Child maltreatment in Kenya, Zambia, and the Netherlands : a cross-cultural comparison of prevalence, psychopathological sequelae, and mediation by PTSS

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: a cross-cultural comparison of prevalence,

psychopathological sequelae, and mediation by PTSS

Mbagaya, C.V.

Citation

Mbagaya, C. V. (2010, December 1). Child maltreatment in Kenya, Zambia, and the Netherlands : a cross-cultural comparison of prevalence,

psychopathological sequelae, and mediation by PTSS. Retrieved from https://hdl.handle.net/1887/16193

Version: Not Applicable (or Unknown)

License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden

Downloaded from: https://hdl.handle.net/1887/16193

Note: To cite this publication please use the final published version (if applicable).

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Child Maltreatment in The Netherlands:

Prevalence, associated Sequelae and Mediation

by Posttraumatic Stress Symptoms

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7.0. Introduction

This chapter presents the results of our Dutch sample, which consisted only of females. We present descriptive statistics and bivariate associations for the variables that we investigated. Next, we present findings on the multivariate associations between child maltreatment variables and psychopathological symptomatology. Finally, we present the results of our test of mediation models with PTSS mediating the association between the various forms of child maltreatment and psychopathological symptoms.

7.1. Descriptives

Table 7.1 presents the means and standard deviations of the childhood maltreatment variables, posttraumatic stress symptoms (PTSS), social desirability and personality outcomes. The prevalence of CSA was 13% while that of CPA was 3%. Those who reported childhood neglect were 42% of the sample while 6%

reported witnessing interparental violence.

Table 7.1

Descriptive Data for Childhood Maltreatment Experiences and Personality Outcomes M

(N=305) SD

Physical abuse 1.12 0.42

Sexual abuse 1.21 0.39

Neglect 1.39 0.37

Witnessing violence 1.12 0.53

Social desirability 2.66 0.38

PTSS 1.71 0.49

Antisocial personality 1.28 0.32

Criminal tendencies 1.25 0.38

Dating violence¹ 3.10 3.21

Externalizing problems 0.00 0.81

Depressive symptoms 1.71 0.47

Borderline symptoms 1.58 0.43

Internalizing problems 1.65 0.42

1 N=254

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Table 7.2 Bivariables and Personality Variablesariate Correlations of Child Maltreatment V 712109811643125 1 Physical abuse 2 Sexual abuse-.02 .073 Neglect .27** 4 Witnessing violence.62**-.01.19** -.13*-.08-.065 Social desirability-.02 6 PTSS.25**.30**.34**.20**-.24** .09.24**.07-.48**.07.12*Antisocial personality7 8 Criminal tendencies.13*.14*.30**.06-.35**.23**.43** -.29**.32**.25**.24**.13*.15*.069 Dating violence.10 .32**.74**.77**.74**-.48**.13*.22**.14*.14*10 Externalizing problems .47**.34**.26**.25**.27**e symptoms-.41**.18**.36**.12*.19**11 Depressiv .44**.71**.49**.35**.34**.21**.54**.17**.28**.18**12 Borderline symptoms-.46** .38**.92**.93**.44**.33**.31**-.47**.55**.19**.35**.16**.22**13 Internalizing problems * p < .05 ** p < .01

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and all psychopathology variables except antisocial personality symptoms.

A history of neglect had significant associations with PTSS, social desirability, criminal tendencies, borderline personality symptoms, depressive symptoms and overall internalizing and externalizing problems. Witnessing interparental violence had significant associations with PTSS, dating violence, depressive symptoms, borderline personality symptoms, and overall internalizing and externalizing problems. Notably, social desirability was negatively related to a history of neglect, PTSS and all the psychopathology variables. This means that the higher the respondents scored on social desirability, the lower they scored on a history of neglect, PTSS and all the psychopathology variables. PTSS had significant associations with all the psychopathological symptoms. This implies that the higher the respondents scored on PTSS, the more psychopathological symptoms they reported.

7.2 Multivariate relations between child maltreatment variables and psychopathological symptomatology

Hierarchical regression analyses were used to test whether childhood maltreatment experiences predicted psychopathological symptoms. In all the analyses, social desirability was entered at step 1. At step 2, background variables (income and age) were entered. At step 3, PTSS was entered and finally at step 4, all childhood maltreatment variables (physical abuse, sexual abuse, neglect, and witnessing interparental violence) were added.

