The mediating role of childhood maltreatment in the association between residence migration and adolescent depression.

BACKGROUND: It is well established that residence migration can negatively affect the mental health of adolescents. However, the related factors that mediate the association between residence migration and depression are still uncertain. METHODS: The participants were 16,037 adolescents in junior middle schools. A self-administered questionnaire was used for the survey. In addition to collecting general demographic characteristics of the participants, including age, gender, local residence status, only child status, parental marriage status and parent-child relationship, the questionnaire also contained the 9-item Patient Health Questionnaire, the short form of the Childhood Trauma Questionnaire and the Connor-Davidson Resilience Scale. Data analysis was conducted using SPSS software. RESULTS: A total of 14,059 valid questionnaires were collected, resulting in 12,122 local adolescents, defined as being born and raised locally, and 1937 migrant adolescents, defined as being transferred from other regions. Meanwhile, 53.3 % of local adolescents and 58.2 % of migrant adolescents reported depressive symptoms. This result indicated that residence migration might contribute to depression symptoms(OR = 1.136, 95%CI: 1.013-1.273, p < 0.05). Childhood maltreatment and parental divorce are risk factors for depression in migrant adolescents. For all adolescents, resilience and a good parent-child relationship may reduce the risk of depression. Childhood maltreatment completely mediates residence migration-related depression(95 % bootstrap CI = 0.146, 0.323). CONCLUSION: This study revealed that residence migration could contribute to adolescent depression, and childhood maltreatment may largely mediate this process, providing new insight into the relationship between adolescent depressive symptoms and residence migration. Reducing childhood maltreatment may effectively improve the depressive symptoms of migrant adolescents.

Interparental Coercive Control and Child and Family Outcomes: A Systematic Review.

Coercive control (CC) is a core facet of intimate partner violence (IPV) and involves asserting power, dominance, and control over another person. Although the adverse impacts of childhood exposure to interparental IPV have been well documented, the outcomes of childhood exposure to interparental CC have not been systematically examined. This study aimed to address this gap by reviewing available empirical evidence on interparental CC and child and family outcomes. Articles were identified by searching electronic databases using keywords relating to CC, children and parents, and child wellbeing outcomes. The final review included 51 studies that reported on adverse outcomes pertaining to parenting and family relationships (k = 29), child internalizing and externalizing problems (k = 7), social-emotional development (k = 5), and physical/health development (k = 17). Specifically, studies reported that CC was associated with increased parental psychopathology, poorer family functioning, harsher parenting and higher levels of child abuse, strained parent-child relationships, children used as tools and co-victims of CC, increased risk of child internalizing and externalizing problems, limited socializing opportunities, increased bullying, poorer perinatal outcomes, limited access to healthcare, and increased risk of child mortality. Evidence identified CC as a unique contributor to adverse child wellbeing outcomes, independent of exposure to IPV more broadly. Results indicated that the impacts of childhood exposure to CC are complex, far reaching, and, in some cases, devastating. The limitations of the findings, as well as implications for practice, policy, and research are discussed.

Adult Maltreatment Risk Factors: Adding Community-Level Factors to an Individual-Level Field.

Adult maltreatment is a pervasive problem in the United States and has serious individual and societal consequences. Adult protective services (APS) agencies are the social services programs responsible for serving older adults and adults with disabilities who may be experiencing adult maltreatment. The adult maltreatment literature differentiates elder maltreatment from the maltreatment of adults with disabilities, yet APS agencies serve both groups. Understanding the etiology of adult maltreatment as well as the associated risk and protective factors is crucial for APS workers, clinical practitioners, researchers, and policymakers. To advance the evidence in this area, we undertook a scoping review to examine recent evidence on risk and protective factors associated with adult maltreatment. Searches of nine electronic databases were conducted in 2020 to identify studies published in peer-reviewed journals since 2010. A total of 29 studies were included in the final review. The findings identified several categories of risk factors associated with the individual: demographic traits, socioeconomic characteristics, physical and mental health, interpersonal issues, and historical events. Several studies identified caregiver and alleged perpetrator risk factors. However, the current body of research lacks community and contextual risk and protective factors. Therefore, we present several potential data sources that may be leveraged to examine the links between social-contextual characteristics and adult maltreatment. These data may be combined with APS data to advance the field's understanding of risk and protective factors through advanced analytic techniques.

