Childhood psychological maltreatment subtypes and adolescent depressive symptoms

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Contents lists available at ScienceDirect

Child Abuse & Neglect

Research article

Childhood psychological maltreatment subtypes and adolescent depressive symptoms Elise Paul a,b,∗ , John Eckenrode a,b a b

Department of Human Development, G87 Martha Van Rensselaer Hall, Cornell University, Ithaca, NY 14853, USA Bronfenbrenner Center for Translational Research, Beebe Hall, Cornell University, Ithaca, NY 14853, USA

a r t i c l e

i n f o

Article history: Received 19 February 2015 Received in revised form 18 May 2015 Accepted 27 May 2015 Available online xxx Keywords: Childhood psychological maltreatment Timing of maltreatment Adolescent depression

a b s t r a c t The aim of this study was to understand how subtypes and the timing of psychological maltreatment contribute to adolescent depressive symptoms at age 14. The sample included 638 youth from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). At age 12, youth reported experiences of psychological maltreatment (degradation, isolating, and terrorizing), physical abuse (endangerment and physical injury), and sexual abuse that occurred before and during elementary school/last year. Multivariable regression models were conducted separately for females and males at each of the two time periods and accounted for demographics, primary caregiver depressive symptoms, other maltreatment subtypes, and youth-reported age 12 depressive symptoms. For girls, caregiver degradation was the only maltreatment subtype that contributed unique variance to depressive symptoms. Degradation before elementary school and chronic degradation had a stronger impact on depression symptoms. Only caregiver isolating behaviors during elementary school/last year and chronic isolation predicted depressive symptoms in boys. These results suggest that childhood psychological maltreatment is multi-dimensional and is implicated in the etiology of adolescent depressive symptoms. Future prevention efforts should consider parental psychological maltreatment in reducing risk for adolescent depression. © 2015 Elsevier Ltd. All rights reserved.

Introduction Maltreatment in childhood has been linked with a variety of mental health problems in adolescence and adulthood (Cicchetti & Toth, 1995; Gilbert et al., 2009; Green et al., 2010), particularly depression (e.g. Nelson et al., 2002; Widom, DuMont, & Czaja, 2007). Despite the multidimensional nature of childhood maltreatment (Barnett, Manly, & Cicchetti, 1993), much of this literature has operationalized maltreatment as either present or absent. Studies that have considered maltreatment types have typically focused on sexual and physical abuse, while psychological maltreatment has received less attention (Feiring & Zielinski, 2011). Child protective service investigations and substantiations of psychological maltreatment occurring alone are less common than those of physical and sexual abuse and neglect (Schneider, Ross, Graham, & Zielinski, 2005; Trickett, Mennen, Kim, & Sang, 2009), possibly owing to a perception that this form of maltreatment is not as deleterious as other forms of abuse and neglect (Egeland, 2009). Nonetheless, numerous studies suggest it is a predictor of later psychosocial difficulties (e.g. Berzenski & Yates, 2010; McGee, Wolfe, & Wilson, 1997; Shaffer, Yates, & Egeland, 2009). The current