In the prediction of antisocial personality symptoms, social desirability was a significant predictor, β = -.45 (p <.01). The higher the respondents scored on social desirability the lower they scored on antisocial personality symptoms.

Income and age were not related to antisocial personality symptoms. PTSS was significantly related to antisocial personality symptoms, β = .12 (p = .05). This means that the higher the respondents scored on PTSS the higher they also scored on antisocial personality symptoms. The fourth step in the regression model was not significant. This means that after taking into account PTSS, social desirability and the background variables none of the childhood maltreatment variables were related to antisocial personality symptoms (see Table 7.3). The predictors and covariates together accounted for 25% of the variance in antisocial personality symptoms scores.

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Table 7.3

Regression Analysis Predicting Antisocial Personality Symptoms from Childhood Maltreatment Experiences with Social Desirability, Income, Age, and PTSS as Covariates

R R² R²Ch F_change df Beta¹ p

Step 1 .48 .23 .23 92.20 (1, 303) <.01

Social desirability -.45 <.01

Step 2 .49 .24 .00 0.36 (2, 301) .70

Income .02 .70

Age -.06 .28

Step 3 .50 .25 .02 7.23 (3, 300) <.01

PTSS .12 .05

Step 4 .51 .26 .01 0.71 (4, 296) .59

Physical abuse .11 .11

Sexual abuse .03 .58

Neglect -.01 .83

Witnessing violence -.04 .50

1 Betas are derived from the final block of the regression model

Childhood maltreatment experiences, social desirability, PTSS, income, and age together accounted for 21% of the variance in criminal tendencies (Table 7.4).

Social desirability was significantly related to criminal tendencies, β = -.31 (p <.01).

This implies that respondents who had higher scores on social desirability had lower scores on criminal tendencies. Income and age were not related to criminal tendencies. Also, PTSS was not a significant predictor of criminal tendencies.

After controlling for the effect of social desirability, PTSS and background variables, having a history of neglect was associated with criminal tendencies, β = .23 (p < .01). This implies that those who had higher scores on a history of neglect were likely to report more criminal behaviour. None of the other childhood maltreatment variables had significant relations with criminal tendencies when PTSS, social desirability, and the background variables were taken into account.

Hierarchical regression analysis was also conducted for the prediction of dating violence from childhood maltreatment variables and covariates (Table 7.5).

Social desirability was significantly related to dating violence, β = -.24 (p <.01).

This means that higher scores on social desirability were associated with lower scores on dating violence. Income and age were nonsignificant in the prediction of dating violence. PTSS was also not significantly related to dating violence.

After controlling for the effect of social desirability, PTSS and the background variables, none of the childhood maltreatment variables were significantly related to dating violence.

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Table 7.4

Regression Analysis Predicting Criminal Tendencies from Childhood Maltreatment Experiences with Social Desirability, Income, Age, and PTSS as Covariates

R R² R²Ch F_change Df Beta¹ p

Step 1 .34 .12 .12 41.71 (1, 303) <.01

Step 2 .36 .13 .01 1.28 (2, 301) .28

Income .04 .46

Age .02 .73

Step 3 .38 .15 .14 7.79 (1, 300) <.01

PTSS .05 .42

Step 4 .46 .21 .06 5.28 (4, 296) <.01

Neglect .23 <.01

Witnessing violence -.07 .31

1 Betas are derived from the final block of the regression model Table 7.5

Regression Analysis Predicting Dating Violence from Childhood Maltreatment Experiences with Social Desirability, Income, Age, and PTSS as Covariates

Step 1 .29 .08 .08 22.92 (1, 252) <.01

Step 2 .29 .09 .00 0.20 (2, 250) .82

Income -.03 .62

Age -.04 .50

Step 3 .34 .12 .03 8.55 (1, 249) <.01

PTSS .14 .06

Step 4 .37 .13 .02 1.37 (4, 245) .25

Physical abuse -.07 .40

Neglect .02 .79

Witnessing violence .15 .06

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Table 7.6 presents the results of the hierarchical regression predicting depressive symptoms from childhood maltreatment variables and covariates. Together, the predictors and covariates accounted for 35% of the variance in depressive symptoms. Social desirability had a significant association with depressive symptoms, β = -.31 (p <.01). This implies that the higher the respondents scored on social desirability the lower they scored on depressive symptoms. Neither age nor income was significantly related to depressive symptoms. PTSS was significantly related to depressive symptoms, β = .32 (p <.01) with higher scores on PTSS associated with more depressive symptoms. After controlling for social desirability, background variables and PTSS, only a history of neglect, β = .19 (p <.01) remained a significant predictor of depressive symptoms. Thus, higher scores on neglectful experiences during childhood were associated with more depressive symptoms.

