Examination of protective factors that promote prosocial skill development among children exposed to intimate partner violence

This retrospective cohort study examined prosocial skills development in child welfare-involved children, how intimate partner violence (IPV) exposure explained heterogeneity in children's trajectories of prosocial skill development, and the degree to which protective factors across children's ecologies promoted prosocial skill development. Data were from 1,678 children from the National Survey of Child and Adolescent Well-being I, collected between 1999 and 2007. Cohort-sequential growth mixture models were estimated to identify patterns of prosocial skill development between the ages of 3 to 10 years. Four diverse pathways were identified, including two groups that started high (high subtle-decreasing; high decreasing-to-increasing) and two groups that started low (low stable; low increasing-to-decreasing). Children with prior history of child welfare involvement, preschool-age IPV exposure, school-age IPV exposure, or family income below the federal poverty level had higher odds of being in the high decreasing-to-increasing group compared with the high subtle-decreasing group. Children with a mother with greater than high school education or higher maternal responsiveness had higher odds of being in the low increasing-to-decreasing group compared with the low stable group. The importance of maternal responsiveness in fostering prosocial skill development underlines the need for further assessment and intervention. Recommendations for clinical assessment and parenting programs are provided.

Differences and similarities between children and adolescent exposed to interpersonal traumas with and without Intellectual Disability: An explorative study

BACKGROUND

Individuals with intellectual disability (ID) are more vulnerable to traumatic and stressful events, increasing their risk of developing post-traumatic stress disorder (PTSD).

AIMS

This study aimed to investigate differences in psychopathology, post-traumatic symptoms, and adaptive functioning in a sample of Italian children and adolescents with and without ID. It also sought to determine whether the type of interpersonal trauma was associated with distinct psychopathological outcomes.

METHODS AND PROCEDURES

Sixty-six children and adolescents exposed to interpersonal trauma (physical/sexual abuse, domestic violence, and neglect), were selected and divided into two groups based on the presence or absence of ID. Assessment consisted of structured parent interviews and parent-reported questionnaires. For each scale, comparisons between subtests were performed.

OUTCOMES AND RESULTS

Children and adolescents with ID were more likely to exhibit more severe post-traumatic symptoms, anxiety issues, social problems, and poorer adaptive functioning, with the exception of the practical domain, which appeared to be equally impaired in both groups. In terms of interpersonal trauma typology, exposure to physical/sexual abuse and domestic violence led to greater post-traumatic symptoms compared to neglect.

CONCLUSION AND IMPLICATIONS

Interpersonal trauma significantly affects children and adolescents, with or without ID, highlighting the need for tailored treatments for both groups.

Implementing trauma-informed care in a special education setting: An initial exploration of a multi-tiered model

Implementing trauma-informed care in a special education environment serving youth from historically marginalized communities with high levels of exposure to potentially traumatic events (PTEs) requires a systematic tiered approach consistent with public health guidelines. Little is known about the implementation of this framework in special education settings where youth have significant emotional and behavioral difficulties. To address this need, a consultant-community partnership was forged between a hospital providing mental health services and a therapeutic day school that serves a special education cooperative. The current case study explores the design and implementation of a three-tiered model of trauma-informed care in a special education setting. This study will address the specific practices implemented at each tier, discuss successes and challenges, and summarize future directions for research, practice, and policy.

Impacts of child sexual abuse: The mediating role of future orientation on academic outcomes

BACKGROUND

Child Sexual Abuse (CSA) has significant impacts on an individual's physical and mental well-being including substance use, depression, anxiety, post-traumatic stress disorder, relationship issues, as well as sexual revictimization in adulthood. Positive future orientation is associated with higher educational outcomes and successful goal attainment, but CSA survivors have lower educational attainment and less employment opportunities leading to less financial security in adulthood.

OBJECTIVE

Our study seeks to examine whether future orientation mediates the relationship between CSA and academic outcomes using data from the Kaplan Longitudinal and Multigenerational Study (KLAMS).

PARTICIPANTS & SETTING

KLAMS is a U.S. based panel study which captures information about the mental health, relationships, academic outcomes, and deviant behavior of two generations of family members at multiple points in time. In the present study, we use data from two separate interviews with the children (N = 2084) of the original respondents.

METHODS

We estimated a series of regressions using generalized structural equation modeling to examine the relationship between child sexual abuse, future orientation, and three different types of academic outcomes.

RESULTS

Youth who experienced sexual abuse had lower grades in school, were more likely to drop out, and had lower levels of education than children with no history of sexual abuse. Negative future orientation mediated the relationship between child sexual abuse and all three outcomes.

CONCLUSIONS

In support of existing research, we found child sexual abuse has a negative impact on positive future orientation, and positive future orientation contributes to better academic outcomes.

Adversity, Engagement, and Later Achievement: The Role of Emotion Regulation and Parent-Child Relationship Quality

Background

Students who have experienced adversity tend to demonstrate poorer academic outcomes than their non-maltreated peers. Academic engagement, a multidimensional, motivational construct, associated with a myriad of positive academic outcomes is an important academically-related mechanism that can be leveraged to improve the outcomes of this population.

Objective

The present study aimed to better understanding of how engagement develops in the context of adversity by exploring the effects emotion regulation skills and parent-child relationships have on engagement development.

Participants and setting

Analyses were conducted on 795 participants in the NSCAW dataset.

Methods

Path analysis was used to estimate mediation and moderated mediation models.

Results

Emotion regulation skills significantly mediated the effect experiencing trauma symptoms had on engagement. Parent-child relationship quality moderated the mediation effect emotion regulation skills had on the relationship between experiencing trauma symptoms and engagement.

Conclusions

Emotion regulation skills and parent-child relationship quality are potential intervention targets to improve engagement for students who have experienced adversity.