The Association Between Child Maltreatment and Pathological Narcissism: A Three-Level Meta-Analytic Review.

Emerging evidence has documented the positive association between child maltreatment and both phenotypes of pathological narcissism (i.e., vulnerable and grandiose narcissism). However, results across these studies are inconsistent. Therefore, the present meta-analysis aimed to examine the extent to which child maltreatment is associated with vulnerable and grandiose narcissism, and whether these associations differed by study or sample characteristics. A systematic literature review was conducted in Web of Science, ScienceDirect, PubMed, Google Scholar, and China National Knowledge Infrastructure. Three-level meta-analyses were performed in R to synthesize the effect sizes. A total of 15 studies (N = 9,141 participants) producing 129 effect sizes were included. Results showed that child maltreatment was positively related to both vulnerable narcissism (mean r = .198; p < .001) and grandiose narcissism (mean r = .087; p < .001), but only to a small extent. Further, the association between child maltreatment and vulnerable narcissism was stronger for neglect (r = .278) than for physical abuse (r = .130). The strength of the association between child maltreatment and grandiose narcissism was larger for samples that were on average younger than 18 years (r = .187) than for samples that were on average older than 18 years (r = .068). Also, the strength of the association was stronger for females than for males. Child maltreatment is a risk factor for developing both vulnerable and grandiose narcissism. Interventions targeting pathological narcissism should be aware of potential trauma resulting from victimization of child maltreatment.

Health Professionals: Identifying and Reporting Child Physical Abuse-a Scoping Review.

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category.

"Does It Really Get Better After Dad Leaves?" Children's Experiences With Domestic Violence: A Qualitative Systematic Review.

Domestic violence (DV) can persist and escalate post-separation. However, little focus has been given to children exposed to DV during this period. This review aims to consolidate the available evidence on children's post-separation experiences with DV caused by their fathers. A qualitative systematic review was carried out. Six electronic databases were searched from the inception of each database until July 2022. Qualitative studies of children aged below 24 years, with biological fathers that committed DV, of which each had experienced parental separation were selected. Twenty studies were included in this review after screening according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Using Sandelowski and Barroso's analysis method, a meta-summary and a meta-synthesis were conducted. Three major themes with eight subthemes were identified: (1) continued abuse post-separation, (2) child's wavering mind of their fathers, and (3) wrangling between past and present. Overall, the findings highlighted that the experience of DV persisted post-separation through various forms of abuse. Children also struggled with mixed feelings and thoughts toward their fathers. They found it hard to trust their fathers and were cautious about their fathers' intentions regarding love and interest. Some children had difficulty interacting with their fathers and were exploited by them. Different stakeholders such as healthcare professionals and court officials can play a significant role in supporting and protecting children exposed to DV and schools can play a significant role in empowering children against DV.

Child Maltreatment as a Risk Factor for Rejection Sensitivity: A Three-Level Meta-Analytic Review.

Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies (N = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r = 0.230; p < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse (r = 0.275) than for physical abuse (r = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences.

Measuring Violence Against Children: A COSMIN Systematic Review of the Psychometric and Administrative Properties of Adult Retrospective Self-report Instruments on Child Abuse and Neglect.

Valid, meaningful, and reliable adult retrospective measures of violence against children (VAC) are essential for establishing the prevalence, risk factors, and long-term effects of VAC. We aim to summarize the available evidence on the psychometric properties of adult retrospective VAC measures and to provide evidence-based recommendations for appropriate measure selection. We searched six electronic databases and gray literature for studies that report on the development, content validity, or psychometric properties of adult retrospective child abuse and neglect measures for this review (PROSPERO: CRD4201706). We used the 2018 Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria to evaluate each included study and measure. We assessed if measures included questions on frequency or severity, the perpetrator, or the location of the violence, and noted the administrative practicalities for each instrument such as length, readability, available translations, and cost to access. We identified 288 studies and 77 measures. The quality of evidence ranged from "low" to "high," depending on the measure and the psychometric properties assessed. The measures with the most robust evidence available across multiple contexts are the: ACE and ACE-IQ; FBQ and FBQ-U; CTQ and CTQ-SF; and ICAST-R. This review shows the strengths and weaknesses of retrospective VAC measures. The substantial evidence presented in this review can be used by researchers to make psychometrically sound decisions for measurement selection which should be supported by extensive piloting and adaptation to the respective local context.

