AFRICAN AMERICAN STEPFATHER-STEPCHILD RELATIONSHIPS, MARITAL QUALITY, AND MENTAL HEALTH

Marital quality and depression as mediators linking childhood maltreatment to adult physical health

BACKGROUND

Childhood maltreatment is known to influence adult physical health among midlife adults. Evidence suggests that depressive symptoms mediate the association. However, research has discounted the role of marital quality in understanding health outcomes among adults maltreated in childhood.

OBJECTIVE

To advance this line of inquiry, we examined the relationship between marital quality and depressive symptoms in a sequential mediation model linking childhood maltreatment to adult physical health over ten years.

PARTICIPANTS AND SETTING

Our sample consisted of midlife adults (n = 550) from three waves of the Midlife Development in the United States (MIDUS) study. The majority (n = 91.4 %) were white. At MIDUS 2, the mean age was 54.84 (SD = 10.78) and the mean age at MIDUS 3 was 63.96 (SD = 10.81).

METHODS

Structural equation modeling was used to examine the degree to which marital quality and depressive symptoms mediated the relationship between childhood maltreatment and adult physical outcomes. Bootstrapping procedures were used to estimate the indirect effects.

RESULTS

The serial mediation effects from maltreatment to adult physical health through marital quality and depressive symptoms were significant. Likewise, the simple indirect effects from maltreatment to subjective evaluations and the number of chronic health conditions through depressive symptoms were also significant.

CONCLUSIONS

Childhood maltreatment is linked to adult physical health problems through marital quality and depressive symptoms, suggesting that the quality of adult marriages may play a critical role in health outcomes. Improving the quality of marriages may reduce risk factors, such as depression, that potentate future physical health problems.

A Longitudinal Investigation into Marital Quality as a Mediator Linking Childhood Abuse to Positive and Negative Affective Symptoms

OBJECTIVE

Childhood abuse is positively associated with adult mental health problems and adult interpersonal relationships have been previously suggested to be a mediator. The role of marital partners, however, is less well understood. The current study will investigate marital quality as a mediator linking childhood abuse and positive and negative affective symptoms.

METHODS

The current study utilized three waves of data from the Midlife Development in the United States. Using a sample of 1,104 married adults (95.4% White), structural equation modeling examined the mediating effect of marital quality linking childhood abuse to positive and negative affective symptoms over a 20-year period.

RESULTS

Structural equation modeling revealed that childhood abuse was inversely associated marital quality, but was not directly associated with positive or negative affective symptoms. Marital quality was positively associated with greater positive affect and negatively associated with lower negative affect over a nine-year period, controlling for prior symptoms. Tests of indirect effects indicate that marital quality mediated the relationship between childhood abuse to both positive and negative affective symptoms, fully accounting for the association.

DISCUSSION

It appears that childhood abuse impacts the quality of adults' marriages, which may have significant implications for both positive and negative aspects of adult mental health. Marriages may be an important factor in understanding mental health in midlife and older adults among adults who were abused. Interventions should target the quality of adult marriages, and focusing on marital support, strain, and disagreement may be particularly effective.

Pathology in Relationships

Committed, long-term romantic relationships are ubiquitous among modern society. They are one of the most important contexts for the development, maintenance, and treatment of psychopathology. In this review, I first place psychopathology within the most commonly cited theoretical model of marital satisfaction and stability and then discuss how relationship satisfaction is conceptualized and assessed in this literature. In the second half of the review, I describe the theories regarding how romantic relationships may be connected to psychopathology. Relationship distress is easily incorporated into a diathesis-stress model as an important trigger for psychopathology. Next, I review cross-sectional research, longitudinal research, and treatment efficacy research linking relationship quality and psychopathology. I provide evidence for the robustness of these effects and areas where research must expand. I finish with a summary section that synthesizes what is known about the mechanisms linking relationship distress and psychopathology.