The Effects of Gender and Violence Exposure On Trauma Symptoms in Cocaine-Exposed 11-Year-Olds
Child violence exposure (VE) has been associated with increased risk of trauma symptoms (TS) including anger, depression, anxiety, dissociation, and posttraumatic stress. Research has indicated that VE girls are at an increased risk for depression and anxiety, and older adolescents tend to have more TS. However, the role of gender as it relates to specific TS domains is poorly understood for the preadolescent age group. This study examines the effects of VE and gender on TS in a sample of high risk (drug-exposed) 11-year-olds.
Data are drawn from a NIDA-funded longitudinal matched comparison group study examining the effects of prenatal cocaine exposure. Multiple regression analysis examining the effects of VE at age 10 (measured by the Assessment to Liability and Exposure to Substance Use and Antisocial Behavior scale and recoded into a dichotomous variable at the upper quartile), gender, and TS at age 11 (measured by the Trauma Symptom Checklist for Children’s anger, depression, anxiety, dissociation, and posttraumatic stress scales) was conducted using numerous control variables (prenatal cocaine exposure, parent substance use, parental monitoring, parental attachment, home quality, adoptive/foster care status and pubertal timing). Only covariates correlated with VE and TS at p<.20 land significant in regression analysis at p<.10 were retained.
The sample was 80.1% African American and 52.2% female (n = 207). A third (33.3%) of girls and 24.1% of boys were VE (ns). Preliminary bivariate analyses showed significantly higher depression and anxiety scores in girls but no other significant TS differences. In multiple regression analysis, VE was related to anger (β=.37, p<.001), anxiety (β=.32, p<.001), depression (β=.29, p<.01), dissociation (β=.20, p<.01) and posttraumatic stress (β=.42, p<.001). Female gender was related to higher risk of anger and anxiety, and significant interaction effects indicated stronger effects of VE on depression and posttraumatic stress for girls. Additionally, home quality was a significant protective factor for anger and depression, parental monitoring was a significant protective factor for depression, and adoptive/foster care status was a significant risk factor for anger.
Conclusions and Implications
Findings demonstrate higher sensitivity among girls to the effects of VE on depression and posttraumatic stress. Further, girls were at higher risk than boys for anxiety and anger, accounting for VE and other covariates. The presence of a significant interaction for depression but not anxiety demonstrates the importance of examining these internalizing symptoms separately. The increased risk for anger found in VE girls contrasts with some research suggesting boys’ susceptibility to externalizing symptoms. Particularities of the measured construct, sample, or developmental stage may explain this. While the potential role of additional traumatic exposures in girls’ risk for TS needs further study, researchers and practitioners should consider potential gender differences in how preadolescents cognitively and emotionally respond to VE. Furthermore, the protective effects of parental monitoring and home quality on preadolescent TS need further research. The susceptibility of the VE children in this study to TS, along with their developmental stage, suggests the need for substance use and suicide prevention as early as elementary school.