Psychological maltreatment, meaning-centered coping, psychological flexibility, and suicide cognitions: A moderated mediation model

BACKGROUND

Mental health problems are currently diversifying, increasing the possibility of suicide. Exposure to psychological maltreatment is one of the factors that increases suicidal cognitions. In addition, psychological flexibility and meaning-centered approaches may be effective in coping with suicidal cognitions.

OBJECTIVE

A hypothesized model was tested to examine the relationships among psychological maltreatment, suicidal cognitions, psychological flexibility, and meaning-centered coping.

METHOD

Data were collected from a sample of 652 participants. Mediation and moderation analyses were conducted to examine the mediating and moderating role of psychological flexibility and meaning-centered coping in the relationship between childhood psychological maltreatment and suicide cognitions among Turkish adults.

RESULTS

The results of the study indicated significant negative and positive relationships between psychological maltreatment, suicide cognitions, psychological flexibility, and meaning-centered coping. The findings suggest that psychological flexibility and meaning-centered coping have a serial mediating effect on the relationship between psychological maltreatment and suicide cognitions. Furthermore, according to the study results, psychological flexibility plays a moderating role both between psychological maltreatment and suicidal cognitions and between meaning-centered coping and suicidal cognitions.

CONCLUSIONS

The study suggests that psychological maltreatment can be considered as a risk factor and meaning-centered coping and psychological flexibility as protective factors in suicide prevention studies.

'It's not like we use the word emotional abuse'. A study on Norwegian child welfare workers understanding of emotional abuse

BACKGROUND

Despite the recognition of emotional abuse (EA) as the most pervasive and harmful of all forms of child maltreatment, it is argued to be less understood than other forms of child maltreatment. EA is regarded as a standalone form for maltreatment and an essential factor embedded in all other forms of maltreatment of children, such as physical and sexual abuse. Thus, it is crucial for child welfare workers to understand EA, as one of their core mandates is to prevent and protect children from all forms of maltreatment.

OBJECTIVE

This study aims to explore how child welfare workers in Norway describe and understand EA.

PARTICIPANTS AND SETTING

The study included 24 child welfare workers in 6 child welfare offices in Norway.

METHODS

The data were obtained from focus group interviews and analyzed using reflexive thematic analysis.

RESULTS

Overall, the findings reveal that EA was unfamiliar to the child welfare workers, and that there is a low degree of awareness on EA among the study participants. Further, EA is closely connected to whether parents provide sufficient emotional care for their children and is understood as part of the complex situation surrounding the child.

CONCLUSIONS

This article concludes with the need for reflective and sensitive discussions regarding understanding and awareness of EA in child welfare work. This has the potential to lead to greater insights into how EA is understood by child welfare workers as well as to enhance child welfare workers' abilities to describe, communicate about, and document EA.

Family-Based Psychosocial Care for Transgender and Gender-Diverse Children and Youth

Parental and caregiver inclusion is critical in providing psychosocial care for transgender and gender-diverse (TGD) children and adolescents. High levels of trauma among TGD youth call for the use of evidence-based models and resources to decrease family rejection and increase affirmation and support while healing trauma that is both related to and unrelated to the child's gender identity and expression. The integrated Family Acceptance Project-Trauma-Focused Cognitive Behavioral Therapy treatment model provides a structured and effective approach to engaging TGD youth with trauma and their parents.

Self-criticism and romantic relationship satisfaction as serial mediators of links between childhood psychological maltreatment and loneliness

BACKGROUND

Psychological maltreatment may be one of the causes of adults' loneliness despite having a partner. There are some links between psychological maltreatment, self-criticism, relationship satisfaction, and loneliness in the literature. But the nature of these links requires further explanation.

OBJECTIVE

The present study examined the serial mediation role of self-criticism and romantic relationship satisfaction on the pathway from childhood psychological maltreatment to loneliness, in a Turkish sample.

PARTICIPANTS AND SETTINGS

In total 403 individuals (Female = 294, Male = 109) participated from 53 different cities in Türkiye. Participants were either dating (65.8 %), had a fiancée (4 %), or were married (30.3 %).

