Predictors of Resilience in Maltreated and Nonmaltreated Latino Children

Multiple mediation of the association between childhood emotional abuse and adult obesity by anxiety and bulimia - a sample from bariatric surgery candidates and healthy controls

Bulimia, which means a person has episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over their eating, is the most primitive reason for being overweight and obese. The extended literature has indicated that childhood emotional abuse has a close relationship with adverse mood states, bulimia, and obesity. To comprehensively understand the potential links among these factors, we evaluated a multiple mediation model in which anxiety/depression and bulimia were mediators between childhood emotional abuse and body mass index (BMI). A set of self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), Beck Anxiety Inventory, Beck Depression Inventory (BDI), and Eating Disorder Inventory (EDI), was sent out. Clinical data from 37 obese patients (age: 29.65 ± 5.35, body mass index (BMI): 37.59 ± 6.34) and 37 demographically well-matched healthy people with normal body weight (age: 31.35 ± 10.84, BMI: 22.16 ± 3.69) were included in the investigation. We first performed an independent t-test to compare all scales or subscale scores between the two groups. Then, we conducted Pearson correlation analysis to test every two variables' pairwise correlation. Finally, multiple mediation analysis was performed with BMI as the outcome variable, and childhood emotional abuse as the predictive variable. Pairs of anxiety, bulimia, and depression, bulimia were selected as the mediating variables in different multiple mediation models separately. The results show that the obese group reported higher childhood emotional abuse (t = 2.157, p = 0.034), worse mood state (anxiety: t = 5.466, p < 0.001; depression: t = 2.220, p = 0.030), and higher bulimia (t = 3.400, p = 0.001) than the healthy control group. Positive correlations were found in every pairwise combination of BMI, childhood emotional abuse, anxiety, and bulimia. Multiple mediation analyses indicate that childhood emotional abuse is positively linked to BMI (β = 1.312, 95% CI = 0.482-2.141). The model using anxiety and bulimia as the multiple mediating variables is attested to play roles in the relationship between childhood emotional abuse and obesity (indirect effect = 0.739, 95% CI = 0.261-1.608, 56.33% of the total effect). These findings confirm that childhood emotional abuse contributes to adulthood obesity through the multiple mediating effects of anxiety and bulimia. The present study adds another potential model to facilitate our understanding of the eating psychopathology of obesity.

A Systematic Review of Community-Level Protective Factors in Children Exposed to Maltreatment

Childhood maltreatment and neglect are associated with a host of negative outcomes. Yet, some children show resilience despite their exposure to these traumatic events. Several protective factors have been documented in the literature, but few studies focus on protective factors in the child's community that can promote resilience. The purpose of this review was to provide a comprehensive portrait of the impact of community protective factors on the resilience of abused and neglected children. The databases PsycNet and PubMed were used to screen the literature relying on the following inclusion criteria: (1) published in English or in French; (2) report empirical and quantitative data; (3) include a minimum sample size of 30 participants; (4) rely on a sample of maltreated children or adolescents under the age of 24; (5) examine the associations between community protective factors and indicators of psychological adaptation; and (6) include outcome measures that assessed either positive adaptation or the absence of symptomatology in participants. Of the 9,553 articles identified, 44 studies met the eligibility criteria for inclusion in this review. Although many protective factors show significant results, several methodological limitations remain to be examined to affirm that these community variables have a significant impact on the level of resilience of maltreated children. Since child maltreatment is a systemic issue, it remains important to fully understand how community protective factors operate on the resilience of these children as it can greatly inform practitioners and community institutions on how to intervene with populations at risk of maltreatment.

Scales and Interventions for Resilience among Treatment-Seeking Patients with Depression: A Systematic Review

Introduction

Resilience is an ability of an individual to effectively adjust and thrive in adverse stressful conditions. Resilience has protective and compensatory effects against depression. Evaluating resilience clinically and modifying it among patients with depression hugely impacts their prognosis. We aimed to explore different clinical scales for measuring resilience as well as interventions used with an intent to improve resilience among patients with depression.

Methods

A systematic literature review was conducted by searching PubMed central, Biomed central, and google scholar, using relevant MeSH keywords. The population of interest were the patients who were clinically diagnosed with Bipolar or Unipolar Depression and the population were not restricted to any country. Clinical scales for evaluation and interventions for resilience among patients with depression were set as an outcome of the study. Randomized controlled trials (RCTs), Quasi-experimental studies, observational studies, and narrative reviews were considered relevant research designs for extraction.

Results

A total of 8689 articles were identified and 13 articles were included in the final review, which yielded five scales that have been identified and have been used to evaluate resilience among the patients who are clinically diagnosed with depression and six different interventions for building resilience among patients with depression.

Conclusion

Resilience-building interventions will not only act as a preventive measure against depression but also help in promoting recovery and sustaining remission after a depressive episode. Clinical evaluation of resilience and management will significantly support boosting emotional experience.

Parenting Styles and Psychological Resilience: The Mediating Role of Error Monitoring

Parenting styles are associated with children's psychological resilience. However, the underlying mechanisms of this have not been investigated. Parenting styles influence how individuals respond to self-inflicted errors, and error monitoring is related to psychological resilience. Therefore, this study proposed that error monitoring might be a bridging factor between parenting styles and psychological resilience. Seventy-two young healthy adults were recruited for this study. Parenting styles were assessed using the Parental Bonding Instrument, and psychological resilience was measured using the Connor-Davidson Resilience Scale. Error monitoring was investigated in the Flanker task using event-related potentials (ERPs), and two error-related components of ERPs were measured: error-related negativity (ERN) and error positivity. Mediation analyses showed that the ERN partially mediated the relationship between parenting styles and psychological resilience. Specifically, a higher level of self-reported parental overprotection was related to larger ERN amplitude, which in turn was associated with lower psychological resilience. Additionally, a higher level of self-reported parental allowance of autonomy was related to lower ERN amplitude, which in turn was linked to higher psychological resilience. These results suggest that shaping children's sensitivity in early automatic error detection is one possible mechanism through which parental styles influence their psychological resilience.