∗ Corresponding author. http://dx.doi.org/10.1016/j.chiabu.2015.05.018 0145-2134/© 2015 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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study contributes to the extant literature by disaggregating psychological maltreatment into three subtypes and examining how associations with depression vary by sex and with timing of maltreatment. Definitions of Psychological Maltreatment Childhood psychological maltreatment has been variously defined, but most research definitions include acts of omission (neglect) and commission (abuse) that convey to the child that they are unwanted or worthless (Hart et al., 2011). The American Professional Society on the Abuse of Children (APSAC 2011) defines six subtypes of psychological maltreatment (a) spurning (hostile rejection/degradation), rejection, and degradation; (b) exploiting or corrupting; (c) terrorizing; (d) ignoring or denying emotional responsiveness; (e) isolating; and (f) mental, health, and educational neglect. The National Incidence Study (NIS) is a periodic, congressionally mandated assessment of national child maltreatment rates that uses a sentinel reporting system (Sedlak et al., 2010). The fourth NIS (NIS-4), conducted in 2005 and 2006, included 8 codes for emotional abuse and 11 for emotional neglect that overlap closely with the APSAC definitions. For example, the NIS-4 emotional abuse codes of terrorizing the child, threatening various forms of maltreatment, tying or confining in an enclosed space, and verbal abuse parallel APSAC’s terrorizing, isolating, and spurning subtypes. The NIS-4 emotional neglect codes specify inadequate nurturance and affection and allowing inappropriate or unlawful behavior, which as similar to APSAC subtypes (b) and (d) above. Investigations of psychological maltreatment also use the terms emotional maltreatment, emotional abuse, or emotional neglect. Despite this multidimensional nature, most studies of childhood psychological maltreatment treat the construct unitarily (Allen, 2008). Depression and Psychological Maltreatment Among other psychosocial difficulties, research has found depression to be linked with psychological maltreatment. Depression is characterized by feelings of worthlessness and guilt, hopelessness, and a loss of interest in activities. Risk for the first onset of depression is highest in early adolescence (Avenevoli, Swendsen, He, Burstein, & Merikangas, 2015; Kessler et al., 2005), and adolescent depression confers risk for depression in adulthood (Lewinsohn, Rohde, Klein, & Seeley, 1999). Depression is also the most common psychiatric disorder found in death by suicide (Bridge, Goldstein, & Brent, 2006) and is strongly associated with suicidal ideation and behaviors (Nock et al., 2013). Given the characteristics of depression, it is not surprising that psychological maltreatment, or caregiver–child relationships that communicate to the child that they are flawed, worthless, unloved, or endangered, is associated with an increased vulnerability for depression. Several studies and one review have concluded that childhood psychological maltreatment is more consistently linked to depression than physical or sexual abuse (e.g. Alloy, Abramson, Smith, Gibb, & Neeren, 2006). In cross-sectional studies of youth and adults that have accounted for other forms of abuse and neglect, psychological maltreatment in childhood has been found to be related to chronic or recurrent major depressive disorder (Bifulco, Moran, Baines, Bunn, & Stanford, 2002), lifetime episodes of depression (Chapman et al., 2004), depressive symptoms (Crow, Cross, Powers, & Bradley, 2014; Spertus, Yehuda, Wong, Halligan, & Seremetis, 2003; Teicher, Samson, Polcari, & McGreenery, 2006), low self-esteem (Solomon & Serres, 1999), and internalizing problems (McGee et al., 1997). Longitudinal studies that have used youth-reports of maltreatment confirm these associations (Liu, Alloy, Abramson, Iacoviello, & Whitehouse, 2009; Stuewig & McCloskey, 2005). Children who have experienced psychological maltreatment as children may develop low self-esteem (Briere & Runtz, 1990; Kim & Cicchetti, 2006) and maladaptive cognitive styles (Calvete, 2014; Crawford & Wright, 2007; Gibb & Abela, 2008). Using data from the National Comorbidity Survey, SachsEricsson, Verona, Joiner, and Preacher (2006) found that self-criticism mediated the relationship between parental verbal abuse and depression/anxiety symptoms. The results from the aforementioned studies suggest that when childhood psychological maltreatment is considered, it is related to an increased likelihood of depressive symptomatology in adolescence and adulthood. Dimensions of Psychological Maltreatment Though most psychological maltreatment research has treated psychological maltreatment unitarily, evidence from several studies suggests that particular dimensions of psychological maltreatment may differentially impact psychosocial development. Using data from the Minnesota Longitudinal Study of Parents and Children, Shaffer et al. (2009) found differences in developmental processes related to emotional abuse and emotional neglect. Social withdrawal mediated the relation between emotional abuse in early childhood, but not emotional neglect, and adolescent socioemotional competence. In a longitudinal study designed to assess the impact of marital violence on children, parents who were physically harsh to their children were also more rejecting of their children in adolescence. This rejection in adolescence was related to adolescents’ proneness to experiencing shame, which in turn was linked to depression (Stuewig & McCloskey, 2005). Taussig and Culhane (2010) examined prospective relationships between an overall measure and four subtypes of emotional maltreatment obtained from official records. One of the subtypes, parental verbal aggression, predicted lower self-esteem in preadolescent males, but not females (ages 9–11). Using the same data as the present study, Schneider et al. (2005) identified four categories of emotional maltreatment from Child Protective Services (CPS) reports; threats to psychological safety/security, acceptance and self-esteem, threats Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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to age-appropriate autonomy, and physical restriction. Two of these subtypes, threats to psychological security and threats to the child’s sense of autonomy, predicted anger and post-traumatic stress symptoms at age 8, respectively. A more recent study using the LONGSCAN data examined relationships between the four subtypes of emotional maltreatment identified by Schneider and colleagues (2005) and psychosocial outcomes at age 18 (English, Thompson, White, & Wilson, 2015), again using CPS reports as the source of the maltreatment data. Threats to the child’s psychological safety/security (e.g. abandonment, exposure to extreme domestic violence, and coercive discipline practices) predicted anger/irritability, anxious arousal, depressive symptoms, and suicidal ideation, while acceptance/self-esteem (e.g. ridiculing, excessive hostility) was associated with anxious arousal. In addition to adolescent outcomes, research has also demonstrated the importance of childhood psychological maltreatment in early adulthood. In a study of college undergraduates, feelings of shame and vulnerability to harm mediated the relationship between emotional neglect, but not emotional abuse, and dissociative symptoms (Wright, Crawford, & Del Castillo, 2009). Allen (2008) reported cross-sectional relationships between the childhood psychological maltreatment subtype “ignoring” with depression symptoms, “terrorizing” with anxiety and somatic complaints, and “degradation” with borderline personality disorder features. These studies suggest that examining specific dimensions of psychological maltreatment are important to understanding its role in predicting maladjustment. The age at which childhood maltreatment occurs may also be important for understanding internalizing outcomes like depression (English et al., 2005; Kaplow & Widom, 2007; Manly, Kim, Rogosch, & Cicchetti, 2001). Several studies have operationalized the timing of maltreatment as age of first onset, but most have not included a measure of psychological maltreatment. For example, on study showed that early first incidence (ages 0–5) of any maltreatment (physical abuse, sexual abuse, or neglect) was more strongly associated than later onset (ages 6–11) with depressive symptoms in adulthood (Kaplow & Widom, 2007). Using the same data, another study showed that harsh physical punishment that started after age 5 related to higher externalizing and internalizing symptoms in 8th grade compared to maltreatment starting before age 5 (Keiley, Howe, Dodge, Bates, & Pettit, 2001). Using data from the National Longitudinal Study of Adolescent Health, Dunn, McLaughlin, Slopen, Rosand, and Smoller (2013) examined age at first exposure to physical abuse and sexual abuse. Similar sized odds ratios (ORs 1.47–1.99) were found for physical and sexual abuse occurring in early childhood (ages 0–5), middle childhood (ages 6–10), and adolescence (ages 11–17) and depression, but the strongest associations of physical abuse with depression were found for early childhood abuse (OR = 1.99). Sexual abuse that occurred in adolescence (OR = 1.96) showed the strongest relation to depression, with early childhood abuse having a similar risk (OR = 1.90). Most studies of childhood psychological maltreatment have not examined age at which the maltreatment occurred. The Minnesota Longitudinal Study of Parents and Children is one exception. Emotional abuse observed in the laboratory during toddlerhood predicted greater levels of anger, problems with impulse control, and hyperactivity during preschool (Egeland, Sroufe, & Erickson, 1983). Emotional neglect, which was also observed in the laboratory and characterized by emotional unresponsiveness to infant bids for attention contributed to low self-esteem, noncompliance, and excessive dependence on teachers in preschool. Using the same sample, early emotional abuse was associated with social withdrawal in middle childhood, which in turn was related to early adolescent self-esteem and peer competence in boys (Shaffer et al., 2009). Using a subsample of 8 year olds from one of the five LONGSCAN sites, English et al. (2005) reported stronger associations of physical abuse and emotional maltreatment allegations from CPS reports with reductions in daily living skills if the age at first CPS report was before the child’s first birthday. In 14 year olds with CPS reports from all five LONGSCAN sites, earlier age at first CPS report for any maltreatment type was also linked with reduced expectations of academic/employment success (Thompson et al., 2012). Others have found relations between verbal abuse in childhood and a range of problems in adolescence and adulthood, including personality disorders (Johnson et al., 2001), dissociation, and anger/hostility (Teicher et al., 2006).

