Research has demonstrated that youth who are sexually or physically abused are at greater risk for developing depression. Although the association between depression and child maltreatment has been well documented, much less is known about the potential differences in the clinical presentation of depressive symptomatology among these victims. The current study examines differences in symptoms of depression in adolescents based on differing histories of abuse (i.e., sexual abuse only, physical abuse only, sexual and physical abuse, and no history of sexual or physical abuse), abuse incident characteristics, and gender. Participants were drawn from a subsample (n = 548) from the National Survey of Adolescents who met criteria for major depressive episode in the past year. Results indicate significant differences in severity of depression and specific depressive symptoms based on type of abuse experienced and gender. Implications for the clinical assessment and treatment of depressed adolescents with regard to abuse history are discussed.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
Angold, A., Costello, E. J., & Worthman, C. M. (1998). Puberty and depression: The roles of age, pubertal status and pubertal timing. Psychological Medicine, 28, 51-61.
3.
Angold, A., Messer, S. C., Stangl, D., Farmer, E. M. Z., Costello, E. J., & Burns, B. J. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88, 75-80.
4.
Angold, A., & Rutter, M. (1992). Effects of age and prepubertal status on depression in a large clinical sample. Developmental Psychopathology, 4, 5-28.
5.
Boney-McCoy, S., & Finkelhor, D. (1995). Psychosocial sequelae of violent victimization in a national youth sample. Journal of Consulting and Clinical Psychology, 63, 726-736.
6.
Boney-McCoy, S., & Finkelhor, D. (1996). Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships? A longitudinal, prospective study. Journal of Consulting and Clinical Psychology, 64, 1406-1416.
7.
Brent, D. A. (1995). Risk factors for adolescent suicide and suicidal behavior: Mental and substance abuse disorders, family environmental factors, and life stress. Suicide and Life-Threatening Behavior, 25, 52-63.
8.
Brent, D. A., Bridge, J., Johnson, B. A., & Connolly, J. (1996). Suicidal behavior runs in families: A controlled family study of adolescent suicide victims. Archives of General Psychiatry, 53, 1145-1152.
9.
Brown, E., & Kolko, D. (1999). Child victims’ attributions about being physically abused: An examination of factors associated with symptom severity. Journal of Abnormal Child Psychology, 27, 311-322.
10.
Centers for Disease Control. (2002). National Vital Statistics Report, 50 (16), 1-48.
11.
Clark, D. B., De Bellis, M. D., Lynch, K. G., Cornelius, J. R., & Martin, C. (2003). Physical and sexual abuse, depression, and alcohol use disorders in adolescents: Onsets and outcomes. Drug and Alcohol Dependence, 69, 51-60.
12.
Cohen, P., Cohen, J., Kasen, S., Velez, C., Hartmark, C., Johnson, J., et al. (1993). An epidemiological study of disorders in late child-hood adolescence, I: Age and gender specific prevalence. Journal of Child Psychology and Psychiatry and Allied Disciplines, 34, 851-867.
13.
Cyranowski, J. M., Frank, E., Young, E., & Shear, M. K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: A theoretical model. Archives of General Psychiatry, 57, 21-27.
14.
Essau, C. A., & Petermann, F. (1999). Depressive disorders in children and adolescents: Epidemiology, risk factors, and treatment. Norvale, NJ: Jason Aronson.
15.
Faust, J., Runyon, M. K., & Kenny, M. C. (1995). Family variable associated with the onset and impact of intrafamilial childhood sexual abuse. Clinical Psychology Review, 15, 443-456.
16.
Finkelhor, D., & Dzuiba-Leatherman, J. (1994). Victimization of children. American Psychologist, 49, 173-183.
17.
Finzi, R., Har-Even, D., Shnit, D., & Weizman, A. (2002). Psychosocial characterization of physically abused children from low socioeconomic households in comparison to neglected and nonmaltreated children. Journal of Child and Family Studies, 11, 441-453.
18.
Fischer, D. G., & McDonald, W. L. (1998). Characteristics of intrafamial and extrafamial child sexual abuse. Child Abuse and Neglect, 22, 915-929.
19.
Gorey, K. M., Richter, N. L., & Snider, E. (2001). Guilt, isolation and hopelessness among female survivors of childhood sexual abuse: Effectiveness of group work intervention. Child Abuse and Neglect, 25, 347-355.
20.
