The Interplay of Depression and Hostile Attributions in the Link Between PTSD Symptoms and Peer Victimization in Child Victims of Sexual Abuse

Abstract

This study sought to test a serial mediation model in which depressive symptoms and hostile attributions mediate the relationship between post-traumatic stress symptoms and peer victimization in a sample of child victims of sexual abuse. Participants included 771 children aged 6 to 12 years old, consulting specialized intervention settings following disclosure of sexual abuse. Children completed questionnaires assessing their levels of post-traumatic stress symptoms, depressive symptoms and experiences of peer victimization in the school context. Vignettes were used to assess hostile attributions for instrumental and relational provocations. Results of the path analysis revealed that post-traumatic stress symptoms were associated with depressive symptoms, which were linked to greater hostile attributions for relational provocations, which were in turn associated to a greater likelihood of reporting peer victimization. Hostile attributions for instrumental provocations were not related to peer victimization.

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References

  1. 1.

    Barth J, Bermetz L, Heim E, Trelle S, Tonia T (2013) The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. Int J Public Health 58(3):469–483. https://doi.org/10.1007/s00038-012-0426-1

    Article  PubMed  Google Scholar 

  2. 2.

    Hébert M, Amédée LM, Blais M, Gauthier-Duchesne A (2019) Child sexual abuse among a representative sample of Quebec high school students: prevalence and association with mental health problems and health-risk behaviors. Can J Psychiatry 12:1–19. https://doi.org/10.1177/0706743719861387

    Article  Google Scholar 

  3. 3.

    Steine IM, Winje D, Skogen JC, Krystal JH, Milde AM, Bjorvatn B et al (2017) Posttraumatic symptom profiles among adult survivors of childhood sexual abuse: a longitudinal study. Child Abuse Negl 67:280–293. https://doi.org/10.1016/j.chiabu.2017.03.002

    Article  PubMed  Google Scholar 

  4. 4.

    Amédée LM, Tremblay-Perreault A, Hébert M, Cyr C (2019) Child victims of sexual abuse: teachers’ evaluation of emotion regulation and social adaptation in school. Psychol Sch 56(7):1077–1088. https://doi.org/10.1002/pits.22236

    Article  Google Scholar 

  5. 5.

    Kim J, Cicchetti D (2010) Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. J Child Psychol Psychiatry 51(6):706–716. https://doi.org/10.1111/j.1469-7610.2009.02202.x

    Article  PubMed  Google Scholar 

  6. 6.

    Auslander W, Tlapek SM, Threlfall J, Edmond T, Dunn J (2015) Mental health pathways linking childhood maltreatment to interpersonal revictimization during adolescence for girls in the child welfare system. J Interpers Violence 33(7):1169–1191. https://doi.org/10.1177/0886260515614561

    Article  PubMed  Google Scholar 

  7. 7.

    Kokkinos CM, Voulgaridou I (2018) Relational victimization, callous-unemotional traits, and hostile attribution bias among preadolescents. J Sch Violence 17(1):111–122. https://doi.org/10.1080/15388200.2016.1222500

    Article  Google Scholar 

  8. 8.

    Ostrov JM, Kamper KE (2015) Future directions for research on the development of relational and physical peer victimization. J Clin Child Adolesc Psychol 44(3):1–11. https://doi.org/10.1080/15374416.2015.1012723

    Article  Google Scholar 

  9. 9.

    Aloia LS, Solomon DH (2015) Attachment, mental health, and verbal aggressiveness in personal relationships. J Aggress Maltreat Trauma 24(2):169–184. https://doi.org/10.1080/10926771.2015.1002650

    Article  Google Scholar 

  10. 10.

    Pouwels JL, Lansu TAM, Cillessen HN (2016) Participant roles of bullying in adolescence: status characteristics, social behavior, and assignment criteria. Aggress Behav 42(3):239–253. https://doi.org/10.1002/ab.21614

    Article  PubMed  Google Scholar 

  11. 11.