Early childhood maltreatment and profiles of resilience among child welfare-involved children

Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.

School- and community-level protective factors for resilience among chronically maltreated children in Japan

PURPOSE

Few studies have investigated how school- and community-level modifiable factors might enhance resilience, defined as an ability to recover from and cope with adversity, among chronically maltreated pre-adolescent children. This study aims to investigate school and community factors that can increase children's resilience following maltreatment.

METHODS

We used data from the Adachi child health impact of living difficulty (A-CHILD) Study, a population-based prospective longitudinal study starting with first-grade children in all public elementary schools in Adachi City, Tokyo, Japan in 2015. Children who experienced chronic maltreatment while in 1st and 4th grades and whose resilience scores were available at those grades were included in the analysis (N = 789). Crude and multiple regressions were used to examine associations of child-reported school factors (i.e., school social capital, number of friends to consult with) and community factors (i.e., having a non-parental role model and supportive adult, having a third place, which is defined as a place other than home to spend time after school) with parent-reported resilience at 4th grade. These regressions were also performed stratified by sex.

RESULTS

School social capital and having a non-parental role model at 4th grade were positively associated with resilience after adjusting covariates, including resilience at 1st grade [coefficient = 3.63, 95% confidence intervals (CI) 2.26-4.99; coefficient = 2.52, 95% CI 0.57-4.38, respectively]. Analysis by sex revealed that having a supportive adult, but not a role model, was associated with resilience among girls (coefficient = 5.50, 95% CI 0.20-10.8).

CONCLUSIONS

The findings suggest that school and community factors can promote resilience following child maltreatment, and these factors are different between boys and girls.

Methodological inconsistencies confound understanding of language measurement in the child maltreatment population: A systematic review

BACKGROUND

While researchers have found a link between childhood maltreatment and language difficulties, the underlying mechanisms remain unclear and replication across the literature is inconsistent.

OBJECTIVE

To conduct a systematic review examining the methodological inconsistencies related to studies' samples construction, maltreatment measurement, and language outcomes using a language acquisition theory-based approach.

METHODS

Using the PRISMA framework, a literature search was conducted across five databases to identify studies that have investigated the effects of maltreatment on the language dimensions of vocabulary and grammar. Data were extracted for participant and maltreatment characteristics.

RESULTS

Fifty articles were reviewed. The results revealed: 1) maltreated children performed consistently below peers on grammar but not vocabulary assessments, 2) disproportionate use of vocabulary assessments, 3) considerable variability on participant characteristics and limited multidimensional measurement of maltreatment exposure, and 4) only nine studies analyzed the relationship between a maltreatment dimension (e.g., type, severity) and language.

CONCLUSIONS

Based on the results of this review, we propose three calls to action: 1) more language acquisition research in the child maltreatment field, 2) specificity when constructing samples with maltreated children, and 3) comprehensive and multidimensional maltreatment measurement. Implications for education were examined.

The Long-Term Effects of Early Childhood Resilience Profiles on School Outcomes among Children in the Child Welfare System

This study aimed to examine the association between early childhood resilience profiles and later school outcomes (academic achievement and school involvement) among children in the U.S. child welfare system. This study compared 827 children aged 3-5 years in three latent profile groups (poor emotional and behavioral resilience, low cognitive resilience, and multi-domain resilience) to their baseline profiles using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). At the three-year follow-up, children with low emotional and behavioral resilience profiles and children with the multi-domain resilience profile had significantly higher basic reading skills, reading comprehension, and math reasoning compared to children with low scores on the cognitive resilience profile. Furthermore, children with the multi-domain resilience profile had significantly higher levels of emotional school engagement than did those with the low emotional and behavioral resilience profile and considerably higher levels of behavioral school engagement compared to those with the low cognitive resilience profile. The findings highlight the persistent effects of early resilience into the later childhood years. Moreover, our results suggest the need for early identification of and intervention for children with low cognitive or emotional/behavioral resilience during the preschool years to promote academic success and school engagement during the school-age years.

Understanding the Mechanisms through Which Family Risk Affects Adolescent Mental Health: A Model of Multisystemic Resilience in Context

There is substantial evidence that exposure to family adversity significantly and negatively impacts positive adolescent development by placing adolescents at increased risk of experiencing developmental difficulties, including conduct problems. Although the mechanisms responsible for these effects are still largely unknown, a novel line of inquiry in the resilience field conceptualizes positive adaptation, following exposure to atypical adversity, as resulting from complex interactions of systems at multiple ecological levels. The purpose of the present analysis was to apply this multisystemic resilience framework to the study of positive adaptation following exposure to family adversity in a sample of Canadian adolescents (n = 230; mean age 16.16, SD = 1.38) and South African adolescents (n = 421; mean age = 15.97, SD = 1.19) living in economically volatile communities dependent on the oil and gas industry. Cross-sectional survey data were used to investigate the mechanisms through which family adversity exercises its impact on adolescent conduct problems by accounting for their caregiving, peer, and community resources. Results of two moderated mediation analyses showed that family adversity impacts adolescent externalizing mental health negatively, via disrupted caregiving, when other resources are also considered. For the Canadian adolescents, these negative impacts were protectively moderated by peer support, but not moderated by appreciation for community traditions. In contrast, peer support showed no significant protective effect for the South African sample, while a strong appreciation for community traditions was positively and significantly associated with conduct difficulties. Contextual dynamics (e.g., social unrest) provide a plausible explanation for the discrepant results and bring attention to the importance of theorizing resilience in context.

