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. Author manuscript; available in PMC: 2026 Mar 10.
Published in final edited form as: Child Maltreat. 2018 Dec 4;24(2):203–212. doi: 10.1177/1077559518814680

Does Social Support Mediate the Association between Maltreatment Experiences and Depressive Symptoms in Adolescence

Sonya Negriff 1,*, Julie A Cederbaum 1, Daniel S Lee 1
PMCID: PMC12970608  NIHMSID: NIHMS2140815  PMID: 30514100

Abstract

The current study examined social support as a mediator between maltreatment experiences (number of victimizations, maltreatment types) and depressive symptoms in adolescence. The data came from the first two timepoints of a longitudinal study of the effects of maltreatment on adolescent development. The enrolled sample were 454 male and females, (n=303 maltreated; n=151 comparison) between 9–13 years (Mage=10.82); Time 2 occurred approximately one year after baseline. Maltreatment data came from case records; participants reported on perceived social support and depressive symptoms. Results from path models indicated that depressive symptoms mediated the association between maltreatment experiences (i.e., physical abuse, neglect, and number of maltreatment victimizations,) and family social support. There was no evidence that social support functioned as a mediator. This is the first study to find support for depressive symptoms as a mechanism linking maltreatment with decreased perceived family support. These findings point to the importance of assessing mental health and support simultaneously to understand the functioning of youth with maltreatment histories.

Keywords: child maltreatment, social support, depressive symptoms

Experiences of major depressive episodes among adolescents has steadily increased since 2004; in 2016, 3.1 million adolescents age 12 to 17 years (12.8%) reported a major depressive episode in the past year (CBHSQ, 2017). Observing violence and family conflict generally (Eisman, Stoddard, Heinze, Caldwell, & Zimmerman, 2015), and experiencing maltreatment specifically (Li, D’Arcy, & Meng, 2016; Salazar, Keller, & Courtney, 2011), are associated with depressive symptoms. Further, there is a known dose effect, whereby chronicity of maltreatment increases the likelihood of experiencing internalizing behaviors (Jaffee & Maikovich-Fong, 2011; Jonson-Reid, Kohl, & Drake, 2012). Perceived social support is a known correlate of life satisfaction over time, with positive affect predicted by this support (Siedlecki, Salthouse, Oishi, & Jeswani, 2014). While there are established links between maltreatment and internalizing behaviors, there are inconsistent findings regarding the mediating effect of social support from family and friends. To address this gap, the present study examined the impact of experiencing maltreatment as a child on depressive symptoms during early adolescence and whether family and friend support mediated this association.

Childhood Maltreatment and Depression in Early Adolescence

There is a well-established link between child maltreatment and mental distress in later life (Dion et al., 2016; Dunn, McLaughlin, Slopen, Rosand, & Smoller, 2013; Infurna, Reichl, Parzer, Schimmenti, Bifulco, & Kaess, 2016; Nanni, Uher, & Danese, 2012). In their meta-analysis Nanni et al. (2012) found that experiences of childhood maltreatment were associated with recurrent and persistent depressive episodes. A more recent meta-analysis found that these relationships may be more nuanced with physical abuse and neglect strongly associated with depression, but sexual abuse less so (Infurna et al., 2016). Dunn and colleagues (2013), who found that individuals who had experienced physical abuse were at higher risk for depression, echo this finding. Chronicity of maltreatment appears to place individuals at even greater risk for internalizing behaviors. Jonson-Reid and colleagues (2012) noted a dose effect of child maltreatment, with more maltreatment predicting a linear relationship with negative childhood outcomes. This dose effect was also found in a nationally representative sample of children reported for maltreatment; those who had experienced maltreatment at multiple developmental periods had more internalizing problems (Jaffee & Maikovich-Fong, 2011). Given the risk of depression, along with other internalizing symptoms among individuals who have experienced maltreatment, identifying mechanisms that reduce negative mental health outcomes is integral for promoting healthy development among maltreated youth.