    Rueger SY, Malecki CK, Demaray MK (2011) Stability of peer victimization in early adolescence: effects of timing and duration. J Sch Psychol 49(4):443–464. https://doi.org/10.1016/j.jsp.2011.04.005

    Article  PubMed  Google Scholar 

  12. 12.

    Singham T, Viding E, Schoeler T, Arseneault L, Ronald A, Cecil CM et al (2017) Concurrent and longitudinal contribution of exposure to bullying in childhood to mental health: the role of vulnerability and resilience. JAMA Psychiatry 74(11):1112–1119. https://doi.org/10.1001/jamapsychiatry.2017.2678

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Hébert M, Langevin R, Daigneault I (2016) The association between peer victimization, PTSD, and dissociation in child victims of sexual abuse. J Affect Disord 193:227–232. https://doi.org/10.1016/j.jad.2015.12.080

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Tremblay-Perreault A, Hébert M (2020) Uncovering the association between child sexual abuse, peer victimization and behavior problems using child, parent and teacher reports. J Sch Violence 19(3):336–348. https://doi.org/10.1080/15388220.2019.1697276

    Article  Google Scholar 

  15. 15.

    Pittenger SL, Schreier A, Meidlinger K, Pogue JK, Theimer K, Flood MF et al (2019) Psychological distress and revictimization risk in youth victims of sexual abuse. J Interpers Violence 34(9):1930–1960. https://doi.org/10.1177/0886260516658755

    Article  PubMed  Google Scholar 

  16. 16.

    Risser HJ, Hetzel-Riggin MD, Thomsen CJ, McCanne TR (2006) PTSD as a mediator of sexual revictimization: the role of reexperiencing, avoidance, and arousal symptoms. J Trauma Stress 19(5):687–698. https://doi.org/10.1002/jts.20156

    Article  PubMed  Google Scholar 

  17. 17.

    Tremblay-Perreault A, Amédée LM, Hébert M (2017) Peer victimization in sexually abused children: self-blame and post-traumatic stress symptoms as possible mechanisms. Int J Child Adolesc Resil 5(1):4–19

    Google Scholar 

  18. 18.

    Lahav Y, Talmon A, Ginzburg K, Spiegel D (2019) Reenacting past abuse—identification with the aggressor and sexual revictimization. J Trauma Dissociation 20(4):378–391. https://doi.org/10.1080/15299732.2019.1572046

    Article  PubMed  Google Scholar 

  19. 19.

    Flory JD, Yehuda R (2015) Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations. Dialogues Clin Neurosci 17(2):141–150

    Article  Google Scholar 

  20. 20.

    Stander VA, Thomsen CJ, Highfill-McRoy RM (2014) Etiology of depression comorbidity in combat-related PTSD: a review of the literature. Clin Psychol Rev 34(2):87–98. https://doi.org/10.1016/j.cpr.2013.12.002

    Article  PubMed  Google Scholar 

  21. 21.

    Angelakis S, Nixon RD (2015) The comorbidity of PTSD and MDD: implications for clinical practice and future research. Behav Change 32(1):1–25. https://doi.org/10.1017/bec.2014.26

    Article  Google Scholar 

  22. 22.

    Chang C, Kaczkurkin AN, McLean CP, Foa EB (2018) Emotion regulation is associated with PTSD and depression among female adolescent survivors of childhood sexual abuse. Psychol Trauma 10(3):319–326. https://doi.org/10.1037/tra0000306

    Article  PubMed  Google Scholar 

  23. 23.

    Reijntjes A, Kamphuis JH, Prinzie P, Telch MJ (2010) Peer victimization and internalizing problems in children: a meta-analysis of longitudinal studies. Child Abuse Negl 34(4):244–252. https://doi.org/10.1016/j.chiabu.2009.07.009

    Article  PubMed  Google Scholar 

  24. 24.