Internalizing and Externalizing Symptoms in Adolescents With and Without Experiences of Physical Parental Violence, a Latent Profile Analysis on Violence Resilience

Questionnaire data from a cross-sectional study on social resilience in adolescence, with a sample of N = 1,974 Swiss seventh grade high school students ages 12-14 (M = 11.76; SD = 0.65) was used to identify and compare violence resilience profiles. Person-centered latent profile analysis (LPA) was applied and allowed for the grouping of adolescents into profiles of internalizing (depression/anxiety, dissociation) and externalizing symptoms (peer aggression, peer victimization, classroom disruption) and differentiation of adolescents with (n = 403) and without (n = 1,571) physical parental violence experiences. Subsequently, a multinomial logistic regression analysis was conducted to further investigate the sociodemographic predictors of violence resilience profiles. With LPA, we identified four distinct profiles for both adolescent groups (with and without parental physical violence experiences). The results showed three particularly burdened profiles of adolescents, one with higher externalizing and one with higher internalizing symptoms, which did not occur simultaneously to the same extent. Furthermore, the third profile contained adolescents with both elevated internalizing and externalizing symptoms, the comorbid profile. The fourth profile consisted of the majority of adolescents, who exhibited little or no internalizing and externalizing symptoms, the so-called no/low symptomatic profile. A differentiated view of the symptoms can create added value regarding the understanding of violence resilience. Moreover, in the multinomial logistic regression, significant associations were found between the profiles and adolescents' gender in the group of adolescents with parental physical violence experiences, but none were found in relation to sociocultural status and migration background.

Child Maltreatment and Mental Health in Middle Childhood: A Longitudinal Study in Japan

Toxic stress caused by child maltreatment can lead to adverse mental health outcomes in later life, yet unmeasured confounding has been a major issue in many previous studies. To examine the association between child maltreatment and resilience and behavior problems among early elementary school-age children, we used data from a population-based longitudinal survey targeting all first-grade children in 2015 in Adachi City, a ward in Tokyo, Japan. Children whose caregivers provided valid responses during the 2015 (first grade; ages 6-7 years), 2016 (second grade; ages 7-8 years), and 2018 (fourth grade; ages 9-10 years) waves of the study were included in the analysis (n = 2,920). Fixed-effects regression models revealed that child maltreatment was inversely associated with resilience (β = -0.89, 95% confidence interval (CI): -1.05, -0.72) and prosocial behavior (β = -0.03, 95% CI: -0.05, -0.003) and positively associated with behavior problems (β = 0.32, 95% CI: 0.27, 0.37) over 4 years of follow-up (2015-2018), after controlling for all time-invariant confounders and measured time-varying confounders and survey year. These associations were consistent across sex. Child maltreatment may hamper the development of resilience and prosocial behavior and induce behavior problems in early elementary school children over time. Future researchers should identify modifiable protective factors for better mental health among maltreated children.

Profiles of Resilience from Early to Middle Childhood among Children Known to Child Protection Services

OBJECTIVE

The processes facilitating resilience are likely to be influenced by individual, familial and contextual factors that are dynamic across the life-course. These factors have been less studied in relation to resilience profiles evident in the developmental period between early to middle childhood, relative to later periods of adolescence or adulthood.

METHOD

This study examined factors associated with resilience in a cohort of 4,716 children known to child protection services by age 13 years, in the Australian State of New South Wales. Latent profile and transition analyses were used to identify multi-dimensional profiles of resilience as evident in social, emotional and cognitive functioning when assessed in early childhood (time 1 [T1], age 5-6 years) and middle childhood (time 2 [T2], age 10-11 years). Logistic regression models were used to investigate factors associated with two types of resilience identified: a transition profile of stress-resistance (i.e., represented by a typically developing profile at both T1 and T2) delineated in the largest subgroup (54%) of children, and a smaller subgroup (13%) with a profile of emergent resilience (i.e., typically developing at T2 following a vulnerable profile at T1).

RESULTS

Factors associated with resilience profiles included being female, and personality characteristics of openness and extraversion; other factors associated with stress-resistance, specifically, included higher socioeconomic status, non-Indigenous background, higher perceived port at home and at school, and not having a parent with a history of criminal offending.

CONCLUSIONS

Resilience processes appear to involve a complex interplay between individual, family, and community characteristics requiring interagency support.

Cultural Contributors to Ego-Resiliency and Associations with Depressive Problems in Midwestern Latino Youth

Ego-resiliency is an enduring psychological construct reflecting how individuals-adapt to environmental stressors, conflict, and change which is linked to positive adjustment. Ego-resiliency has not been examined in Latino youth, despite their high risk for mental health problems; nor have cultural precursors to ego-resiliency been examined. Given these gaps, we examined whether familism values (supportive, obligation, and referent) were associated with ego-resiliency and, in turn, depressive problems in Latino adolescents across two time points (N = 123, mean age = 11.53). Results indicated that supportive familism was associated positively with ego-resiliency and negatively with depressive problems. Ego-resiliency negatively predicted depressive problems across time, controlling for prior levels, suggesting that ego-resiliency may have long-term effects on depressive problems in Latino youth.