Child Maltreatment, Social Support, and Depression

Social support has been identified as a critical variable that may reduce the negative effects of early life trauma and has been most commonly theorized as a moderating or protective factor. This conceptualization has been termed the buffering hypothesis (Cohen & Wills, 1985) because social support offers a protective or buffering effect against the ill effects of early life stress. The buffering hypothesis has garnered substantial support with studies showing social support mitigated the effect of life stressors with more support leading to better outcomes (Feeny & Collins, 2015). Social support has also been shown to reduce loneliness (Lee & Goldstein, 2016) and be protective from mental distress, making support an important factor in positive mental health outcomes.

Social support has also been theorized to have a mediational role between maltreatment and later depressive symptoms. Child maltreatment is a fundamental failure in the caregiver-child relationship that may cause deficits in interpersonal skills and hamper the ability to maintain or form support networks (Cicchetti & Toth, 1995). This is supported by evidence showing that maltreated youth have poor social support networks (Horan & Widom, 2015; Negriff, James, & Trickett, 2015; Sperry & Widom, 2013). This isolation could place youth who have experienced maltreatment at greater risk for mental health problems, including depression as social support has been shown as a key factor in preventing psychological distress (Dion et al., 2016; Salazar, Keller, & Courtney, 2011). Thus, understanding the mechanisms that can reduce mental distress is important for identifying intervention points to support individuals who have experienced child maltreatment.

This conceptualization of social support as a mediator is supported by the social support deterioration deterrence model which stipulates that stress causes erosion of social relationships and subsequent challenges in coping with adversity, precipitating mental distress (Norris & Kaniasty, 1996; Vranceanu, Hobfoll, & Johnson, 2007). This model is supported by a number of studies showing indirect effects from child maltreatment to psychological distress via social support (Pepin & Banyard, 2006; Punamäki, Komproe, Qouta, El-Masri, & de Jong, 2005). However, few have examined the outcome of depression in particular. Several studies have tested mediation in cross-sectional models, with discordant results. One study found that social support mediated the association between father-perpetrated maltreatment (self-reported) and depression severity in adolescence (Seeds, Harkness, & Quilty, 2010), while another did not find a mediation effect in a sample of adult women (Vranceanu, Hobfoll, & Johnson, 2007). A longitudinal analysis of youth transitioning out of foster care showed partial mediation effects of social support on the association between self-reported maltreatment and depression (Salazar, Keller, & Courtney, 2011). Similarly, Sperry and Widom (2013) showed long-term effects of maltreatment on depression in adulthood via social support. Overall, the literature indicates social support is a mechanism through which maltreatment may cause changes in depressive symptoms. However, no studies have examined this in young adolescence, a period of documented increase in depressive symptoms (Costello, Erkanli, & Angold, 2006; Nolen-Hoeksema & Girgus, 1994; Thapar, Collishaw, Pine, & Thapar, 2012).

While numerous studies have linked child maltreatment with social support, the results have not converged (e.g., (Appleyard, Yang, & Runyan, 2010; Seeds, Harkness, & Quilty, 2010). Particularly for maltreated youth, the source of support may provide critical insights into the increased vulnerability to mental health problems. Some studies find that support from both family and friends is associated with reduced internalizing symptoms (Folger & Wright, 2013; Wilson & Scarpa, 2014) while others show that support from friends is most important (Dion et al., 2016; Evans, Steel, & DiLillo, 2013). A recent meta-analysis found that social support can reduce the likelihood of reported depression but noted that a variety of stressful contexts may impede children and adolescents from benefitting fully from the benefits of support (Rueger, Malecki, Pyun, Aycock, & Coyle, 2016). For maltreated youth, because families are often the source of the stressor, we would not expect families to provide stronger support than peers (or other adults outside the household). In addition, while researchers have moved towards greater use of social network data (compared to social support measures) when exploring influences of support, little is known about the social networks of maltreated youth (Negriff, James, & Trickett, 2015) and studies that have examined support among maltreated youth have focused on the type of support rather than from whom the individual is receiving support.