The results of the hierarchical regression analysis conducted to predict borderline personality symptoms are presented in Table 7.7. Childhood maltreatment variables and covariates together accounted for 43% of the variance.

Social desirability was significantly related to borderline personality symptoms, β

= -.36 (p <.01). The higher the respondents scored on social desirability, the lower they scored on borderline personality symptoms. Income and age were not related to borderline personality symptoms. After controlling for social desirability and the background variables, PTSS had a significant association with borderline personality symptoms, β = .39 (p <. 01). This means that higher scores on PTSS were associated with higher scores on borderline personality symptoms. After taking into account PTSS, social desirability, and the background variables, again only a history of neglect was associated with borderline personality symptoms.

This means that respondents who had high scores on neglectful experiences during childhood had more borderline personality symptoms, β = .10 (p = .05).

Table 7.6

Regression Analysis Predicting Depressive symptoms from Childhood Maltreatment Experiences with Social Desirability, Income, Age, and PTSS as Covariates

Step 1 .41 .17 .17 61.10 (1, 303) <.01

Step 2 .43 .19 .02 3.72 (2, 301) .03

Income -.07 .15

Age .00 .97

Step 3 .57 .33 .14 62.37 (1, 300) <.01

PTSS .32 <.01

Step 4 .60 .35 .04 4.27 (4, 296) <.01

Neglect .19 <.01

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Table 7.7

Regression Analysis Predicting Borderline Personality Symptoms from Childhood Maltreatment Experiences with Social Desirability, Income , Age, and PTSS as covariates

Step 1 .46 .21 .21 80.86 (1, 303) <.01

Step 2 .46 .21 .00 .27 (2, 301) .77

Income .00 .95

Age -.08 .09

Step 3 .64 .41 .20 100.97 (1, 300) <.01

PTSS .39 <.01

Step 4 .66 .43 .02 2.37 (4, 296) .05

Neglect .10 .05

7.3. Mediation of the association between child maltreatment variables and psychopathological symptoms by PTSS

Our hierarchical regression analyses showed that PTSS significantly contributed to the variance in antisocial personality symptoms, depressive symptoms, and borderline personality symptoms. In order to examine whether the association between the various childhood maltreatment variables and psychopathology outcomes could in part be explained through PTSS, we carried out mediation analyses of all the maltreatment variables and psychopathology symptoms examined in this study. Similar to the mediation analyses that we conducted in our Kenyan and Zambian samples, we followed the procedure summarized by Baron and Kenny (1986) in order to test for mediation by PTSS in the Dutch sample.

First, there should be a significant relation between the childhood maltreatment variable and PTSS; second, there should be a significant relation between PTSS and the psychopathology variable; third, there should be a significant association between the child maltreatment variable and the psychopathology variable (total effect); and lastly, the association between the maltreatment variable and the psychopathology variable ought to decrease when PTSS is controlled for (direct effect).

In determining whether PTSS was indeed a potent mediator of the association

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between PTSS and antisocial personality symptoms was significant, β = .22 (p <

.01). The regression weight of the total effect of CPA and antisocial personality was also significant, β = .12 (p < .05). After PTSS was included in the regression, the regression weight of the direct effect dropped to nonsignificant level, β = .06 (p = .25). This implied complete mediation of the association between CPA and antisocial personality symptoms by PTSS. The Sobel test (z) showed that PTSS significantly mediated the association of CPA and antisocial personality symptoms, z = 2.84 (p < .01).