Study Aims This study sought to make several contributions to our understanding of three of the five childhood psychological maltreatment subtypes outlined by APSAC (2011) and similar to NIS-4 definitions (Sedlak et al., 2010). First, a prospective longitudinal design will be used, providing a more rigorous examination of the relationship between psychological maltreatment subtypes and adolescent depressive symptoms. Based on prior work that has found psychological maltreatment to be a stronger predictor of depression than other maltreatment types, we expect similar findings. Because of the similarity of caregiver degradation to symptoms of depression, we anticipate that this form of psychological maltreatment will emerge as a significant predictor of depression symptoms. Second, we examine how the time period (before elementary school and during elementary school) in which maltreatment subtypes occurred influences adolescent depressive symptoms. Prior empirical findings regarding the timing of maltreatment have been mixed, however developmental theory (Cicchetti & Toth, 1995) suggests that maltreatment occurring earlier will be more harmful. Third, analyses of the impact of different maltreatment subtypes will be stratified by youth sex. Prior work regarding sex differences in the impact of psychological maltreatment has been mixed. We use youth reports of maltreatment, rather than official records, for two reasons. Prior work using data from two of the five LONGSCAN sites showed that youth reports relate more strongly than maltreatment measures based on CPS reports to psychosocial outcomes (Everson et al., 2008). Further, compared to sexual and physical abuse, youth and CPS reports of Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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psychological maltreatment had the lowest rate of agreement, with new reports of psychological maltreatment responsible for most of the discrepancy (Everson et al., 2008). Methods Participants The sample for this study consisted of 638 youth from all five sites of The Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). LONGSCAN is a consortium of five research studies in the Midwest, Southwest, Northwest, South, and East United States. Data collection began in 1991 with over 1,300 children and their primary caregivers. Recruitment strategies varied by site and used common data collection methods and procedures in the form of caregiver and child interviews (Runyan et al., 1998). Youth were included in the present analysis if they had complete data on all study variables. There were no significant differences in primary caregiver education, gender, household income, any of the maltreatment measures, or depressive symptoms between the removed cases and the analytic sample. Youth who were Hispanic or mixed race/multi-ethnic, however, were more likely to have missing data, 2 (3, N = 1353) = 14.20, p = 0.003. Outcome Measure Youth reports of depressive symptoms associated with DSM-IV diagnostic criteria were assessed at age 14 using the National Institute of Mental Health Computerized Diagnostic Interview Schedule for Children IV (NIMH DISC-IV; Shaffer et al., 1996). The depressive symptoms variable was kept in its continuous form for all analyses (22 items, ˛ = .83). Diagnosis for major depressive disorder was not examined due to the low number of youth who met criteria (n = 15). Paired samples t-tests showed significant increases in depressive symptoms between years 12 and 14 for males t(318) = 4.10, p < .001 and females t(318) = 3.98, p < .001. Child Maltreatment Measures At the age 12 interview, youth were administered project-developed measures of psychological maltreatment, physical abuse, and sexual abuse (Knight, Smith, Martin, Lewis, & the LONGSCAN Investigators, 2008). The psychological maltreatment and physical abuse scales were based on definitions developed by Barnett et al. (1993) and the American Professional Society on the Abuse of Children (Hart, Brassard, & Karlson, 1996). The sexual abuse measure reflected definitions provided by Barnett and colleagues (1996). A pre-test was conducted with a small number (n = 24) of outpatient adolescents to ensure comprehension of question wording (Knight et al., 2000). Agreement between youth self-reports and maltreatment codes abstracted from CPS reports was poor, indicating low convergent validity. However, much of this discrepancy was due to underreporting of maltreatment in CPS reports, especially emotional maltreatment (Everson et al., 2008). Other validity information on these project-developed measures has not been published. The Audio Computer Assisted Self-Administered Interview (A-CASI) methodology provided a visual and audio demonstration of each item. Each instrument began with yes/no stem items inquiring about specific maltreatment experiences over the lifetime. When stem items were endorsed, follow-up questions were asked about the frequency (e.g. never, sometimes, often) of the maltreatment (a) before elementary school, (b) from the start of elementary school until the time of the interview, and (c) in the last year. To avoid confounding frequency with the occurrence of different maltreatment subtypes, follow-up responses were coded 0/1 and summed so that scales represent the number of maltreatment subtypes experienced. Measures reflecting maltreatment before elementary school and since the start of elementary school to the present time period were used in these analyses. Maltreatment subtype scores from each time period that correspond to APSAC (2011) definitions of emotional maltreatment were derived as outlined below. The psychological maltreatment scale inquired about the experience of 18 behaviors directed at the youth by the primary caregiver and was divided into 3 subscales for the current study. The degradation subscale (5 items) assessed parenting behaviors such as calling names and teasing, blaming for problems, and embarrassing the youth by putting them down in front of others. Unusual punishment in the form of tying up or locking the youth in a closet and trying to stop the youth from making friends outside the family were included in the isolation subscale (2 items). Finally, 9 items such as threats to kick the youth out of the home, permanent abandonment, and threats to kill or hurt the youth made up the terrorizing scale. Too few youth endorsed the item reflecting corrupting/exploiting (parents made you steal something, have sex, or sell drugs for money) for it to be used. The physical abuse instrument (15 items) asked about experiences by any adult. Two subscales, endangerment and injury, were derived. Endangerment items (6) focused on potentially injurious physical abuse such as being bitten, thrown, hit, kicked/punched, and shot at with a gun but missed. The injury subscale (9 items) consisted of items such as bleeding or needing stitches because of a cut, being made unconscious, and given a bruise or black eye. The sexual abuse measure (11 items) inquired about experiences with any adult or older child. Examples include non-contact sexual abuse, fondling, oral/genital sexual abuse, and penetration. Internal reliabilities for both time periods of psychological maltreatment (Cronbach’s alphas .78–.81), physical abuse (alphas .64–.67) and sexual abuse (alphas .79–.84) subscales were acceptable. Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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Consistent with prior research (Macfie, Cicchetti, & Toth, 2001), maltreatment chronicity was operationalized as the number of time periods during which youth endorsed one or more item for each maltreatment subscale. The scale ranged from 0 to 2. Control Variables Multivariable analyses controlled for seven potentially confounding variables. Youth race/ethnicity (White, Black, Hispanic, and mixed race/other) and gender (male, female) were collected from the primary caregiver at the age 4 interview. Caregiver education in years (0–20) and household income per year (coded 1–12 in $5,000 increments) were obtained from the primary caregiver at the age 12 interview. Data from the age 8 interview was used to fill in missing values for caregiver education (n = 5) and household income (n = 5) at age 12. LONGSCAN study site was controlled for as a fixed effect to account for differing recruitment strategies. Primary caregiver depressive symptoms were assessed at the age 12 interview using The Center for Epidemiologic Studies Depression Scale (CES-D) (Radloff, 1977). Reliability and construct validity of the CES-D in measuring depressive symptoms have been demonstrated (Radloff, 1977). Responses to 20 items were summed so that higher scores indicate more depressive symptoms (˛ = .89, range 0–53). Youth depressive symptoms at age 12 were assessed using the Trauma Symptom Checklist for Children (TSC-C; Briere, 1996). The TSC-C is a standardized 54-item checklist for children and adolescents ages 8–16 that has been shown to have good internal reliability (Briere, 1996) and good concurrent validity (Lanktree & Briere, 1990, 1995). Youth report the frequency with which they experienced each symptom on a scale ranging from 0 (never) to 3 (almost all the time). Internal reliability for the 10 depression items was good (˛ = .82). Statistical Analysis Data analyses were conducted using Stata version 13.0 (StataCorp, 2013). Sex differences in depressive symptoms were explored using a one-way analysis of variance (ANOVA). Pearson correlations were used to test relationships between maltreatment measures and depressive symptoms. We provide a more conservative set of analyses than those done by English et al. (2015) by controlling for Type I error, utilizing zero-inflated Poisson regressions that are more appropriate for the distribution of the outcome variable, and accounting for age 12 depressive symptoms to examine change in this outcome two years later. We also use youth self-reports rather than CPS reports of maltreatment, since psychological maltreatment is especially likely to be underreported to CPS (Everson et al., 2008). We examine age 14 depressive symptoms because of the substantial increase in this outcome during early adolescence (Avenevoli et al., 2015; Kessler et al., 2005) and because of the significant increase in depressive symptoms in this sample between years 12 and 14. The depressive symptoms variable was zero-inflated, positively skewed, and over-dispersed. We used the “countfit” procedure in Stata (Long & Freese, 2006) to compare the relative fit of Poisson, zero-inflated Poisson (ZIP), negative binomial, and zero-inflated negative binomial regression models. Among the four model types, the residuals for the ZIP regressions were the smallest and therefore were preferred over the other three models. ZIP models have two parts and therefore produce two sets of coefficients; a logistic component modeling the zeroes in the outcome, and a count component that follows the Poisson distribution (Lambert, 1992). Only results from count components will be presented here. Multivariable models were stratified by sex because of significant interactions of sex and maltreatment measures in preliminary analyses. We tested six multivariable ZIP regression models (three for females, three for males) that controlled for other maltreatment types, demographics, and age 12 depressive symptoms. No significant non-linearity was found between maltreatment measures and the outcome variable. To examine potential problems with collinearity, variance inflation factors were obtained by running each of the six multivariable models as ordinary least squares regression. Since a Bonferroni correction may be overly conservative, we modified the correction. Instead of adjusting for all analyses, we used a Bonferroni-corrected p-value for each set of analyses (Pearson correlations and multivariable regressions), yielding adjusted p-values of 0.001 (0.05/36). All tests were two-sided. Results Descriptive Statistics and Correlational Analyses Half of the sample (50.0%) was female, and the majority of the participants were Black/African American (56.4%). The median household income was $25,000–$29,999 per year, which is less than the median household income in the United States of $42,148 at the time of data collection (U.S. Census Bureau, 2001). The average years of caregiver education was 12.26 years (SD = 2.24), and 23.4% of caregivers had not completed high school or equivalent. At the time of the survey, 19.6% of U.S. adults did not have a high school diploma (Bauman & Graf, 2003). Primary caregivers reported an average 11.15 (SD = 9.89) depression symptoms on the CES-D, which is well below the cut-off of 16 that is commonly used to indicate high depression symptoms (Radloff, 1977). Girls (M = 4.71, SD = 4.25) reported significantly more depressive symptoms than did boys (M = 3.20, SD = 3.38), F(1, 636) = 24.69, p < 0.001. Descriptive statistics for maltreatment measures and Pearson correlations with age 14 depressive symptoms by youth gender are presented in Table 1. Of the maltreatment measures, fifteen showed significant relationships with depressive Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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Table 1 Descriptive statistics for age 12 child maltreatment measures and Pearson correlations with age 14 depressive symptoms by youth sex. Variable