Livestreaming Technology and Online Child Sexual Exploitation and Abuse: A Scoping Review.

Livestreaming of child sexual abuse (LSCSA) is an established form of online child sexual exploitation and abuse (OCSEA). However, only a limited body of research has examined this issue. The Covid-19 pandemic has accelerated internet use and user knowledge of livestreaming services emphasizing the importance of understanding this crime. In this scoping review, existing literature was brought together through an iterative search of eight databases containing peer-reviewed journal articles, as well as grey literature. Records were eligible for inclusion if the primary focus was on livestream technology and OCSEA, the child being defined as eighteen years or younger. Fourteen of the 2,218 records were selected. The data were charted and divided into four categories: victims, offenders, legislation, and technology. Limited research, differences in terminology, study design, and population inclusion criteria present a challenge to drawing general conclusions on the current state of LSCSA. The records show that victims are predominantly female. The average livestream offender was found to be older than the average online child sexual abuse offender. Therefore, it is unclear whether the findings are representative of the global population of livestream offenders. Furthermore, there appears to be a gap in what the records show on platforms and payment services used and current digital trends. The lack of a legal definition and privacy considerations pose a challenge to investigation, detection, and prosecution. The available data allow some insights into a potentially much larger issue.

The Effectiveness of Parenting Programs in Preventing Abusive Head Trauma: A Systematic Review and Meta-Analysis.

Parenting programs are the most common intervention for preventing the lethal form of child maltreatment, abusive head trauma (AHT). However, certain results of the effects of these programs have not yet been compared across studies. A systematic review with meta-analysis is warranted to quantitively synthesize the available evidence to identify effective elements and strategies of the programs for preventing AHT. This review aims to estimate AHT preventive parenting programs' pooled effect on the reduction of AHT incidence, the improvement of parental knowledge, and the increased use of safe strategies in response to infants' inconsolable crying. Studies published in English and Mandarin were searched and retained if they were randomized control trials (RCTs) or with a quasi-experimental design, included an AHT preventive parenting program, and provided data that quantified targeted outcomes. Eighteen studies were included in this review. AHT preventive parenting programs had a pooled effect on improving parents' knowledge and increasing the use of safe coping strategies in response to inconsolable crying but not on the incidence of AHT and parents' emotional self-regulation. Subgroup analyses showed that the intervention effects were mostly present across study designs or measurements and emerged in the reduction of AHT incidence compared with historical controls. The findings suggest that AHT preventive parenting programs enhance parenting knowledge and skills to provide safe care for infants. Further efforts to evaluate AHT parenting programs on the reduction of AHT incidence are necessary for decision-making on allocating and disseminating interventions.

Does Child Maltreatment Reduce or Increase Empathy? A Systematic Review and Meta-analysis.

Arguments about the associations between child maltreatment and empathy remain controversial. This systematic review and meta-analysis aim to estimate the direction and magnitude of the relationships between child abuse and neglect and empathy. Four English databases (Web of Science, PsycInfo, PubMed, and Cochrane Library), three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu), and grey literature were systematically searched. We extracted data related to the associations between child maltreatment and empathy and pooled them using random effects models. A total of 24 eligible studies involving 22,580 participants and 176 estimates were included in the analyses. Overall, child maltreatment was significantly related to reduced empathy (r_ = -0.15, 95% CI [-0.17, -0.13]). Specifically, the rank-order mean effect size of subtypes of maltreatment on empathy is: emotional neglect (r_ = -0.18, 95% CI [-0.25, -0.12]) > physical neglect (r_ = -0.16, 95% CI [-0.23, -0.09]) > emotional abuse (r_ = -0.15, 95% CI [-0.21, -0.10]) > physical abuse (r_ = -0.12, 95% CI [-0.17, -0.07]) > sexual abuse (r_ = -0.07, 95% CI [-0.14, -0.01]). Furthermore, the meta-regression results suggested that the aggregated associations between child maltreatment and empathy were not inflated by publication bias, but they were moderated by the age of respondents, sample size, publication language, empathy measurement, and maltreatment type. The results indicate that general maltreatment and its subtypes are associated with reduced empathy. Parent training and empathy enhancement programs should be designed to help children with a history of childhood maltreatment, respectively, from an early stage.