In the same way, regressions and Sobel tests were completed in order to find out whether the associations between antisocial personality symptoms and the three other child maltreatment variables in our study -- childhood sexual abuse (CSA), a history of neglect, and witnessing interparental violence -- were mediated by PTSS. The results showed that PTSS did not mediate the association between CSA and antisocial personality because the association between CSA and antisocial personality symptoms was nonsignifcant, β = .06 (p = .25). Similarly, PTSS did not mediate the association between a history of neglect and antisocial personality symptoms because the association between neglectful experiences in childhood and antisocial personality symptoms was nonsignificant β = .09 p = .12). In the same way, PTSS did not mediate the association between witnessing interparental violence and antisocial personality symptoms because the association between witnessing interparental violence and antisocial personality symptoms was not significant, β = .07 (p = .22).

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Table 7.8.

PTSS Mediating the Association between Child Maltreatment Variables and Antisocial Personality Symptoms

Child Maltreatment variable Regressions B SE β

Physical abuse

Mediation test 2.84 (p < .01)

Physical abuse – PTSS¹ 0.26 .06 .22**

PTSS - Antisocial Personality¹ 0.15 .04 .22**

Physical abuse – Antisocial

Personality¹ 0.09 .04 .12*

Physical abuse - Antisocial

Personality controlling for PTSS 0.05 .04 .06

Sexual abuse

Sexual abuse - PTSS¹ 0.36 .07 .29**

Sexual abuse – Antisocial

Personality¹ 0.05 .05 .06

Sexual abuse - Antisocial

Personality controlling for PTSS -0.01 -.01 .90

Neglect

Neglect - PTSS¹ 0.42 .07 .32**

Neglect - Antisocial Personality¹ 0.08 .05 .09 Neglect - Antisocial Personality

controlling for PTSS 0.01 .05 .01

Witnessing violence

PTSS - Witnessing violence¹ 0.17 .05 .18**

Witnessing violence - Antisocial

Personality¹ 0.04 .03 .07

Witnessing violence - Antisocial

Personality controlling for PTSS 0.02 .03 .96

* p < .05. **p < .01.

1 controlling for the third variable

Table 7.9 shows the regression coefficients and the Sobel test results of the mediation models involving childhood maltreatment variables and criminal tendencies. The model testing CPA, PTSS and criminal tendencies showed significant associations between CPA and PTSS, β = .22 (p < .01), and between PTSS and criminal tendencies, β = .21 (p < .01). Further, the regression weight of the total effect of CPA on criminal tendencies was significant, β = .13 (p < .05). After controlling for PTSS, the weight of the direct effect dropped to a nonsignificant level, β = .08 (p = .22). The Sobel test showed that PTSS fully mediated the association of CPA and criminal tendencies, z = 2.67 (p < .01).

Similarly, the model testing CSA, PTSS and criminal tendencies showed a

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criminal tendencies dropped to a nonsignificant level, β = .07 (p = .22). The Sobel test indicated that the complete mediation of the association between CSA and criminal tendencies by PTSS was significant, z = 2.79 (p < .01). In the same way, the model testing neglect, PTSS, and criminal tendencies showed a significant association between a history of neglect and PTSS, β = .29 (p < .01) and between PTSS and criminal tendencies, β = .15 (p < .01). The regression weight of the total effect of a history of neglect on criminal tendencies was significant, β = .30 (p

< .01). After controlling for PTSS, the regression weight of the direct effect of neglectful experiences during childhood on criminal tendencies dropped but remained significant, β = .25 (p < .01). Sobel test results showed that the partial mediation by PTSS was significant, z = 2.24 (p = .02).

In contrast, PTSS did not mediate the association between witnessing interparental violence and criminal tendencies. This is because of the nonsignificant association between witnessing interparental violence and criminal tendencies, β = .06 (p = .28).

Table 7.9.

PTSS Mediating the Association between Child Maltreatment Variables and Criminal Tendencies

Child maltreatment Regressions B SE β

Physical abuse

Physical abuse - PTSS¹ 0.26 .06 .22**

PTSS - Criminal tendencies ¹ 0.17 .05 .31**

Physical abuse - Criminal

tendencies ¹ 0.12 .05 .13*

Physical abuse - Criminal

tendencies controlling for PTSS 0.07 .05 .08

Sexual abuse

Sexual abuse - Criminal tendencies ¹ 0.13 .05 .14*

Sexual abuse - Criminal tendencies

Neglect history

Mediation test 2.24 (p = .02)

Neglect - PTSS¹ 0.39 .07 .29**

Neglect - Criminal tendencies ¹ 0.31 .06 .30**

Neglect - Criminal tendencies

controlling for PTSS 0.26 .06 .25**

Witnessing violence

Witnessing violence - PTSS¹ 0.17 .05 .18**

Witnessing violence - Criminal

tendencies ¹ 0.05 .04 .06

Witnessing violence - Criminal

tendencies controlling for PTSS 0.01 .04 .02

* p < .05. ** p < .01

1 controlling for the third variable.