METHOD

The data was collected using Psychological Maltreatment Questionnaire, UCLA Loneliness Scale, Self-criticism Rumination Scale, and the Relationship Assessment Scale.

RESULTS

Structural equation modeling results indicated that self-criticism and romantic relationship satisfaction fully mediated the impact of psychological maltreatment on loneliness. The model was a good fit [χ² (29, N = 403) = 63.846, p < .001; χ²/df = 2.20; SRMR = 0.061; RMSEA = 0.055; GFI = 0.969; CFI = 0.979; NFI = 0.963; IFI = 0.979].

CONCLUSIONS

Childhood experiences of psychological maltreatment can continue to haunt individuals, even as adults. Although being in a relationship can help individuals with their loneliness, psychologically maltreated adults may feel lonely in their relationships due to self-criticism and dissatisfaction. Interventions focused on childhood psychological maltreatment and self-criticism may help lonely adults. Along with this focus, relationship satisfaction can be addressed in family/couple counseling.

Mediating effect of fear and externality of happiness in the association between psychological maltreatment and psychological well-being

This study aims to explore whether psychological maltreatment predicts young adults' psychological well-being through fear of happiness and externality of happiness. The current study included 490 young adults from a public university in an urban city in Turkey. Participants were 36% male, and they ranged in age from 18 to 39 years (M= 21.77, SD = 2.40). Findings from the study revealed that psychological maltreatment had a significant predictive effect on psychological well-being, fear of happiness, and externality of happiness. Further, fear of happiness and externality of happiness mediated the impact of psychological maltreatment on psychological well-being. These findings indicate that fear and externality of happiness are important sources that can help to explain the association between childhood psychological maltreatment and psychological well-being among young adults. Therefore, there is a need to design a more comprehensive prevention and intervention approach for improving people's psychological well-being in the context of psychological maltreatment.

Latent profiles of childhood psychological maltreatment and their links to adult mental health in China and the UK

BACKGROUND

Though links between childhood maltreatment and mental health have been established, little known about how specific types of childhood maltreatment tend to cluster and how the resulting patterns of exposure impact mental health outcomes.

METHOD

The current study used latent profile analyses in Chinese (N = 544) and UK (N = 589) samples to identify childhood psychological maltreatment profiles (i.e., profiles of psychological abuse, psychological neglect, and psychological non-support) in different country contexts, and their associations with a range of mental health (i.e., depression, anxiety, anger, physical aggression, verbal aggression, and hostility), and broader well-being (i.e., self-esteem) outcomes. Unadjusted as well as analyses adjusted for adverse childhood experiences (ACEs) were conducted.

RESULTS

Four profiles were identified in both samples, but their nature differed between the Chinese sample ("Psychological Non-support", "Low-Maltreated", "High-Maltreated", and "Severe-Maltreated") and the UK sample ("Low-Maltreated", "Moderate-Maltreated", "High-Maltreated", and "Severe-Maltreated"). Individuals in the "Psychological Non-support" in China and "Low-Maltreated" class in the UK displayed better mental health outcomes-lower levels of depression, anxiety, and aggression, and higher self-esteem. In contrast, individuals in the "Severe-Maltreated" profiles in both the Chinese and UK samples displayed poorer mental health outcomes-higher depression, anxiety, and aggression, and lower self-esteem. Interventions and prevention efforts are needed for individuals categorized in profiles affected by psychological maltreatment.

CONCLUSION

This study highlights the importance of using targeted intervention or prevention to prevent psychological maltreatment, as well as improve mental health outcomes in individuals who have experienced psychological maltreatment.

Psychological maltreatment and adolescent internet harassment perpetration: The mediating role of deviant peer affiliation and the moderating role of self-compassion

BACKGROUND

Psychological maltreatment has been regarded as a risk factor for adolescent internet harassment. However, previous studies failed to take family, peer, and individual factors into account comprehensively when comes to adolescent internet harassment perpetration.

OBJECTIVE

Based on the Social-Ecological Diathesis-Stress Model, the present study established a moderated mediation model to investigate the mediating role of deviant peer affiliation in the association between psychological maltreatment and adolescent internet harassment perpetration, as well as the moderating role of self-compassion.