The literature also suggests that characteristics of maltreatment may be essential to understanding the association between maltreatment, social support, and mental health. For example, while both friend and family support was important in reducing depression and anxiety symptoms among individuals with maltreatment histories regardless of abuse severity, social support was found to mitigate negative outcomes only for individuals with lower levels of cumulative maltreatment (Evans, Steel, & DiLillo, 2013). This suggests that chronicity of maltreatment may reduce the positive buffering effect of support. In addition, type of maltreatment may influence the impact of social support for reducing mental distress. Wilson and Scarpa (2014) found that while perceived social support from family and friends was protective against mental distress for individuals who experienced physical abuse, it did not have a buffering effect for persons who had experienced sexual abuse. Further, in this work, support from a significant other was a risk factor for poorer mental health for those with sexual abuse histories. Taken together, these studies highlight the need to disentangle the impact of support on positive mental health by exploring from whom support is received and how that support influences the mental health of individuals who have experienced various types and chronicity of maltreatment.

The Current Study

While there is a link between child maltreatment and depressive symptoms in adolescence, variability in outcomes exists. One explanation may be differences in the perception of social support that can mitigate the effects of early trauma. While a number of studies have examined social support as a moderator, far fewer have tested it as a mechanism by which maltreatment experiences may transfer into mental health symptoms. Based on findings showing poor social support networks for maltreated youth (Trickett & Negriff, 2011), and the strong associations between social support and depression (Santini, Koyanagi, Tyrovolas, Mason, & Haro, 2015), the current study tested a longitudinal model examining the effect of child maltreatment on social support, and in turn, depressive symptoms in early adolescence. Additionally, due to previous research indicating these associations may vary by maltreatment type or chronicity, separate models were tested to examine a) maltreatment type (i.e., physical abuse, sexual abuse, emotional abuse, and neglect; and b) number of maltreatment experiences. It was hypothesized that a higher number of maltreatment experiences would result in poorer social support, which in turn would predict higher levels of depressive symptoms. In addition, physical abuse in particular was expected to predict lower social support and subsequent depressive symptoms. These aims were tested using a sample of youth referred to child welfare and a comparison group from the same neighborhoods. This data overcomes several limitations in the prior literature through the use of documented maltreatment from case records as well as a longitudinal design that allows better temporal inferences and testing of mediation effects.

Method

Participants

The present study used data from the first two assessments (approximately 1 year apart) of an ongoing longitudinal study examining the effects of maltreatment on adolescent development. At Time 1 the sample was composed of 454 adolescents aged 9–13 years (241 boys and 213 girls). Table 1 contains participant characteristics.

Table 1.

Participant Characteristics For Time 1 and 2

Demographic Variable Group
Maltreated Comparison
Time 1 Time 2 Time 1 Time 2
n 303 250 151 142
Age, M (SD) 10.84 (1.15) 12.02 (1.21) 11.11 (1.15) 12.28 (1.26)
Gender (%)
 Male 50 48 60 60
 Female 50 52 40 40
Ethnicity (%)
 African American 40 40 32 32
 Latino 35 36 47 45
 White 12 11 10 11
 Mixed Biracial 13 13 11 12
Living Arrangement (%)
 With Parent 52 63 93 94
 Foster or kinship care 48 37 7 6
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Recruitment.

The maltreatment group (n = 303) were recruited from active cases in the Children and Family Services (CFS) agency of a large West Coast city. The inclusion criteria were: (1) a new substantiated referral to CFS during the preceding month for any type of maltreatment (e.g., neglect, physical abuse, sexual abuse, emotional abuse); (2) age of 9–12 years; (3) identified as Latino, African American, or Caucasian (non-Latino); and (4) residing in 1 of 10 zip codes in a designated county at the time of referral to CFS. With the approval of CFS and the Institutional Review Board of the affiliated university, potential participants were contacted and asked to indicate their willingness to participate. Of those contacted, 77% agreed to participate.

The comparison group (n = 151) was recruited using names from school lists of children aged 9–12 years residing in the same 10 zip codes as the maltreated sample. Caretakers of potential participants were contacted and asked to indicate their interest in participating; 50% of the comparison families contacted agreed to participate. To ensure the fidelity of the comparison sample, caretakers were asked about involvement with CFS and none indicated prior or current contact with CFS.