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Table 7.10 shows the regression coefficients and the Sobel test results of the mediation models involving childhood maltreatment variables and dating violence. PTSS did not mediate the associations between CPA and dating violence and between a history of neglect and dating violence. This was because of the nonsignificant associations between CPA and dating violence, β = .06 (p = .37) and between a history of neglect and dating violence, β = .10 (p = .11).

Conversely, the model testing CSA, PTSS and dating violence showed that there was a significant association between CSA and PTSS, β = .28 (p < .01) and between PTSS on dating violence, β = .22 (p < .01). The regression weight of the total effect of CPA and dating violence was also significant, β = .13 (p = .04).

After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .06 (p = .33), implying complete mediation of the association between CSA and dating violence by PTSS. The Sobel test showed that this mediation was significant, z = 2.80 (p < .01).

The model testing witnessing interparental violence, PTSS and dating violence showed significant associations between witnessing interparental violence and PTSS, β = .17 (p < .01) and between PTSS and dating violence, β = .22 (p < .01). The regression weight of the total effect of witnessing interparental violence on dating violence was β = .15 (p < .05). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .10 (p = .11) implying complete mediation of the association between witnessing interparental violence and dating violence by PTSS. The Sobel test showed that this mediation was significant, z = 2.22 (p = .02).

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Table 7.10.

PTSS Mediating the Association Between Child Maltreatment Variables and Dating Violence

Regressions B SE β

Physical abuse

PTSS - Dating violence¹ 1.55 .41 .24**

Physical abuse - Dating violence¹ 0.43 .48 .06 Physical abuse - Dating violence

Sexual abuse

Sexual abuse - Dating violence¹ 1.04 .45 .13*

Sexual abuse - Dating violence

Neglect

Neglect - PTSS¹ 0.44 .08 .33**

Neglect - Dating violence¹ 0.87 .54 .10 Neglect - Dating violence

Witnessing violence Mediation test 2.22(p = .02)

Witnessing violence - Dating

violence¹ 0.96 .41 .15*

Witnessing violence - Dating

violence controlling for PTSS 0.67 .41 .10

* p < .05. ** p < .01

The regression coefficients and the Sobel test results of the mediation model involving childhood maltreatment variables and the overall score for externalizing problems are presented in Table 7.11. The results showed that PTSS significantly mediated all the associations between the child maltreatment variables and externalizing behaviour problems. The model testing CPA, PTSS and externalizing behaviour problems showed that the association between CPA and PTSS was significant, β = .20 (p < .01). The association between PTSS and externalizing problems was also significant β = .30 (p < .01). Further, the regression weight of the total effect of CPA on externalizing problems was significant, β = .14 (p = .02). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .06 (p = .28). The Sobel test showed that PTSS fully mediated the association between CPA and externalizing problems, z = 3.27 (p <.01).

Similarly, the model testing CSA, PTSS and externalizing problems showed significant associations between CSA and PTSS, β = .26 (p < .01), and between PTSS and externalizing problems, β = .30 (p = .01). The regression weight of the total effect of CSA on externalizing problems was β = .14 (p < .01). After controlling

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for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .05 (p = .37). The Sobel test showed that the complete mediation of the association between CSA and externalizing problems by PTSS was significant, z

= 3.46 (p < .01).

In the same away, the model testing a history of neglect, PTSS and externalizing problems showed significant associations between a history of neglect and PTSS, β = .28 (p < .01), and between PTSS and externalizing problems, β = .27 (p < .01). The regression weight of the total effect of neglectful experiences during childhood on externalizing problems was also significant, β = .22 (p < .01). After controlling for PTSS, the regression weight of the direct effect dropped but remained significant, β = .13 (p = .04). The Sobel test showed that PTSS partially mediated the association between a history of neglect and externalizing problems, z = 3.51 (p <.01).