Academic Outcomes Among Children Who Experienced or Were Exposed to Physical Abuse

All forms of family violence may negatively affect a child's development. However, research on child maltreatment is primarily focused on the child who is directly maltreated and does not often account for how other children in the family experience the abuse. The central aim of our study was to better understand how children's direct experience of physical abuse and exposure to physical abuse influence their academic outcomes. Data were taken from the Minnesota Departments of Education and Human Services. The sample was developed from a population-level cohort of 8-10 years old children (N = 1740) from two groups: Child Protective Service (CPS)-involved (a child who allegedly experienced physical abuse or a child who was exposed to the alleged physical abuse of another child in their household) and the matched comparison. Exposure to intimate partner violence (IPV) was also measured for CPS-involved children. School attendance and academic achievement were examined over 4 years. Descriptive statistics and Generalized Estimating Equations (GEE) were used to answer the three research questions. Over time, declines in attendance for children exposed to physical abuse were significantly greater than those of their matched peers. Exposure to IPV for CPS-involved children resulted in further declines in attendance. Math proficiency of children who experienced physical abuse declined at a significantly faster rate than their matched peers. The decline in reading proficiency of both children who experienced physical abuse and children exposed to physical abuse was more significantly pronounced than that of their matched peers. Differences in math and reading proficiency were eliminated when IPV exposure was taken into account. Child protection workers and school professionals should be aware of negative effects of experiences of and exposures to child maltreatment and work collaboratively to provide academic support, counseling, and other interventions to support children's academic stability.

Coping Methods Used by College Undergraduate and Graduate Students while Experiencing Childhood Adversities and Traumas

Experiences in childhood, both positive and negative, are crucial to a child's progression. Childhood traumas and adversities are detrimental to children's development and can have long term consequences that manifest themselves in young adulthood. The purpose of this study is to inductively explore coping strategies used by young adults during their experience of childhood traumas and adversities. A sample of college students from a diverse northeastern university (N = 146) provided quantitative and qualitative survey responses. Students were asked, "What were the tools you used to cope with adversity and/or traumatic events?" Participants responded to the prompt based on their experiences from childhood. The researchers analyzed the qualitative data using a mixed-method, thematic approach to coding participant responses. Additional quantitative information is explored to explain emerging qualitative themes. Two salient themes of coping strategies emerged, providing support for Machado et al. (2020): (1) Emotion-Focused Coping and (2) Problem-Focus Coping. Minor themes built on the findings in the area of Emotion-Focused Coping, highlighting processes of (i) emotional regulation, (ii) emotional expression, and (iii) emotional avoidance. Excerpts from this study's participants suggest that individuals dealing with adversities and traumas find a variety of ways to cope. These coping strategies can be implemented into institutions' everyday practices to aid children during their time of vulnerability. The article provides recommendations for school administrators, leadership teams, and any professional specializing in school culture, curriculum, and social work.

Childhood maltreatment, emotion regulation strategies and depressive symptoms during spousal bereavement

BACKGROUND

Childhood maltreatment increases the risk of depression, especially after experiencing a stressful life event, such as bereavement. Employing emotion regulation strategies can mitigate the impact childhood maltreatment has on depression later in life following the loss of a spouse.

OBJECTIVE

We evaluated how cognitive reappraisal and expressive suppression moderated the impact of childhood maltreatment and depressive symptoms following spousal bereavement.

PARTICIPANTS AND SETTING

We examined 130 bereaved individuals 3 months after the death of a spouse, 4 months after the death of a spouse, and 6 months after the death of a spouse.

METHODS

We utilized a mixed model approach to test the interaction between childhood maltreatment and cognitive reappraisal and between childhood maltreatment and expressive suppression to predict depressive symptoms across 3 time points.

RESULTS

Cognitive reappraisal moderated the relationship between childhood maltreatment and depressive symptoms (b = - 0.17,p = .003); expressive suppression did not (b = 0.06,p = .452). Participants who used less cognitive reappraisal had a positive relationship between childhood maltreatment and depressive symptoms (b = 3.27,p < .001);participants who used more cognitive reappraisal did not (b = 1.09,p = .065).

CONCLUSIONS

Childhood maltreatment interacted with cognitive reappraisal, but not expressive suppression, to predict depressive symptoms following spousal bereavement. This study reveals how emotion regulation strategies can be utilized as a tool to buffer the impact of childhood maltreatment on mental health following a stressor later in life, which can serve as a target for future interventions for individuals experiencing a stressful life event.

Longitudinal Association Between Child Psychological Abuse and Neglect and Academic Achievement in Chinese Primary School Children: A Moderated Mediation Model

To investigate the relationships among child psychological abuse and neglect (CPAN), children’s learning engagement, family socioeconomic status (family SES), and children’s academic achievement, 271 children (M_age = 9.41 ± 0.81 years old) and their parents participated in this study with a longitudinal design. Results revealed that learning engagement at T1 mediated the relationship between CPAN at T1 and academic achievement at T2 when gender, age, grade, and academic achievement at T1 were under control. Family SES at T1 moderated the relationship between children’s learning engagement at T1 and academic achievement at T2. The association between learning engagement and academic achievement was stronger among children from lower family SES. Our findings highlighted the negative impact of CPAN and the critical role of learning engagement in children’s academic achievement, especially for those from low SES families.

Co-developmental trajectories of parental involvement: Relations to academic achievement and externalizing and internalizing problems among Chinese elementary schoolchildren

BACKGROUND

Parental involvement is an important multi-faceted factor in children's academic performance and school behaviour. However, most prior studies have involved cross-sectional designs, with few studies exploring the co-developmental nature of various parental involvement characteristics over time and their associations with children's academic achievement, externalizing, and internalizing problems.

AIMS

This study explored (a) co-developmental trajectories of seven parental involvement characteristics in elementary schoolchildren, and (b) relations to children's academic achievement, externalizing, and internalizing problems.

SAMPLE AND METHODS

A total of 3553 Chinese elementary schoolchildren (M_age  = 9.90, SD = .72; 53.9% boys) completed relevant measures on 4 occasions at 6-month intervals. Parallel process latent class growth modelling was used for examining study hypotheses.

RESULTS

Four co-developmental trajectories of parental involvement were identified: 'High motivation and involvement', 'Low motivation and involvement', 'Incongruent motivation and involvement', and 'Incongruent motivation and high involvement'. The highest academic achievement and fewest externalizing and internalizing problems were observed for schoolchildren in the 'High motivation and involvement' class, followed by those who were in the 'Incongruent motivation and high involvement' and 'Incongruent motivation and involvement' classes, and finally, schoolchildren were the 'Low motivation and involvement' class.

CONCLUSIONS

The identification of heterogeneous trajectories with differential outcomes highlights the importance of individual differences considerations in understanding the co-developmental patterns of parental involvement, suggesting that specific interventions need to be formulated for differing groups.

