Delineating the maladaptive pathways of child maltreatment: A mediated moderation analysis of the roles of self-perception and social support

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The current study investigated concurrent and longitudinal mediated and mediated moderation pathways among maltreatment, self-perception (i.e., loneliness and self-esteem), social support, and internalizing and externalizing behavior problems. For both genders, early childhood maltreatment (i.e., ages 0-6) was related directly to internalizing and externalizing behavior problems at age 6, and later maltreatment (i.e., ages 6-8) was directly related to internalizing and externalizing behavior problems at age 8. Results of concurrent mediation and mediated moderation indicated that early maltreatment was significantly related to internalizing and externalizing behavior problems at age 6 indirectly both through age 6 loneliness and self-esteem for boys and through age 6 loneliness for girls. Significant moderation of the pathway from early maltreatment to self-esteem, and for boys, significant mediated moderation to emotional and behavioral problems were found, such that the mediated effect through self-esteem varied across levels of social support, though in an unexpected direction. No significant longitudinal mediation or mediated moderation was found, however, between the age 6 mediators and moderator and internalizing or externalizing problems at age 8. The roles of the hypothesized mediating and moderating mechanisms are discussed, with implications for designing intervention and prevention programs.





Appleyard,Karen;Yang,Chongming;Runyan,Desmond K.. 2010. Delineating the maladaptive pathways of child maltreatment: A mediated moderation analysis of the roles of self-perception and social support. Development and psychopathology 22(2): 337-352.

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Karen Appleyard Carmody

Associate Professor in Psychiatry and Behavioral Sciences

Karen Appleyard Carmody, PhD, serves as the Deputy Director of the Duke National Center for Child Traumatic Stress (NCCTS). She is a licensed psychologist and Associate Professor in the Department of Psychiatry and Behavioral Sciences as well as the Department of Psychology and Neuroscience. Her clinical and research expertise is in infant mental health, child-parent attachment, early childhood trauma and maltreatment, and evidence-based practices to address these issues. Prior to serving at the national level, she served the Durham and NC communities for 13+ years at the Center for Child & Family Health, where she served as the Director of Early Childhood Prevention Programs. In this role, she directed three evidence-based home visiting programs serving over 1,000 families per year supported by local, state, and federal funding, and managed two federal SAMHSA grants enhance Durham's early childhood system of care and support statewide early childhood mental health workforce development. She has significant experience providing trauma treatment to children and families. Additionally, Dr. Appleyard Carmody conducted program evaluation and dissemination projects for evidence-based practices for young children who have experienced trauma and early adversity, including Attachment and Biobehavioral Catch-up (ABC) and Parent-Child Interaction Therapy (PCIT). Dr. Appleyard Carmody also is engaged at the state and national level, serving on the North Carolina Infant and Early Childhood Mental Health Association Board of Directors (Past President), the American Psychological Association's Division 37 Section on Child Maltreatment Board (Past President), and the Home Visiting Applied Research Collaborative research council.

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