In testing whether PTSS mediated the association between witnessing interparental violence and externalizing problems, we found that witnessing interparental violence had a significant association with PTSS, β = .16 (p < .01).

There was also a significant association between PTSS and externalizing problems, β = .31 (p = .01). The regression weight of the total effect of witnessing interparental violence on externalizing problems was β = .13 (p = .03). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .07 (p = .22). The Sobel test showed that the complete mediation of the association between witnessing interparental violence and externalizing problems by PTSS was significant, z = 2.65 (p < .01).

In testing whether PTSS mediated the association between child maltreatment experiences and depressive symptoms, a series of regressions and Sobel tests were conducted. The results showed that PTSS significantly mediated the associations between the various child maltreatment variables and depressive symptoms (Table 7.12 ) The model testing CPA, PTSS, and depressive symptoms showed significant associations between CPA and PTSS, β = .16 (p < .01), and between PTSS and depressive symptoms, β = .45 (p < .01). Further, the regression weight for the total effect of CPA on depressive symptoms was significant, β = .19 (p <

.01). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .08 (p = .14). The Sobel test results showed that PTSS, fully mediated the association of CPA and depressive symptoms, z = 2.98 (p <

.01).

In the same way, the model testing CSA, PTSS, and depressive symptoms showed significant associations between CSA and PTSS β = .25 (p < .01), and between PTSS and depressive symptoms, β = .48 (p < .01). The regression weight of the total effect of CSA on depressive symptoms was β = .12 (p = .03). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = -.02 (p = .67). The Sobel test showed that the complete mediation of the association between CSA and depressive symptoms by PTSS was significant, z = 4.50 (p < .01).

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significant, β = .36 (p < .01). After controlling for PTSS, the regression weight of the direct effect dropped but remained significant, β = -.23 (p < .01). The Sobel test showed that the partial mediation of the association between a history of neglect and depressive symptoms by PTSS was significant, z = 3.23 (p < .01).

Similarly, the model involving witnessing interparental violence in childhood, PTSS, and depressive symptoms showed significant associations between witnessing interparental violence and PTSS, β = .12 (p = .02), and between PTSS and depressive symptoms, β = .46 (p < .01). The regression weight of the total effect of witnessing interparental violence on depressive symptoms was β = .18 (p < .01).

After controlling for PTSS, the direct effect dropped to a nonsignificant level, β

= .09 (p = .09). The Sobel test showed that PTSS fully mediated the association between witnessing interparental violence and depressive symptoms, z = 2.13 (p

< .01).

Table 7.11.

PTSS Mediating the Association between Child Maltreatment Variables and Externalizing Problems

Physical abuse

PTSS - Externalizing¹ 0.51 .09 .30**

Physical abuse – Externalizing¹ 0.26 .11 .14*

Physical abuse - Externalizing

Sexual abuse

Sexual abuse – Externalizing¹ 0.30 .12 .14**

Sexual abuse - Externalizing

Neglect

Mediation test 3.51 (p < .01)

Neglect - PTSS¹ 0.38 .07 .28

Neglect – Externalizing¹ 0.49 .12 .22**

Neglect - Externalizing controlling

for PTSS 0.29 .13 .13*

Witnessing violence Mediation test 2.65 (p < .01)

Witnessing violence – Externalizing¹ 0.20 .08 .13*

Witnessing violence - Externalizing

* p < .05. ** p < .01.

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Table 7.12.

PTSS Mediating the Association between Child Maltreatment Variables and Depressive Symptoms

Child Maltreatment Regressions B SE β

Physical abuse Mediation test 2.98 (p < .01)

Physical abuse – Depressive

symptoms¹ 0.19 .06 .16**

PTSS – Depressive symptoms¹ 0.44 .05 .45**

Physical abuse – Depressive

symptoms¹ 0.21 .06 .19**

Physical abuse - Depressive

symptoms controlling for PTSS 0.09 .06 .08

Sexual abuse Mediation test 4.50 (p< .01)

PTSS - Depressive symptoms¹ 0.46 .05 .48**

Sexual abuse – Depressive

symptoms¹ 0.15 .07 .12*

Sexual abuse – Depressive

symptoms controlling PTSS -0.03 .06 -.02

Neglect Mediation test 3.23 (p< .01)