COVID-19 and Caregiver Risk Factors for Child Maltreatment: The Pandemic in Review.

The COVID-19 pandemic has fostered an environment for increased risk of child maltreatment (CM) as families experience increased psychosocial and financial burdens and spend unprecedented amounts of time together in the home. This narrative review aimed to summarize empirical findings on existing or new pandemic-related risk factors among caregivers. A combination of search terms related to CM and COVID-19 were used to identify articles published within five databases between February 2020 and July 2022. Literature searches produced 113 articles, of which 26 published across 12 countries met inclusion criteria. Four previously well-established risk factors for CM perpetration continued to persist during the pandemic, including stress, parental mental health, financial concerns, and parental substance use. Of note, inconsistent definitions and measures were used to capture these risk factors. Several additional emerging and understudied risk factors were also identified among limited articles, such as food insecurity and parental education. Findings emphasize the ongoing need for evidence-based interventions to address CM risk during the pandemic, including parent training programs. However, consolidated measures and consistent conceptualization of risk factors are needed to advance the study of CM. Going forward, practitioners and researchers should (a) strengthen the identification process for families at greatest risk for CM, and particularly those vulnerable to pandemic-related stressors; and (b) augment delivery of CM prevention strategies and evidence-based programs to fit the pandemic context.

The Role of Attachment, Insecurity, and Stress in Partner Maltreatment: A Meta-Analysis.

Negative, destructive, and abusive behaviors in romantic relationships can vary from explicit kinds of abuse and aggression to more subtle and seemingly innocuous slights against or ways of treating a partner. However, regardless of the severity or explicit nature, these behaviors all, to one extent or another, reflect acts of invalidation, disrespect, aggression, or neglect toward a partner, and could be considered maltreatment of a partner. The current paper proposes the term partner maltreatment as a broad overarching concept, which was used to facilitate a meta-analytic synthesis of the literature to examine the associations between attachment insecurity (i.e., attachment anxiety, attachment avoidance) and perpetration of partner maltreatment. Additionally, this paper situated partner maltreatment within an attachment-based diathesis-stress perspective to explore the moderating role of stress. Five databases were systematically searched for published and unpublished studies that examined the direct association between perpetrator's adult attachment orientation and perpetration of partner maltreatment behaviors. We synthesized effect sizes from 139 studies (N = 38,472) and found the effect between attachment insecurity and acts of partner maltreatment varied between r = .11 to .21. Our findings provide meta-analytic evidence to suggest that attachment insecurity is a significant individual vulnerability factor (diathesis) associated with partner maltreatment; and that when individuals with an insecure attachment orientation experience stress, the tendency to perpetrate partner maltreatment is typically heightened. The findings of this meta-analysis provide empirical evidence for the importance of considering and addressing contextual factors, especially stress, for those individuals and couples seeking therapy for partner maltreatment.

Self-esteem buffers the stress sensitizing effect of childhood maltreatment on adolescent nonsuicidal self-injury.

