Journal of Family Violence

, Volume 27, Issue 6, pp 511–522 | Cite as

Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health

  • Carole HoovenEmail author
  • Paula S. Nurius
  • Patricia Logan-Greene
  • Elaine A. Thompson


Childhood exposure to violence and victimization is a significant public health problem, with potentially long-lasting, deleterious effects on adult mental health. Using a longitudinal study design, 123 young adults—identified in adolescence as at-risk for high school dropout—were examined for the effects of multi-domain childhood victimization on emotional distress and suicide risk, net of adolescent risk and protective factors, including family dysfunction. The hypothesis that higher levels of cumulative childhood victimization would be significantly associated with mental health maladjustment in young adulthood was confirmed by the analysis. However, the victimization predictors of adult emotional distress were different than the predictors of adult suicide risk. These findings indicate the need for prevention and intervention approaches that include thorough assessment, and focus on the childhood and adolescent problem areas that are most consequential for long-term psychological well-being.


Young adult Victimization Emotional distress Suicide 


  1. Anda, R. (2010). The health and social impact of growing up with adverse childhood experiences: The human and economic costs of the status quo. Retrieved from
  2. Benjet, C., Borges, G., & Medina-Mora, M. E. (2010). Chronic childhood adversity and onset of psychopathology during three life stages: childhood, adolescence and adulthood. Journal of Psychiatric Research, 44, 732–740.PubMedCrossRefGoogle Scholar
  3. Briere, J., & Runtz, M. (1990). Differential adult symptomatology associated with three types of child abuse histories. Child Abuse & Neglect, 14, 357–364.CrossRefGoogle Scholar
  4. Brodsky, B. S., & Stanley, B. (2008). Adverse childhood experiences and suicidal behavior. Psychiatric Clinics of North America, 31, 223–235.PubMedCrossRefGoogle Scholar
  5. Brown, G. W., Craig, T. K. J., Harris, T. O., Handley, R. V., & Harvey, A. L. (2007a). Development of retrospective interview measure of parental maltreatment using the Childhood Experience of Care and Abuse (CECA) instrument: a life course study of adult chronic depression. Journal of Affective Disorders, 103, 205–215.PubMedCrossRefGoogle Scholar
  6. Brown, G. W., Craig, T. K. J., Harris, T. O., Handley, R. V., & Harvey, A. L. (2007b). Validity of retropsective measures of early maltreatment and depressive episodes using the Childhood Experience of Care and Abuse (CECA) instrument: a life-course study of adults chronic depression. Journal of Affective Disorders, 103, 217–224.PubMedCrossRefGoogle Scholar
  7. Brown, G. W., Craig, T. K. J., Harris, T. O., Handley, R. V., Harvey, A. L., & Serido, J. (2007c). Child-specific and family-wide risk factors using the retrospective Childhood Experience of Care & Abuse (CECA) instrument: a life-course study of adult chronic depression. Journal of Affective Disorders, 103, 225–236.PubMedCrossRefGoogle Scholar
  8. Browne, C., & Winkelman, C. (2007). The effect of childhood trauma on later psychological adjustment. Journal of Interpersonal Violence, 22, 684–697.PubMedCrossRefGoogle Scholar
  9. Casey, E., & Nurius, P. S. (Eds.). (in press). Acquaintance sexual assault and sexual harassment treatment and prevention among teens (2nd ed.). New York: Oxford University Press.Google Scholar
  10. Centers for Disease Control and Prevention. (2008). Youth risk behavior surveillance-United States, 2007. Morbidity and Mortality Weekly Report, 57(SS-4), 1–131.Google Scholar
  11. Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40, 1239–1252.PubMedCrossRefGoogle Scholar
  12. Deater-Deckard, K., & Dodge, K. A. (1997). Externalizing behavior problems and discipline revisited: nonlinear effects and variation by culture, context, and gender. Psychological Inquiry, 8(3), 161–175.CrossRefGoogle Scholar