    Prinstein MJ, Cheah CSL, Guyer AE (2010) Peer victimization, cue interpretation, and internalizing symptoms: preliminary concurrent and longitudinal findings for children and adolescents. J Clin Child Adolesc Psychol 34(1):11–24. https://doi.org/10.1207/s15374424jccp3401_2

    Article  Google Scholar 

  25. 25.

    Beck AT (1967) Depression. Harper and Row, New York

    Google Scholar 

  26. 26.

    Dodge KA (2006) Translational science in action: hostile attributional style and the development of aggressive behavior problems. Dev Psychopathol 18(3):791–814. https://doi.org/10.1017/S0954579406060391

    Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Schepman K, Fombonne E, Collishaw S, Taylor E (2014) Cognitive styles in depressed children with and without comorbid conduct disorder. J Adolesc 37:622–631. https://doi.org/10.1016/j.adolescence.2014.04.004

    Article  PubMed  Google Scholar 

  28. 28.

    Mathieson LC, Murray-Close D, Crick NR, Woods KE, Zimmer-Gembeck M, Geiger TC et al (2011) Hostile intent attributions and relational aggression: the moderating roles of emotional sensitivity, gender and victimization. J Abnorm Child Psychol 39:977–987. https://doi.org/10.1007/s10802-011-9515-5

    Article  PubMed  Google Scholar 

  29. 29.

    Dodge KA (1993) Social–cognitive mechanisms in the development of conduct disorder and depression. Annu Rev Psychol 44:559–584. https://doi.org/10.1146/annurev.ps.44.020193.003015

    Article  PubMed  Google Scholar 

  30. 30.

    Classen CC, Palesh OG, Aggarwal R (2005) Sexual revictimization: a review of the empirical literature. Trauma Violence Abuse 6(2):103–129. https://doi.org/10.1177/1524838005275087

    Article  PubMed  Google Scholar 

  31. 31.

    Pollak SD, Cicchetti D, Hornung K, Reed A (2000) Recognizing emotion in faces: developmental effects of child abuse and neglect. Dev Psychol 36(5):679–688. https://doi.org/10.1037/0012-1649.36.5.679

    Article  PubMed  Google Scholar 

  32. 32.

    Rieder C, Cicchetti D (1989) Organizational perspective on cognitive control functioning and cognitive–affective balance in maltreated children. Dev Psychol 25:382–392. https://doi.org/10.1037/0012-1649.25.3.382

    Article  Google Scholar 

  33. 33.

    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington

    Book  Google Scholar 

  34. 34.

    Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, Van IJzendoorn MH (2007) Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull 133(1):1–24. https://doi.org/10.1037/0033-2909.133.1.1

    Article  PubMed  Google Scholar 

  35. 35.

    Pollack SD (2008) Mechanisms linking early experience and the emergence of emotions: illustrations from the study of maltreated children. Curr Dir Psychol Sci 17(6):370–375. https://doi.org/10.1111/j.1467-8721.2008.00608.x

    Article  Google Scholar 

  36. 36.

    De Bellis (2001) Developmental traumatology: the psychobiological development of maltreated children and its implications for research, treatment, and policy. Dev Psychopathol 13(3):539–564. https://doi.org/10.1017/s0954579401003078

    Article  PubMed  Google Scholar 

  37. 37.

    Chemtob C, Roitblat HC, Hamada RS, Carlson JG, Twentyman CT (1988) A cognitive action theory of post-traumatic stress disorder. J Anxiety Disord 2:253–275. https://doi.org/10.1016/0887-6185(88)90006-0

    Article  Google Scholar 

  38. 38.

    Swartz JR, Graham-Bermann SA, Mogg K, Bradley BP, Monk CS (2011) Attention bias to emotional faces in young children exposed to intimate partner violence. J Child Adolesc Trauma 4(2):109–122. https://doi.org/10.1080/19361521.2011.573525

    Article  Google Scholar 

  39. 39.