Neglect - PTSS¹ 0.25 .07 .19**

Neglect – Depressive symptoms¹ 0.46 .07 .36**

Neglect - Depressive symptoms

controlling for PTSS 0.29 .07 .23**

Witnessing violence Mediation test 2.13 (p= .03)

Witnessing violence - PTSS¹ 0.11 .05 .12*

Witnessing violence – Depressive

symptoms¹ 0.16 .05 .18**

Witnessing violence - Depressive

symptoms controlling PTSS 0.08 .05 .09

* p < .05. ** p < .01.

The regression coefficients and the Sobel test results of the mediation models involving childhood maltreatment variables and borderline personality symptoms are presented in Table 7.13. PTSS significantly mediated the associations between all the child maltreatment variables and borderline personality symptoms.

The model testing CPA, PTSS, and borderline personality symptoms showed significant associations between CPA and PTSS, β = .14 (p < .01), and between PTSS and borderline personality symptoms, β = .52 (p < .01). The regression weight of the total effect of CPA on borderline personality symptoms was also significant, β = .21 (p < .01). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .09 (p = .09). The Sobel

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.01), and between PTSS and borderline personality symptoms, β = .54 (p < .01). The regression weight of the total effect of CSA on borderline personality symptoms was also significant, β = .18 (p < .01). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .02 (p < .71), implying complete mediation by PTSS. Consequently, the Sobel test indicated that the mediation of the association between CSA and borderline personality symptoms by PTSS was significant, z = 4.21(p < .01).

The model testing a history of neglect, PTSS, and borderline personality symptoms showed significant associations between a history of neglect and PTSS, β = .28 (p < .01) and between PTSS and borderline personality symptoms, β = .27 (p < .01). The regression weight of the total effect of a history of neglect on borderline personality symptoms was also significant, β = .22 (p < .01). After controlling for PTSS, the regression weight of the direct effect of a history of neglect on borderline personality symptoms dropped but remained significant, β = .13 (p = .04). The Sobel test showed that the partial mediation by PTSS was significant, z = 3.51 (p < .01).

The model involving witnessing interparental violence showed significant associations between witnessing interparental violence in childhood and PTSS, β = .11 (p = .03), and between PTSS and borderline personality symptoms, β = .53 (p < .01). The regression weight of the total effect of witnessing interparental violence on borderline personality symptoms was also significant, β = .17 (p <

.01). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .06 (p = .21), implying complete mediation of the association between witnessing interparental violence and borderline personality symptoms by PTSS. The Sobel test showed that this mediation was significant, z

= 1.97 (p = .05).

Table 7.14 presents the regression coefficients and the Sobel test results of the mediation models involving childhood maltreatment variables and the overall score for internalizing problems. The model testing CPA, PTSS, and internalizing problems showed significant associations between CPA and PTSS, β = .14 (p <

.01), and between PTSS on internalizing problems, β = .52 (p < .01). The regression weight of the total effect of CPA on internalizing problems was also significant, β = .22 (p < .01). After controlling for PTSS, the regression weight of the direct effect dropped to a nonsignificant level, β = .09 (p = .08). This implies that the mediation of the association between CPA and internalizing problems by PTSS was complete. The Sobel test showed that this mediation was significant, z = 2.59 (p <.01).

In the same way, the model testing CSA, PTSS, and internalizing problems showed a significant associations between CSA and PTSS, β = .22 (p < .01), and between PTSS and internalizing problems, β = .55 (p < .01). The regression weight of the total effect of CSA on internalizing problems was β = .16 (p < .01). After controlling for PTSS, the relation between CSA and internalizing problems became nonexistent, β = .00 (p = .95). The Sobel test showed that the complete mediation of the association between CSA and internalizing problems by PTSS was significant, z = 4.20 (p < .01).

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The model testing a history of neglect, PTSS, and internalizing problems showed significant associations between a history of neglect and PTSS, β = .17 (p <

.01) and between PTSS and internalizing problems, β = .48 (p < .01). The regression weight of the total effect of a history of neglect on internalizing problems was also significant, β = .35 (p < .01). After controlling for PTSS, the regression weight of the direct effect of a history of neglect on internalizing problems dropped but remained significant, β = .19 (p = .04). The Sobel test showed that the partial mediation of the association between neglectful experiences during childhood and internalizing problems by PTSS was significant, z = 3.00 (p < .01).