Peer Status as a Potential Risk or Protective Factor: A Latent Profile Analysis on Peer Status and Its Association with Internalizing Symptoms in Adolescents with and without Parental Physical Abuse Experience

Research has well established that parental physical abuse experiences can lead to devastating consequences for adolescents, with peer relationships acting as both protective and risk factors. With the person-centered latent profile analysis (LPA), we analyzed questionnaire data from a cross-sectional study in 2020 composed of a sample of 1959 seventh-grade high school students from Switzerland. This study investigated and compared peer-status profiles combining peer acceptance and peer popularity for adolescents with and without parental physical abuse experiences. We conducted a multinomial logistic regression analysis to investigate further depression, anxiety, and dissociation as predictors of profile membership. With LPA, we identified three distinct profiles for adolescents within the subgroup with experiences of parental physical abuse (n = 344), namely liked, liked-popular, and rejected-unpopular. Within the subgroup of adolescents without parental physical abuse experiences (n = 1565), LPA revealed four profiles, namely liked, liked-popular, rejected-unpopular, and average. For adolescents with parental physical abuse experiences, higher levels of dissociation significantly indicated they were more likely to belong to the rejected-unpopular group than belong to the liked group. Anxious students without experiences of parental physical abuse were more likely to belong to the rejected-unpopular and liked profiles than belong to the liked-popular and average profiles. These findings clearly argue for a deeper understanding of the role of parental physical abuse when analyzing the relationship between dissociation and anxiety and peer status. Operationalizing peer status with the four individual dimensions of likeability, rejection, popularity, and unpopularity was valuable in that the role of peer rejection with respect to different internalizing symptoms became apparent.

Exploring the mediating effect of academic engagement on math and reading achievement for students who have experienced maltreatment

BACKGROUND

Students who experience maltreatment tend to underperform academically relative to their peers, requiring an understanding of academically-related mechanisms that are potential intervention targets. Academic engagement, a multidimensional construct that is influential in students' investment in learning and the school context, is one such mechanism that has been associated with positive academic outcomes and develops through interactions between students and their environment.

OBJECTIVE

The purpose of this study was to examine how maltreatment experiences and trauma symptoms were indirectly associated with academic achievement in adolescence through academic engagement.

PARTICIPANTS AND SETTING

The study was conducting on a subsample of 583 youths from the National Study of Child and Adolescent Wellbeing II (NSCAW II) cohort.

METHODS

Structural equation modeling was used to examine the indirect effect engagement on the relationship between maltreatment and trauma symptomology and academic achievement.

RESULTS

Academic engagement significantly mediated trauma symptoms and later standardized reading (β = -0.02; 95 % CI [-0.04, -0.0004]) and math (β = -0.02; 95 % CI [-0.05, -0.0003]) achievement test scores. However, similar mediating effects were not found for engagement on maltreatment and later standardized reading (β = -0.01; 95 % CI [-0.03, 0.01]) and math (β = -0.01; 95 % CI [-0.03, 0.01]) achievement test scores.

CONCLUSIONS

These findings suggest that variability in academic outcomes was indirectly associated with engagement but only for students who exhibited trauma symptoms rather than experiencing maltreatment alone. The findings suggest future researchers should consider engagement should as an academically-related mechanism to help students who were maltreated succeed academically.

Bullying Victimization Among Peruvian Children: The Predictive Role of Parental Maltreatment

Bullying among schoolchildren is increasingly being recognized as a major problem. Although previous studies have examined parental maltreatment as a risk factor for bullying, the evidence on this topic remains limited in Latin America. The aim of this study was then to measure the prevalence of bullying victimization among a nationally representative sample of Peruvian children and to test the association between bullying victimization and parental maltreatment in Peru. This study used a pooled data set from the 2013 and 2015 Peru National Surveys on social relations. Participants were Peruvian children aged from 9 years to 11 years in the fourth, fifth, and sixth grade of primary in both public and private schools nationwide. The results indicated that almost one third of Peruvian children have experienced physical bullying and nearly half of them psychological bullying. However, only a small percentage reported experiencing bullying very frequently. Furthermore, it was found that parental maltreatment in any form-physical or psychological-was strongly and positively associated with physical and psychological bullying victimization. The results also showed that the probabilities of being physically or psychologically bullied were higher among children who experienced physical or psychological parental maltreatment than among children who have not experienced such violence. The probabilities of being bullied were even higher among children who experienced both types of parental maltreatment. Consistent with previous research, these findings suggest that the relationship that children establish with their parents will largely determine how they interact with their peers.

Child Maltreatment, School Bonds, and Adult Violence: A Serial Mediation Model

Physically abused youth are vulnerable to experiencing difficulties across multiple domains of school functioning. Most of the literature examining the relationship between child physical abuse (CPA) and adult violence has focused narrowly on academic outcomes rather than taking a broader view that explores the processes undergirding school engagement and connections. The present study adopted Connell's model of school engagement, connectedness and outcomes within a social bond framework to examine (a) the link between CPA and school social bonds, (b) the link between CPA and adult violence persistence, and (c) the mediational (parallel, serial) effects of school bonds (engagement, connection, and achievement) on violence perpetration in adulthood. Consistent with previous research, results indicated that children who experience physical abuse have poorer academic performance, which, in turn, is related to future violent trajectories. We further found that the relationship between CPA and violence persistence is mediated by a process of bonding to school that begins with being actively engaged in school activities and ends with higher levels of academic achievement. In particular, some of the "school achievement" effect found in previous research operates through behavioral and emotional manifestations and may be partly explained through physically abused children's lessened ability to be engaged with and connected to school activities. We conclude with a discussion of the policy implications stemming from our findings.