Applicability of the Ego-Resilience Scale (ER89) in the Chinese Cultural Context: A Validation Study

This study examined the cross-cultural validity of the Ego-Resilience Scale (ER89) in the Chinese cultural context. The ER89 was translated and culturally adapted into Chinese by following the psychometric validation procedures, in an adolescent sample ( N = 943) of 13- to 18-year-olds. A series of psychometric analyses were conducted, including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), analysis for measurement invariance across gender groups, analysis for criterion-related validity evidence, and internal consistency reliability estimates. The results supported the use of ER89 scale in the Chinese cultural context (ER89-C). The empirical findings suggest a two-factor structure of ER89-C (openness to life experiences [OL] and optimal regulation [OR]). The findings also revealed that ER89-C has the expected correlations with external and theoretically related constructs. Overall, ER89-C is shown to possess favorable psychometric characteristics for its use as an assessment tool for ego-resilience level of Chinese adolescents.

The physical health costs of positive adaptation to childhood adversity

Theories of allostatic load suggest that recurrent adaptive adjustments in contexts of adversity may have a negative impact on physical well-being. To test this hypothesis, this study evaluated 6-year-old children's ego-resilience and physical abuse experiences on behavior problems and physical illness at the age of 8 years. A significant interaction between ego-resilience and physical abuse exposure indicated that, although ego-resilience buffered physically abused children from internalizing problems, it also predicted more physical illness in that group. Findings contribute to the growing body of evidence suggesting that efforts to mobilize an adaptive response in contexts of adversity may exact a cost on physical well-being.

Understanding the Buffering Effects of Protective Factors on the Relationship between Adverse Childhood Experiences and Teen Dating Violence Perpetration

Prior research has demonstrated the scope and impact of adverse childhood experiences (ACEs) on health and wellbeing. Less is known about the trajectories from exposure to ACEs, such as witnessing family conflict and violence in the community, to teen dating violence perpetration, and the protective factors that buffer the association between early exposure to ACEs and later teen dating violence perpetration. Students (n = 1611) completed self-report surveys six times during middle and high school from 2008 to 2013. In early middle school, the sub-sample was 50.2% female and racially/ethnically diverse: 47.7% Black, 36.4% White, 3.4% Hispanic, 1.7% Asian/Pacific Islander, and 10.8% other. Youth were, on average, 12.7 years old. Latent transition analysis was used to assess how trajectories of exposure to parental conflict and community violence during middle school transition into classes of teen dating violence perpetration (e.g., sexual, physical, threatening, relational, and verbal) in high school. Protective factors were then analyzed as moderators of the transition probabilities. Three class trajectories of ACEs during middle school were identified: decreasing family conflict and increasing community violence (n = 103; 6.4%), stable low family conflict and stable low community violence (n = 1027; 63.7%), stable high family conflict and stable high community violence (n = 481; 29.9%). A three class solution for teen dating violence perpetration in high school was found: high all teen dating violence class (n = 113; 7.0%), physical and verbal only teen dating violence class (n = 335; 20.8%), and low all teen dating violence class (n = 1163; 72.2%). Social support, empathy, school belonging and parental monitoring buffered some transitions from ACEs exposure trajectory classes to teen dating violence perpetration classes. Comprehensive prevention strategies that address multiple forms of violence while bolstering protective factors across the social ecology may buffer negative effects of exposure to violence in adolescence.

What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review

OBJECTIVES

Children exposed to social adversity-hardship as a result of social circumstances such as poverty or intergenerational trauma-are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes.

DESIGN

Systematic search conducted in CINAHL, MEDLINE and PsychInfo from January 2004 to October 2018 using the keywords 'resilien* and child* in the title or abstract. Eligible studies: (1) described children aged 5-12 years; (2) identified exposure to social adversity; (3) identified resilience; and (4) investigated factors associated with resilience.

OUTCOME MEASURES

(1) approaches to identifying resilience and (2) factors associated with resilient outcomes.

RESULTS

From 1979 studies retrieved, 30 studies met the inclusion criteria. Most studies were moderate to high quality, with low cultural competency. Social adversity exposures included poverty, parent loss, maltreatment and war. Only two studies used a measure of child resilience; neither was psychometrically validated. Remaining studies classified children as resilient if they showed positive outcomes (eg, mental health or academic achievement) despite adversity. A range of child, family, school and community factors were associated with resilient outcomes, with individual factors most commonly investigated. The best available evidence was for cognitive skills, emotion regulation, relationships with caregivers and academic engagement.

CONCLUSIONS

While there is huge variation in the type and severity of adversity that children experience, there is some evidence that specific individual, relational and school factors are associated with resilient outcomes across a range of contexts. Such factors provide an important starting point for effective public health interventions to promote resilience and to prevent or ameliorate the immediate and long-term impacts of social adversity on children.

Childhood maltreatment and perceived stress in young adults: The role of emotion regulation strategies, self-efficacy, and resilience

Childhood maltreatment has many deleterious outcomes; however, trait resilience as well as emotion regulation strategies, including suppression and reappraisal, may mediate between childhood maltreatment and later perceived stress. For this study, 267 college students (183 females and 84 males; M age = 19.77, SD = 2.29) completed self-report measures of parental psychological and physical maltreatment, parental emotion neglect, habitual use of suppression and reappraisal strategies, emotion regulation self-efficacy, trait resilience, and recent perceived stress. Analyses were conducted to investigate gender-specific associations. In females, both suppression and reappraisal mediated the relationship between maternal/paternal emotional neglect and perceived stress, and suppression also mediated the relationship between maternal psychological maltreatment and perceived stress. Trait resilience mediated the relationships of all three types of maternal maltreatment, paternal psychological maltreatment, and paternal emotional neglect with perceived stress in females. There were no significant mediation effects in males. Thus, interventions aiming at reducing perceived stress associated with maternal or paternal emotional neglect or maternal psychological maltreatment in women may benefit from targeting both suppression and reappraisal. Such interventions may also be enhanced by efforts to strengthen trait resilience.

