Mindfulness As a Moderator of the Relationship between Child Maltreatment and Mental Health Outcomes

Background and Purpose. Research suggests that child maltreatment increases risks of developing mental health issues. However, not all individuals who experience child maltreatment develop mental illness. Certain protective factors, such as mindfulness, may safeguard against negative outcomes associated with child maltreatment. Meanwhile, research on mindfulness’s potential benefits for maltreated adolescents in particular is lacking. This study examined the moderating effects of mindfulness in pathways from child maltreatment (emotional abuse, physical abuse, sexual abuse, and neglect) to mental health outcomes (anxiety and aggression). It addressed research gaps to include whether mindfulness is an amenable protective factor for maltreated adolescents and the extent of benefits it may confer to them. Grounded in Luthar’s (1993) conceptualization of childhood resilience and Creswell and Lindsay’s (2014) mindfulness stress buffering account, this study investigated mindfulness as a moderator (M) between child maltreatment (X) and mental health outcomes (Y). It hypothesized: 1) child maltreatment predicts higher anxiety and aggression, 2) higher mindfulness predicts lower anxiety and aggression, and 3) mindfulness moderates child maltreatment’s negative effects on mental health such that at high mindfulness levels maltreated adolescents have lower anxiety and aggression compared to non-maltreated adolescents.

Methods. This study analyzed data from the Young Adolescent Project, an ongoing longitudinal study of the effects of child maltreatment on development. The multiethnic sample included 351 adolescent participants (223 maltreated, 128 non-maltreated, mean age = 18.3 years) at 7-year follow-up (Time 4; 77% retention rate). Maltreated participants were recruited from active cases in a child welfare agency. Non-maltreated participants were recruited based on matching demographic profiles. Prospective reports of child maltreatment were measured by the Maltreatment Case Record Abstraction Instrument (MCRAI) at Time 1. The Comprehensive Trauma Interview (CTI) at Time 4 captured additional self-reported child maltreatment experiences. The Mindful Attention Awareness Scale (MAAS), Child and Adolescent Mindfulness Measure (CAMM), Multidimensional Anxiety Scale for Children (MASC), and Reactive-Proactive Aggression Questionnaire (RPQ) were also utilized at Time 4. Step-wise hierarchical linear regression analyses tested main and interaction effects of child maltreatment and mindfulness on anxiety and aggression.

Results. Mindfulness negatively predicted anxiety and aggression. Mindfulness buffered negative effects of emotional abuse on anxiety and sexual abuse on aggression. At higher mindfulness levels, emotionally abused participants reported lower anxiety and sexually abused participants reported lower aggression compared to their non-abused counterparts. Mindfulness benefited emotionally and sexually abused participants at roughly twice the rates of benefit for non-abused counterparts. Mindfulness moderated the pathway from physical abuse to anxiety with unexpected directionality in the interaction effect. Prospective maltreatment reports uncovered aggression-related findings and conjoint prospective-and-self reports revealed anxiety-related findings.

Conclusions and Implications. Mindfulness is an amenable protective factor and it may benefit maltreatment survivors especially. Objective maltreatment reporting may better suit externalizing symptoms and self-reports may be pertinent for internalizing symptoms. Post-hoc analyses suggest that unexpected directionality in the moderation of physical abuse on anxiety may be due to adaptively heightened vigilance among females, as opposed to maladaptive neuroticism. Replication studies utilizing larger sample sizes are recommended to advance knowledge of mindfulness’s protective potential.