Cecil, CAM; (2013) The Impact of Childhood Maltreatment in a Community Sample of High-Risk Youth. Doctoral thesis , UCL (University College London).

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Abstract

Childhood maltreatment represents a global phenomenon and a major public health concern. Despite considerable advances in the field, a number of important gaps have yet to be fully addressed. The current thesis set out to empirically address four outstanding research questions using data drawn from a community sample of high-risk youth. First, we examined whether childhood maltreatment and community violence exposure exert independent, additive or interactive effects on mental health (Chapter 2). Findings point to the existence of both common and distinct effects. While maltreatment predicted symptoms across a broad range of mental health domains, the impact of community violence was more constrained. Typically, these forms of adversity additively affected mental health. Second, we explored whether distinct forms of maltreatment uniquely impact mental health functioning (Chapter 3). Maltreatment types were highly interrelated and frequently co-occurring. We identified both shared and unique effects of maltreatment types on mental health. Emotional abuse emerged as the sole unique contributor to internalizing difficulties and trauma symptoms. Third, we investigated whether variants of callous-unemotional traits in youth are differentially associated with maltreatment history and markers of individual functioning (Chapter 4). Maltreatment was a key discriminating factor between variants. The combination of high anxiety and high callous-unemotional traits indexed a particularly vulnerable group of youth characterized by increased psychopathology and suicide risk. Finally, we tested the psychometric properties of the first non-verbal screening tool of family aggression (Chapter 5). We found initial support for the reliability, validity and diagnostic accuracy of this measure in detecting multiple forms of family aggression, including direct victimization and exposure to intimate partner violence. Overall, findings from the current thesis significantly advance knowledge of the processes by which interrelated forms of developmental adversity combine to affect mental health, as well as elucidating factors associated with individual heterogeneity to maltreatment responses.

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