Characterizing competence among a high-risk sample of emerging adults: Prospective predictions and biological considerations

Few conditions epitomize severe and chronic stress to a greater extent than child maltreatment, which can derail development across multiple domains of functioning and throughout the life course. Furthermore, child maltreatment tends to co-occur with other adversities, such as poverty. Many individuals grow up under the stressful conditions of these adversities and exhibit developmental competence. The current study prospectively charted the developmental progression of economically disadvantaged maltreated and nonmaltreated children from childhood to emerging adulthood, and examined patterns of competence across multiple developmental domains of functioning central to the period of emerging adulthood. The study investigated childhood precursors to these patterns of adaptation and maladaptation, as well as the physiological cost of these patterns of adaptation (i.e., C-reactive protein; CRP). Latent class analysis revealed four distinct classes of functioning: multifaceted competence across domains (Multifaceted Competence); (multifaceted maladaptation across domains (Multi-Problem); (c) and two classes with mixed patterns of competence and maladaptation (Externalizing Problems and Work/School Impairment). Maltreated individuals were less likely than nonmaltreated individuals to demonstrate patterns of multifaceted competence and more likely to demonstrate aggregate maladaptation across domains. Additionally, Black men who demonstrated a pattern of multifaceted psychosocial competence also evidenced higher levels of low-grade inflammation (indexed by CRP), suggesting physiological distress was associated with adaptation in the context of stress among these individuals. Findings demonstrate the heterogenous patterns of functioning and diverse developmental outcomes that follow early adversity.

Effect of home environment on academic achievement in child protective service-involved children: Results from the second national survey of child and adolescent well-being study

BACKGROUND

Children involved with Child Protective Services (CPS) have been shown to have lower academic achievement. It is unclear whether certain qualities of the home environment can optimize academic achievement in this vulnerable population.

OBJECTIVE

This study sought to determine whether home environments with higher levels of emotional support and cognitive stimulation predict later academic achievement and whether this relationship is moderated by placement type (i.e. biological/adoptive parent care, kinship care, or non-kinship foster care).

PARTICIPANTS AND SETTING

This study included 1,206 children from the second National Survey of Child and Adolescent Well-Being (NSCAW-II) who were involved with CPS between 2-7 years of age.

METHODS

Multivariate analyses were completed to examine the effect of the Home Observation for Measurement of the Environment (HOME) score on later Woodcock-Johnson III Tests of Achievement (WJ-ACH) scores. Moderation analyses were conducted to determine the effect of placement type on this relationship.

RESULTS

Although these relationships between HOME scores and WJ-ACH scores were significant in bivariate analyses, they were not statistically significant in multivariate analyses, primarily due to the variable of household income. Although children placed primarily in non-kinship foster care demonstrated higher WJ-ACH scores for Passage Comprehension and Letter-Word Identification subscales, placement type did not appear to moderate the relationship between HOME scores and academic achievement.

CONCLUSION

Child- and caregiver-level factors, as well as financial resources available in the environment, may account for the relationship between home environment and academic achievement.

Expanding the search for emerging mental ill health to safeguard student potential and vocational success in high school: A narrative review

AIM

Young people experiencing mental ill health are more likely than their healthy aged peers to drop out of high school. This can result in social exclusion and vocational derailment. Identifying young people at risk and taking action before an illness is established or school dropout occurs is an important goal. This study aimed to examine evidence for the risk markers and at risk mental states of the clinical staging model (stage 0-1b) and whether these risk states and early symptoms impact school participation and academic attainment.

METHOD

This narrative review assembles research from both the psychiatry and education literature. It examines stage 0 to stage 1b of the clinical staging model and links the risk states and early symptoms to evidence about the academic success of young people in high school.

RESULTS

In accordance with the clinical staging model and evidence from education literature, childhood trauma and parental mental illness can impact school engagement and academic progress. Sleep disturbance can result in academic failure. Undifferentiated depression and anxiety can increase the risk for school dropout. Subthreshold psychosis and hypomanic states are associated with functional impairment and high rates of Not in Employment, Education, or Training (NEET) but are not recognized in the education literature.

CONCLUSION

Risk markers for emerging mental ill health can be identified in education research and demonstrate an impact on a student's success in high school. Clear referral protocols need to be embedded into school life to reduce risk of progression to later stages of illness and support school participation and success.

Prospective Associations of Child Maltreatment Subtypes With Adult Educational Attainment: Tests of Mediating Mechanisms Through School-Related Outcomes

This study tests a developmental cascades model in which childhood maltreatment is hypothesized to influence adult educational attainment by increasing attention problems and reducing successful school experiences during adolescence. Two path models tested direct and indirect associations of childhood maltreatment with adult educational attainment. Model 1 used three parent-reported subtypes of childhood maltreatment (physical/emotional abuse, sexual abuse, neglect). Model 2 added an agency-reported measure of childhood maltreatment. Both models detected indirect effects of childhood maltreatment subtypes on adult educational attainment through attention and school discipline problems, poor school engagement, and low extracurricular involvement. Model 2 also detected a direct effect of agency-reported childhood maltreatment on the adult outcome. Regardless of the type of maltreatment or data source used, school factors mediated the associations of childhood maltreatment on adult educational attainment. Promoting school engagement and reducing disciplinary referrals for maltreated youth could improve their educational attainment over the long term.

Analysis of the relationship between earthquake-related losses and the frequency of child-directed emotional, physical, and severe physical abuse in Haiti

BACKGROUND

Child abuse is a public health and human rights issue that is prevalent worldwide. All forms of abuse against children can have negative physical and mental health consequences. Under post-disaster situations, where there is a potential for increased stress and decreased social support among caregivers, the risk of child abuse may be higher.

OBJECTIVE

To explore the association between earthquake-related losses (family-related and property-related) and the experience of emotional, physical, and severe physical child abuse in the household for children aged 2-14 in Haiti.

METHODS

A nationally representative sample of Haitian households from the 2012 Demographic and Health Survey (DHS) was used. Descriptive analyses were summarized using frequencies and measures of central tendency. Associations between earthquake-related loss and child abuse was assessed using log-binomial regression modelling.

RESULTS

Two years following the earthquake, and after considering potentially confounding variables, death of a household member was associated with a higher likelihood of a child being victim to emotional (RR = 1.11, 95 % CI: 1.05-1.17) and severe physical abuse (RR = 1.50, 95 % CI: 1.15-1.96). Conversely, injury of a household member was associated with a lower likelihood of a child experiencing emotional abuse (RR = 0.93, 95 % CI: 0.87-0.99).

CONCLUSIONS

There were associations between earthquake-related losses and some forms of child abuse; the results were not consistent across all exposures and outcomes. The high prevalence of reported child abuse indicates a need for interventions to reduce child abuse in homes overall. There is also need for further research into the aetiology and influences specific to different types of abuse.

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

BACKGROUND

Posttraumatic stress disorder (PTSD) is one of the psychopathological consequences of sexual and/or physical abuse. The economic burden is assumed to be high, whereas health-related quality of life and education is negatively affected. This study aims to determine health care costs, health-related quality of life, and educational interruption in adolescents and young adults with PTSD after sexual and/or physical abuse in Germany.