Females (n = 319) M (SD)

Depressive symptoms 4.71 (4.25) < Elementary school 0.38 (0.89) Degradation 0.21 (0.15) Isolating 0.20 (0.66) Terrorizing Endangerment 0.11 (0.41) Physical injury 0.10 (0.34) Sexual abuse 0.21 (0.96) Elementary school/last year 0.61 (1.09) Degradation 0.03 (0.17) Isolating 0.29 (0.75) Terrorizing 0.13 (0.45) Endangerment 0.14 (0.42) Physical injury 0.38 (1.29) Sexual abuse Maltreatment chronicity 0.52 (0.78) Degradation 0.05 (0.29) Isolating 0.29 (0.61) Terrorizing 0.17 (0.50) Endangerment 0.20 (0.54) Physical injury Sexual abuse 0.19 (0.51)

Range

Males (n = 319)

Depressive symptoms (r)

M (SD)

Range

Depressive symptoms (r)

0–18

–

3.20 (3.38)

0–21

–

0–5 0–1 0–5 0–4 0–2 0–8

0.29 0.08 0.15 0.06 0.08 0.06

0.29 (0.74) 0.03 (0.20) 0.17 (0.67) 0.07 (0.36) 0.07 (0.36) 0.12 (0.53)

0–4 0–2 0–7 0–3 0–4 0–4

0.20 0.26 0.26 0.10 0.09 0.14

0–5 0–1 0–5 0–3 0–2 0–9

0.30 0.16 0.22 0.13 0.22 0.13

0.47 (0.93) 0.03 (0.20) 0.30 (0.84) 0.15 (0.48) 0.13 (0.49) 0.20 (0.70)

