Histories of Childhood Maltreatment and Victimization in Adolescent Girls: The Role of PTSD
Methods: The study utilized baseline data from a trauma-focused CBT study that included 136 adolescent girls, ages 12-18 years old (mean age=14.8, SD=1.6). The girls were referred by case managers and staff from Child Protective Services. The sample was primarily youths of color—African American (85 %), and White (15 %). The girls’ current living situations were as follows: 59% with biological parents, relatives, or adopted parents; 27% in foster homes; and 14% in group homes. Structured face-to-face interviews included the following variables: 1) Frequency of Aggressive Behaviors—As Victims (18 items) assessing how many times they experienced physical, verbal, and relational aggression in the last 3 months; 2) PTSD symptoms (Foa, 2001), 3) Physical Abuse, Sexual Abuse, and Physical Neglect (Bernstein & Fink’s Childhood Trauma Questionnaire), and 4) Demographics (age, race, living situation). Data analyses included descriptive statistics, simple correlations, and path analysis to evaluate the hypothesis of mediation.
Results: Ninety percent of the girls experienced some form of victimization in the last 3 months. Correlational analyses indicated that girls who reported higher levels of physical abuse experienced higher frequencies of aggressive behaviors as victims (r = .23, p<. 01). In contrast, no significant relationships were found between either sexual abuse and physical neglect and aggressive behaviors. Sixty-six percent of the girls endorsed PTSD symptoms in the borderline-clinical range. To determine if PTSD mediated this relationship, a path analysis was conducted. Results showed that higher levels of PTSD was significantly related to higher levels of both physical abuse (B = .27, p<.001) and aggressive behaviors (B = .56, p<.0001). Furthermore, the relationship between physical abuse and aggression was no longer significant (B = .08, p<.27). Bootstrapped confidence intervals (Preacher and Hayes, 2004) confirmed the significant mediating (indirect) effect (p<.05).
Conclusions and Implications: One pathway by which physical abuse influences adolescent re-victimization is through PTSD symptoms. Results suggest that trauma treatment to reduce PTSD symptoms may be an important strategy for preventing interpersonal violence in this population.