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Does striving to succeed come at a physiological or psychosocial cost for adults who experienced child maltreatment?

Published online by Cambridge University Press:  22 November 2017

Jenalee R. Doom*
University of Michigan
Vivienne M. Hazzard
University of Michigan
Katherine W. Bauer
University of Michigan
Cari Jo Clark
Emory University
Alison L. Miller
University of Michigan
Address correspondence and reprint requests to: Jenalee R. Doom, Center for Human Growth & Development, University of Michigan, North Ingalls Building, 300 North Ingalls Street, Ann Arbor, MI 48109; E-mail:


While striving to succeed in the face of adversity may provide individuals with outward benefits, it may come at a cost to individuals’ physical health. The current study examines whether striving predicts greater physiological or psychosocial costs among those who experienced child maltreatment, a stressor that disrupts the caregiving environment and threatens relationship security. Using data from the National Longitudinal Study of Adolescent to Adult Health, we tested whether greater striving after childhood maltreatment would come at a cost, increasing underlying cardiovascular disease (CVD) risk and depressive symptoms despite showing outward success via income and college degree attainment. The study included 13,341 Black, Hispanic, and White adolescents who self-reported striving and their experiences of childhood neglect, physical abuse, and sexual abuse. As young adults, participants reported depressive symptoms, income, and college degree attainment and completed a health assessment from which a 30-year Framingham-based CVD risk score was calculated. Higher striving was associated with lower CVD risk and depressive symptoms, and higher income and college degree attainment, regardless of maltreatment history. These findings highlight the potential for striving as a target for interventions and support the need to examine multiple biological and behavioral outcomes to understand the multifaceted nature of resilience.

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This research uses data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from Grant P01-HD31921 for this analysis. NICHD National Research Service Award F32HD088029 supported Jenalee R. Doom.


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