0–5 0–2 0–7 0–4 0–4 0–4

0.19 0.25 0.22 0.05 0.12 0.07

0–2 0–2 0–2 0–2 0–2 0–2

0.34 0.13 0.23 0.15 0.20 0.13

0.45 (0.74) 0.06 (0.27) 0.28 (0.62) 0.15 (0.45) 0.12 (0.40) 0.17 (0.50)

0–2 0–2 0–2 0–2 0–2 0–2

0.22 0.24 0.18 0.05 0.02 0.15

Note: Bold indicates statistical significance with Bonferroni-corrected p-value (0.05/36 = 0.001).

symptoms. For girls, caregiver degradation that occurred during each of the time periods showed similar relationships to depressive symptoms, followed by terrorizing and physical injury during elementary school/last year. Regarding chronicity, experiencing caregiver, terrorizing, and physical injury during more time periods corresponded with more depressive symptoms in girls. For boys, isolating and terrorizing during each time period showed the largest correlations with depression symptoms, followed by degradation at each time epoch. Chronicity of caregiver isolating and degradation were significantly related to depression symptoms in males. Multivariable Analyses We used zero-inflated Poisson (ZIP) regression models to evaluate multivariable associations between maltreatment subtypes from each time period and depressive symptoms at age 14 (Table 2). Analyses were run separately for females and males. To check for multivariable variance inflation, each model was run as an ordinary least squares regression to obtain variance inflation factor (VIF) values. VIFs did not exceed 2.50 in any of the six multivariable models, indicating that correlations between maltreatment measures did not bias estimates. After accounting for demographics, other maltreatment subtypes, and age 12 depressive symptoms, degradation at both time points was predictive of increased depressive symptomatology in females between ages 12 and 14. However, compared to more recent degradation, degradation that occurred before elementary school showed much stronger associations with depressive symptoms, and chronic degradation showing the strongest effects. No other maltreatment type was related to depression symptoms in girls. For male adolescents, only isolating during elementary school/last year remained a significant predictor of an increase in depression symptoms. Isolation before elementary school was significant at the p = 0.001 level. Chronic isolation also showed strong associations with depression symptoms in boys. Discussion This aim of this study was to examine the longitudinal impact of specific psychological maltreatment experiences occurring during early childhood and in the elementary school years on middle adolescent depressive symptoms. To the best of our knowledge, this is the first study to consider both timing and subtype dimensions of youth-reported psychological maltreatment while accounting for other forms of maltreatment using a prospective longitudinal design. In addition, analyses were stratified by youth sex, allowing for examination of differences in the impact of specific maltreatment subtypes and timing on adolescent depressive symptoms. Using a rigorous design, different maltreatment variables emerged as independent predictors of depression in females and males. Further, results varied according to when the specific maltreatment experiences occurred. Two years after girls reported their maltreatment experiences, increased acts of degradation by primary caregivers before and during elementary school/last year were predictive of elevated depressive symptoms, even when controlling for demographics, other maltreatment types and prior depressive symptoms. Given the blaming and belittling nature of the items on this subscale, it is not Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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Table 2 Multivariablea regression models for child maltreatment measures predicting depressive symptoms. Females

Males Depressive symptoms

B (SE) < Elementary school Degradation Isolating Terrorizing Endangerment Physical injury Sexual abuse Elementary school/last year Degradation Isolating Terrorizing Endangerment Physical injury Sexual abuse Maltreatment chronicity Degradation Isolating Terrorizing Endangerment Physical injury Sexual abuse

p

B (SE)

p

0.210 (0.032) −0.246 (0.175) −0.006 (0.045) −0.073 (0.081) 0.098 (0.090) −0.067 (0.029)

0.000 0.159 0.903 0.367 0.931 0.020

−0.037 (0.053) 0.468 (0.147) 0.074 (0.050) 0.131 (0.121) −0.130 (0.114) 0.092 (0.059)

0.494 0.001 0.138 0.278 0.254 0.119

0.105 (0.0278) 0.166 (0.129) −0.029 (0.041) −0.019 (0.066) 0.062 (0.069) −0.001 (0.019)

0.000 0.196 0.475 0.774 0.369 0.974

0.104 (0.039) 0.678 (0.132) 0.013 (0.044) 0.054 (0.094) 0.007 (0.075) −0.087 (0.057)

0.007 0.000 0.761 0.566 0.928 0.125

0.233 (0.038) 0.053 (0.075) −0.025 (0.049) −0.083 (0.059) 0.156 (0.056) −0.139 (0.055)

0.000 0.477 0.613 0.159 0.006 0.012

0.079 (0.047) 0.509 (0.099) 0.027 (0.060) 0.081 (0.093) −0.155 (0.102) 0.038 (0.061)

0.097 0.000 0.658 0.383 0.129 0.530

a Multivariable models controlled for demographics, primary caregiver depressive symptoms, and youth age 12 depressive symptoms. Bold indicates statistical significance with Bonferroni-corrected p-value (0.05/36 = 0.001).