Upon enrollment in the study, the maltreatment and comparison groups were compared on the demographic variables. The two groups were similar in age (M = 10.93 years, SD = 1.16), gender (53% male), race (38% African American, 39% Latino, 12% biracial, and 11% Caucasian), and neighborhood characteristics (based on census tract information) (Trickett, Mennen, Negriff, & Horn, 2011). However, they differed in terms of living arrangements; 93% of the comparison group lived with a biological parent compared to 52% of the maltreatment group.

Attrition

The attrition rate between Time 1 and Time 2 was 13.4% (n = 61). Attrition analyses indicated that participants who did not take part in the study at Time 2 were more likely to be in the maltreatment group (OR = 4.38, p < .01).

Procedure

Assessments were conducted at an urban research university. After assent and consent were obtained from the adolescent and caretaker, respectively, the adolescent completed questionnaires and tasks during a 4-hour protocol. The measures used in the analyses represent a subset of the questionnaires administered during the protocol, which also included hormonal, cognitive, and behavioral measures. Both children and caretakers were paid for their participation according to the guidelines of the National Institutes of Health standard compensation for healthy volunteers.

Measures

Maltreatment Classification.

Research assistants abstracted information from child welfare case records obtained for the time period prior to study enrollment in order to quantify maltreatment experiences (see (Trickett, Mennen, Kim, & Sang, 2009) for details of the record abstraction). For each child welfare report, a child could have from 1–4 separate instances of reported maltreatment victimization (i.e., physical abuse, emotional abuse, sexual abuse or neglect). To create the variable indicating the total number of maltreatment experiences each of the maltreatment types were summed for all case record reports yielding the variable cumulative number of maltreatment victimizations. Across all reports, the number of maltreatment victimizations ranged from 1–20 for males and 1–18 for females. To categorize maltreatment type four dummy coded variables were created: 1) sexual abuse (vs. other maltreatment vs. comparison), 2) physical abuse (vs. other maltreatment vs. comparison), 3) emotional abuse (vs. other maltreatment vs. comparison), and 4) neglect (vs. other maltreatment vs. comparison). This approach to categorization of maltreatment types was used because the data indicated 70% of the maltreatment group experienced more than one type of maltreatment.

Family and friends social support.

The social support networks of the adolescents were assessed using a series of name-generator questions (e.g., Who do you hang out with, who takes you places you need to go, who makes you feel better when you are upset, and who can you count on to always be there for you?; (Bogat, Chin, Sabbath, & Schwartz, 1985). Adolescents named as many people as they wanted. For each person named, follow-up questions asked included: (1) sex (male vs. female), (2) age (continuous), (3) relationship to the adolescent (biological parent, step-parent, foster parent, sibling, grandparent, other relative, friend, romantic partner, neighbor, classmate, professional, step-parent, foster sibling, step-sibling), (4) frequency of contact (a few times a year or less to almost every day), (5) whether they go to them for guidance or advice (yes/no), and (6) whether they can count on the person for help when they need something (yes/no).

The follow-up questions were used to create composite variables for individuals in the network who provided important forms of support. Based on previous literature showing that emotional and instrumental support are integral for foster care youth (Greeson & Bowen, 2008), receipt of social support was calculated using follow-up questions, “Do you go to this person for guidance or advice?” and “Can you count on this person to be there for you or to help when you need something?” which have been deemed to indicate emotional and instrumental support, respectively (House, 1981). Each person that provided either one or both types of support was coded as a source of social support. Thus, the following variables were created: (1) number of biological family members who provide support, (2) number of friends who provide support.

Depressive symptoms.

Adolescents completed the 27-item Children’s Depression Inventory (CDI; (Kovacs, 1981, 1992). They rated statements such as “I am sad all the time” and “I feel like crying every day,” on a three-point scale (range of possible scores = 0–54). The CDI has demonstrated good reliability and been shown to correlate with other measures of childhood depressive symptoms (Kovacs, 1992). While the CDI has an established clinical cutoff for depression, in the current study the full scale was used to indicate the continuum of depressive symptoms. The Cronbach’s alpha for T1 was .86 and for T2 was .83.

Covariates.