  13. DeVellis, R. F. (2012). Scale development: Theory and application (Vol. 26) (3rd ed.). Newbury Park: Sage.Google Scholar
  14. Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span. American Medical Association, 286, 3089–3096.CrossRefGoogle Scholar
  15. Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the Adverse Childhood Experiences Study. The American Journal of Psychiatry, 160, 1453–1460.PubMedCrossRefGoogle Scholar
  16. Eggert, L. L., Thompson, E. A., Herting, J. R., & Nicholas, L. J. (1994). Prevention research program: reconnecting at-risk youth. Issues in Mental Health Nursing, 15(2), 107–135.PubMedCrossRefGoogle Scholar
  17. Eggert, L. L., Herting, J. R., & Thompson, E. A. (1995). The high school questionnaire: Profile of experiences. Seattle: University of Washington.Google Scholar
  18. Fellitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adulthood: the adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.CrossRefGoogle Scholar
  19. Fergusson, D. M., Beautrais, A. L., & Horwood, L. J. (2003). Vulnerability and resiliency to suicidal behaviours in young people. Psychological Medicine, 33, 61–73.PubMedGoogle Scholar
  20. Fergusson, D. M., Horwood, L. J., Ridder, E. M., & Beautrais, A. (2005). Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood. Psychological Medicine, 35, 983–993.PubMedCrossRefGoogle Scholar
  21. Finkelhor, D., Ormrod, R. K., Turner, H. A., & Hamby, S. L. (2005a). Measuring poly-victimization using the juvenile victimization questionnaire. Child Abuse & Neglect, 29, 1297–1312.CrossRefGoogle Scholar
  22. Finkelhor, D., Turner, H. A., Ormrod, R. K., & Hamby, S. L. (2005b). The victimization of children and youth: a comprehensive national survey. Child Maltreatment, 10, 5–25.CrossRefGoogle Scholar
  23. Finkelhor, D., Ormrod, R., & Turner, H. A. (2007). Poly-victimization: a neglected component in child victimization. Child Abuse & Neglect, 31, 7–26.CrossRefGoogle Scholar
  24. Finkelhor, D., Ormrod, R., & Turner, H. A. (2009). Lifetime assessment of poly-victimization in a national sample of children and youth. Child Abuse & Neglect, 33, 403–411.CrossRefGoogle Scholar
  25. Galambos, N. L., Barker, E. T., & Krahn, H. J. (2006). Depression, self-esteem, and anger in emerging adulthood: seven-year trajectories. Developmental Psychology, 42, 350–365.PubMedCrossRefGoogle Scholar
  26. Gladstone, G. L., Parker, G. B., Mitchell, P. B., Malhi, G. S., Wilhelm, K., & Austin, M. (2004). Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. The American Journal of Psychiatry, 161, 1417–1425.PubMedCrossRefGoogle Scholar
  27. Hammen, C., Henry, R., & Daley, S. E. (2000). Depression and sensitization to stressors among young women as a function of childhood adversity. Journal of Consulting and Clinical Psychology, 68, 782–787.PubMedCrossRefGoogle Scholar
  28. Henry, B., Moffit, E. G., Caspi, A., Langley, J., & Silva, P. A. (1994). On the “remembrance of things past”: a longitudinal evaluation of the retrospective method. Psychological Assessment, 6(2), 92–101.CrossRefGoogle Scholar
  29. Higgins, D. J., & McCabe, M. P. (2000). Relationships between different types of maltreatment during childhood and adjustment in adulthood. Child Maltreatment, 5, 261–272.PubMedCrossRefGoogle Scholar
  30. Higgins, D. J., & McCabe, M. P. (2001). Multiple forms of child abuse and neglect: adult retrospective reports. Aggression and Violent Behavior, 6, 547–578.CrossRefGoogle Scholar
  31. Hill, T. D., Kaplan, L. M., French, M. T., & Johnson, R. J. (2010). Victimization in early life and mental health in adulthood: an examination of the mediating and moderating influences of psychosocial resources. Journal of Health and Social Behavior, 51(1), 48–63.PubMedCrossRefGoogle Scholar
  32. Holahan, C. J., Valentiner, D. P., & Moos, R. H. (1994). Parental support and psychological adjustment during the transition to young adulthood in a college sample. Journal of Family Psychology, 8(2), 215–223.CrossRefGoogle Scholar
