Adolescent Childbirth Moderates the Association between Childhood Sexual Abuse and Depressive Symptoms in Emerging Adulthood

• In Event: Parenthood at Risk: Disentangling Influences of Maternal Childhood Maltreatment from Other Adverse Experiences

Abstract

Depression is one of the most common mental health disorders among adolescents and young adults (World Health Organization, 2019). It increases the risk for many negative consequences across the lifespan, including increased vulnerability to suicidality (Mahli & Mann, 2018). Studies have shown that childhood maltreatment and adolescent pregnancy and childbirth can increase risk for the development of depression (e.g., Cicchetti & Toth, 2016; Li et al., 2016; Estrin et al., 2019), and recent findings suggest that adolescent pregnancy and childhood maltreatment interact to heighten risk for depression in late adolescence (Russotti et al., 2020).There is a need to extend this work to understand the etiology of depression in the transition to adulthood, a developmental period marked by heightened vulnerability (Arnett, 2000). However, few studies have examined the interactive and unique associations between childhood maltreatment, adolescent pregnancy and childbirth, and depressive symptoms in emerging adulthood. Those that have often use retrospective measures of maltreatment and pregnancy, with limited specificity regarding subtypes of maltreatment, and the distinction between adolescent pregnancy and childbirth.

Addressing these gaps and using a prospective, longitudinal design, this study aimed to examine whether adolescent pregnancy and childbirth would heighten the vulnerability of childhood physical and sexual abuse on depression symptoms in the transition to emerging adulthood for young women with a history of dual-system involvement. The sample was 166 young women who enrolled in a randomized clinical trial of Treatment Foster Care Oregon for girls with juvenile justice involvement. In this study, time 1 was baseline (Mage = 15.31 SDage = 1.17) and time 2 was a follow-up when participants were transitioning to emerging adulthood (Mage = 22.85, SDage = 3.11). Over half of the sample experienced physical abuse (57.6%) and sexual abuse (66.7%); participants were from a range of racial and ethnic backgrounds White (63.3%), Multiracial (22.4%), Black (2%), Native American (2%), Latina (10.2%). Maltreatment data were collected through official child welfare records; adolescent pregnancy and childbirth data were prospectively collected through caregiver and participant report, every 6 months; depressive symptoms were measured using the Center for Epidemiological Studies-Depression Scale (Radloff, 1977).

Moderation analyses were performed using the Process macro for SPSS (version 3.4.1;
Hayes, 2019) to test whether adolescent pregnancy and childbirth moderated the associations between child sexual abuse and physical abuse and emerging adulthood depression symptoms, after considering the effects of age, randomization condition, and baseline depression symptoms. Results showed that the effect of adolescent childbirth on depressive symptoms in emerging adulthood was significantly heightened for participants who experienced child sexual abuse (b = 8.29, p = .03, 95% CI[.87, 15.71]. There was no evidence that child physical abuse and adolescent pregnancy and childbirth individually or interactively predicted emerging adult depressive symptoms. Policy and Practice implications underscore the need to screen for depression in the transition to emerging adulthood, and further, the need to screen for childhood sexual abuse to determine if additional supports are needed for adolescents with this trauma history who are experiencing pregnancy and who may be at heightened risk for depression.

Authors

• Maria Schweer-Collins, University of Oregon
  Presenting Author

• Camille Cioffi, University of Oregon
  Non-Presenting Author

• Leslie D. Leve, University of Oregon
  Non-Presenting Author