Pathways of Chronic Victimization, Stress, and Adolescent and Adult Mental Health

Purpose: Research has linked physical child abuse to later depression and anxiety (Batten, et al., 2004; MacMillan, et al. 2004). Being the victim of violence in adolescence may further increase the risk for adult depression among those who were earlier abused. However, little is known about the unique and combined effects of child abuse and other, possibly later forms, of victimization. Additionally, other stressors in the family and surrounding environment may add to an even great extent to the vulnerability of some individuals. In fact, child abuse, later victimization, and other stressors may work in combination to undermine the development of children and to increase their risk for later mental health problems.

This study used data from the Lehigh Longitudinal Study to examine long-term mental health effects of chronic physical child abuse, physical victimization in adolescence, and cumulative stress from childhood through the adolescence. We hypothesized that physical abuse, later victimization, and stressors would each increase mental health problems in adolescence and adulthood, and that they might also work synergistically to increase far more than one risk factor alone the overall likelihood of adult depression and anxiety.

Methods: Path analyses were used to assess relationships between childhood and adolescent risks, adolescent and adult depression and adult anxiety.

Results: A model comprised of the childhood, adolescent, and adulthood variables fit the data adequately (chi-square() = 3.39 (p .19); CFI = .997; TLI = .973; RMSEA= .045). Childhood abuse independently predicted depression in adolescence and adulthood (ß= 0.1, p < 0.05; ß=0.13, p < 0.01). Adolescent stress also independently predicted depression in adolescence and adulthood (ß= 0.48, p < 0.001; ß=0.11, p < 0.05), as well as adult anxiety (ß= 0.15, p < 0.05). Physical victimization in adolescence predicted adolescent depression (ß= 0.12, p <0.05). Additionally, adolescent stress mediated the relationship between victimization and depression in adolescence (ß= 0.08, p <0.05). And, adolescent depression meditated the relationship between adolescent stress and adult anxiety and depression (ß= 0.13, p < 0.001; ß=0.19, p < 0.001). Adolescent depression also mediated the effect of adolescent victimization on adult anxiety and depression (ß= 0.03, p < 0.05 ; ß= 0.05, p <0.05). Together, adolescent stress and depression mediated the effects of adolescent physical victimization on adult depression and adult anxiety (ß= 0.03, p <0.05; ß=0.02, p <0.05). Variables in the model explained 28% of the variance in adolescent depression, 24% in adult depression, and 15% in adult anxiety.

Implications: Findings highlight the need to address both stressors and depression in adolescence. As important, findings underscore the need for prevention programs targeting risk factors for child abuse-- and for treatment programs designed to help those who have been victimized so as to prevent later mental health problems.