4.3 Article

Direct and Indirect Effects of Child Abuse and Environmental Stress: A Lifecourse Perspective on Adversity and Depressive Symptoms

Journal

AMERICAN JOURNAL OF ORTHOPSYCHIATRY
Volume 88, Issue 2, Pages 180-188

Publisher

AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/ort0000283

Keywords

depression; cumulative stress; child abuse; life course; mental health

Funding

  1. National Institute on Drug Abuse [R01DA032950]
  2. Office of Behavioral and Social Sciences Research [RO1 HD049767]
  3. Office of Behavioral Social Sciences Research [R01DA032950]
  4. EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT [R01HD049767] Funding Source: NIH RePORTER
  5. NATIONAL INSTITUTE ON DRUG ABUSE [R01DA032950] Funding Source: NIH RePORTER

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There is a great deal of evidence about the mental health implications of physical child abuse and environmental stressors, or hardships that people experience at the household and neighborhood level (e.g., neighborhood violence; economic hardship, substance abuse, or conflict among family members). Yet, studies often focus on either abuse or environmental stress, not both, or examine abuse and environmental stressors as a combined set of experiences. Less is known, therefore, about how child abuse and environmental stress might work as either distinct or interrelated risks to diminish mental health over time. In this longitudinal study, we used path analyses to examine the cumulative effects of physical child abuse and environmental stressors on adult depressive symptoms among a sample of children followed into adulthood (N = 356). The goal was to assess whether chronic physical child abuse remains an independent predictor of adult outcomes once we accounted for the cumulative effects of household and neighborhood stressors across the lifecourse. Cumulative measures of physical child abuse and environmental stress each independently predicted a higher likelihood of adult depressive symptoms (beta = .122, p < .01 and beta = .283, p < .001, respectively). After accounting for adolescent depressive symptoms, only cumulative environmental stressors independently predicted depressive symptoms (beta = .202, p < .001). Tests of the indirect effect of cumulative environmental stress on the relationship between cumulative physical abuse and adult depressive symptoms were marginally statistically significant. Results add to literature that examines child abuse, adversity, and lifecourse perspectives on health.

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