PARTICIPANTS AND SETTING

A total of 1,592 Chinese adolescents (51.07 % girls, M_age = 13.23 years) participated in the current study.

METHOD

The participants completed questionnaires regarding demographics, psychological maltreatment, internet harassment perpetration, deviant peer affiliation, and self-compassion.

RESULTS

Psychological maltreatment was positively related to adolescent internet harassment perpetration. Mediation analyses revealed that deviant peer affiliation partially mediated this relationship (indirect effect = 0.14, 95 % CI = [0.09, 0.20]). Moderated mediation analyses further indicated that self-compassion not only moderated the link between psychological maltreatment and adolescent internet harassment perpetration, with the effect being significant only for adolescents with low levels of self-compassion, but also moderated the indirect association between psychological maltreatment and internet harassment perpetration via deviant peer affiliation, with the association being much more potent for adolescents with low levels of self-compassion.

CONCLUSIONS

This study highlights the importance of considering multiple circumstantial and individual factors to understand the development of adolescents' externalizing problems.

Psychological maltreatment and aggression in preadolescence: Roles of temperamental effortful control and maladaptive cognitive emotion regulation strategies

BACKGROUND

Aggression is a type of externalization problem, which is common in preadolescence. The cause of preadolescents' aggression can be traced to their adverse family experiences, such as childhood psychological maltreatment. Therefore, exploring the cause and mechanism underlying aggressive behavior in preadolescents who have experienced psychological maltreatment is critical to preadolescents' healthy development.

OBJECTIVE

The purpose of this study is to explore the mediating effects of effortful control and maladaptive cognitive emotion regulation strategies in the relationship between psychological maltreatment and aggressive behavior among preadolescents.

PARTICIPANTS AND SETTING

A total sample of 940 preadolescents (50.53 % males and 49.47 % females, M_age = 9.75 years, SD = 1.17) were selected from two primary schools in Liaoning province, China. All preadolescents were in grades 3-5.

METHODS

The participants completed questionnaires regarding psychological maltreatment, effortful control, cognitive emotion regulation strategies, and aggression.

RESULTS

The results revealed that: (a) psychological maltreatment was positively associated with aggressive behavior; and (b) effortful control and maladaptive cognitive emotion regulation mediated the link between psychological maltreatment and aggression in a sequential pattern.

CONCLUSIONS

The present study provides further understanding of the relations between psychological maltreatment and aggression, and it also provides prevention and intervention suggestions concerning how to reduce the effect of psychological maltreatment on aggressive behavior among preadolescents.

Psychological maltreatment and depression symptoms among Chinese adolescents: A multiple mediation model

BACKGROUND

Adolescents are at risk of depression, and recent studies also found a high prevalence of depression among Chinese adolescents. Therefore, it is necessary to explore the risk and protective factors of depression among Chinese adolescents.

OBJECTIVE

This study examined the direct effect of psychological maltreatment on depression symptoms in adolescents and the mediating roles of emotion regulation and social support in their relationship.

METHOD

Data were collected from Chinese senior high school students (N = 687, 36.5 % males and 63.5 % females, M_age = 16.44 years, SD = 0.78) who completed the measures of psychological maltreatment, depression symptoms, perceived social support, and emotion regulation strategies, including cognitive reappraisal and expressive suppression.

RESULTS

The results indicated that: (a) psychological maltreatment was positively correlated with depression symptoms; (b) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms separately; (c) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms in a sequential pattern.

CONCLUSION

Psychological maltreatment was positively associated with depression symptoms in adolescents. Emotion regulation and perceived social support both significantly mediated the relationship between psychological maltreatment and depression symptoms.