METHODS

This analysis used data of 87 participants aged 14-21 years of a randomized controlled trial. Health care utilization, health-related quality of life (EQ-5D-5L), sick leave days, productivity, and delay or failure to achieve educational aims were assessed. Health care costs from a payer perspective were calculated using unit costs for the year 2014.

RESULTS

Mean health care costs for a six-month period were 5,243€ (SE 868€). In particular, costs of inpatient stays in psychiatric hospitals, general hospitals and rehabilitation as well as child welfare institutions were high. In addition, health-related quality of life was lower due to anxiety/depression, resulting in a mean EQ-5D index and EQ-VAS score of 0.70 and 61.0, respectively. Furthermore, participants reported on average 27 sick leave days, a productivity loss of 61%, and a delay in education attainment as well as having been unable to achieve educational aims.

CONCLUSION

PTSD in adolescents and young adults is associated with a high economic burden. Health-related quality of life was substantially reduced. Furthermore, delay and productivity losses in education were observed.

CLINICAL TRIAL REGISTRATION

German Clinical Trials Register identifier: DRKS00004787; date of registration: 18th March 2013; https://www.drks.de.

Can socioeconomic and psychosocial factors predict the duration of orthodontic treatment?

INTRODUCTION AND OBJECTIVES

Very little is known about the role of socioeconomic and psychosocial factors in predicting orthodontic treatment duration. Thus, this study aimed to test whether socioeconomic position (SEP) and psychosocial factors, namely, family environment and resiliency can predict orthodontic treatment duration.

METHODS

Data were analysed from a hospital-based, prospective, longitudinal study that recruited 145 consecutively selected 12- to 16-year-old male and female adolescents. Baseline SEP and psychosocial data were collected by a validated child self-completed questionnaire before the placement of fixed appliances. Linear regression analysis was used.

RESULTS

The response rate was 98.6 per cent and the dropout was 8.2 per cent. Maternal emotional support was an important predictor of orthodontic treatment duration. Adolescents with high levels of maternal emotional support were more likely to have a shorter orthodontic treatment duration (by nearly four months) than those with low levels of maternal emotional support (P = 0.02). Parental SEP, paternal emotional support, maternal and paternal control, as well as resiliency were not significantly associated with orthodontic treatment duration (P > 0.05). The multivariable regression analysis (including age, gender, and malocclusion severity) confirmed the significance of maternal emotional support as a predictor of orthodontic treatment duration.

CONCLUSIONS

Maternal emotional support is an important predictor of orthodontic treatment duration. This may be explained by a higher maternal involvement in the orthodontic treatment, which may have facilitated achieving the required orthodontic treatment outcome in a shorter treatment duration.

The Impact of Trauma-Based Training on Educators

An extensive literature establishing the prevalence of Adverse Childhood Experiences (ACEs) and their destructive impact over the lifespan has motivated recent efforts to fundamentally alter the educational milieu. One such initiative, entitled "Compassionate Schools," involves the training of educators in trauma-informed and trauma-sensitive practices, in the hopes of creating scholastic environments more conducive to widespread resilience. Despite encouraging initial reports, few studies have empirically evaluated the impact of Compassionate Schools training on attendees. The current investigation reports the results of two studies. In Study 1, participants completed a questionnaire 6 months after their Compassionate Schools trainings, including items relevant to mindset and behavior change. In Study 2, participants completed the Attitudes Relevant to Trauma Informed Care (ARTIC) scale before and after a Compassionate Schools training. The majority of participants in Study 1 reported enduring changes in mindset and behavior as a result of their trainings, and described those changes in terms consistent with the Compassionate Schools model. ARTIC responses in Study 2 suggested marked trauma-informed attitudinal improvements between pre- and post-training assessments. These data, although preliminary, are consistent with the Compassionate Schools paradigm, and empirically support its promise as a ACEs-informed intervention for educators.

Timing of the first report and highest level of child protection response in association with early developmental vulnerabilities in an Australian population cohort

BACKGROUND

Childhood maltreatment is associated with early childhood developmental vulnerabilities. However, the extent to which higher levels of child protection responses confer benefit to developmental competencies, and the impact of earlier timing of first reports in relation to early childhood vulnerability remains unclear.

OBJECTIVE

We examined associations between early developmental vulnerabilities and (1) the highest level of child protection response (where OOHC was deemed the highest response among other types of reports/responses), and (2) the developmental timing of the first child protection report.

PARTICIPANTS AND SETTING

Participants included 67,027 children from the New South Wales Child Development Study, of whom 10,944 were reported to child protection services up to age 5 years.

METHODS

A series of Multinomial Logistic Regressions were conducted to examine focal associations.

RESULTS

Children with substantiated maltreatment reports showed the strongest odds of vulnerability on three or more developmental domains (adjusted OR = 4.90; 95% CI = 4.13-5.80); children placed in OOHC showed slightly better physical, cognitive and communication competencies (adjusted ORs from 1.83 to 2.65) than those with substantiated reports that did not result in OOHC placements (adjusted OR from 2.77 to 3.67), when each group was compared to children with no child protection reports. Children with first maltreatment reports occurring in the first 18 months of life showed the strongest likelihood of developmental vulnerabilities on three or more developmental domains (adjusted OR = 3.56; 95% CI = 3.15-4.01) relative to children with no child protection reports.

CONCLUSION

Earlier reports of maltreatment may signal the need for targeted remediation of early developmental competencies to mitigate early developmental difficulties.

Mediating effect of emotional/behavioral problems and academic competence between parental abuse/neglect and school adjustment

The current study examined the mediating effects of emotional/behavioral problems and academic competence between parental abuse/neglect and a child's school adjustment by investigating 2070 student surveys from the Korean Child Youth Panel Study (KCYPS). A path analysis yielded the following key findings. Firstly, childhood abuse and neglect showed a significant negative and direct effect on school adjustment. It is particularly important to note that the effect of neglect was bigger than that of abuse in this study. Secondly, emotional/behavioral problems were found to partially mediate between abuse/neglect and school adjustment. Thirdly, academic competence partially mediated the effect of neglect on school adjustment, while it did not mediate the effect of abuse on school adjustment. The indirect effect of parental neglect via emotional/behavioral problems and academic competence was stronger than that of parental abuse. The influence of parental abuse and neglect on children's school adjustments was discussed in terms of emotional/behavioral problems and academic competence considering unique Korean cultural context.

