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Did you know that by age 18, almost one in five teenagers in the United States will have experienced some form of child maltreatment, such as physical, emotional and sexual abuse (Gilbert et al., 2009)? This finding is worrisome because child maltreatment is one of the strongest predictors of poor mental and physical health outcomes later in life (Basu, McLaughlin, Misra, & Koenen, 2017; Green et al., 2010).
 
Yet, even though child maltreatment can be so harmful, both researchers and clinicians alike know that many people turn out OK. In fact, some people not only avoid these negative health outcomes, but some even maintain high emotional well-being, including a capacity to overcome future adversities.
 
In this study, we wanted to better understand resilient capacity – or one’s belief in their ability to cope successfully with challenges– and how different aspects of child maltreatment might influence this capacity in adulthood.
 
In studying this relationship, we focused on three specific aspects of child maltreatment experiences: how the specific types of child maltreatment exposure mattered, how co-occurrence of multiple types of maltreatment mattered, and if there were differences in resilient capacity based on the developmental timing – or age period when youth first experienced maltreatment. By identifying which of these features were related to resilient capacity, we hoped to begin to understand how early experiences shape later psychological factors and identify better ways to intervene to improve these resilient capacities.
 
To explore this relationship, we analyzed data from 1,962 African American adults living in Atlanta, GA. Each participant reported their experiences of child maltreatment, exposure to other types of trauma, their perceived resilient capacity, and current depression and posttraumatic stress disorder (PTSD) symptoms. We examined associations between each feature of child maltreatment (type, co-occurrence, and developmental timing) with resilient capacity, taking into account socio-demographic variables, other lifetime trauma, as well as depression and PTSD symptoms.
 
What did we find? Our study found four important things.

  • First, people who experienced maltreatment reported lower resilient capacity than people who were never exposed to maltreatment. In particular, people who were emotionally abused had lower resilient capacity than their unexposed peers, even when taking into account experiences of other trauma across their lives.
  • Second, people exposed to multiple forms of maltreatment, such as physical and emotional abuse and witnessing violence in the household, reported lower resilient capacity compared to people who were unexposed or who had fewer maltreatment experiences.
  • Third, resilient capacity was strongly related to depression and PTSD – people with high depression or PTSD symptoms reported lower resilient capacity. However, regardless of one’s current symptoms, people who experienced emotional abuse or multiple forms of maltreatment still reported lower resilient capacity.
  • Fourth, timing of maltreatment largely did not matter; there wasn't a specific time in childhood when maltreatment was particularly impactful on later resilient capacity.

We think there are several key-take ways from this work. As interest in boosting resilience to adversity grows (e.g., Joyce et al., 2018), researchers and clinicians should pay attention to how child maltreatment might impact this capacity. Future research should continue to examine how maltreatment experiences affect later resilient capacity, such as studying additional maltreatment features and observing how these relationships play out over time. Considering the role of child maltreatment in shaping resilient capacity has the potential to inform strategies that could promote health and well-being in the face of adversity.

References

Basu, A., McLaughlin, K. A., Misra, S., & Koenen, K. C. (2017). Childhood Maltreatment and Health Impact: The Examples of Cardiovascular Disease and Type 2 Diabetes Mellitus in Adults. Clin Psychol (New York), 24(2), 125-139. doi:10.1111/cpsp.12191

Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. Lancet, 373(9657), 68-81. doi:10.1016/S0140-6736(08)61706-7

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. Arch Gen Psychiatry, 67(2), 113-123. doi:10.1001/archgenpsychiatry.2009.186

Joyce, S., Shand, F., Tighe, J., Laurent, S. J., Bryant, R. A., & Harvey, S. B. (2018). Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ open, 8(6), e017858. doi: 10.1136/bmjopen-2017-017858

Reference Article:

Nishimi, K., Choi, K.W., Davis, K.A., Powers, A., Bradley, B. & Dunn, E.C. (2019), Features of childhood maltreatment and resilient capacity in adulthood: results from a large, community-based sample. Journal of Traumatic Stress

Questions for Discussion:

  • We were able to examine the type, co-occurrence, and developmental timing of child maltreatment as key features that may associate with later resilient capacity. What are other maltreatment features future research should assess in relation to resilient capacity?
  • Accounting for current psychological distress symptoms explained most, but not all, of the association between maltreatment and resilient capacity. In light of this finding, should researchers examining resilient capacity always take into account current distress?
  • How might these findings inform how clinicians or practitioners treat or prevent distress following adversity or trauma?

About the Author:

Kristen Nishimi, MPH is doctoral candidate in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health and a graduate student researcher in the lab of Dr. Erin Dunn (www.thedunnlab.com) within the Psychiatric and Neurodevelopmental Genetics Unit at Massachusetts General Hospital. Kristen’s research focuses on the impact of early adversity on mental and physical health outcomes, focusing on understanding the processes of psychological resilience.