Psychological maltreatment: An operationalized definition and path toward application

Psychological maltreatment (PM) of children has been difficult to define and even more challenging to operationalize consistently. This fact contributes to child PM being under-recognized and under-addressed by professionals that interact with children with mental health, behavioral, and developmental issues; and by systems such as child welfare, clinical and judicial systems. In this paper, we propose a definition of child PM that is both overarching and operationalized in a manner that will support consistent, fair, and unbiased application in applied contexts. The operationalized definition delineates the nature of caregiver acts that can amount to PM, as well as the level of experienced and potential impact of said act (s) that constitute PM. We detail our rationale for the definition. We discuss the need for field trials to establish the utility of the definition. We explain the necessary training and systems that would be required for the definition to be consistently and accurately applied. We believe that this definition has the potential to substantially enhance systems' abilities to recognize and address child PM, and thereby enhance children's and families' wellbeing.

Child psychological/emotional abuse and neglect: A definitional conceptual framework

Purpose

This study developed a definitional conceptual framework to clarify the nature of the definitions of psychological/emotional abuse and neglect (PEA) and to test the efficacy of this framework by applying it to three different types of definitions.

Methods

The definitional conceptual framework was developed from conceptual issues addressed by the previous literature. The framework was then applied to three types of definitions: (i) abstract definitions in the literature describing what PEA is, (ii) operational definitions in practice guidelines provided for professionals, and (iii) research studies on professionals' definitions of PEA.

Results

The framework was able to show that definitions of PEA were often not specific about their inherent definitional components or how the ways in which they were similar or different from other definitions. To the extent that the nature of the definitions was explicit, the framework was able to clearly distinguish the considerable variation in the nature of PEA definitions both within and across the three types of definitions.

Conclusions

Policy, practice, and research on PEA (and other forms of child abuse and neglect) are unlikely to progress without clarity about the definitions being used (in terms of their conceptual components) and the rationale for using the specific definitions chosen. The framework provided by the study is an effective tool for describing the components used in PEA definitions and thus distinguishing the differences between definitions. The framework should also be applicable for other types of child abuse and neglect.

Psychological maltreatment and substance use among college students: Psychological distress, belongingness, and social support

Substance use in college students is an important public health problem associated with substantial consequences. It is a critical step to examine risk and protective factors associated with substance use to develop prevention and intervention strategies for promoting college students' healthy development and well-being. The present cross-sectional study aimed to examine the mediating role of psychological distress in the relationship between childhood psychological maltreatment and substance use and the moderating effect of social support and belongingness in this association among college students. The sample of this cross-sectional study included 382 emerging adults. Participants included 56.8% female and 43.2% male, and they ranged in age between 20 and 29 years (M = 22.05, SD = 2.17). Findings from the study first confirmed that psychological maltreatment was a significant predictor of social support, belongingness, psychological distress, and substance use. Subsequent results revealed that psychological distress mediated the association between psychological maltreatment and college students' substance use. Also, belongingness and social support had a buffering effect on this association. The findings suggest that psychological maltreatment is a significant risk factor in developing substance use behavior and that belongingness and social support services can serve as protective resources. Based on these results, prevention and intervention services focusing on improving the feeling of belonging and social support could be conducive to the decreased substance use of psychologically maltreated emerging adults.

Childhood psychological maltreatment, optimism, aversion to happiness, and psychological adjustment among college students

Although there is increasing empirical evidence of the negative impact of childhood maltreatment on adult mental health and well-being, little is known about the underlying factors that mitigate the link between psychological maltreatment and psychological adjustment. A critical step is to examine these mechanisms to develop prevention and intervention strategies to decrease the adverse impacts of child maltreatment on psychological adjustment and well-being among young adults. The presented study aimed to explore the association between childhood psychological maltreatment and young adults' psychological adjustment through aversion to happiness, optimism, and pessimism. The sample of this study comprised 511 college students. Participants included 64% female, with ranging in age between 18 and 39 years (M = 21.36, SD = 2.55). Findings from the study indicated that aversion to happiness was a significant mediator in the association of psychological maltreatment with pessimism, optimism, and psychological adjustment. Further, optimism and pessimism mitigated the link of both aversion to happiness and psychological maltreatment with psychological adjustment. The findings indicate that optimism-based strategies are key to fostering psychological adjustment and could help to reduce the negative impacts of aversion to happiness and child maltreatment on young adults' adjustment and wellbeing.