Violence exposure and neural systems underlying working memory for emotional stimuli in youth

Violence exposure during childhood is common and associated with poor cognitive and academic functioning. However, little is known about how violence exposure influences cognitive processes that might contribute to these disparities, such as working memory, or their neural underpinnings, particularly for cognitive processes that occur in emotionally salient contexts. We address this gap in a sample of 54 participants aged 8 to 19 years (50% female), half with exposure to interpersonal violence. Participants completed a delayed match to sample task for emotional faces while undergoing functional magnetic resonance imaging scanning. Violence-exposed youth performed worse than controls on happy and neutral, but not angry, trials. In whole-brain analysis, violence-exposed youth had reduced activation in the left middle frontal gyrus and right intraparietal sulcus during encoding and the left superior temporal sulcus and temporal-parietal junction during retrieval compared to control youth. Reduced activation in the left middle frontal gyrus during encoding and the left superior temporal sulcus during retrieval mediated the association between violence exposure and task performance. Violence exposure influences the frontoparietal network that supports working memory as well as regions involved in facial processing during working memory for emotional stimuli. Reduced neural recruitment in these regions may explain atypical patterns of cognitive processing seen among violence-exposed youth, particularly within emotional contexts.

The influence of social relationships and school engagement on academic achievement in maltreated adolescents

Adolescents who have experienced maltreatment face many developmental and educational challenges compared with their non-maltreated peers. Research demonstrates the importance of social relationships in academic achievement among non-maltreated youth, and suggests the influence of parent and peer relationships for academic success in maltreated youth as well, including the potential benefit of school engagement. Data for the study comes from the first wave of the second National Survey of Child and Adolescent Well-Being (NSCAW II), a nationally-representative sample of children involved in Child Protective Services in the United States. The study finds that maltreated adolescents' perceptions of relationship quality with both parents and peers significantly predict academic achievement. In addition, results demonstrate a mediating effect of school engagement between parent and peer variables and some academic achievement outcomes.

Trauma exposure in children with and without ADHD: prevalence and functional impairment in a community-based study of 6-8-year-old Australian children

Both ADHD and trauma exposure are common childhood problems, but there are few empirical data regarding the association between the two conditions. The aims of this study were to compare lifetime prevalence of trauma exposure in children with and without ADHD, and to explore the association between trauma exposure and outcomes in children with ADHD. Children aged 6-8 years with ADHD (n = 179) and controls (n = 212) recruited from 43 schools were assessed for ADHD, trauma exposure and comorbid mental health disorders using the Diagnostic Interview Schedule for Children IV. Outcome data were collected by direct child assessment, parent report and teacher-report, and included ADHD symptom severity, internalizing and externalizing problems, quality of life, and academic functioning. Logistic and linear regression models were used to examine differences adjusted for child and family socio-demographics. Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16%; OR: 1.99; 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our sample suggests that clinicians should evaluate for trauma histories in children presenting with ADHD.

Exposure to Family Violence and Internalizing and Externalizing Problems Among Spanish Adolescents

Exposure to intimate partner violence (IPV) and child maltreatment may have devastating consequences on children's development. The aim of this research was to examine the predictive associations between exposure to violence at home (witnessing violence against the mother and/or direct victimization by the parents) and adolescent internalizing and externalizing problems. A total of 613 Spanish adolescents (13-18 years) took part in this study. Results indicate that psychological victimization by the parents predicted an increase in anxious/depressive symptoms, aggressive and rule-breaking behavior, and substance abuse at Time 2. In addition, rule-breaking behavior predicted an increase in adolescents' substance abuse at Time 2. Concerning gender, psychological victimization predicted an increase in anxiety/depression, aggressive behavior, rule-breaking behavior, and substance abuse in boys; whereas in girls, psychological victimization only predicted an increase in anxiety/depression.

The Legacy of Early Abuse and Neglect for Social and Academic Competence From Childhood to Adulthood

This study used data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 267) to investigate whether abuse and neglect experiences during the first 5 years of life have fading or enduring consequences for social and academic competence over the next 3 decades of life. Experiencing early abuse and neglect was consistently associated with more interpersonal problems and lower academic achievement from childhood through adulthood (32-34 years). The predictive significance of early abuse and neglect was not attributable to the stability of developmental competence over time, nor to abuse and neglect occurring later in childhood. Early abuse and neglect had enduring associations with social (but not academic) competence after controlling for potential demographic confounds and early sensitive caregiving.

Evidence for a relationship between child maltreatment and absenteeism among high-school students in Sweden

School absenteeism is a potent predictor of academic failure. Maltreated adolescents have been found to be more absent from school compared to their peers. However, it is scarcely studied in what degree a general population of students with high levels of school absenteeism has been exposed to child maltreatment. Furthermore, it is not known if maltreated school-absentees have specific characteristics compared to not-maltreated absentees. In this article, the first objective was to present and compare the prevalence of six types of child maltreatment in a general population of high school students reporting no, moderate or excessive absenteeism. The second objective was to compare maltreated and not-maltreated students who report absenteeism in respect to mental health, perceived school environment and peer victimization in school. Data from 667 girls and 649 boys (mean age 14.3) was used from the longitudinal multidisciplinary research program LoRDIA (Longitudinal Research on Development In Adolescence). Data was collected via self-report questionnaires in classroom settings. All six types of child maltreatment were overrepresented among absentees. Roughly 25% of absentees reported one subtype of maltreatment (16% in the total population) and a mean of 22% of absentees reported two or more types of maltreatment (11% in the total population). Maltreated absentees reported more mental health problems, personal harassment and worse relationship with their teachers than not-maltreated absentees. There might be specific correlates of school absenteeism among maltreated adolescents and professionals involved in preventing school-absenteeism should be made aware of the relationship between maltreatment and absenteeism.