  33. Hooven, C., Herting, J. R., & Snedker, K. A. (2010). Long-term outcomes for the Promoting CARE suicide prevention program. American Journal of Health Behavior, 34, 721–736.PubMedCrossRefGoogle Scholar
  34. Hooven, C., Snedker, K. A., & Thompson, E. A. (2011). Suicide risk at young adulthood: continuities and discontinuities from adolescence. Youth & Society. Advance online publication. doi:. doi: 10.1177/0044118X11407526.
  35. Hooven, C., Walsh, E. M., Pike, K., & Herting, J. R. (2012). Promoting CARE: including parents in youth suicide prevention. Family & Community Health, 35(3), 1–11.Google Scholar
  36. Hulme, P. A. (2004). Retrospective measurement of childhood sexual abuse: a review of instruments. Child Maltreatment, 9, 201–217.PubMedCrossRefGoogle Scholar
  37. Johnson, J. G., Cohen, P., Gould, M. S., Kasen, S., Brown, J., & Brook, J. S. (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archive of General Psychiatry, 59, 741–749.CrossRefGoogle Scholar
  38. Joiner, T. E., Fitzpatrick, K. K., Berlim, M. T., Fleck, M., Conwell, Y., Witte, T. K., & Rudd, M. D. (2005). Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried. Journal of Abnormal Psychology, 114, 291–303.PubMedCrossRefGoogle Scholar
  39. Joiner, T. E., Sachs-Erichsson, N. J., Wingate, L. R., Brown, J. S., Anestis, M. D., & Selby, E. A. (2007). Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship. Behaviour Research and Therapy, 45, 539–547.PubMedCrossRefGoogle Scholar
  40. Kessler, R. C., Davis, C. G., & Kendler, K. S. (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine, 27, 1101–1119.PubMedCrossRefGoogle Scholar
  41. Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1996). Adolescent suicidal ideation and attempts: prevalence, risk factors, and clinical implications. Clinical Psychology: Science and Practice, 3(1), 25–46.CrossRefGoogle Scholar
  42. Macmillan, R. (2001). Violence and the life course: the consequences of victimization for personal and social development. Annual Review of Sociology, 27, 1–22.CrossRefGoogle Scholar
  43. Marlatt, G. A., & Gordon, J. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guildford.Google Scholar
  44. Masten, A. S., Roisman, G. I., Long, J., & Burt, K. B. (2005). Developmental cascades: linking academic achievement and externalizing and internalizing symptoms over 20 years. Developmental Psychology, 41, 733–746.PubMedCrossRefGoogle Scholar
  45. McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Annals of the New York Academy of Sciences, 896, 30–47.PubMedCrossRefGoogle Scholar
  46. Mitchell, B. A., Wister, A. V., & Gee, E. M. (2004). The ethnic and family nexus of homeleaving and returning among Canadian young adults. The Canadian Journal of Sociology, 29, 543–575.CrossRefGoogle Scholar
  47. Nurius, P. S., Russell, P. L., Herting, J. R., Hooven, C., & Thompson, E. A. (2009). Risk and protective profiles in never exposed, single form, and multiple form victimized youth. Journal of Child & Adolescent Trauma, 2(2), 106–113.CrossRefGoogle Scholar
  48. 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.CrossRefGoogle Scholar
  49. Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin, 128(2), 330–366.PubMedCrossRefGoogle Scholar
  50. Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., & Udry, J. R. (1997). Protecting adolescents from harm: findings from the national longitudinal study on adolescent health. Journal of the American Medical Association, 278, 823–832.PubMedCrossRefGoogle Scholar
  51. Richmond, J. M., Elliot, A. N., Pierce, T. W., Aspelmeier, J. E., & Alexander, A. A. (2009). Polyvictimization, childhood victimization, and psychological distress in college women. Child Maltreatment, 14, 127–147.PubMedCrossRefGoogle Scholar