Differential impacts of participation in organized activities and maltreatment types on adolescent academic and socioemotional development

Participation in organized activities has been largely regarded as beneficial for academic and socioemotional development for adolescents, but the impacts of various types of organized activities for adolescents at risk for maltreatment have been rarely tested. In this study, we investigated the differential impacts of five types of maltreatment exposure (physical maltreatment, sexual maltreatment, neglect, other type, and multiple types) on the associations between four types of organized activities (mentored groups, art and music clubs, sport clubs, and academic clubs) and academic and socioemotional development (school engagement, delinquency, depressive symptoms, and trauma symptoms) of adolescents who were investigated by Child Protective Services (CPS) for maltreatment exposure. Data came from a national, longitudinal sample of 790 adolescents in contact with CPS in the U.S. After controlling for demographic characteristics of participants and prior levels of each outcome, multiple linear regression models were fitted to the data with interactions between the organized activities and the maltreatment types. The main findings of this study included: 1) adolescents who participated in mentored groups, sport clubs, and academic clubs reported higher levels of school engagement; 2) adolescents who participated in academic clubs reported fewer depressive symptoms; 3) adolescents who participated in art and music clubs reported more trauma symptoms compared to non-participants; and 4) the effects of participation in mentored groups on delinquency and trauma symptoms differed by maltreatment type. These results indicate both possible benefits and risks of organized activity participation for adolescents with certain maltreatment exposures.

Resilience following emotional abuse by teachers: Insights from a cross-sectional study with Greek students

An integrative socio-ecological model was developed to investigate the impact of emotional abuse by teachers on children's psychological functioning and test the role of social support and self-confidence as protective factors associated with resilience. Emotional abuse by teachers, social support from family, peers, school and a significant adult from the community, self-confidence and psychological functioning were assessed in a sample of young Greek school students aged 9-12 years (n=223, mean age=10.8, SD=0.885). Results revealed that exposure to emotional abuse by teachers predicted behavioural problems in school students suggesting a negative effect of these experiences on psychological functioning. The bootstrapped mediation model showed that the impact of emotional abuse by teachers on psychological functioning was significantly diminished through the influence of social support and self-confidence. Also, social support exerted a strong positive impact on self-confidence. This is the first study to show that individual and environmental factors using a socio-ecological model of resilience influence the adverse outcomes of this form of abuse in school aged children. These findings suggest that emotional abuse by teachers should be considered as a potential source of behavioural problems and adjustment in elementary students. Social support through its strong effect on self-confidence is an important protective factor of resilience against emotional abuse by teachers.

Psychosocial resilience and vulnerability in Western Australian aboriginal youth

Resilience is defined as a dynamic and contextually embedded process of positive development despite exposure to significant adversity. The Australian Aboriginal and Torres Strait Islander population experience significant disadvantage and adversity relative to the non-Aboriginal population, with disproportionate and increasing rates of Aboriginal children in out-of-home care and substantiated child maltreatment seven times the rates for non-Aboriginal children. Despite decades of resilience research there remains a gap in our understanding of the extent to which specific mechanisms and processes support resilient outcomes. This discussion paper synthesizes findings from our four previously published studies which together illustrate the application of a person-based resilience framework of analysis in the context of Western Australian Aboriginal youth. We discuss the implications of this approach for better understanding processes differentially impacting psychosocial functioning of youth depending on level of family-risk exposure. Data for these studies were available for 1021 Aboriginal youth, 12-17 years, drawn from the 2000-2002 Western Australian Aboriginal Child Health Survey (WAACHS), a population representative survey of 5289 Aboriginal children (0-17 years) living in 1999 families. Multivariate logistic regression analyses were used to model the differential influence of individual, family, cultural and community factors on psychosocial outcomes depending on family-risk context. Key findings revealed 56% of high-risk youth as psychosocially resilient; prosocial friendship and living in low SES neighborhoods uniquely protected psychosocial functioning; and exposure to racism was an additional risk factor for low-risk exposed youth. We conclude that a resilience perspective holds potential for exploring diversity within disadvantaged populations, identifying processes uniquely beneficial for those at greatest risk, and provides crucial insights for communities, practitioners and policy-makers.

Are emotions controllable? Maltreated and non-maltreated youth's implicit beliefs about emotion and aggressive tendencies

Although child maltreatment places youth at substantial risk for difficulties with emotion regulation and aggression, not all maltreated youth show these adverse effects, raising important questions about characteristics that discriminate those who do versus do not evidence long-term negative outcomes. The present investigation examined whether implicit beliefs about emotion moderated the association between maltreatment and aggression. Maltreated (n = 59) and community-matched (n = 66) youth were asked regarding their beliefs about emotion and aggressive behaviors. Beliefs about emotion were more strongly associated with aggression among maltreated youth, particularly physically abused youth. Maltreated youth who believed they had poor ability to control emotion reported significantly higher levels of aggression than comparison youth. However, maltreated youth who believed they had high ability to control emotion did not differ significantly in aggression from that of comparison youth. Findings offer unique insight into a factor that may increase or buffer maltreated youth's risk for aggression and thus highlight potential directions for interventions to reduce aggressive tendencies.

Growth in inhibitory control among low-income, ethnic-minority preschoolers: A group-based modeling approach

The emergence of self-regulation skills such as inhibitory control in children is an important developmental process associated with adjustment across multiple domains. Individual differences in inhibitory control are associated with family socioeconomic status but have not been studied in relation to variations in risk found within a low-income (i.e., high risk) sample (N = 407). Using a group-based modeling approach, change in inhibitory control was examined from 30 to 42 months of age in a sample of low-income Hispanic and African-American children. Patterns of change in inhibitory control were examined in relation to cumulative risk and child externalizing behavior using the Child Behavior Checklist measured at 42 months. A three-group solution was identified as optimally fitting the data, representing patterns of change in inhibitory control: a normative group, exhibiting increasing inhibitory control (48%); a low-stable group (40%); and a high-stable group (12%). Group membership did not differ by child ethnicity or gender. Higher cumulative risk was found among the children in the low-stable group than in the other groups. Mothers reported more externalizing problems at 42 months for children in the low-stable group than in the other groups, even controlling for the effect of cumulative risk. Intervention and policy implications are discussed.

