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A longitudinal study of several potential mediators of the relationship between child maltreatment and posttraumatic stress disorder symptoms

Published online by Cambridge University Press:  21 January 2014

Chad E. Shenk*
Affiliation:
Pennsylvania State University
Frank W. Putnam
Affiliation:
University of North Carolina School of Medicine
Joseph R. Rausch
Affiliation:
University of Cincinnati College of Medicine
James L. Peugh
Affiliation:
University of Cincinnati College of Medicine
Jennie G. Noll
Affiliation:
Pennsylvania State University
*
Address correspondence and reprint requests to: Chad E. Shenk, Department of Human Development and Family Studies and The Network on Child Protection and Well-Being, Pennsylvania State University, 310E Biobehavioral Health Building, University Park, PA 16802; E-mail: ces140@psu.edu.

Abstract

Child maltreatment is a reliable predictor of posttraumatic stress disorder (PTSD) symptoms. However, not all maltreated children develop PTSD symptoms, suggesting that additional mediating variables explain how certain maltreated children develop PTSD symptoms and others do not. The current study tested three potential mediators of the relationship between child maltreatment and subsequent PTSD symptoms: (a) respiratory sinus arrhythmia reactivity, (b) cortisol reactivity, and (c) experiential avoidance, or the unwillingness to experience painful private events, such as thoughts and memories. Maltreated (n = 51) and nonmaltreated groups (n = 59) completed a stressor paradigm, a measure of experiential avoidance, and a semistructured interview of PTSD symptoms. One year later, participants were readministered the PTSD symptoms interview. Results of a multiple mediator model showed the set of potential mediators mediated the relationship between child maltreatment and subsequent PTSD symptoms. However, experiential avoidance was the only significant, specific indirect effect, demonstrating that maltreated children avoiding painful private events after the abuse were more likely to develop a range of PTSD symptoms 1 year later. These results highlight the importance of experiential avoidance in the development of PTSD symptoms for maltreated children, and implications for secondary prevention and clinical intervention models are discussed.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2014 

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