Information about each child’s current living situation was obtained from the participating caregiver at each study visit. To assess placement stability, if adolescents changed caregivers from one study assessment to the next, they were coded accordingly (T1 to T2: n = 51). No comparison youth changed households or caregivers. We also included sex, age, race/ethnicity (minority vs. white), and total number of people named in the social support network.

Data Analysis

Preliminary analyses (t-tests) examined mean differences between maltreatment and comparison groups for the social support and depression variables at each timepoint. Substantive analyses were conducted using a cross-lagged path model in a structural equation modeling framework in Mplus 7.2 (Muthen & Muthen, 2014). Two sets of models were run; the first included the number of maltreatment victimizations and the second with maltreatment type. In the first model, the total number of maltreatment victimizations was included as a manifest variable with direct effects on Time 1 variables (i.e., depressive symptoms, family support, and friend support; also included as manifest variables). All Time 1 variables had direct effects on all Time 2 variables (i.e., depressive symptoms, family support, and friend support). In the second model to examine each of the four maltreatment type variables (i.e., sexual abuse, physical abuse, emotional about, neglect) four separate models were run. In each, the maltreatment type was entered into the model as a predictor of Time 1 depressive symptoms, family support, and friend support. All maltreatment variables had direct effects on Time 1 depressive symptoms, family support, and friend support. In both sets of models, autoregressive effects were included between each timepoint and all variables were allowed to covary within timepoint. Covariates were total number of people in the social support network, stable placement (yes/no), T1 age, race (minority/Caucasian), and sex. All were included as predictors of T1 variables and covaried with the maltreatment variable(s). Full Information Maximum Likelihood (FIML) (Arbuckle, 1996) was used to handle variable-level and longitudinal missingness. The appropriateness of using FIML, which assumes the data to be Missing at Random (MAR) or Missing Completely at Random (MCAR), was tested using Little’s MCAR test in SPSS 24.0. All variables in the path model were entered into the EM missing values analysis. The results indicated that the pattern of missing values was MCAR (χ2 =23.92 (23), p=.41).

Fit indices such as the χ2 (chi-square) goodness-of-fit statistic, the root mean square error of approximation (RMSEA), and comparative fit index (CFI) were used to evaluate the fit of the model to the data. Overall, an adequate model fit is indicated by a nonsignificant χ2, RMSEA of .08 or smaller, and CFI above .90 (Browne & Cudeck, 1993). However, because χ2 is nearly always significant for sample sizes above 400 (Bentler & Bonett, 1980) we relied on the other fit statistics to evaluate the fit of the model (Bentler, 1990). Indirect effects were calculated using the bias-corrected bootstrapping method in Mplus (using the MODEL INDIRECT command). However, due to elevated Type I error rates found under some conditions for bias-corrected bootstrapping, Fritz and colleagues (Fritz, Taylor, & Mackinnon, 2012) recommend the use of this method in conjunction with another with other tests of mediation. In simulation studies the test of joint significance (TJS) demonstrated the best balance of Type I error and statistical power (MacKinnon, Lockwood, Hoffman, West, & Sheets, 2002). As such we report both statistics.

Results

Preliminary Analyses

The mean number of maltreatment victimizations was 3.48 (SD=4.05) and ranged from 1 to 23. Independent samples t-tests indicated few differences between the maltreated and comparison groups on the study variables. As shown in Table 2, maltreated youth named approximately 1.5 fewer people in their support network than the comparison group at Time 1 (p<.05). At Time 2, this difference was no longer significant. While their network was not smaller at Time 2, maltreated youth did name 1 less friend than comparison youth at Time 2 (p<.05). While differences in depressive symptoms by maltreatment and comparison group merely trended towards significance at Time 1 (p<.08), at Time 2, maltreated youth reported significantly higher depressive symptoms than comparison youth (p<.05). Bivariate correlation between total number of maltreatment instances and all study variables showed significant associations between maltreatment and Time 1 family social support (r=−.15, p<.01), and Time 1 depressive symptoms (r=.10, p<.05).

Table 2.