surprising that degradation predicted more depressive symptoms. Our results suggest that belittling and humiliation from caregivers that is chronic or occurs before entry to school may be especially harmful for development. Our findings are similar to and extend the work of several others regarding the unique impact of childhood psychological maltreatment on depression. Using the same sample, English et al. (2015) examined different domains of emotional maltreatment from official records and found threats to psychological security and safety to predict depressive symptoms and suicidal ideation at age 18. Similar to our findings, sexual and physical abuse did not relate to depression (or suicidal ideation), suggesting the importance of measuring and including emotional/psychological maltreatment. Stuewig and McCloskey (2005) reported longitudinal associations of parental rejection in the form of repeated criticism and humiliation in front of others in early adolescence (age 15) led to a greater propensity to experience shame, which in turn was associated with greater levels of depressive symptoms at age 17. In a longitudinal study of low-income middle school students, Donovan and Brassard (2011) used the psychological aggression subscale of the Conflict Tactics Scale (Straus, Hamby, Finkelhor, Moore, & Runyan, 1998) to measure maternal verbal aggression. In boys and girls, greater depressive symptoms were related to higher levels of verbal aggression. Several of the five items in this subscale closely resemble the shaming and humiliating parenting behaviors captured by the degradation subscale used in this study, as well as the measure used by Allen (2008). Allen (2008) reported associations of caregiver ignoring with depression, while degradation related to borderline personality features. This inconsistency in findings could be due to sampling differences or the different ways in which these constructs were measured. We were also unable to examine this subtype, due to data limitations. The degradation item used in his study consisted of one item that asked about experiences of ridicule, embarrassment, and sarcasm from parents. Further research should explore whether this specific form of psychological maltreatment poses vulnerability to depression via impairments in self-esteem, as has been suggested by others (Kim & Cicchetti, 2006). Consistent measures of psychological maltreatment subtypes are also clearly needed. Boys reported more depressive symptoms when parents had more recently prevented them from making friends outside the home or used physical isolation as a form of punishment. Isolation before elementary school was marginally significant, and chronic isolation had a significant negative impact on depression symptoms. Allen (2008) used a similar item to measure isolation, but did not find associations with depression. It could be that the parents in this sample who used these harmful parenting practices did so more frequently than those in Allen’s (2008) sample of undergraduates. Repeated social and physical isolation could lead to the feelings of hopelessness which often characterize depression. We did not find significant multivariable relationships with terrorizing or physical abuse and depression once controls and other maltreatment were taken into account. Allen (2008) reported associations of this maltreatment subtype with anxiety and somatic complaints in adulthood, but not with depression symptoms. It could be that more aggressive and threatening forms of psychological maltreatment have a greater impact on the developing autonomic nervous system via physiological arousal and thus are more likely to lead to these outcomes (Watts-English, Fortson, Gibler, Hooper, & De Bellis, 2006). Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

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There are many mechanisms by which psychological maltreatment in childhood contributes to psychosocial impairment in adolescence. Evidence from animal studies suggests that neglectful parenting causes compromised stress-responsiveness in offspring (Meaney, 2001). Adverse childhood experiences appear to compromise the stress-response systems (Heim & Nemeroff, 2001). Chronic stress associated with maltreatment exposure may contribute to deregulation of the stressresponse system, interfering with an ability to manage future stressors, and predisposing child maltreatment victims to later mental health problems. Preliminary evidence in college students suggests that difficulties with affect regulation may be a mechanism linking psychological maltreatment and depression (Coates & Messman-Moore, 2014) and other psychosocial difficulties (Reddy, Pickett, & Orcutt, 2006). Taken together, these results suggest it may be important to disaggregate various forms of psychological maltreatment when examining this construct. These findings are especially important given the elevated risk for suicide among adolescents with major depressive disorder (Bridge et al., 2006; Nock et al., 2013). Additionally, NIS-4 reported that only slightly more than a third of emotional abuse reports to CPS resulted in an investigation (Sedlak et al., 2010). Relative to other forms of maltreatment, emotional maltreatment is also less likely to be substantiated by CPS (Trickett et al., 2009). Because this type of maltreatment typically does not result in physical marks, it may not be perceived to be as harmful as other maltreatment types (Tonmyr, Draca, Crain, & MacMillan, 2011). Distinguishing poor parenting from psychological maltreatment is also difficult, as it may depend on the age of the child, cultural context, and the severity and frequency of the parenting behaviors (Wolfe & McIsaac, 2011). Limitations The sample used in this study consisted of a high-risk sample and the results can therefore not be generalized to a normative population of adolescents. Although the psychological maltreatment measures used in the current study included more items than most other measures, it was not exhaustive and there are still many ways in which parents can communicate to their children that they are unloved or worthless. Due to data limitations, we were unable to account for denying emotional responsiveness and corrupting/exploiting subtypes. While all of the psychological maltreatment subtypes in this study appear severe, we did not examine maltreatment severity in relation to depression. The time period for which adolescents had to remember childhood maltreatment experiences was shorter than that of adult studies, but the measures used in this study were still retrospective, so subject to forgetting and selective recall. Due to the low number of youth in this sample who met criteria for a major depressive episode, this outcome was not examined. The depressive symptoms reported by youth in this sample might therefore not have been clinically significant. However, prior research has documented impairments associated with depressive symptoms (Johnson, Weissman, & Klerman, 1992) and the risk of subclinical depression for later clinical depression (Cuijpers & Smit, 2004). Conclusions In summary, our results suggest that relative to other forms of maltreatment, psychological maltreatment may be especially harmful for the development of adolescent depressive symptoms. These associations with adolescent depressive symptoms are especially worrisome given the importance of this outcome for suicidal ideation and behaviors (Bridge et al., 2006; Nock et al., 2013). Moreover, we found that specific dimensions of psychological maltreatment were related to depression. Future studies should therefore take into account the multidimensional nature of this often overlooked form of maltreatment (Allen, 2008; English et al., 2015; Trickett et al., 2009). References Allen, B. (2008). An analysis of the impact of diverse forms of childhood psychological maltreatment on emotional adjustment in early adulthood. Child Maltreatment, 13, 307. Alloy, L. B., Abramson, L. Y., Smith, J. M., Gibb, B. E., & Neeren, A. M. (2006). Role of parenting and maltreatment histories in unipolar and bipolar mood disorders: Mediation by cognitive vulnerability to depression. Clinical Child and Family Psychology Review, 9, 23–64. APSAC. (2011). In J. E. Myers (Ed.), The APSAC handbook on child maltreatment (3rd, pp. 215–232). Thousand Oaks: Sage. Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey – Adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 37–44. Barnett, D., Manly, J., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti, & S. L. Toth (Eds.), Advances in applied developmental psychology: Child abuse, child development and social policy. Norwood, NJ: Ablex Publishing Corp. Bauman, K. J., & Graf, N. L. (2003). Educational attainment: 2000. Census 2000 brief. Washington, DC: U.S. Census Bureau. Berzenski, S. R., & Yates, T. M. (2010). A developmental process analysis of the contribution of childhood emotional abuse to relationship violence. Journal of Aggression, Maltreatment & Trauma, 19, 180–203. Bifulco, A., Moran, P. M., Baines, R., Bunn, A., & Stanford, K. (2002). Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression. Bulletin of the Menninger Clinic, 66, 241–266. Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47, 372–394. Briere, J. (1996). Trauma symptom checklist for children. Odessa, FL: Psychological Assessment Resources. Briere, J., & Runtz, M. (1990). Differential adult symptomatology associated with three types of child abuse histories. Child Abuse & Neglect, 14, 357–364. Calvete, E. (2014). Emotional abuse as a predictor of early maladaptive schemas in adolescents: Contributions to the development of depressive and social anxiety symptoms. Child Abuse & Neglect, 38, 735–746. Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217–225.

Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

G Model CHIABU-3003; No. of Pages 10

ARTICLE IN PRESS E. Paul, J. Eckenrode / Child Abuse & Neglect xxx (2015) xxx–xxx

9

Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 541–565. Coates, A. A., & Messman-Moore, T. L. (2014). A structural model of mechanisms predicting depressive symptoms in women following childhood psychological maltreatment. Child Abuse & Neglect, 38, 103–113. Crawford, E., & Wright, M. O. D. (2007). The impact of childhood psychological maltreatment on interpersonal schemas and subsequent experiences of relationship aggression. Journal of Emotional Abuse, 7, 93–116. Crow, T., Cross, D., Powers, A., & Bradley, B. (2014). Emotion dysregulation as a mediator between childhood emotional abuse and current depression in a low-income African-American sample. Child Abuse & Neglect, 38, 1590–1598. Cuijpers, P., & Smit, F. (2004). Subthreshold depression as a risk indicator for major depressive disorder: A systematic review of prospective studies. Acta Psychiatrica Scandinavica, 109, 325–331. Donovan, K. L., & Brassard, M. R. (2011). Trajectories of maternal verbal aggression across the middle school years: Associations with negative view of self and social problems. Child Abuse & Neglect, 35, 814–830. Dunn, E. C., McLaughlin, K. A., Slopen, N., Rosand, J., & Smoller, J. W. (2013). Developmental timing of child maltreatment and symptoms of depression and suicidal ideation in young adulthood: Results from the National Longitudinal Study of Adolescent Health. Depression and Anxiety, 30, 955–964. Egeland, B. (2009). Taking stock: Childhood emotional maltreatment and developmental psychopathology. Child Abuse & Neglect, 33, 22–26. Egeland, B., Sroufe, L. A., & Erickson, M. (1983). The developmental consequence of different patterns of maltreatment. Child Abuse & Neglect, 7, 459–469. English, D. J., Upadhyaya, M. P., Litrownik, A. J., Marshall, J. M., Runyan, D. K., Graham, J. C., & Dubowitz, H. (2005). Maltreatment’s wake: The relationship of maltreatment dimensions to child outcomes. Child Abuse & Neglect, 29, 597–619. English, D., Thompson, R., White, C. R., & Wilson, D. (2015). Why should child welfare pay more attention to emotional maltreatment? Children and Youth Services Review, 50, 53–63. Everson, M. D., Smith, J. B., Hussey, J. M., English, D., Litrownik, A. J., Dubowitz, H., Thompson, R., Dawes Knight, E., & Runyan, D. K. (2008). Concordance between adolescent reports of childhood abuse and child protective service determinations in an at-risk sample of young adolescents. Child Maltreatment, 13, 14–26. Feiring, C., & Zielinski, M. (2011). Looking back and looking forward: A review and reflection on research articles published in child maltreatment from 1996 through 2010. Child Maltreatment, 16, 3–8. Gibb, B. E., & Abela, J. R. (2008). Emotional abuse, verbal victimization, and the development of children’s negative inferential styles and depressive symptoms. Cognitive Therapy and Research, 32, 161–176. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Child maltreatment 1: Burden and consequences of child maltreatment in high-income countries. Lancet, 373, 68–81. Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: Associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67, 113–123. Hart, S. N., Brassard, M. R., Davidson, H. A., Rivelis, E., Diaz, V., & Binggeli, N. (2011). Psychological maltreatment. In J. E. B. Myers (Ed.), The APSAC handbook on child maltreatment (pp. 125–144). Thousand Oaks, CA: Sage. Hart, S. N., Brassard, M., & Karlson, H. C. (1996). Psychological maltreatment. In J. Briere, L. Berliner, J. A. Bulkley, C. Jenny, & T. Reid (Eds.), The APSAC handbook on child maltreatment. Thousand Oaks, CA: Sage Publications. Heim, C., & Nemeroff, C. B. (2001). The role of childhood trauma in the neurobiology of mood and anxiety disorders: Preclinical and clinical studies. Biological Psychiatry, 49, 1023–1039. Johnson, J. G., Cohen, P., Smailes, E. M., Skodol, A. E., Brown, J., & Oldham, J. M. (2001). Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Comprehensive Psychiatry, 42, 16–23. Johnson, J., Weissman, M. M., & Klerman, G. L. (1992). Service utilization and social morbidity associated with depressive symptoms in the community. JAMA: The Journal of the American Medical Association, 267, 1478–1483. Kaplow, J. B., & Widom, C. S. (2007). Age of onset of child maltreatment predicts long-term mental health outcomes. Journal of Abnormal Psychology, 116(1), 176. Keiley, M. K., Howe, T. R., Dodge, K. A., Bates, J. E., & Pettit, G. S. (2001). The timing of child physical maltreatment: A cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Development and Psychopathology, 13, 891–912. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. Kim, J., & Cicchetti, D. (2006). Longitudinal trajectories of self-system processes and depressive symptoms among maltreated and nonmaltreated children. Child Development, 77, 624–639. Knight, E. D., Runyan, D. K., Dubowitz, H., Brandford, C., Kotch, J., Litrownik, A., & Hunter, W. (2000). Methodological and ethical challenges associated with child self-report of maltreatment solutions implemented by the LONGSCAN consortium. Journal of Interpersonal Violence, 15, 760–775. Knight, E. D., Smith, J. B., Martin, L. M., Lewis, T., & the LONGSCAN Investigators. (2008). Measures for assessment of functioning and outcomes in longitudinal research on child abuse volume 3: Early adolescence (ages 12–14). Accessible at the LONGSCAN web site. http://www.iprc.unc.edu/longscan/ Lambert, D. (1992). Zero-inflated Poisson regression, with an application to defects in manufacturing. Technometrics, 34, 1–14. Lanktree, C. B., & Briere, J. (1990, August). Poster session at the annual meeting of the American Psychological Association, Boston. In Early data on the Trauma Symptom Checklist for Children (TSCC). Lanktree, C. B., & Briere, J. (1995). Outcome of therapy for sexually abused children: A repeated measures study. Child Abuse & Neglect, 19, 1145–1155. Lewinsohn, P. M., Rohde, P., Klein, D. N., & Seeley, J. R. (1999). Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 56–63. Liu, R. T., Alloy, L. B., Abramson, L. Y., Iacoviello, B. M., & Whitehouse, W. G. (2009). Emotional maltreatment and depression: Prospective prediction of depressive episodes. Depression and Anxiety, 26, 174–181. Macfie, J., Cicchetti, D., & Toth, S. L. (2001). Dissociation in maltreated versus nonmaltreated preschool-aged children. Child Abuse & Neglect, 25, 1253–1267. Manly, J. T., Kim, J. E., Rogosch, F. A., & Cicchetti, D. (2001). Dimensions of child maltreatment and children’s adjustment: Contributions of developmental timing and subtype. Development and Psychopathology, 13, 759–782. McGee, R. A., Wolfe, D. A., & Wilson, S. K. (1997). Multiple maltreatment experiences and adolescent behavior problems: Adolescents’ perspectives. Development and Psychopathology, 9, 131–149. Meaney, M. J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161–1192. Nelson, E. C., Heath, A. C., Madden, P. A., Cooper, M. L., Dinwiddie, S. H., Bucholz, K. K., Glowinski, A., McLaughlin, T., Dunne, M. P., Statham, D. J., & Martin, N. G. (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: Results from a twin study. Archives of General Psychiatry, 59, 139–145. Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 70, 300–310. Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. Reddy, M. K., Pickett, S. M., & Orcutt, H. K. (2006). Experiential avoidance as a mediator in the relationship between childhood psychological abuse and current mental health symptoms in college students. Journal of Emotional Abuse, 6, 67–85. Runyan, D. K., Curtis, P. A., Hunter, W. M., Black, M. M., Kotch, J. B., Bangdiwala, S., Dubowitz, H., English, D., Everson, M. D., & Landsverk, J. (1998). Longscan: A consortium for longitudinal studies of maltreatment and the life course of children. Aggression and Violent Behavior, 3, 275–285.

