Research That Matters (January 17 - 20, 2008)

Background and Purpose: Maltreated children commonly exhibit depression and externalizing behavior problems. Understanding the developmental course of depression and externalizing behavior problems in maltreated youth could help focus intervention efforts. One explanation for the development of depression and externalizing is that previous difficulties of adaptation cascade and cause others forms of distress. Evidence exists suggesting that earlier externalizing behavior is related both to later externalizing behavior but also to subsequent depression. The mechanisms of risk for maltreated adolescents are not well understood and may not be identical to the risk factors for non-maltreated youth. Further, it is important to understand if maltreated boys and girls experience the same patterns of risk. This study evaluated the manner in which depression and externalizing problems in young adolescents predicted future depression and externalizing problems.

Methods: An ethnically diverse urban sample of 303 adolescents with a documented history of maltreatment and comparison group of 151 non-maltreated adolescents with similar demographic profiles was recruited. The mean age of the sample was 10.9 years at the first measurement point. Adolescents completed the Children's Depression Inventory and the Youth Self-Report at two time points separated by one year. Latent variable cross-lagged panel analyses were conducted with demographic covariates to examine the longitudinal relationships between depression and externalizing behavior. Two multiple-group structural equation models were fit to determine if the patterns of risk are similar for adolescents with and without maltreatment experience and for maltreated boys and maltreated girls.

Results: Both models exhibited good fit to the data. The first model found that maltreated and non-maltreated adolescents showed similar patterns of risk. Autoregressive effects for externalizing behavior and depression were moderately strong and similar in both groups. Earlier depression was not predictive of later externalizing behavior and early externalizing behavior did not predict later depression in either group. A second multiple-group model suggests different patterns of risk for maltreated boys and maltreated girls. Among maltreated females, earlier externalizing behavior was an important predictor of subsequent depression (standardized beta = .45; unstandardized regression weight = .59; p < .01), after controlling for previous depression level and relevant covariates, but was non-significant for maltreated boys. In contrast, the autoregressive effect for depression was powerful for boys (standardized beta = .86; unstandardized regression weight = .28; p < .01) but non-significant for maltreated girls. The autoregressive effect for externalizing behavior was moderately strong and similar in both groups.

Conclusions and Implications: Results suggest that during this developmental phase, depression and externalizing behavior exhibit moderate longitudinal stability and these patterns are similar for maltreated and non-maltreated young adolescents. The gender of maltreated youth, however, exerts an important effect on these relations. Maltreated girls who exhibit early externalizing behavior appear especially vulnerable to subsequent externalizing behavior and later depression. This finding illustrates the important prognostic value of externalizing behavior among maltreated girls and highlights a strategic target for intervention.