  52. Roberts, R. E., & Bengston, V. L. (1993). Relationships with parents, self-esteem, and psychological well-being in young adulthood. Social Psychology Quarterly, 56, 263–277.CrossRefGoogle Scholar
  53. Rosenberg, M. (1965). Society and the adolescent self image. Princeton: Princeton University Press.Google Scholar
  54. Schilling, E. A., Aseltine, R. H., & Gore, S. (2008). The impact of cumulative childhood adversity on young adults mental health: measures, models, and interpretations. Social Science & Medicine, 66, 1140–1151.CrossRefGoogle Scholar
  55. Schumm, J. A., Briggs-Phillips, M., & Hobfoll, S. E. (2006). Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression among inner-city women. Journal of Traumatic Stress, 19, 825–836.PubMedCrossRefGoogle Scholar
  56. Smilkstein, G., Ashworth, C., & Montano, D. (1982). Validity and reliability of the family APGAR as a test of family function. Journal of Family Practice, 15, 303–311.PubMedGoogle Scholar
  57. Spielberger, C. D., Jacobs, G., Russel, S., & Crane, R. S. (1983). Assessment of anger. In J. N. Butcher & C. D. Spielberger (Eds.), Advances in personality measurement assessment (Vol. 2, pp. 159–187). Hillsdale: Lawrence Erlbaum.Google Scholar
  58. Thomas, R., DiLillo, D., Walsh, K., & Polusny, M. A. (2011). Pathways from child sexual abuse to adult depression: the role of parental socialization of emotions and alexithymia. Psychology of Violence, 1(2), 121–135.CrossRefGoogle Scholar
  59. Thompson, E. A., & Eggert, L. L. (1999). Using the suicide risk screen to identify suicidal adolescents among potential high school dropouts. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1506–1514.PubMedCrossRefGoogle Scholar
  60. Turner, H. A., & Butler, M. J. (2003). Direct and indirect effects of childhood adversity on depressive symptoms in young adults. Journal of Youth and Adolescence, 32(2), 89–103.CrossRefGoogle Scholar
  61. Turner, H. A., & Kopiec, K. (2006). Exposure to interparental conflict and psychological disorder among young adults. Journal of Family Issues, 27(2), 131–158.CrossRefGoogle Scholar
  62. Turner, H. A., Finkelhor, D., & Ormrod, R. (2006). The effect of lifetime victimization on the mental health of children and adolescents. Social Science & Medicine, 62(1), 13–27.CrossRefGoogle Scholar
  63. Twenge, J. M. (2011). Generational differences in mental health: are children and adolescents suffering more, or less? The American Journal of Orthopsychiatry, 81, 469–472.PubMedCrossRefGoogle Scholar
  64. Twenge, J. M., & Campbell, W. K. (2008). Increases in positive self-views among high school students: birth-chort changes in anticipated performance, self-satisfaction, self-liking and self-competence. Psychological Science, 19, 1083–1086.CrossRefGoogle Scholar
  65. Vranceanu, A. M., Hobfoll, S. E., & Johnson, R. J. (2007). Child multi-type maltreatment and associated depresssion and PTSD symptoms: the role of social support and stress. Child Abuse & Neglect, 31, 71–84.CrossRefGoogle Scholar
  66. Wickrama, T., & Wickrama, K. A. (2009). Heterogeneity in adolescent depressive symptom trajectories: implications for young adults’ risky lifestyle. Journal of Adolescent Health, 47, 407–413.CrossRefGoogle Scholar
  67. Williams, K. (1997). Preventing suicide in young people: what is known and what is needed. Child: Care, Health and Development, 23(2), 173–185.CrossRefGoogle Scholar
  68. Wyman, P. A., Brown, H., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, W., & Wang, W. (2010). An outcome evaulation of the sources of strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health, 100, 1653–1661.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Carole Hooven
    • 1
    Email author
  • Paula S. Nurius
    • 2
  • Patricia Logan-Greene
    • 3
  • Elaine A. Thompson
    • 1
  1. 1.Department of Psychosocial and Community HealthUniversity of WashingtonSeattleUSA
  2. 2.School of Social WorkUniversity of WashingtonSeattleUSA
  3. 3.School of Social WorkUniversity at BuffaloBuffaloUSA

Personalised recommendations