    Elhers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38(4):319–345. https://doi.org/10.1016/S0005-7967(99)00123-0

    Article  Google Scholar 

  40. 40.

    Wiseman H, Hamilton-Giachritsis C, Hiller RM (2019) The relevance of cognitive behavioral models of post-traumatic stress following child maltreatment: a systematic review. Trauma Violence Abuse. https://doi.org/10.1177/1524838019827894

    Article  PubMed  Google Scholar 

  41. 41.

    Wolfe VV (2002) The children’s impact of traumatic events scale II (CITES-II). In: Wolfe VV (ed) Unpublished assessment instrument. Child and Adolescent Centre, London Health Sciences Centre, London

    Google Scholar 

  42. 42.

    Ladd GW, Kochenderfer-Ladd B (2002) Identifying victims of peer aggression from early to middle childhood: analysis of cross-informant data for concordance, estimation of relational adjustment, prevalence of victimization, and characteristics of identified victims. Psychol Assess 14(1):74–96. https://doi.org/10.1037//1040-3590.14.1.74

    Article  PubMed  Google Scholar 

  43. 43.

    Ladd GW, Ettekal I, Kochenderfer-Ladd B (2017) Peer victimization trajectories from kindergarten through high school: differential pathways for children’s school engagement and achievement? J Educ Psychol 109(6):826–841. https://doi.org/10.1037/edu0000177

    Article  Google Scholar 

  44. 44.

    Kovacs M (1992) Children’s depression inventory: manual. Multi-health Systems, North Tonawanda

    Google Scholar 

  45. 45.

    Crick NR (1995) Relational aggression: the role of intent attributions, feelings of distress, and provocation type. Dev Psychopathol 7(2):313–322. https://doi.org/10.1017/S0954579400006520

    Article  Google Scholar 

  46. 46.

    Wolfe VV, Gentile C, Bourdeau P (1987) History of Victimization Form. Unpublished assessment instrument. London Health Science Centre, London

    Google Scholar 

  47. 47.

    Muthén LK, Muthén BO (1998–2017) Mplus user’s guide, 6th edn. Muthén and Muthén, Los Angeles

  48. 48.

    Enders CK (2001) The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing data. Psychol Methods 6(4):352. https://doi.org/10.1037/1082-989X.6.4.352

    Article  PubMed  Google Scholar 

  49. 49.

    Finkelhor D, Ormrod RK, Turner HA (2007) Re-victimization patterns in a national longitudinal sample of children and youth. Child Abuse Negl 31(5):479–502. https://doi.org/10.1016/j.chiabu.2006.03.012

    Article  PubMed  Google Scholar 

  50. 50.

    Danielson CK, Macdonald A, Amstadter AB, Hanson R, de Arellano MA, Saunders BE et al (2010) Risky behaviors and depression in conjunction with—or in the absence of—lifetime history of PTSD among sexually abused adolescents. Child Maltreat 15(1):101–107. https://doi.org/10.1177/1077559509350075

    Article  PubMed  PubMed Central  Google Scholar 

  51. 51.

    LeMoult J, Gotlib IH (2018) Depression: a cognitive perspective. Clin Psychol Rev 69:51–66. https://doi.org/10.1016/j.cpr.2018.06.00

    Article  PubMed  Google Scholar 

  52. 52.

    Vitaro F, Brendgen M, Barker ED (2006) Subtypes of aggressive behaviors: a developmental perspective. Int J Behav Dev 30(1):12–19. https://doi.org/10.1177/0165025406059968

    Article  Google Scholar 

  53. 53.

    Goldstein SE, Boxer P (2013) Parenting practices and the early socialisation of relational aggression among preschoolers. Early Child Dev Care 183(11):1559–1575. https://doi.org/10.1080/03004430.2012.738200

    Article  Google Scholar 

  54. 54.

