms of victimization remains limited. This study examined connections from family conflict exposure and physical abuse in childhood to violent crime victimization in adulthood, assessing also gender differences and neighborhood influences. Results from logistic regression and hierarchical linear modeling with data from the Chicago Longitudinal Study, a panel of 1,539 low-income, ethnic/racial minority children, unearthed a significant relation between family conflict exposure and later revictimization. Moderated by gender, these analyses showed girls exposed to frequent family conflict are particularly vulnerable to revictimization in adulthood. Exploratory analyses unveiled a potential linkage between childhood physical abuse and later revictimization for men. Neighborhood effects marginally influenced results in one instance. Public health implications are discussed.

The association between childhood maltreatment experiences and the onset of maltreatment perpetration in young adulthood controlling for proximal and distal risk factors

The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6,935 low-income children with (n=4,470) or without (n=2,465) maltreatment reports prior to age 18 followed from ages 1.5 through 11 years through early adulthood (ages 18-26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit.

Does Child Abuse and Neglect Increase Risk for Perpetration of Violence Inside and Outside the Home?

OBJECTIVE

To examine the extent to which abused and neglected children perpetrate three different types of violence within and outside the home: criminal, child abuse, and intimate partner violence and determine whether childhood maltreatment leads to an increased risk for poly-violence perpetration.

METHOD

Using data from a prospective cohort design study, children (ages 0-11) with documented histories of physical and sexual abuse and/or neglect (n = 676) were matched with children without such histories (n = 520) and assessed in young adulthood (average age 29). Official criminal records in conjunction with self-report data were used to assess violent outcomes.

RESULTS

Compared to the control group, individuals with histories of child abuse and/or neglect were significantly more likely to be poly-violence perpetrators, perpetrating violence in all three domains (relative risk = 1.26). All forms of childhood maltreatment (physical and sexual abuse and neglect) significantly predicted poly-violence perpetration.

CONCLUSIONS

These findings expand the cycle of violence literature by combining the distinct literatures on criminal violence, child abuse, and partner violence to call attention to the phenomenon of poly-violence perpetration by maltreated children. Future research should examine the characteristics of maltreated children who become poly-violence perpetrators and mechanisms that lead to these outcomes.