Mean differences in social support network characteristics and depressive symptoms between maltreated and comparison adolescents

Time 1 Time 2
Comparison Maltreated Comparison Maltreated
N 151 301 141 249
Mean (SD) Mean (SD) p Mean (SD) Mean (SD) p
Social Support Variables
Total number of people/social supports 13.85 (8.26) 12.17 (6.25) 0.03 11.21 (5.67) 10.21 (4.96) 0.08
Number of family 6.56 (4.53) 5.89 (3.48) 4.65 (3.09) 4.77 (2.98)
Number of family providing support 6.11 (4.33) 5.47 (3.38) 4.17 (2.79) 4.18 (2.76)
Number of friends 6.32 (4.83) 5.52 (4.91) 5.95 (4.30) 4.94 (3.99) 0.02
Number of friends providing support 4.45 (4.11) 3.96 (4.35) 4.05 (3.83) 3.65 (3.60)
Depressive symptoms 8.44 (6.27) 9.78 (7.66) 0.05 7.04 (5.36) 8.41 (6.60) 0.04
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Note: T-tests were used to examine mean differences between groups.

Path Model

Total maltreatment victimizations.

The full model fit the data well (χ2 = 49.70 [19], p<.01; CFI =.97; RMSEA = .06). The full model can be found in Figure 1. Total maltreatment instances predicted Time 1 depressive symptoms (β = .11, p<.05) and Time 1 family support (β = −.08, p<.05). While Time 1 depressive symptoms predicted Time 2 family support (β = −.10, p<.05), Time 1 family support did not predict Time 2 depressive symptoms (β = −.01, p=.82). Time 1 friend social support predicted Time 2 family social support (β = .46, p<.01). There were autoregressive effects from Time 1 to Time 2 depressive symptoms (β = .51, p<.01) and Time 1 to Time 2 friend social support (β = .92, p<.01). There were no significant covariances within Time. Lastly, there was a significant indirect effect from maltreatment to Time 1 depressive symptoms, to Time 2 family social support (β = −.02, 95% CI [−.04, .00]; TJS p<.05) which accounted for 20% of the total effects. This indicates that higher number of maltreatment victimizations predicted higher depressive symptoms, which then predicted lower family social support.

Figure 1.

Figure 1.

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Path model showing significant paths from maltreatment victimizations to depressive symptoms and social support. Bold arrows show significant mediation effect.

Note: Covariates (not shown) were T1age, sex, race, total number of people in social support network, T1-T2 stable placement. Within time covariances were included in the model but were not significant.

Maltreatment types.

Four independent models were run by maltreatment type and compared the target maltreatment type with a) all other maltreated and b) comparison youth. For physical abuse the model fit the data adequately (χ2 = 78.31 [19], p<.01; CFI =.95; RMSEA = .08). The results showed that experiencing physical abuse predicted Time 1 depressive symptoms (β = −.13, p<.05) indicating that physically abused youth had more depressive symptoms than comparison youth. In turn, Time 1 depressive symptoms had a main effect on Time 2 family social support (β = −.10, p<.05). This was a significant mediation effect from physical abuse, to depressive symptoms, to Time 2 family social support (β = .02., 95% CI [.00, .03]; TJS p<.05) accounting for 27.5% of the total effects. There was also a significant main effect of physical abuse on T1 family social support (β = −.11, p<.05) indicating that physically abused youth reported less social support than youth with other maltreatment types. However, Time 1 family social support did not predict Time 2 depressive symptoms. The model for neglect also fit the data (χ2 = 78.82 [19], p<.01; CFI =.95; RMSEA = .08). There was a significant main effect of neglect on Time 1 depressive symptoms (β = −.11, p<.05), indicating that neglected youth had higher depressive symptoms than comparison youth. As in the prior model there was also a main effect of Time 1 depressive symptoms on Time 2 family social support and a significant mediation effect (β = .02., 95% CI [.00, .03]; TJS p<.05). Emotional abuse and sexual abuse did not predict Time 1 depressive symptoms or social support.

Discussion

Maltreatment is a known correlate of poor mental health. Although social support is often examined as a moderator of this association, theory and evidence suggest that it might be a critical pathway through which the trauma of maltreatment may manifest in mental health symptoms. The current study sought to test both family and friend social support as mediators of the relationship between maltreatment and depressive symptoms. Overall, the results did not support the hypothesized mediation effect; instead, depressive symptoms functioned as a mediator between maltreatment experiences and family social support. This is the first study to find evidence that depressive symptoms may lead to poor social support networks among individuals with childhood maltreatment.