School connectedness and high school graduation among maltreated youth

Maltreated youth have higher rates of school dropout than their non-maltreated peers. School connectedness is a modifiable predictor of school success. We hypothesized maltreated youth's school connectedness (supportive relationships with adults at school and participation in school clubs) would be positively associated with high school graduation. We included youth with at least one Child Protective Services (CPS) report by age twelve from Longitudinal Studies of Child Abuse and Neglect, a prospective cohort study. Participation in extracurricular activities and adult relationships reported at age 16, high school graduation/General Education Development (GED) status reported at age 18, and demographics were provided by youth and caregivers. Maltreatment data were coded from CPS records. The outcome was graduation/receipt of GED. Multivariable logistic regressions examined the association between school connectedness and graduation/receipt of GED, controlling for confounders. In our sample of 318 maltreated youth, 73.3% graduated. School club was the only activity with a statistically significant association with graduation in bivariate analysis. Having supportive relationships with an adult at school was not significantly associated with graduation, though only 10.7% of youth reported this relationship. Maltreated youth who participated in school clubs had 2.54 times the odds of graduating, adjusted for study site, gender, poverty status, caregiver high school graduation status, and age at first CPS report (95% CI: [1.02, 6.33]). Few maltreated youth reported relationships with adults at school, and additional efforts may be needed to support these vulnerable youth. School club participation may represent an opportunity to modify maltreated youth's risk for school dropout.

Social connectedness, stressful life events, and self-injurious thoughts and behaviors among young adults

OBJECTIVES

Preventing self-injurious thoughts and behaviors (SITBs) is particularly challenging on commuter campuses, given lower social cohesion and higher levels of stress than among traditional college populations. The present study examined the relationship between stressful life events (SLEs) and risk for different forms of SITBs, along with the potential buffering role of social connectedness, in a diverse sample of young adults from a commuter college.

METHODS

Participants were 1712 (81% female; 61% racial/ethnic minority; 20% sexual minority) undergraduate and graduate students from a public commuter college in New York City. Participants completed an anonymous survey that inquired about lifetime and recent (past 12months) history of suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI), along with social connectedness and lifetime history of SLEs.

RESULTS

Lower levels of social connectedness and exposure to a higher number of SLEs were associated with engaging in SITBs in the past year, particularly both suicide attempts and non-suicidal self-injury. However, social connectedness did not buffer against the impact of SLEs on SITBs.

LIMITATIONS

Data are cross-sectional, limiting conclusions about directionality, and females were overrepresented.

CONCLUSIONS

Identifying ways to increase social connectedness on diverse commuter campuses may help decrease risk of SITBs. However, it may not buffer against the impact of SLEs on risk of SITBs. Future studies should examine contextual variables (e.g., type and timing of social support) that may play a role in protecting against SITBs, particularly for those with a history of adversity.

A longitudinal study of socioeconomic status, family processes, and child adjustment from preschool until early elementary school: the role of social competence

OBJECTIVE

Using a short-term longitudinal design, this study examined the concurrent and longitudinal relationships among familial socioeconomic status (SES; i.e., family income and maternal and paternal education levels), marital conflict (i.e., constructive and destructive marital conflict), parenting practices (i.e., positive and negative parenting practices), child social competence (i.e., social skills), and child behavioral adjustment (i.e., internalizing and externalizing problems) in a comprehensive model.

METHODS

The sample included a total of 1604 preschoolers aged 5 years at Time 1 and first graders aged 6 years at Time 2 (51.5% male). Parents completed a self-reported questionnaire regarding their SES, marital conflict, parenting practices, and their children's behavioral adjustment. Teachers also evaluated the children's social competence.

RESULTS

The path analysis results revealed that Time 1 family income and maternal and paternal education levels were respectively related to Time 1 social skills and Time 2 internalizing and externalizing problems, both directly and indirectly, through their influence on destructive and constructive marital conflict, as well as negative and positive parenting practices. Notably, after controlling for Time 1 behavioral problems as mediating mechanisms in the link between family factors (i.e., SES, marital conflict, and parenting practices) and behavioral adjustment, Time 1 social skills significantly and inversely influenced both the internalization and externalization of problems at Time 2.

CONCLUSIONS

The merit of examining SES, marital conflict, and parenting practices as multidimensional constructs is discussed in relation to an understanding of processes and pathways within families that affect child mental health functioning. The results suggest social competence, which is influenced by the multidimensional constructs of family factors, may prove protective in reducing the risk of child maladjustment, especially for children who are socioeconomically disadvantaged.

Harsh parenting and academic achievement in Chinese adolescents: Potential mediating roles of effortful control and classroom engagement

This study examined (a) the potential mediating roles of effortful control and classroom engagement in the association between harsh parenting and adolescent academic achievement, and (b) the potential moderating role of gender. Sixth through eighth graders in rural China (n=815, mean age=12.55years) reported on harsh parenting, effortful control, and classroom engagement. Parents also reported on each other's harsh parenting. Academic achievement was assessed by students' test scores and teacher-rated academic performance. Results of structural equation modeling revealed gender differences in patterns of association among the model variables. Harsh parenting was negatively and directly associated with academic achievement for both boys and girls. It was also negatively and indirectly associated with academic achievement via effortful control and classroom engagement sequentially, forming a common indirect "path" for boys and girls. The indirect negative effect of harsh parenting on boys' academic achievement was mainly realized through the mediator of effortful control, whereas this same indirect effect for girls was mainly realized through the mediator of classroom engagement. Jointly, effortful control and classroom engagement precipitates more indirect effects for boys than for girls in the association between harsh parenting and academic achievement. The discussion analyzes the potential "paths" from harsh parenting to adolescent academic achievement, as well as gender differences in these "paths." The current study has implications for teachers and parents eager to improve students' classroom engagement and academic achievement.

Conduct problems in youth and the RDoC approach: A developmental, evolutionary-based view

Problems related to aggression in young people are traditionally subsumed under the header of conduct problems, which include conduct disorder and oppositional defiant disorder. Such problems in children and adolescents are an important societal and mental health problem. In this paper we present an evolutionarily informed developmental psychopathology view of conduct problems inspired by the NIMH Research Domain Criteria (RDoC) initiative. We assume that while there are many pathways to conduct problems, chronic or temporary impairments in the domain of social cognition or mentalizing are a common denominator. Specifically, we conceptualize conduct problems as reflecting temporary or chronic difficulties with mentalizing, that is, the capacity to understand the self and others in terms of intentional mental states, leading to a failure to inhibit interpersonal violence through a process of perspective-taking and empathy. These difficulties, in turn, stem from impairments in making use of a normally evolutionarily protected social learning system that functions to facilitate intergenerational knowledge transmission and protect social collaborative processes from impulsive and aggressive action. Temperamental, biological, and social risk factors in different combinations may all contribute to this outcome. This adaptation then interacts with impairments in other domains of functioning, such as in negative and positive valence systems and cognitive systems. This view highlights the importance of a complex interplay among biological, psychological, and environmental factors in understanding the origins of conduct problems. We outline the implications of these views for future research and intervention.

