A longitudinal study of several potential mediators of the relationship between child maltreatment and posttraumatic stress disorder symptoms
Open accessAbstract
Child maltreatment is a reliable predictor of posttraumatic stress disorder (PTSD) symptoms. However, not all maltreated children develop PTSD symptoms, suggesting that additional mediating variables explain how certain maltreated children develop PTSD symptoms and others do not. The current study tested three potential mediators of the relationship between child maltreatment and subsequent PTSD symptoms: (a) respiratory sinus arrhythmia reactivity, (b) cortisol reactivity, and (c) experiential avoidance, or the unwillingness to experience painful private events, such as thoughts and memories. Maltreated (n= 51) and nonmaltreated groups (n= 59) completed a stressor paradigm, a measure of experiential avoidance, and a semistructured interview of PTSD symptoms. One year later, participants were readministered the PTSD symptoms interview. Results of a multiple mediator model showed the set of potential mediators mediated the relationship between child maltreatment and subsequent PTSD symptoms. However, experiential avoidance was the only significant, specific indirect effect, demonstrating that maltreated children avoiding painful private events after the abuse were more likely to develop a range of PTSD symptoms 1 year later. These results highlight the importance of experiential avoidance in the development of PTSD symptoms for maltreated children, and implications for secondary prevention and clinical intervention models are discussed.
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In a multiple-mediator model along with autonomic nervous system and HPA dysregulation, experiential avoidance was the more potent predictor of subsequent PTSD symptoms in maltreated children and adolescents.
“When tested in a multiple-mediator model along with autonomic nervous system and HPA dysregulation, experiential avoidance was the more potent predictor of subsequent PTSD symptoms in maltreated children and adolescents (Shenk et al. 2014).”
From Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms (2021) · cites this paper as Shenk et al. 2014
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- Authors
- Shenk, C. E., Putnam, F. W., Rausch, J. R., Peugh, J. L., & Noll, J. G.
- Affiliations
- Pennsylvania State University (US)
- University of North Carolina at Chapel Hill (US)
- University of Cincinnati (US)
- Corresponding author
- Shenk, Chad E.
- Venue
- Development and Psychopathology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-01-21
- Volume
- 26
- Issue
- 1
- Pages
- 81-91
- ISSN
- 0954-5794 (ISSN-L)
- 1469-2198
- PMC
- PMC4966883
- OpenAlex
- W2118675997
- Cited by
- 62
- References
- 29
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 6 · 2020: 6 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 11 · 2015: 6
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Development and Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- University of Cincinnati
- National Institutes of Health (5ul1rr026314-03, UL1TR001425, 1UL1RR026314)
- National Center for Research Resources (1UL1RR026314, UL1-RR026314)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD052533)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- child abuse, post-traumatic stress disorder, posttraumatic stress symptoms, experiential avoidance, cortisol response, mediators, secondary prevention
- MeSH terms
- Adolescent, Child Abuse, Female, Heart Rate, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Longitudinal Studies, Pituitary-Adrenal System, Saliva, Stress Disorders, Post-Traumatic, Young Adult
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