Skip to main content

Advertisement

Log in

Maltreatment Characteristics and Emotion Regulation (ER) Difficulties as Predictors of Mental Health Symptoms: Results from a Community-Recruited Sample of Female Adolescents

  • Original Article
  • Published:
Journal of Family Violence Aims and scope Submit manuscript

Abstract

Mental health outcomes vary among maltreated youth, and the factors that impact variance need further investigation. The current study examined how maltreatment characteristics (age at onset, cumulative perpetrators, and cumulative types) and difficulties with emotion regulation (ER) predicted trauma-relevant symptoms among a community-recruited sample of female adolescents with histories of exposure to violence (N = 115; M(SD) age = 15.96 (1.56) years). To predict each trauma-relevant symptom (i.e. anger, anxiety, depression, dissociation, and posttraumatic stress (PTS)), a hierarchical two-step regression was conducted. For Step 1, maltreatment characteristics, taken together, predicted variance in four of five symptoms: anger, anxiety, dissociation, and posttraumatic stress (PTS). Above and beyond variance accounted for by maltreatment characteristics, age at onset predicted variance in anger, anxiety, and PTS symptoms. For Step 2, ER difficulties predicted variance in all symptoms. Findings highlight the need for further research about how maltreatment histories impact subsequent mental health. Results also suggest that ER difficulties should be increasingly considered in models of posttraumatic distress among maltreated youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Alink, L. A., Cicchetti, D., Kim, J., & Rogosch, F. A. (2009). Mediating and moderating processes in the relation between maltreatment and psychopathology: Mother-child relationship quality and emotion regulation. Journal of Abnormal Child Psychology An Official Publication of the International Society for Research in Child and Adolescent Psychopathology, 37(6), 831–843.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beers, S. R., & De Bellis, M. D. (2002). Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. American Journal of Psychiatry, 159(3), 483–486.

    Article  PubMed  Google Scholar 

  • Brassard, M. R., Hart, S. N., & Hardy, D. B. (1993). The psychological maltreatment rating scales. Child Abuse & Neglect, 17(6), 715–729.

    Article  CAS  Google Scholar 

  • Briere, J. (1996). Trauma Symptom Checklist for Children (TSCC), professional manual. Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Cicchetti, D., Rogosch, F. A., Gunnar, M. R., & Toth, S. L. (2010). The differential impacts of early physical and sexual abuse and internalizing problems on daytime cortisol rhythm in school-aged children. Child Development, 81(1), 252–269.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 393–402.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: a clinical perspective. In N. A. Fox (Ed.), the development of emotion regulation: biological and behavioral considerations. Monographs of the society for re- search in child development, 59 (Serial No. 240), 73–100.

  • Collishaw, S., Pickles, A., Messer, J., Rutter, M., Shearer, C., & Maughan, B. (2007). Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample. Child Abuse & Neglect, 31(3), 211–229.

    Article  Google Scholar 

  • Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., & van der Kolk, B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.

    Google Scholar 

  • DePrince, A. P., Combs, M. D., & Shanahan, M. (2009). Automatic relationship–harm associations and interpersonal trauma involving close others. Psychology of Women Quarterly, 33(2), 163–171.

    Article  Google Scholar 

  • Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Polyvictimization and trauma in a national longitudinal cohort. Development and Psychopathology, 19(1), 149–166.

    Article  PubMed  Google Scholar 

  • Finkelhor, D., Turner, H., Ormrod, R., & Hamby, S. L. (2009). Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics, 124(5), 1411–1423.

    Article  PubMed  Google Scholar 

  • Ford, J., Racusin, R., Ellis, C., Daviss, W. B., Reiser, J., Fleischer, A., & Thomas, J. (2000). Child maltreatment, other trauma exposure, and posttraumatic symptoms among children with oppositional defiant & attention deficit hyperactivity disorders. Child Maltreatment, 5, 205–217.

    Article  CAS  PubMed  Google Scholar 

  • Ford, J. D., Racusin, R., Rogers, K., Ellis, C., Schiffman, J., Ribbe, D., et al. (2002). Traumatic Events Screening Inventory for Children (TESI-C) version 8.4. White River Junction: National Center for PTSD and Dartmouth Child Psychiatry Research Group.

    Google Scholar 

  • Freyd, J. J. (1996). Betrayal trauma: the logic of forgetting childhood abuse. Cambridge: Harvard University Press.

