Examining the Independent Protective Effect of Subjective Well-Being on Severe Psychological Distress Among Canadian Adults with a History of Child Maltreatment

Purpose: Childhood maltreatment is a major public health concern that continues to preoccupy the attention of practitioners, researchers, and policy makers. The existing literature has consistently found that maltreatment events such as emotional, physical, and sexual abuse, neglect, and exposure to intimate partner violence are major risk factors for a number of mental health problems later in adulthood including alcohol and substance use, anxiety, depression, and suicide-related behaviors. The experience of childhood maltreatment has also been linked to obesity and severe psychological distress (SPD). Subjective well-being (SWB) which is a measure of an individual’s assets and strengths, and better physical and mental health has been theorized to buffer the adverse effects of trauma and stressful life events on mental health problems. In line with Resilience Portfolio Model, SWB may act as a protective factor against the negative and long-term effects of childhood maltreatment. The purpose of this study was to examine the independent protective effect of SWB on SPD among adult Canadians with a history of child maltreatment.

Methods: This study uses data from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). The CCHS-MH is a cross-sectional survey that collects information on factors that influence mental health through a multidisciplinary approach focusing on social and economic determinants of health. A sample of 8,126 respondents aged 20–69 years old who experienced at least one child maltreatment event before age 16 years was analyzed. Multivariate logistic regression was conducted to identify the independent protective effect of SWB on SPD while simultaneously adjusting for the effect of demographic characteristics, socioeconomic factors, health factors, and mental health diagnoses.

Results: Of the 8,126 respondents examined, 45.7% experienced one child maltreatment event, 22% experienced two child maltreatment events, 15.8% experienced three child maltreatment events, and 16.0% experienced four or more child maltreatment events. Results from the multivariate logistic regression revealed that emotional and psychological well-being had significant independent effects on SPD. Controlling for the effect of demographic, socioeconomic, health and mental health factors, for each additional unit increase in emotional well-being scores, the odds of a respondent having SPD were predicted to decrease by 28% (AOR=0.72; 95% CI=0.69-0.76). Similarly, for each additional unit increase in psychological well-being scores, the odds of a respondent having SPD were predicted to decrease by 10% (AOR=0.90; 95% CI=0.87-0.92). Other factors associated with SPD include younger age, poor self-perceived physical health, and chronic condition. Having post-secondary education, higher income, and being non-White was associated with lower odds of SPD.

Implications: Although, childhood maltreatment is associated with stressful life events later in adulthood, SWB could serve as a protective factor against SPD among maltreated individuals. The present study supports a burgeoning literature emphasizing the positive development of psychosocial resources to promote well-being. Such a development could help alleviate the pain and stress among maltreated individuals. Interventions with maltreated individuals should not only focus on needs and symptom reduction, but also on fostering strengths, such as SWB and resilience, which, in turn, can lead to reduced psychological distress.