Similarly, the model testing the mediation of the relation between witnessing interparental violence and internalizing problems by PTSS showed that the association between witnessing interparental violence and PTSS was significant, β = .10 (p = .05). In the same way, the association between PTSS and internalizing problems was significant, β = .53 (p < .01). Further, there was a significant association between witnessing interparental violence and internalizing problems, β = .19 (p < .01). After controlling for PTSS, the regression weight of the direct effect of witnessing interparental violence on internalizing problems dropped to a nonsignificant level, β = .09 (p =.10). In spite of the drop in the regression weight of the direct effect, the Sobel test showed that PTSS did not significantly mediate the association between witnessing interparental violence and internalizing problems, z = 1.78 (p = .08).

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Table 7.13.

PTSS Mediating the Association between Child Maltreatment Variables and Borderline Personality Symptoms

Physical abuse Mediation test 2.60 (p< .01)

PTSS – Borderline symptoms¹ 0.46 .04 .52**

Physical abuse – Borderline

symptoms¹ 0.22 .06 .21**

Physical abuse - Borderline

symptoms controlling for PTSS 0.09 .05 .09 Sexual abuse

Mediation test 3.95 (p< .01)

Sexual abuse – Borderline

symptoms¹ 0.20 .06 .18**

Sexual Abuse - Borderline

symptoms controlling for PTSS 0.02 .06 .02 Neglect

Mediation test 3.43 (p<

01)

Neglect - PTSS¹ 0.26 .07 .20**

Neglect – Borderline symptoms¹ 0.33 .06 .28**

Neglect - Borderline symptoms

controlling for PTSS 0.13 .06 .12*

Witnessing violence Mediation test 1.97 (p = .05)

Witnessing violence –

Borderline symptoms¹ 0.14 .05 .17**

Witnessing violence - Borderline

* p < .05. ** p < .01.

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Table 7.14.

PTSS Mediating the Association between Child Maltreatment Variables and Internalizing problems

Physical abuse

Mediation test 2.59 (p< .01)

PTSS – Internalizing¹ 0.45 .04 .52**

Physical abuse - Internalizing¹ 0.22 .06 .22**

Physical Abuse - Internalizing

Sexual abuse

Sexual abuse - Internalizing¹ 0.17 .06 .16**

Sexual abuse - Internalizing

Neglect

Neglect - PTSS¹ 0.22 .07 .22**

Neglect - Internalizing ¹ 0.40 .06 .35**

Neglect - Internalizing controlling

for PTSS 0.21 .06 .19**

Witnessing Violence Mediation test 1.78 (p = .08)

Witnessing violence - Internalizing¹ 0.15 .05 .19**

Witnessing violence - Internalizing

* p < .05. ** p < .01.

7.4. Mediation of child maltreatment variables and psychopathological symptoms by social desirability

Similar analyses were conducted to determine if social desirability significantly mediated the associations between childhood maltreatment variables and psychopathological symptomatology. In all the mediation models, social desirability was not a significant mediator of the association between child maltreatment variables and psychopathological symptoms. This implies that the need to give socially desirable responses did not influence the association between the child maltreatment variables and psychopathological symptoms; therefore the substantive models involving PTSS in the Dutch sample were valid.

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significantly related to antisocial personality symptoms, depressive symptoms and borderline personality symptoms. After controlling for social desirability, background variables and PTSS, a history of neglect was the only child maltreatment variable that was associated with psychopathological symptoms, more specifically with criminal tendencies, depressive symptoms and borderline personality symptoms.

The mediation models showed that PTSS significantly mediated the associations between CPA and all psychopathological symptoms except dating violence. Also, PTSS significantly mediated the associations between CSA and all psychopathology outcomes except antisocial personality symptoms.

In addition, PTSS significantly mediated the associations between neglect and all psychopathological symptoms except antisocial personality symptoms and dating violence. Further, PTSS significantly mediated the associations between witnessing interparental violence and the following psychopathological symptoms: dating violence; externalizing behaviour problems; depressive symptoms; and borderline personality symptoms.