    Google Scholar 

  • Garner, P. W., & Spears, F. M. (2000). Emotion regulation in low-income preschoolers. Social Development, 9(2), 246–264.

    Article  Google Scholar 

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.

    Article  Google Scholar 

  • Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115(4), 850–855.

    Article  PubMed  Google Scholar 

  • Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: conceptual foundations. In J. J. Gross & J. J. Gross (Eds.), Handbook of emotion regulation (pp. 3–24). New York: Guilford Press.

    Google Scholar 

  • Grothe, K. B., Dutton, G. R., Jones, G. N., Bodenlos, J., Ancona, M., & Brantley, P. J. (2005). Validation of the beck depression inventory-II in a low-income african american sample of medical outpatients. Psychological Assessment, 17(1), 110–114.

    Article  PubMed  Google Scholar 

  • Gunnar, M. R., & Vasquez, D. M. (2001). Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Development and Psychopathology, 13, 515–538.

    Article  CAS  PubMed  Google Scholar 

  • Hamby, S., Finkelhor, D., Turner, H., & Ormrod, R. (2010). The overlap of witnessing partner violence with child maltreatment and other victimizations in a nationally representative survey of youth. Child Abuse & Neglect, 34(10), 734–741.

    Article  Google Scholar 

  • Higgins, D. J. (2004). The importance of degree versus type of maltreatment: a cluster analysis of child abuse types. Journal of Psychology Interdisciplinary and Applied, 138(4), 303–324.

    Article  PubMed  Google Scholar 

  • Higgins, D. J., & McCabe, M. P. (2001). Multiple forms of child abuse and neglect: adult retrospective reports. Aggression and Violent Behavior A Review Journal, 6, 547–578.

    Article  Google Scholar 

  • Higgins, D. J., & McCabe, M. P. (2000). Multi-type maltreatment and the long-term adjustment of adults. Child Abuse Review, 9, 6–18.

    Article  Google Scholar 

  • Jonson-Reid, M., Drake, B., Chung, S., & Way, I. (2003). Cross-type recidivism among child maltreatment victims and perpetrators. Child Abuse & Neglect, 27(8), 899–917.

    Article  Google Scholar 

  • Kaplow, J., & Widom, C. S. (2007). Age of onset of child maltreatment predicts long-term mental health outcomes. Journal of Abnormal Psychology, 116, 176–187.

    Article  PubMed  Google Scholar 

  • Kaplow, J., Dodge, K., Amaya-Jackson, L., & Saxe, G. (2005). Pathways to PTSD, part II: sexually abused children. The American Journal of Psychiatry, 162(7), 1305–1310.

    Article  PubMed Central  PubMed  Google Scholar 

  • Keiley, M., Howe, T., Dodge, K., Bates, J., & Pettit, G. (2001). The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Development and Psychopathology, 13(4), 891–912.

    PubMed Central  CAS  PubMed  Google Scholar 

  • Kim, J., & Cicchetti, D. (2010). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of Child Psychology and Psychiatry, 51(6), 706–716.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lilly, M. M., & Hong Phylice Lim, B. (2012). Shared pathogeneses of posttrauma pathologies: attachment, emotion regulation, and cognitions. Journal of Clinical Psychology, 0(0), 1–12.

  • Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Maccoby, E. E. (1983). Social-emotional development and response to stressors. In M. Rutter & N. Garnezy (Eds.), Stress, coping, and development in children (pp. 217–234). New York: McGraw-Hill.

    Google Scholar 

  • Mulvihill, D. (2005). The health impact of childhood trauma: an interdisciplinary review, 1997–2003. Issues in Comprehensive Pediatric Nursing, 28, 115–136.

    Article  PubMed  Google Scholar 

  • Neumann, A., van Lier, P. C., Gratz, K. L., & Koot, H. M. (2010). Multidimensional assessment of emotion regulation difficulties in adolescents using the difficulties in emotion regulation scale. Assessment, 17(1), 138–149.

    Article  PubMed  Google Scholar 

  • Nolen-Hoeksema, S., & Aldao, A. (2011). Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms. Personality and Individual Differences, 51(6), 704–708.

    Article  Google Scholar 

  • Ohan, J., Myers, K., & Collett, B. (2002). Ten-year review of rating scales. IV: scales assessing trauma and its effects. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1401–1422.