Childhood Maltreatment and Early Developmental Vulnerabilities at Age 5 Years

This study examined associations between maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (M_age  = 5.62 years, SD = .37) drawn from the Australian state of New South Wales, using linked administrative data for the children and their parents (collected 2001-2009). Associations were estimated between (a) any maltreatment, (b) the number of maltreatment types, and (c) the timing of first reported maltreatment and vulnerability and risk status on multiple developmental domains (i.e., physical, social, emotional, cognitive, and communication). Pervasive associations were revealed between maltreatment and all developmental domains; children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple domains, relative to nonmaltreated children.

General and emotion-specific alterations to cognitive control in women with a history of childhood abuse

BACKGROUND

Although limited, the literature suggests alterations in activation of cognitive control regions in adults and adolescents with a history of childhood abuse. The current study examined whether such alterations are increased in the face of emotionally-distracting as compared to emotionally neutral information, and whether such alterations occur in brain regions that exert cognitive control in a more top-down sustained manner or a more bottom-up transient manner.

METHODS

Participants were young adult women (ages 23-30): one group with a history of childhood physical or sexual abuse (N = 15) and one with no trauma exposure (N = 17), as assessed through the Trauma History Questionnaire and a two-stage interview adapted from the National Crime Victims Survey. Participants underwent fMRI scanning while completing hybrid block/event-related versions of a classic color-word and an emotional Stroop paradigm (threat and positive words). This paradigm allowed us to examine both sustained (activation persisting across blocks) and transient (event-specific activation) aspects of cognitive control.

RESULTS

Women with a history of childhood abuse demonstrated decreased recruitment of frontal-parietal regions involved in cognitive control and enhanced recruitment of a ventral attention surveillance network during blocks of both versions of the Stroop task. Additionally, they had less suppression of brain regions involved in self-referential processes for threat blocks, but greater suppression of these regions for positive blocks. Severity of avoidance symptoms was associated with sustained activation in lateral prefrontal regions, whereas hyperarousal/re-experiencing symptoms were associated with sustained activity in temporal regions. No differential effects were observed for transient control.

CONCLUSIONS

Results suggest exposure to childhood abuse is associated with blunted recruitment of brain regions supporting task-set maintenance but hypervigilance for task-irrelevant information, regardless of whether distractors are emotionally neutral or emotional. Exposure to childhood abuse is also associated with less suppression of default mode brain regions associated with self-referential processing in the face of irrelevant threat information, but heightened ability to suppress similar processing for irrelevant positive information.

Examining the relationship between child maltreatment and school performance in public schools in Saudi Arabia: A pilot study

AIMS

The aim of this study was to examine the relationship between child maltreatment (CM) and school performance among adolescents in Saudi Arabia.

METHODS

A cross-sectional study was conducted in Riyadh, Saudi Arabia, in 2014. The enrolment criteria included both male and female Saudi students ( n=674; 52.7% male) aged 12-19 years ( M_age=15.6±1.6 years), attending intermediate and secondary schools belonging to the Ministry of National Guard. A self-administered questionnaire was used to gather information on different forms of abuse that had occurred in the past or were currently occurring.

RESULTS

Poor school performance was more likely in students who lived among substance-use family members or guardians compared with those who did not (33.3% vs. 11.4%; p<0.01), those with an imprisoned family member compared with those without (26.5% vs. 11.2%; p<0.01), those who were psychologically abused compared with those who were not abused (21.0% vs. 10.1%; p<0.01), those who were physically abused compared with those who were not abused (18.9% vs. 9.3%; p<0.01), and those suffering multiple forms of abuse compared with those not abused (23.4% vs. 9.7%; p<0.01). Logistic regression analysis showed that household dysfunction was the most predisposing factor to poor performance in school, and included living among substance-use family members or guardians (odds ratio=4.0; 95% confidence interval=1.7-9.5) and living with imprisoned family member (odds ratio=3.1, 95% confidence interval=1.5-6.3).

CONCLUSIONS

CM, along with family structure and dynamics, has an adverse relationship with students' school performance. These findings highlight the importance of increasing awareness of the impact of CM on school performance among families, schools and the community.

The Student-Teacher Relationship Quality of Abused Children

Considering the association between children's quality of relationships with teachers and their academic adjustment, information pertaining to how abused children are functioning in their relationships with teachers could be useful in promoting their academic success- yet there has been limited research in this area. The purpose of this study was to use cluster analyses to explore within-group differences in relational schemas and quality of student-teacher relationships for 70 abused children. Two clusters of abused children emerged, and as hypothesized, there were significant differences in student-teacher relationships for the two clusters. The cluster with more positive relational schemas had less conflict and less dependency reported by their teachers compared to the cluster with negative relational schemas. However, there were no differences between the clusters in terms of closeness with teachers. Implications for practice in schools is discussed.

Examining the independent protective effect of subjective well-being on severe psychological distress among Canadian adults with a history of child maltreatment

The purpose of this study was to examine the independent protective effect of subjective well-being on severe psychological distress among adult Canadians with a history of child maltreatment. Data for this study were obtained from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). A sample of 8126 respondents aged 20-69 years old who experienced at least one child maltreatment event was analyzed using binary logistic regression with severe psychological distress as the outcome variable. Of the 8126 respondents with a history of child maltreatment, 3.9% experienced severe psychological distress within the past month. Results from the multivariate logistic regression revealed that emotional and psychological well-being each had a significant effect on severe psychological distress. For each unit increase in emotional well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 28% and for each unit increase in psychological well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 10%, net the effect of demographic, socioeconomic, and health factors. Other factors associated with psychological distress included: younger age, poor self-perceived physical health, and chronic condition. Having post-secondary education, having a higher income, and being non-White predicted lower odds of severe psychological distress. Although, child maltreatment is associated with stressful life events later in adulthood, subjective well-being could serve as a protective factor against severe psychological distress among adults who experienced maltreatment when they were children.