Preschoolers' self-regulation moderates relations between mothers' representations and children's adjustment to school

Consistent with models of environmental sensitivity (Pluess, 2015), research suggests that the effects of parents' behaviors on child adjustment are stronger among children who struggle to regulate their thoughts, feelings, and behaviors compared with children with better self-regulation. This study extended prior research by assessing maternal representations of the child, which presumably underlie mothers' parenting behaviors, to evaluate the moderating influence of preschoolers' self-regulation on relations between mothers' representations and changes in children's negative and positive developmental adjustment outcomes from preschool to first grade. Participants were 187 mothers and their preschoolers. Mothers' representations were assessed via the coherence of their verbal narratives regarding their preschooler and teachers reported on preschoolers' self-regulation. In preschool and first grade, examiners rated children's externalizing behavior problems and ego-resilience, and teachers rated children's externalizing behavior problems and peer acceptance. Consistent with the environmental sensitivity framework, the coherence of mothers' narratives predicted changes in adjustment among children with self-regulation difficulties, but not among children with better self-regulation. Preschoolers with self-regulation difficulties whose mothers produced incoherent narratives showed increased externalizing behavior problems, decreased ego-resilience, and lower peer acceptance across the transition to school. In contrast, preschoolers with better self-regulation did not evidence such effects when their mothers produced incoherent narratives. The implications of these findings for understanding and supporting children's adjustment during the early school years are discussed. (PsycINFO Database Record

Psychological maltreatment, emotional and behavioral problems in adolescents: The mediating role of resilience and self-esteem

In this study, structural equation modeling was used to examine the mediating role of resilience and self-esteem in the relationships between psychological maltreatment-emotional problems and psychological maltreatment-behavioral problems in adolescents. Participants were 937 adolescents from different high schools in Turkey. The sample included 502 female (53.6%) and 435 male (46.4%) students, 14-19 years old (mean age=16.51, SD=1.15). Results indicated that psychological maltreatment was negatively correlated with resilience and self-esteem, and positively correlated with behavioral problems and emotional problems. Resilience and self-esteem also predicted behavioral problems and emotional problems. Finally, psychological maltreatment predicted emotional and behavioral problems mediated by resilience and self-esteem. Resilience and self-esteem partially mediated the relationship between psychological maltreatment-behavioral and psychological maltreatment-emotional problems in adolescents. Thus, resilience and self-esteem appear to play a protective role in emotional problems and behavioral problems in psychologically maltreated individuals. Implications are discussed and suggestions for psychological counselors and other mental health professionals are presented.

Profiles and predictors of behavioral resilience among children in child welfare

Children living in out-of-home care have experienced a multitude of adversities, often resulting in compromised functioning. The current study used Ontario Looking After Children (OnLAC) project data to estimate developmental trajectories of behavioral outcomes (i.e., conduct and emotional problems) over a 4-year period (i.e., ages 6-10 to 9-13) in 313 children living in out-of-home care. Predictors measured at baseline (e.g., sex) and across the subsequent 4-year period (e.g., parenting practices) were also investigated. Findings indicated that 64.2% and 58.6% followed resilient trajectories for conduct behaviors and emotional functioning, respectively. Predictors of resilient trajectories included internal developmental assets, number of children in the home, whether the child was receiving treatment, and positive parenting. Findings need to be interpreted with an understanding that children in out-of-home care have varying levels of functioning across various domains (e.g., educational, social) other than the ones measured here. Predictors were static and dynamic and cut across various contexts, emphasizing the importance of considering child functioning within an ecological model.

A Meta-Analysis of Cross Sectional Studies Investigating Language in Maltreated Children

PURPOSE

In this review article, meta-analysis was used to summarize research investigating language skills in maltreated children.

METHOD

A systematic search of published studies was undertaken. Studies were included in the meta-analysis if they investigated language skills in groups comprising maltreated and nonmaltreated children. Studies were selected if these 2 groups of children were of comparable age and from a similar socioeconomic background.

RESULTS

A total of 26 studies were identified that met the inclusion criteria. Results from the meta-analysis showed that maltreated children demonstrated consistently poorer language skills with respect to receptive vocabulary (k = 19; standardized mean difference [SMD] = .463; 95% confidence interval [CI; .293, .634]; p < .001), expressive language (k = 4; SMD =.860; 95% CI [.557, 1.163]; p < .001), and receptive language (k = 9; SMD =.528; 95% CI [.220, .837]; p < .001).

CONCLUSION

Together, these results indicate a reliable association between child maltreatment and poor language skills.

Moderation of maltreatment effects on childhood borderline personality symptoms by gender and oxytocin receptor and FK506 binding protein 5 genes

In this investigation, gene-environment-gender interaction effects in predicting child borderline personality disorder symptomatology among maltreated and nonmaltreated low-income children (N = 1,051) were examined. In the context of a summer research camp, adult-, peer-, and self-report assessments of borderline precursor indicators were obtained, as well as child self-report on the Borderline Personality Features Scale for Children. Genetic variants of the oxytocin receptor genotype and the FK506 binding protein 5 gene CATT haplotype were investigated. Children who self-reported high levels of borderline personality symptomatology were differentiated by adults, peers, and additional self-report on indicators of emotional instability, conflictual relationships with peers and adults, preoccupied attachment, and indicators of self-harm and suicidal ideation. Maltreated children also were more likely to evince many of these difficulties relative to nonmaltreated children. A series of analyses of covariance, controlling for age and ancestrally informative markers, indicated significant Maltreatment × Gene × Gender three-way interactions. Consideration of the maltreatment parameters of subtype, onset, and recency expanded understanding of variation among maltreated children. The three-way interaction effects demonstrated differential patterns among girls and boys. Among girls, the gene-environment interaction was more consistent with a diathesis-stress model, whereas among boys a differential-sensitivity interaction effect was indicated. Moreover, the genetic variants associated with greater risk for higher borderline symptomatology, dependent on maltreatment experiences, were opposite in girls compared to boys. The findings have important implications for understanding variability in early predictors of borderline personality pathology.