While we did not find a significant indirect effect from maltreatment to depression via social support, there were mediation effects between maltreatment experiences (i.e., number of maltreatment victimizations, physical abuse, and neglect) and family social support through depressive symptoms. In terms of number of maltreatment victimizations, a higher number of maltreatment experiences predicted higher levels of depressive symptoms which, in turn, predicted lower perceived family social support. These findings are inconsistent with a number of studies that find social isolation predicts subsequent depression. In a study of adolescents, less supportive family environments predicted depressive symptoms but not the vice versa (Sheeber, Hops, Alpert, Davis, & Andrews, 1997). On the other hand, an analysis of adolescent girls showed that poor parental social support predicted increased depressive symptoms and that baseline depressive symptoms predicted lower peer (but not parent) support (Stice, Ragan, & Randall, 2004). A prospective study of adolescents found that depressive symptoms predicted changes in symptoms for girls and that initial symptoms predicted lower family support (Slavin & Rainer, 1990). Along with the results of the current study, the extant evidence supports a model in which depressive symptoms lead to decreased perceived social support, though our findings do not suggest a reciprocal relationship as in other studies (Slavin & Rainer, 1990; Stice, Ragan, & Randall, 2004).

There is both theoretical and empirical support for depression being a precursor to poor social support. Negative self-statements, complaints, reassurance-seeking, and inappropriate self-disclosure shown by those with depression may contribute to the loss of social relationships (Coyne, 1976; Starr & Davila, 2008). Adolescents with depression may exhibit inappropriate social behaviors such as irritability and social withdrawal precipitated by anhedonia (Mitchell, McCauley, Burke, & Moss, 1988) that make it difficult to maintain social relationships (Bell-Dolan, Reaven, & Peterson, 1993; Strauss, Forehand, Frame, & Smith, 1984) In fact, evidence indicates that depressive symptoms predict lower perceived family social support, but not peer social support (Slavin & Rainer, 1990), a finding consistent with ours. An implication of these results is that depressive symptomatology may actually precipitate the loss of social support that is needed as a protective factor. Importantly, the indirect effect from maltreatment to family social support via depressive symptoms suggests that treatment for children with early trauma must continue to include a family-centered approach to clinical intervention. Family members should be educated regarding the potential social consequences of depression and learn strategies to maintain social relationships with youth experiencing depression. Strengthening these vulnerable families can positively influence the family system, and in turn, the mental health of the youth. In addition, a focus on the manifestation of depressive symptoms among maltreated youth might enhance understanding of the specific underlying mechanism that contributes to poor family social support (e.g., negative self-statements, inappropriate self-disclosure, etc.; Coyne, 1976; Starr & Davila, 2008). An emphasis on maintaining and or increasing supportive social interactions and relationships is also indicated from our results (e.g., via social skills training or socialization intervention groups at schools) to curb the social disruption youth experience; this is consistent with evidence-based elements from Cognitive-Behavioral Therapy and Interpersonal Therapy models (Hetrick, Cox, Witt, Bir, & Merry, 2016).

Although we found no support for a mediation effect from maltreatment to depressive symptoms through social support, there was a main effect of maltreatment victimizations on family social support. Specifically, a higher number of maltreatment victimizations was associated with fewer family members being identified as supportive. This association may be due to the documented effect that maltreatment has on interpersonal interactions, with maltreated youth showing more aggression, less prosocial behavior, and less positive affect in friendship dyads than nonmaltreated youth (Parker & Herrera, 1996; Teisl, Rogosch, Oshri, & Cicchetti, 2012; Youngblade & Belsky, 1989). On the other hand, contact with the child welfare system and various related consequences from this engagement may also disrupt family relationships. The maltreated group varied in living situation, nearly half lived with a foster or kin caregiver, which ostensibly influences social support. However, post hoc analyses showed that the main findings did not differ based on whether the youth was living with a biological parent or not, pointing to the likelihood that it is the event of being reported for maltreatment (and having contact with a social worker) that influences the perception of support from family members, regardless of placement. In the current study we are unable to disentangle the influence of maltreatment from the effects of involvement with child welfare, and the most likely explanation is that it is a combination of these experiences that is detrimental to maintaining family support after a report of maltreatment. Future qualitative work will help to better understand the points of fracture in family support.