Hanson, R. F., Fricker-Elhai, A., Self-Brown, S., Kilpatrick, D. G., Saunders, B. E., & Resnick, H. S. (2004). Relations among family environment, violence exposure and psychosocial outcomes among youth—Part II: Findings from the National Survey of Adolescents. Manuscript submitted for publication.
21.
Hanson, R. F., Self-Brown, S., Kilpatrick, D. G., Fricker-Elhai, A., Saunders, B. E., & Resnick, H. S. (2004). The relationship between family environment and violence exposure among youth—Part I: Findings from the National Survey of Adolescents. Manuscript submitted for publication.
22.
Harkness, K. L., & Wildes, J. E. (2002). Childhood adversity and anxiety versus dysthymia co-morbidity in major depression. Psychological Medicine, 32, 1239-1249.
23.
Harrington, R., Fudge, H., Rutter, M., Pickles, A., & Hill, J. (1990). Adult outcomes of childhood and adolescent depression I: Psychiatric status. Archives of General Psychiatry, 47, 465-473.
24.
Hill, J. (2003). Childhood trauma and depression. Current Opinions in Psychiatry, 16, 3-6.
25.
Jehu, D. (1989). Mood disturbances among women clients sexually abused in childhood: Prevalence, etiology, treatment. Journal of Interpersonal Violence, 4, 164-184.
26.
Johnson, D. M., Pike, J. L., & Chard, K. M. (2001). Factors predicting PTSD, depression, and dissociative severity in female treatment-seeking childhood sexual abuse survivors. Child Abuse and Neglect, 25, 179-198.
27.
Johnson, R. M., Kotch, J. B., Catellier, D. J., Winsor, J. R., Dufort, V., Hunter, W., et al. (2002). Adverse behavioral outcomes and emotional outcomes from child abuse and witnessed violence. Child Maltreatment, 7, 179-186.
28.
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180.
29.
Kilpatrick, D. G., Acierno, R., Saunders, B. E., Resnick, H. S., Best, C. L., & Schnurr, P. P. (2000). Risk factors for adolescent substance abuse and dependence: Data from a national sample. Journal of Consulting and Clinical Psychology, 68, 19-30.
30.
Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. (2003). Violence, risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692-700.
31.
Kilpatrick, D. G., & Saunders, B. E. (1999) Prevalence and consequences of child victimization: Results from the National Survey of Adolescents(Final report, revised). Charleston: Medical University of South Carolina.
32.
Mannarino, A., & Cohen, J. (1996). Abuse-related attributions and perceptions, general attributions, and locus of control in sexually abused girls. Journal of Interpersonal Violence, 11, 162-180.
33.
McLeer, S. V., Deblinger, E., Atkins, M. S., Foa, E. B., & Ralphe, D. L. (1988). Post-traumatic stress disorder in sexually abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 2, 650-654.
34.
Moeller, A. T., & Steel, H. R. (2002). Clinically significant change after cognitive restructuring for adult survivors of childhood sexual abuse. Journal of Rational-Emotive and Cognitive Behavior Therapy, 20, 49-64.
35.
Nagata, T., Kaye, W. H., Kiriike, N., Rao, R., McConaha, C., & Plotnicov, K. H. (2001). Physical and sexual abuse histories in patients with eating disorders: A comparison of Japanese and American patients. Psychiatry and Clinical Neurosciences, 55, 333-340.
36.
Nolen-Hoeksema, S. (1994). An interactive model for the emergence of gender differences in depression in adolescence. Journal of Research on Adolescence, 4, 519-534.
37.
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867-879.
38.
Ruggiero, K. J., McLeer, S. V., & Dixon, J. F. (2000). Sexual abuse characteristics associated with survivor psychopathology. Child Abuse and Neglect, 24, 951-964.
39.
Runyon, M. K., & Kenny, M. C. (2002). Relationship of attributional style, depression, and posttrauma distress among children who suffered physical or sexual abuse. Child Maltreatment, 7, 254-264.
40.
Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598-611.
41.
Treatment for Adolescents with Depression Study Team. (2003). Treatment for Adolescents with Depression Study (TADS): Rationale, design, and methods. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 531-542.
42.
Tremblay, C., Hebert, M., & Piche, C. (2000). Type I and type II post-traumatic stress disorder in sexually abused children. Journal of Child Sexual Abuse, 9, 65-90.