Please cite this article in press as: Paul, E., & Eckenrode, J. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect (2015), http://dx.doi.org/10.1016/j.chiabu.2015.05.018

G Model CHIABU-3003; No. of Pages 10

10

ARTICLE IN PRESS E. Paul, J. Eckenrode / Child Abuse & Neglect xxx (2015) xxx–xxx

Sachs-Ericsson, N., Verona, E., Joiner, T., & Preacher, K. J. (2006). Parental verbal abuse and the mediating role of self-criticism in adult internalizing disorders. Journal of Affective Disorders, 93, 71–78. Sedlak, A. J., Mettenburg, J., Basena, M., Peta, I., McPherson, K., & Greene, A. (2010). Fourth national incidence study of child abuse and neglect (NIS-4). Washington, DC: US Department of Health and Human Services. Shaffer, D., Fisher, P., Dulcan, M., Davies, M., Piacentini, J., Schwab-Stone, M., Lahey, B., Bourdon, K., Jensen, P., Bird, H., Canino, G., & Regier, D. (1996). The NIMH Diagnostic Interview Schedule for Children (DISC-2): Description, acceptability, prevalence, and performance in the MECA study. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 865–877. Shaffer, A., Yates, T. M., & Egeland, B. R. (2009). The relation of emotional maltreatment to early adolescent competence: Developmental processes in a prospective study. Child Abuse & Neglect, 33, 36–44. Schneider, M. W., Ross, A., Graham, J. C., & Zielinski, A. (2005). Do allegations of emotional maltreatment predict developmental outcomes beyond that of other forms of maltreatment? Child Abuse & Neglect, 29, 513–532. Solomon, C. R., & Serres, F. (1999). Effects of parental verbal aggression on children’s self-esteem and school marks. Child Abuse & Neglect, 23, 339–351. Spertus, I. L., Yehuda, R., Wong, C. M., Halligan, S., & Seremetis, S. V. (2003). Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abuse & Neglect, 27, 1247–1258. StataCorp. (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP. Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W., & Runyan, D. (1998). Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: Development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22, 249–270. Stuewig, J., & McCloskey, L. A. (2005). The relation of child maltreatment to shame and guilt among adolescents: Psychological routes to depression and delinquency. Child Maltreatment, 10, 324–336. Taussig, H. N., & Culhane, S. E. (2010). Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care. Archives of Pediatrics & Adolescent Medicine, 164, 739–746. Teicher, M., Samson, J., Polcari, A., & McGreenery, C. (2006). Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. American Journal of Psychiatry, 163, 993–1000. Thompson, R., Wiley, T. R., Lewis, T., English, D. J., Dubowitz, H., Litrownik, A. J., Isbell, P., & Block, S. (2012). Links between traumatic experiences and expectations about the future in high risk youth. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 293. Tonmyr, L., Draca, J., Crain, J., & MacMillan, H. L. (2011). Measurement of emotional/psychological child maltreatment: A review. Child Abuse & Neglect, 35(10), 767–782. Trickett, P. K., Mennen, F. E., Kim, K., & Sang, J. (2009). Emotional abuse in a sample of multiply maltreated, urban young adolescents: Issues of definition and identification. Child Abuse & Neglect, 33, 27–35. U.S. Census Bureau, Current Population Reports, P60-213. (2001). Money income in the United States: 2000. Washington, DC: U.S. Government Printing Office. Watts-English, T., Fortson, B. L., Gibler, N., Hooper, S. R., & De Bellis, M. D. (2006). The psychobiology of maltreatment in childhood. Journal of Social Issues, 62, 717–736. Widom, C. S., DuMont, K., & Czaja, S. J. (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Archives of General Psychiatry, 64, 49–56. Wolfe, D. A., & McIsaac, C. (2011). Distinguishing between poor/dysfunctional parenting and child emotional maltreatment. Child Abuse & Neglect, 35(10), 802–813. Wright, M. O. D., Crawford, E., & Del Castillo, D. (2009). Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse & Neglect, 33, 59–68.

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