BACKGROUND: Adversity in childhood increases the risk of psychopathology, perhaps by influencing sensitivity to recent stressful life events (SLEs). However, little is known about the stress-sensitizing effect of childhood adversity on nonsuicidal self-injury (NSSI), whether stress sensitization exists in specific types of SLEs, and the stress-buffering effect of self-esteem. This study aimed to investigate whether exposure to child maltreatment increases adolescent's vulnerability to the effects of dependent and independent SLEs on later NSSI and whether self-esteem buffers this risk. METHODS: We conducted a two-wave study with 18-month intervals. 601 Chinese adolescents completed self-report measures of child maltreatment, SLEs, self-esteem, and NSSI. RESULTS: Results supported the stress sensitization hypothesis for child maltreatment regarding dependent SLEs, with dependent SLEs significantly predicting later NSSI only in maltreated adolescents. Moreover, self-esteem buffered the relationship between dependent SLEs and NSSI in maltreated adolescents but amplified the relationship in non-maltreated adolescents. In the maltreated group, dependent SLEs predicted increased NSSI only in those with low self-esteem. In contrast, in the control group, dependent SLEs were significantly associated with NSSI in individuals with high self-esteem. LIMITATIONS: We did not collect information on the timing of exposure to child maltreatment. Future studies that assess child maltreatment during critical periods of development may be able to identify sensitive period in which maltreatment sensitizes individuals to stress in adolescents. CONCLUSION: Findings provide preliminary evidence that child maltreatment has a stress-sensitizing effect on adolescent NSSI. Improving self-esteem may mitigate the associations between SLEs and NSSI in adolescents exposed to child maltreatment.

Pediatrician as Advocate and Protector: An Approach to Medical Neglect for Children with Medical Complexity.

For children with medical complexity (CMC), gaps in medical care can result in significant harm. When concerns for medical neglect arise for CMC, pediatricians may experience ethical challenges in attempting to simultaneously avoid harm, promote well-being, respect family goals and values, and maintain a positive therapeutic relationship. This article proposes an ethics-guided approach to identifying and addressing underlying modifiable risk factors for medical neglect through collaboration with family caregivers and other stakeholders (eg, medical providers, school staff, and community resources). Pediatricians should recognize their critical role, beyond only as a mandated reporter, to be a mandated supporter.

Childhood Maltreatment and Revictimization: A Systematic Literature Review.

There is established evidence that childhood/adolescent victimization is associated with victimization in adulthood although the underlying mechanisms are not still clear. The current study aimed to systematically review empirical studies examining potential psychological factors linking childhood maltreatment to victimization in adulthood and the gaps in the literature. Following PRISMA protocol, 71 original studies consisting of a total sample of n = 31,633 subjects were analyzed. Symptom severity for various trauma-related disorders, dissociation, emotion dysregulation, and risky sexual behaviors emerged as potential predictors of revictimization. While these potential risk factors mediate the relationship between childhood maltreatment and adulthood victimization, evidence for additional factors such as social support, attachment styles, maladaptive schemas, and risk detection is very limited. Addressing these intrapersonal risk factors, found by prior studies, in interventions and preventive programs might decrease the probability of revictimization. The interactions between the identified risk factors have not been studied well yet. Hence, more research on mediating risk factors of revictimization is needed.

Maltreatment in Daycare Settings: A Review of Empirical Studies in the Field.

Daycare maltreatment refers to abusive and/or neglectful acts perpetrated by teachers, directors, non-professionals or volunteers, family members of staff, and peers in a daycare setting. Despite growing evidence of its occurrence, the prevalence and consequences of daycare maltreatment for the child, the parent(s), and their dyad are largely unknown. This qualitative systematic literature review was conducted to synthesize the existing literature referring to daycare maltreatment, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In order to be included in the analysis, the manuscripts needed to report empirical findings regarding maltreatment in daycare settings, be written in English, be published in a peer-reviewed journal or a dissertation, and be accessible by our research team. In all, 25 manuscripts met the above criteria and were included in the review. Our results indicate that reports of daycare maltreatment are characterized by early age of abused children, inferring mainly to sexual, physical, and emotional abuse. The majority of these manuscripts reported caregivers' and teachers' abuse, while peer victimization was reported much less. In addition, the findings demonstrated a higher representation of female perpetrators compared to abuse in other scenarios. Although some indications of long-term implications are reported in the manuscripts, a well-validated measure for assessment of daycare maltreatment seems to be lacking. These findings contribute to a more nuanced understanding of the complex experience and ramifications of daycare maltreatment, providing insight into its multi-faceted implications.

Association of Food Insecurity With Multiple Forms of Interpersonal and Self-Directed Violence: A Systematic Review.