    Article  PubMed  Google Scholar 

  • Perfect, M. M., Tharinger, D. J., Keith, T. Z., & Lyle-Lahroud, T. (2011). Relations between Minnesota multiphasic personality inventory–a scales and rorschach variables with the scope and severity of maltreatment among adolescents. Journal of Personality Assessment, 93(6), 582–591.

    Article  PubMed  Google Scholar 

  • Repetti, R., Taylor, S., & Seeman, T. (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin, 128(2), 330–366.

    Article  PubMed  Google Scholar 

  • Ribbe, D. (1996). Psychometric review of Traumatic Event Screening Instrument for Children (TESI-C). In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation (pp. 386–387). Lutherville: Sidran Press.

    Google Scholar 

  • Saunders, B. E. (2003). Understanding children exposed to violence: toward an integration of overlapping fields. Journal of Interpersonal Violence, 18(4), 356–376.

    Article  Google Scholar 

  • Shipman, K., Zeman, J., Penza, S., & Champion, K. (2000). Emotion management skills in sexually maltreated and nonmaltreated girls: a developmental psychopathology perspective. Development and Psychopathology, 12, 47–62.

    Article  CAS  PubMed  Google Scholar 

  • Sirles, E., Smith, J., & Kusama, H. (1989). Psychiatric status of intrafamilial child sexual abuse victims. Journal of the American Academy of Child and Adolescent Psychiatry, 28(2), 225–229.

    Article  CAS  PubMed  Google Scholar 

  • Soenke, M., Hahn, K. S., Tull, M. T., & Gratz, K. L. (2010). Exploring the relationship between child abuse and analogue generalized anxiety disorder: the mediating role of emotion dysregulation. Cognitive Therapy and Research, 34(5), 401–412.

    Article  Google Scholar 

  • Thornberry, T. P., Henry, K. L., Ireland, T. O., & Smith, C. A. (2010). The causal impact of childhood-limited maltreatment and adolescent maltreatment on early adult adjustment. Journal of Adolescent Health, 46(4), 359–365.

    Article  PubMed Central  PubMed  Google Scholar 

  • Trickett, P. K., Noll, J. G., & Putnam, F. W. (2011). The impact of sexual abuse on female development: lessons from a multigenerational, longitudinal research study. Development and Psychopathology, 23(2), 453–476.

    Article  PubMed Central  PubMed  Google Scholar 

  • Tull, M. T., Barnett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38, 303–313.

    Article  PubMed  Google Scholar 

  • Watts-English, T., Fortson, B. L., Gibler, N., Hooper, S. R., & DeBellis, M. D. (2006). The psychobiology of maltreatment in childhood. Journal of Social Issues, 62(4), 717–736.

    Article  Google Scholar 

  • Weinberg, A., & Klonsky, E. D. (2009). Measurement of emotion dysregulation in adolescents. Psychological Assessment, 21(4), 616–621.

    Article  PubMed  Google Scholar 

  • Zeman, J., & Garber, J. (1996). Display rules for anger, sadness, and pain: it depends on who is watching. Child Development, 67(3), 957–973.

    Article  CAS  PubMed  Google Scholar 

  • Zeman, J., Klimes-Dougan, B., Cassano, M., & Adrian, M. (2007). Measurement issues in emotion research with children and adolescents. Clinical Psychology Science and Practice, 14(4), 377–401.

    Article  Google Scholar 

Download references

Acknowledgments

Thanks to current and former members of the Traumatic Stress Studies Group at the University of Denver. The National Institute of Justice grant, 2009-MU-MU-0025, awarded to Anne P. DePrince, PhD, supported this research. This research was carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans. This project was supported by a PROF Award from the University of Denver and Award No. 2009-MU-MU-0025 from the National Institute of Justice Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this report are those of the authors and do not necessarily reflect those of the Department of Justice or the National Institute of Justice.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jane M. Sundermann.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sundermann, J.M., DePrince, A.P. Maltreatment Characteristics and Emotion Regulation (ER) Difficulties as Predictors of Mental Health Symptoms: Results from a Community-Recruited Sample of Female Adolescents. J Fam Viol 30, 329–338 (2015). https://doi.org/10.1007/s10896-014-9656-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10896-014-9656-8

Keywords

Navigation