Psychological maltreatment, coping flexibility, and death obsession during the COVID-19 pandemic: A multi-mediation analysis

Recent psychological studies have reported that child maltreatment is a common issue during the COVID-19 pandemic, with negative factor leading to greater risk of occurrence of mental health problems. However, the relationship between psychological maltreatment and psychological factors is complex. Understanding the factors, which may help to provide interventions, is a critical step for mental health providers. This study aims to examine the relationships between psychological maltreatment, coping flexibility, coronavirus anxiety, coronavirus stress, and death distress. We collected data from 394 Turkish young adults (76% male: average age 21.36 ± 2.57 years) during the outbreak of COVID-19. The results of multi-mediation analysis showed that psychological maltreatment was positively related to the death obsession. More importantly, this relationship could be explained through the mediated effects of coping flexibility, coronavirus anxiety, and coronavirus stress. This study highlights the non-negligible role of psychological maltreatment in affecting death obsession and the role of coping flexibility in explaining the psychological influence of maltreatment.

Psychological Maltreatment and Loneliness in Adolescents: Social Ostracism and Affective Experiences

Psychological maltreatment is an important public health concern that has been linked with a variety of negative psychosocial consequences and adjustment problems in childhood to adulthood. The purpose of the current study sought to explore the direct and indirect associations between psychological maltreatment, social ostracism, affective experiences, and loneliness among high school Turkish adolescents. Participants were comprised of 791 adolescents attending three public high schools in Turkey. Students were mostly male with a mean age of 16.35 (SD = 1.09) years. Findings from the analyses indicated that social ostracism mediated the relationship between psychological maltreatment and both positive and negative affective experiences. Social ostracism and affective experiences mediated the effect of psychological maltreatment on adolescent feelings of loneliness. Results of the present study suggest that social ostracism and affective experiences are important mechanisms that may help to understand the impacts of psychological maltreatment on adolescent feelings of loneliness.

Psychological Maltreatment and Spiritual Wellbeing in Turkish College Young Adults: Exploring the Mediating Effect of College Belonging and Social Support

The purpose of this study is to examine whether college belonging and social support mediate the association between childhood psychological maltreatment and spiritual wellbeing among college young adults. The sample of the present study included 493 college young adults (33% male), ranging in age between 18 and 39 years (M = 21.35, SD = 2.56). The results showed that psychological maltreatment not only had a direct predictive effect on spiritual wellbeing but also an indirect predictive effect on spiritual wellbeing through college belonging and social support. These findings present important implications for research and practices by providing an in-depth understanding of the association between psychological maltreatment and spiritual wellbeing among Turkish college students.

Psychological maltreatment: Definition and reporting barriers among American professionals in the field of child abuse

BACKGROUND

Despite reliable definitions and evidence of harm to children, psychological maltreatment (PM) is significantly less reported to Child Protective Services than physical or sexual abuse in the United States (U.S. Department of Health and Human Services, 2016).

OBJECTIVE

The goal of this study was to identify factors influencing identification and intent to report psychological maltreatment.

PARTICIPANTS AND SETTING

The sample was comprised of membership of the American Professional Society on the Abuse of Children (APSAC), a multi-disciplinary group of professionals in the field of child maltreatment.

METHODS

An anonymous online survey was administered with a 39 % (N = 538) response rate.

RESULTS

Only 4 of the 18 items, preselected by experts as representing all PM subtypes in the APSAC- endorsed definition (Hart, Brassard, Baker, & Chiel, 2019), were identified by most respondents as definitely PM. Most respondents believed that PM was associated with harmful outcomes "sometimes" or "mostly." Respondents revealed an intent to report to CPS only 4 of the 18 PM behaviors. Identification of a behavior as PM and as harmful predicted intent to report, explaining between 8-11 percent of the variance.

CONCLUSION

Professionals in the field of maltreatment need more training on identification and reporting of PM. A model definition of PM should be developed in order to increase reliability of identification of psychological maltreatment.

Psychological maltreatment: An international challenge to children's safety and well being

BACKGROUND

Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment.

OBJECTIVES

This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment.

PARTICIPANTS AND SETTINGS

NA.