Economic stress, broadly defined, is associated with an increased likelihood of multiple forms of violence. Food insecurity is a distinct economic stressor and material hardship that is amenable to programmatic and policy intervention. To inform intervention and identify gaps in the current evidence base, we conducted a systematic review to synthesize and critically evaluate the existing literature regarding the association between food insecurity and five forms of interpersonal and self-directed violence: intimate partner violence (IPV), suicidality, peer violence and bullying, youth dating violence, and child maltreatment, in high-income countries. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and searched six electronic databases from their start date through February of 2022. We included studies that examined food insecurity as the exposure and an outcome measure of IPV, suicide, suicidality, peer violence, bullying, youth dating violence, or child maltreatment; were peer-reviewed and published in English; reported quantitative data; and took place in a high-income country. We identified 20 relevant studies. Nineteen studies found that food insecurity was associated with an increased likelihood of these forms of violence. Results highlight the potential for programs and policies that address food insecurity to function as primary prevention strategies for multiple forms of violence and underscore the importance of trauma-informed approaches in organizations providing food assistance. Additional theory-driven research with validated measures of food insecurity and clearly established temporality between measures of food insecurity and violence is needed to strengthen the existing evidence base.

Childhood maltreatment, trait resilience and prenatal distress among expecting mothers and fathers in the FinnBrain Birth Cohort Study.

BACKGROUND: In this study we examined the association between childhood maltreatment exposure (CME) and psychological distress, including symptoms of depression and anxiety, during pregnancy. Additionally, we explored the potential moderating effect of trait resilience on these associations. METHODS: The study is part of the ongoing FinnBrain Birth Cohort Study. The sample consisted of 3016 mothers and 1934 fathers. The data were collected using self-report questionnaires, including EPDS, SCL-90, CD-RISC-10 and TADS. We conducted ANOVAs and linear logistic regression analyses to examine the associations between depression, anxiety, resilience, and CMEs. RESULTS: CMEs were associated with increased psychological distress, including depression symptoms and anxiety, and decreased trait resilience among both mothers and fathers. Additionally, trait resilience had a moderating effect on the association between fathers' CMEs and psychological distress, while no significant moderating effect was found among mothers. Furthermore, among both mothers and fathers, higher trait resilience was associated with decreased anxiety and depressive symptoms. LIMITATIONS: Due to cross-sectionality, it is not possible to establish a causal relationship between CMEs, resilience, and parental distress. Additionally, the study does not provide insights into the underlying factors or processes that contribute to the development of trait resilience. CONCLUSIONS: Trait resilience may have a positive impact on parents' mental health during pregnancy. This study is the first to investigate the significance of fathers' trait resilience during pregnancy. In clinical settings, it is essential to identify parents with low levels of resilience and provide them with appropriate support, recognizing them as a vulnerable group.

Childhood psychological maltreatment and adolescent depressive symptoms: Exploring the role of social anxiety and maladaptive emotion regulation strategies.

BACKGROUND: Despite emerging evidence for the effect of childhood psychological maltreatment on adolescent depressive symptoms, the underlying processes for this effect are largely under-investigated. This study examined a conceptual framework for the effect of childhood psychological maltreatment on adolescent depressive symptoms through social anxiety disorder (SAD) and maladaptive emotion regulation strategies. METHODS: The participants were 1649 Chinese middle school students (751 girls and 898 boys) with a mean age of 16.29 ± 1.04 years old. A moderation-mediation model hypothesized that childhood psychological maltreatment predicts adolescent depressive symptoms, with SAD as a mediator and maladaptive emotion regulation strategies as a moderator. RESULTS: Childhood psychological maltreatment significantly positively predicted adolescent depressive symptoms, while SAD mediated the relation. Maladaptive emotion regulation strategies moderated the pathways from psychological maltreatment to depressive symptoms (but not from psychological maltreatment to SAD) and from SAD to adolescent depressive symptoms. LIMITATIONS: Subjective measures, and the cross-sectional design are the main limitations. CONCLUSIONS: SAD plays a mediating role in the relation between childhood psychological maltreatment and depressive symptoms. Maladaptive emotion regulation strategies exacerbate the relation between childhood psychological maltreatment and depressive symptoms, as well as the relation between SAD and depressive symptoms. These results highlight the importance of addressing social anxiety in reducing adolescent depressive symptoms by improving their cognitive emotion regulation strategies.