Review: Adoption, fostering, and the needs of looked-after and adopted children

BACKGROUND

This review of the literature examines adoption, fostering, and the needs of looked-after and adopted children. Three domains of research about looked-after children are examined.

FINDINGS

There is extensive evidence that early adverse experiences affect psychological and neurobiological development in looked-after and adopted children. There is also evidence that some looked-after and adopted children show remarkable resilience in the face of adversity; intervention research provides evidence of the ability to reduce risks and promote positive outcomes in this population. The intervention studies have revealed not only the potential for improved behavioral trajectories but also the plasticity of neurobiological systems affected by early stress.

CONCLUSION

Foster and adopted children face many challenges, but scientific knowledge also provides reason for hope and information about how to maximize positive outcomes.

What childhood characteristics predict psychological resilience to economic shocks in adulthood?

This paper investigates whether people's psychological resilience to one of the most important economic shocks - job loss - can be predicted using early childhood characteristics. Using a longitudinal data that tracked almost 3000 children into adulthood, we showed that the negative effect of unemployment on mental well-being and life satisfaction is significantly larger for workers who, as adolescents, had a relatively poor father-child relationship. Maternal unemployment, on the other hand, is a good predictor of how individuals react psychologically to future unemployment. Although the results should be viewed as illustrative and more research is needed, the current article provides new longitudinal evidence that psychological resilience to job loss may be determined early on in the life cycle.

Distinguishing among disruptive behaviors to help predict high school graduation: does gender matter?

This study examined unique predictive associations of aggressive and hyperactive-inattentive behaviors in elementary school with high school graduation. The current study also investigated whether these associations were moderated by gender. At Time 1, 745 children in the 3rd through 5th grades completed peer ratings on their classmates' disruptive behaviors. At Time 2, school records were reviewed to determine whether students graduated within four years of entering high school. Results showed that gender and hyperactivity-inattention are uniquely associated with high school graduation, but childhood aggression is not. Results also indicated that gender moderated associations between hyperactivity-inattention and graduation. Among boys, hyperactive-inattentive behaviors were not significantly associated with graduation, above and beyond aggression. In contrast, among girls, hyperactive-inattentive behaviors in childhood were significantly associated with graduation even after controlling for aggression. These findings suggest that in middle childhood, hyperactive-inattentive behaviors may be a more meaningful predictor of high school graduation than other forms of early disruptive behavior (e.g., aggression), especially for girls. Such findings could have significant implications for prevention and intervention programs designed to target children at risk for dropping out of school.

The relationship between adult health and childhood maltreatment, as moderated by anger and ethnic background

Childhood maltreatment, anger, and racial/ethnic background were examined in relation to physical health, psychological well-being, and blood pressure outcomes. This study used data from a diverse sample of African American, Latino, and Caucasian participants (N=198). Results from a series of multiple regressions indicated anger and total childhood maltreatment were robust predictors of poorer health. Although correlational analyses found maltreatment from the mother and father were associated with poorer health outcomes, when considered as part of the regression models, only a relationship between maltreatment from the mother and physical health was found. Greater anger scores were linked with lower blood pressure, particularly systolic blood pressure. Generally, more psychological and physical symptom reporting was found with greater anger scores, and higher levels of total maltreatment also predicted physical symptoms. The pattern of interactions indicated anger was more detrimental for African American participant's (and marginally so for Latino participant's) physical health. Interestingly, interactions also indicated total childhood maltreatment was related to fewer symptoms for Latino participants. Although child maltreatment may be viewed as a moral and/or human rights issue, this study provides evidence that it can also be viewed as a public health issue. Our study demonstrated that known health risk factors such as anger and maltreatment may operate in a different pattern dependent on ethnic/cultural background. The findings suggest health and health disparities research would benefit from greater exploration of the differential impact of certain moderating variables based on racial/ethnic background.

A roadmap for the integration of culture into developmental psychopathology

In this paper, I propose a roadmap for the integration of culture in developmental psychopathology. This integration is pressing because culture continues to be somewhat disconnected from theory, research, training, and interventions in developmental psychopathology, thus limiting our understanding of the epigenesis of mental health. I argue that in order to successfully integrate culture into developmental psychopathology, it is crucial to (a) study cultural development, (b) consider both individual-level and social-level cultural processes, (c) examine the interplay between culture and biology, and (d) promote improved and direct cultural assessment. I provide evidence in support of each of these guidelines, present alternative conceptual frameworks, and suggest new lines of research. Hopefully, that these directions will contribute to the emerging field of cultural development and psychopathology, which focuses on the elucidation of the cultural processes that initiate, maintain, or derail trajectories of normal and abnormal behavior.