For maltreatment type, physically abused youth had both higher depressive symptoms and lower social support from family at Time 1. However, only depressive symptoms predicted subsequent outcomes (social support) at Time 2. Similar to the number of maltreatment victimizations, those youth with physical abuse had higher depressive symptoms and that predicted lower perceived social support from family at Time 2. Neglect predicted depressive symptoms but not low social support, which is unexpected given that many features of neglect are measured by the absence of support (both instrumental and emotional) (Dubowitz et al., 2005). On the other hand, it may not be as surprising that physical abuse was associated with lower perceived family support given that national statistics show parents are the perpetrators of abuse in 91.4% of cases in the U.S. (Romero-Martínez, Figueiredo, & Moya-Albiol, 2014; U.S. Department of Health & Human Services, 2018). The absence of an association for sexual abuse is likely due to power, given the smaller number of youth who were experienced this form of maltreatment.

Limitations

A number of limitations should be noted when interpreting these results. First, both depressive symptoms and social support were self-report, potentially increasing the shared method variance. Additionally, scores on both measures decreased from Time 1 to Time 2. The decrease in social support may be due to the shift from larger less intimate peers group in early adolescence, to fewer close friendships in mid adolescence (Steinberg, 2013). Contrary to expectations, depressive symptoms also decreased between timepoints. This may be due, in part, to mental health treatment the youth in this study may have received as part of trauma care. It should also be noted that the current measure of social support was more indicative of the size of the social support network than a nuanced measure of the quality of support and the results should be interpreted as such. While other studies have examined gender differences in these associations, we controlled for gender, limiting the inferences of our results. Post hoc multiple-group model did not indicate gender moderated any of the parameters in the model. Additionally, our comparison sample did not indicate involvement with child welfare upon enrollment, but this does not preclude the existence of unreported maltreatment experiences. Based on a self-report measure at Time 4 of the study, 46% of the comparison group indicated they experienced maltreatment. While this is not trivial, we want to note that official reports and self-reports of maltreatment do not have complete convergence and seem to index difference aspects of early experiences (McGee, Wolfe, Yuen, Wilson, & Carnochan, 1995; Negriff, Schneiderman, & Trickett, 2017; Widom, Weiler, & Cottler, 1999). Post hoc analyses showed no appreciable changes to the results when this was included as a covariate. We also did not measure new maltreatment experiences occurring between Time 1 and 2, which may have affected depressive symptoms or social support. We should also note that while the test of joint significance showed significant mediation effect the upper limit of the confidence interval of bias-corrected bootstrap indirect effect was zero indicating a trend effect. Therefore, these results should be replicated in order to corroborate this mediation effect from maltreatment to poor family support via depressive symptoms. Lastly, we truncated our analysis at two waves of data in order to test straightforward mediation models. It may be that family social support has long-term effects on depression, a possibility to investigate in future studies.

Conclusion

The results of this study show that a higher number of maltreatment victimizations, as well as the presence of physical abuse or neglect, increase subsequent depressive symptoms; in turn, this leads to lower perceived social support from family in our sample of early adolescents. This is the first study to demonstrate the effect of depressive symptoms on the perceived social support for maltreated youth. These finding may pave the way for more nuanced understanding about the pathways from childhood maltreatment to mental health.

Table 3.

Correlations between study variables

Total maltreatment victimizations T1 #family support T1 # friend support T2 #family support T2 # friend support T1 depressive symptoms
T1 #family support −.15** 1.00
T1 # friend support −.01 .08 1.00
T2 #family support −.09 .39** −.08 1.00
T2 # friend support .00 .15** .27** .04 1.00
T1 depressive symptoms .10* −.12** −.10* −.05 −.10* 1.00
T2 depressive symptoms .08 −.10* −.05 −.05 −.09 .50**
Open in a new tab
**

p<.01

*

p<.05

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