Child maltreatment affects millions of youths in the United States and poses numerous detrimental effects to individuals, families, and the community. Neglect is the most commonly reported yet least studied form of child maltreatment. All types of child maltreatment may result in negative outcomes, but the chronic and pervasive nature of child neglect poses a significant threat to child development. No studies have been published evaluating the role of child neglect in the development of Posttraumatic Stress Disorder (PTSD) and PTSD-related symptoms.

This study examined whether neglect has an additive traumatic effect on maltreated adolescents. The first hypothesis was that adolescents who had experienced only neglect, in the absence of other maltreatment, would exhibit PTSD, dissociation, and depression symptoms similar to peers who had a history of other maltreatment. The second hypothesis was that adolescents who had experienced neglect in concert with other maltreatment would exhibit more severe symptoms of PTSD, dissociation, and depression than adolescents who had experienced maltreatment without neglect. The third hypothesis was that gender, age, and specific family factors will influence symptom severity of PTSD, dissociation, and depression symptoms.

INTRODUCTION

CONCLUSIONS

REFERENCES

Child Neglect and Trauma: The Additive Traumatic Effects of Neglect on Maltreated Adolescents

Adrianna Wechsler, Harpreet Kaur, Christina Patterson, Christopher KearneyUniversity of Nevada, Las Vegas

Participants:67 adolescents from Child Haven/Department of Family ServicesAges 11 – 17 years (M=14.5, SD=1.6)36 females, 30 males, 1 male to female transgender individual

Procedure:Participants were in CPS custody at time of assessment. Once assent and consent forms were completed, a semi-structured interview and self-report forms were completed. All participation was voluntary, and the assessment could be stopped at any time. Assessments were conducted in a confidential environment. Following each assessment, participants were debriefed and provided with a journal for thoughts/feelings and information on relaxation techniques and healthy coping strategies. All information was then deidentified and stored in a locked cabinet.

Measures:Demographic Information Sheet:

Gathered information about race/ethnicity, age, gender, country of origin, religion, SES, and biological parental information

Children’s PTSD Inventory (CPTSD-I) (Saigh, 1998):Semi-structured interview for ages 7-18 to assess for DSM-IV-TR PTSD

Adolescent Dissociative Experiences Scale (A-DES) (Armstrong et al., 1997):A 30-item self-report questionnaire for ages 12-18 on a Likert-type scale to assess dissociative symptoms

Children’s Depression Inventory (CDI) (Kovacs, 1992):A 27-item self-report questionnaire that assesses depression in children ages 7-17 in the two weeks prior to the assessment

Family Environment Scale (FES) (Moos & Moos, 1986):90-item true/false self-report questionnaire assessing aspects of family-of-origin

METHODS RESULTS: ONE-WAY ANOVA

Study findings indicate that adolescents who experienced neglect exhibited PTSD-related symptoms similar to adolescents who experienced other forms of maltreatment. Results did not support the notion that neglect has an additive traumatic effect on maltreated youth. However, this study disproves the misconception that neglect is a benign form of maltreatment. Neglected youth are as likely to develop PTSD, depression, and dissociation symptoms as their physically, sexually, and otherwise abused peers.

Female participants exhibited significantly more PTSD, depression, and dissociative symptoms than male participants. Results also indicate that specific family factors and social supports relate to PTSD and may influence symptom expression.

Results should be interpreted with caution due to specific study limitations. Limitations include a relatively small sample size, potential misinformation from youths, lack of parental reports, lack of biological measures, reliance on a shelter-based population, and incomplete records.

Figure 3: Means for CPTSD-I Symptoms by Maltreatment History

*CPTSD-I E displayed a trend towards significance (p=.07).

RESULTS: T-TESTS

Administration on Children, Youth, and Families (2007). Child maltreatment 2005 (U.S. Department of Healthand Human Services No. 16). Washington, DC: U.S. Government Printing Office.

Azar, S. T., & Wolfe, D. A. (2006). Child physical abuse and neglect. In E. Mash & R. Barkley (Eds.), Treatment of childhood disorders (3rd ed.) (pp. 595-646). New York: Guilford.Hildyard, K. L., & Wolfe, D. A. (2002). Child neglect: Developmental issues and outcomes. Child Abuse and Neglect, 26, 679-695.McSherry, D. (2007). Understanding and addressing the 'neglect of neglect': Why are we making a

mole-hill out of a mountain? Child Abuse and Neglect, 31, 607-614. National Research Council. (1993). Understanding child abuse and neglect. Washington, DC: National Academy Press. Retrieved from http://books.nap.edu/openbook.php.Wolock, I., & Horowitz, B. (1985). Child maltreatment as a social problem: The neglect of neglect. American Journal of Orthopsychiatry, 54, 530-543.

Figure 1: CPTSDI-I Scores by Maltreatment Types

Figure 2: Self-report of Ethnic Identity (N=67)

AA= Asian-American; NA= Native American

Figure 4: Means for CDI and A-DES Symptoms by Maltreatment History

*CDI D: Adolescents with a history of neglect only had means significantly lower than adolescents with a history of maltreatment alone or maltreatment in concert with neglect ** A-DES D: Adolescents with a history of neglect only had mean scores significantly lower than adolescents with a history of maltreatment alone or maltreatment in concert with neglect

Figure 6: PTSD-Related Symptom Means by Neglect History

Note: * = p<.05; ** = p< .01

Table 1: Dependent Variables of PTSD Related Symptoms

CPTSD-I A-DES CDI Total Score Total Score Total ScoreA Situational Reactivity A Dissociative Amnesia A Negative MoodB Reexperiencing B Absorption/ B Interpersonal

Imaginative Involvement ProblemsC Avoidance/Numbing C Passive Influence C IneffectivenessD Increased Arousal D Depersonalization/ D Anhedonia Derealization E Significant Distress E Negative Self- Esteem

Figure 5: PTSD-Related Symptom Means by Gender

Note: * = p<.05; ** = p<.01; *** = p<.001Does not include the one male to female transgender participant