Multilevel correlates of behavioral resilience among children in child welfare

Resilience, defined as positive adaptation and functioning following exposure to significant adversity, is an important topic of investigation in child welfare. The current study used data from the Ontario Looking After Children (OnLAC) project to estimate the prevalence of behavioral resilience (i.e., lower frequency of conduct and emotional problems, higher frequency of prosocial behavior) in 531 5-9 year olds living in out-of-home care, and to determine how behaviorally-resilient children are functioning in other domains (i.e., peer relationships and academic performance). Furthermore, hierarchical linear modeling was used to examine the contribution of four levels of analysis (i.e., child, family, child welfare worker, and child welfare agency) on behaviors and to identify the contribution of predictor variables within each of these levels. Findings indicated that 50-70% of children exhibited resilience on one behavioral outcome while approximately 30% showed resilience on at least two of the outcomes. Also, 8.4-9.6% exhibited resilience on one of the behavioral outcomes in addition to peer relationships and academic performance. The child level accounted for the highest proportion of total explained variance in behavioral outcomes, followed by the family-, child welfare worker-, and child welfare agency-levels. A number of child and foster family variables predicted behavioral functioning. Findings indicate that it is important to inquire about children's functioning across multiple domains to obtain a comprehensive developmental assessment. Also, child and foster family characteristics appear to play considerable roles in the promotion of behavioral resilience.

Annual Research Review: Resilient functioning in maltreated children--past, present, and future perspectives

BACKGROUND

Through a process of probabilistic epigenesis, child maltreatment progressively contributes to compromised adaptation on a variety of developmental domains central to successful adjustment. These developmental failures pose significant risk for the emergence of psychopathology across the life course. In addition to the psychological consequences of maltreatment, a growing body of research has documented the deleterious effects of abuse and neglect on biological processes. Nonetheless, not all maltreated children develop maladaptively. Indeed, some percentage of maltreated children develops in a resilient fashion despite the significant adversity and stress they experience.

METHODS

The literature on the determinants of resilience in maltreated children is selectively reviewed and criteria for the inclusion of the studies are delineated.

RESULTS

The majority of the research on the contributors to resilient functioning has focused on a single level of analysis and on psychosocial processes. Multilevel investigations have begun to appear, resulting in several studies on the processes to resilient functioning that integrate biological/genetic and psychological domains.

CONCLUSIONS

Much additional research on the determinants of resilient functioning must be completed before we possess adequate knowledge based on a multiple levels of analysis approach that is commensurate with the complexity inherent in this dynamic developmental process. Suggestions for future research on the development of resilient functioning in maltreated children are proffered and intervention implications are discussed.

Theoretical perspective: resilience in medically fragile adolescents

Medically fragile adolescents require medical technology and skilled care from parents and nurses in daily life. These adolescents may be ventilator dependent, require intravenous nutrition or medications, depend on nutritional or respiratory support, and depend on nursing care or other medical devices for daily living. Much of the extant research on medically fragile children and adolescents has lacked an overarching theoretical perspective. Findings suggest that peer relationships, family support, technology dependence, school attendance, and self-esteem are concepts of relevance for these adolescents. Thus, a theoretical framework derived from the risk and resilience literature was developed to identify the nature of their interrelationships using theory derivation techniques. The resilience in medically fragile adolescents framework was derived using concepts described by these adolescents. Further study is needed to test this model in medically fragile adolescents with hopes to foster positive outcomes for these adolescents.

Gene × Environment interaction and resilience: effects of child maltreatment and serotonin, corticotropin releasing hormone, dopamine, and oxytocin genes

In this investigation, gene-environment interaction effects in predicting resilience in adaptive functioning among maltreated and nonmaltreated low-income children (N = 595) were examined. A multicomponent index of resilient functioning was derived and levels of resilient functioning were identified. Variants in four genes (serotonin transporter linked polymorphic region, corticotropin releasing hormone receptor 1, dopamine receptor D4-521C/T, and oxytocin receptor) were investigated. In a series of analyses of covariance, child maltreatment demonstrated a strong negative main effect on children's resilient functioning, whereas no main effects for any of the genotypes of the respective genes were found. However, gene-environment interactions involving genotypes of each of the respective genes and maltreatment status were obtained. For each respective gene, among children with a specific genotype, the relative advantage in resilient functioning of nonmaltreated compared to maltreated children was stronger than was the case for nonmaltreated and maltreated children with other genotypes of the respective gene. Across the four genes, a composite of the genotypes that more strongly differentiated resilient functioning between nonmaltreated and maltreated children provided further evidence of genetic variations influencing resilient functioning in nonmaltreated children, whereas genetic variation had a negligible effect on promoting resilience among maltreated children. Additional effects were observed for children based on the number of subtypes of maltreatment children experienced, as well as for abuse and neglect subgroups. Finally, maltreated and nonmaltreated children with high levels of resilience differed in their average number of differentiating genotypes. These results suggest that differential resilient outcomes are based on the interaction between genes and developmental experiences.

Resilience following child maltreatment: a review of protective factors

OBJECTIVE

Child maltreatment is linked with numerous adverse outcomes that can continue throughout the lifespan. However, variability of impairment has been noted following child maltreatment, making it seem that some people are more resilient. Our review includes a brief discussion of how resilience is measured in child maltreatment research; a summary of the evidence for protective factors associated with resilience based on those studies of highest quality; a discussion of how knowledge of protective factors can be applied to promote resilience among people exposed to child maltreatment; and finally, directions for future research.

METHOD

The databases MEDLINE and PsycINFO were searched for relevant citations up to July 2010 to identify key studies and evidence syntheses.

RESULTS

Although comparability across studies is limited, family-level factors of stable family environment and supportive relationships appear to be consistently linked with resilience across studies. There was also evidence for some individual-level factors, such as personality traits, although proxies of intellect were not as strongly related to resilience following child maltreatment.

CONCLUSIONS

Findings from resilience research needs to be applied to determine effective strategies and specific interventions to promote resilience and foster well-being among maltreated children.