    Calvete E, Orue I (2011) The impact of violence exposure on aggressive behavior through social information processing in adolescents. Am J Orthopsychiatry 81(1):38–50. https://doi.org/10.1111/j.1939-0025.2010.01070.x

    Article  PubMed  Google Scholar 

  55. 55.

    Perren S, Ettekal I, Ladd G (2013) The impact of peer victimization on later maladjustment: mediating and moderating effects of hostile and self-blaming attributions. J Child Psychol Psychiatry 54(1):46–55. https://doi.org/10.1111/j.1469-7610.2012.02618.x

    Article  PubMed  Google Scholar 

  56. 56.

    Turner HA, Finkelhor D, Hamby SL, Shattuck A, Ormrod RK (2011) Specifying type and location of peer victimization in a national sample of children and youth. J Youth Adolesc 40:1052–1067. https://doi.org/10.1007/s10964-011-9639-5

    Article  PubMed  Google Scholar 

  57. 57.

    McElvaney R (2015) Disclosure of child sexual abuse: delays, non-disclosure and partial disclosure. What the research tells us and implications for practice. Child Abuse Rev 24(3):159–169. https://doi.org/10.1002/car.2280

    Article  Google Scholar 

  58. 58.

    Yancey CT, Hansen DJ (2010) Relationship of personal, familial, and abuse-specific factors with outcome following childhood sexual abuse. Aggress Violent Behav 15(6):410–421. https://doi.org/10.1016/j.avb.2010.07.003

    Article  Google Scholar 

  59. 59.

    Cohen JA, Mannarino AP, Deblinger E (2017) Treating trauma and traumatic grief in children and adolescents. The Guilford Press, New York

    Google Scholar 

  60. 60.

    Webb C, Hayes A, Grasso D, Laurenceau JP, Deblinger E (2014) Trauma-focused cognitive behavioral therapy for youth: effectiveness in a community setting. Psychol Trauma 6(5):555–562. https://doi.org/10.1037/a0037364

    Article  PubMed  PubMed Central  Google Scholar 

  61. 61.

    Hertel PT, Mathews A (2011) Cognitive bias modification: past perspectives, current findings, and future applications. Perspect Psychol Sci 6(6):521–536. https://doi.org/10.1177/1745691611421205

    Article  PubMed  Google Scholar 

  62. 62.

    Hiemstra W, De Castro BO, Thomaes S (2019) Reducing aggressive children’s hostile attributions: a cognitive bias modification procedure. Cogn Ther Res 43:387–398. https://doi.org/10.1007/s10608-018-9958-x

    Article  Google Scholar 

  63. 63.

    Lisk SC, Pile V, Haller SPW, Kumari V, Lau JYF (2018) Multisession cognitive bias modification targeting multiple biases in adolescents with elevated social anxiety. Cogn Ther Res 42:581–597. https://doi.org/10.1007/s10608-018-9912-y

    Article  Google Scholar 

  64. 64.

    Lau JYF, Sharma NP, Bennett E, Dhakal S, Vaswani A, Pandey R et al (2019) Acceptability of a brief training programme targeting attention and interpretation biases for threat in youth with a history of maltreatment. Behav Cogn Psychother 1–6:370–375. https://doi.org/10.1017/S1352465819000663

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank the practitioners of the different intervention settings as well as all the children and families that participated in this project.

Funding

This research was supported by a Grant from the Canadian Institutes of Health Research awarded to the first author.

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Correspondence to Martine Hébert.

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Hébert, M., Tremblay-Perreault, A. & Myre, G. The Interplay of Depression and Hostile Attributions in the Link Between PTSD Symptoms and Peer Victimization in Child Victims of Sexual Abuse. Child Psychiatry Hum Dev 52, 291–300 (2021). https://doi.org/10.1007/s10578-020-01011-7

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Keywords

  • Peer victimization
  • Child sexual abuse
  • Attributions
  • PTSD
  • Depression