METHOD

Literature review, intervention description of fabricated or induced illness, and expert opinion.

RESULTS

PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence.

CONCLUSIONS

PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.

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

BACKGROUND

Psychological maltreatment (PM) is equivalent in harm to other forms of child maltreatment and yet it is not included in all US State child abuse statutes and past research using the National Child Abuse and Neglect Data System (NCANDS, 1998, 2007, 2008) identified 300-480-fold differences in substantiated cases across US States. This variation is inconsistent with the significance of the problem and the availability of reliable operational definitions.

PARTICIPANTS AND SETTING

US State statutes were coded and compared with reported rates of four different forms of child maltreatment in the 2014 and 1998 NCANDS data sets.

METHODS

Data were extracted from NCCANDS and State statutes were coded independently by the authors (kappa = .96).

RESULTS

For 2014, the difference in reported rates of PM between the State with the lowest rate and the State with the highest rate was 523-fold which was much higher than for physical (30-fold) and sexual abuse (20-fold) but not neglect (524-fold). Statutes still use the term "mental injury" from the original Child Abuse Prevention and Treatment Act (Child Abuse Prevention & Treatment Act, 1974) and two thirds did not define it. Reported rates of PM in NCANDS were not correlated with whether PM was defined in the statute but when a harm standard was present, reported rates were statistically lower. Almost 70% of statutes mentioned a current trend (e.g., sexual/human trafficking) demonstrating a willingness by States to amend statutes.

CONCLUSIONS

A common, reliable definition of PM (and other forms of maltreatment) in CAPTA, NCANDS, and US State statutes is necessary for the US to have a surveillance system that allows for the assessment of the effects of policies on reported rates of all forms of maltreatment.

Psychological maltreatment and its relationship with self-esteem and psychological stress among adolescents in Tanzania: a community based, cross-sectional study

BACKGROUND

Despite the growing recognition of childhood psychological maltreatment as a public health and human rights concern, it remains rampant in developing countries including Tanzania and has a negative impact on the victim's self-esteem during adolescence. There is a lack of published studies in Tanzania that examine the relationship between childhood psychological maltreatment and self-esteem during adolescence. This study describes the relationship between childhood psychological maltreatment and self-esteem and psychological distress among adolescents in Tanzania.

METHODS

This was a cross-sectional, community-based study of secondary school students that was conducted in randomly selected secondary schools in five regions in Tanzania between April 2016 and February 2017. A multistage cluster sampling technique was employed to obtain the required number of study participants. The Rosenberg self-esteem scale, Kessler psychological distress scale (K10) and Childhood Trauma Questionnaire (CTQ) questionnaires were used to measure the variables in the study. Pearson correlation analysis was used to analyse the correlation between variables (Psychological maltreatment and self-esteem and psychological distress).

RESULTS

A sample of 1000 secondary school students was recruited for this study, of which 553 (55.3%) were males and 447 (44.7%) were females. The mean age at presentation was 16.45 ± 6.42 years. Out of the 1000 participants, 766 (76.6%) experienced psychological maltreatment. Emotional abuse was reported in 24.7% of the participants, while emotional neglect was reported in 51.9% of cases. There was a strong positive correlation between psychological maltreatment and self-esteem (r = 0.55, p < 0.001), whereas the correlation between psychological maltreatment and psychological distress was significantly but weak (r = - 0.086, p = 0.007). The results also show a strong positive correlation between psychological distress and self-esteem (r = 0.16, p < 0.001).

CONCLUSION

Finding from this study demonstrated that childhood psychological maltreatment is prevalent in our setting and is associated with psychological distress and low self-esteem during adolescence. Urgent intervention targeting at reducing occurrence of childhood psychological maltreatment is necessary to reduce the incidence of low self-esteem and psychological distress among Tanzanian adolescents.

Maltreatment, attachment, and substance use in adolescence: Direct and indirect pathways

Past research indicates that maltreatment increases risk for adolescent substance use; however, research is limited on how attachment between adolescents and their parents influences this relationship. The present study examined psychological and physical maltreatment, attachment avoidance and attachment anxiety, and substance use (i.e., cigarettes, alcohol, marijuana, and 'other drugs') among adolescents between the ages of 12 and 18 (N = 737; 59.3% female; Mage = 14.69, SD = 1.46). Psychological maltreatment was significantly related to cigarettes, alcohol, and marijuana use, and physical maltreatment was related to cigarette and marijuana use. Exposure to both forms of maltreatment was also associated with increased attachment avoidance and attachment anxiety, but only attachment avoidance predicted substance use. Indirect paths indicated that attachment avoidance mediated the relationship between psychological maltreatment and cigarette (B = 0.14, CI [0.001, 0.314]) and alcohol use (B = 0.09, CI [0.011, 0.188]). Attachment avoidance also mediated the relationship between physical maltreatment and cigarette (B = 0.15, CI [0.031, 0.311]) and alcohol use (B = 0.09, CI [0.027, 0.185]). No significant mediated effects for attachment anxiety emerged. Attachment avoidance may increase risk for substance use because youth have a lower rate of disclosing their activities to their parents, and do not seek or accept their guidance. Instead, they may turn to peers who also engage in substance use as a source of support. Interventions designed to increase parent-teen attachment security and decrease attachment avoidance may be particularly useful in reducing risk for substance use.

Maltreatment type, exposure characteristics, and mental health outcomes among clinic referred trauma-exposed youth

Building upon prior research documenting differential effects of psychological maltreatment, physical, and sexual abuse on youth mental health outcomes (Spinazzola et al., 2014), the present study sought to clarify the relative predictive contributions of type of maltreatment compared to salient exposure characteristics. The sample included 5058 clinic-referred youth from the Core Dataset (CDS) of the National Child Traumatic Stress Network (NCTSN) with lifetime histories of exposure to one or more of three specific types of maltreatment: psychological maltreatment (PM), physical abuse (PA), and sexual abuse (SA). First, we examined variations in salient trauma characteristics (age of onset, duration of exposure, number of co-occurring trauma types, and perpetrator type and number) by maltreatment group. Second, we examined whether type of maltreatment remained associated with mental health measures after adjusting for demographic variables and trauma characteristics. Profiles for youth with PM were more severe than youth who experienced either PA or SA only. Co-occurring PM and PA was associated with the most severe trauma exposure profile and with severity of PTSD symptoms, even after adjusting for demographic and trauma characteristics. Youth exposed to SA only had a distinct trauma profile and greater PTSD symptom severity after adjusting for demographic and trauma characteristic variables. Study findings hold important implications for trauma screening, assessment, and intervention, as well as for traumatic stress research methods that extend beyond abuse-specific or cumulative-risk approaches.

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

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

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.

Quality of life in maltreated children and adult survivors of child maltreatment: a systematic review

PURPOSE

To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect.

METHODS

The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers.

RESULTS

The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related.

CONCLUSION

Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.

Intergenerational effects of war trauma among Palestinian families mediated via psychological maltreatment

We tested the hypothesis that intergenerational effects of parents' war trauma on offspring's attachment and mental health are mediated by psychological maltreatment. Two hundred and forty children and their parents were sampled from a war-prone area, Gaza, Palestine. The parents reported the number and type of traumatic experiences of war they had had during their lifetime before the child's birth and during a current war when the child was 10-12 years old. The children reported their war traumas, experiences of psychological maltreatment, attachment security, and symptoms of posttraumatic stress (PTSS), depression, and aggression. The direct and indirect intergenerational effects of war trauma were tested in structural equation models. The hypotheses were confirmed for father's past war exposure, and disconfirmed for mother's war exposure. The father's past war trauma had a negative association with attachment security and positive association with the child's mental health problems mediated by increased psychological maltreatment. In contrast, the mother's past war trauma had a negative association with the child's depression via decreased psychological maltreatment. The mother's current war trauma had a negative association with the child's depression and aggression via decreased psychological maltreatment. Among fathers, past war exposure should be considered as a risk factor for psychological maltreatment of children and the associated attachment insecurity and mental health problems. Among mothers, war exposure as such could be given less clinical attention than PTSS in the prevention of psychological maltreatment of children.