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. Author manuscript; available in PMC: 2022 Jul 1.
Published in final edited form as: Psychol Trauma. 2021 Feb 4;13(5):603–610. doi: 10.1037/tra0001003

Childhood Maltreatment and Resource Acquisition in African American Women: The Role of Self-Esteem

Sarah M Clark 1, Timothy D Immelman 2, Ariel Hart 3, Nadine J Kaslow 1
PMCID: PMC8486339  NIHMSID: NIHMS1738431  PMID: 33539156

Abstract

Objective:

Childhood maltreatment (CM) is a public health crisis that results in negative physical, mental health, and psychosocial (e.g., resource attainment) outcomes. Resource attainment is a critical outcome for marginalized populations, such as low-income African American women. This study addresses the gap in the literature regarding the association between CM and effectiveness of resource attainment and the potential mediating role of self-esteem in this association for African American women.

Method:

Data were gathered from a large public inner-city, university-affiliated healthcare system in the Southeastern U.S. Participants selected were low-income African American women who have experienced intimate partner violence (IPV) and have attempted suicide in the prior year. The participants for this study completed the Childhood Trauma Questionnaire, the Beck Self-Esteem Scale, and the Effectiveness in Obtaining Resources Scale.

Results:

Mediation analyses using bootstrapping with 213 women revealed the powerful role self-esteem plays in explaining the link between CM and resource attainment in low-income African American women. Specifically, overall CM and four of its subtypes (emotional abuse, physical abuse, emotional neglect, and physical neglect) were all associated with decreased resource attainment via the effect of decreased self-esteem. Sexual abuse was the only subtype of CM not significantly associated with self-esteem nor effectiveness of resource attainment.

Conclusion:

This research highlights the importance of screening for CM, its subtypes, and resource attainment in this population and bolstering self-esteem through psychological interventions to increase women’s capacity to effectively secure necessary community resources.

Keywords: Childhood maltreatment, effectiveness in obtaining resources, resource attainment, self-esteem, African American women

Childhood maltreatment (CM) is a public health crisis that results in an economic burden of up to $2 trillion annually (Peterson et al., 2018). Over 675,000 children are victimized in the United States (U.S.) every year and with an estimated prevalence of 39.8% (U.S. Department of Health & Human Services, 2020). CM is defined by the Centers for Disease Control and Prevention as any act or omission that causes harm or has the potential threat of harm to children by anyone with a custodial role (e.g., parents, guardians, caregivers, clergy, coaches, and teachers) (Leeb et al., 2008). CM is divided into subtypes based on the presence of abuse or neglect. These include emotional/ psychological abuse, physical abuse, sexual abuse, medical neglect, emotional/psychological neglect, and physical neglect (U.S. Department of Health & Human Services, 2020). Data reveal that 15.5% of victims of CM experience two or more subtypes of maltreatment.

CM is a major social problem for all sociodemographic groups. However, there are differences in rates based on ethnoracial background (U.S. Department of Health & Human Services, 2020). For example, although African Americans make up only 13.5% of the U.S. population, 20.6% of CM victims are African American. This overrepresentation extends to mortality rates. However, ethnoracial differences are no longer true when socioeconomic status (SES) is controlled. Regardless of racial or ethnic background, poverty is positively correlated with CM; higher levels of poverty are associated with higher levels of CM (Kim & Drake, 2018; Mersky & Janczewski, 2018). Because African Americans are disproportionately affected by poverty, CM should be studied in this population (Kaiser Family Foundation, 2019).

CM has biopsychosocial effects for individuals across sociodemographic groups. A landmark study of adverse childhood experiences (ACEs), including CM and household dysfunction, brought heightened national attention to the topic (Felitti et al., 1998).1 This study highlighted the impact of CM on morbidity and mortality rates extending into adulthood. Results suggested a dose-response association between ACEs and risk factors for adult causes of death including health behavior problems and medical conditions, further supported by later research (e.g., Norman et al., 2012; Paras et al., 2009). CM and other ACEs have been linked to early substance use, psychopathology, and suicidality (e.g., Hussey et al., 2006; Norman et al., 2012). They have been associated with interpersonal consequences, such as increased incidence of violence as victims and perpetrators, physical and sexual victimization, and intimate partner violence (IPV) (Hussey et al., 2006; McMahon et al., 2015).

However, no attention has been paid to the impact of CM on people’s ability to acquire stress-buffering resources. Because poverty is associated with increased CM and decreased resource availability, it is critical to identify the mechanisms by which CM is associated with resource attainment. Studies on the relation between CM and overall effectiveness in obtaining resources (EOR) (Sullivan et al., 1992) in adulthood have not been published. However, research has revealed an association between CM and the acquisition of individual types of resources. Specifically, compared to their counterparts with no history of CM, individuals who have a history of CM are more likely to have housing insecurity as adults, experience homelessness, have elevated rates of household food insecurity in adulthood, have a history of school difficulties and impaired academic performance, have difficulty becoming gainfully employed, use healthcare resources yet less likely to have health insurance, and have lower levels of perceived global social support (Curry, 2017; Metzler et al., 2017; Romano et al., 2015; Steine et al., 2017; Sun et al., 2016).

In addition to determining if there is a link between CM and effectiveness of obtaining resources, factors that contribute to this association need to be ascertained. Prior research has shown that major depressive disorder (MDD), a correlate of suicidality, and IPV are associated with decreased ability to successfully obtain resources (Fletcher, 2010; Hetling et al., 2016). We target self-esteem as a potential mediator because it can present subtly and is less commonly a focus of screening or target of psychotherapy when compared to MDD or IPV.

A history of CM affects self-esteem into adulthood, however, there is a shortage of research on the mechanisms by which CM affects the development and maintenance of self-esteem (Choi et al., 2016). In a seminal piece, Bowlby (1958) theorized that harsh or inconsistent caregiving during childhood may socialize children to perceive their lives as negative. More recent theorizing has suggested that authoritarian or neglectful parenting styles may lead to lower social competence, a critical correlate of self-esteem. This can subsequently reduce the number of contacts on one’s social network – an important prerequisite to community resources such as job opportunities and social mobility (Kazemi et al., 2010). Parenting style also can lead to difficulties in emotion regulation and associated psychological disorders (Gottman et al., 1997).

More specifically, CM subtypes have been associated with a descending trajectory of self-esteem over time (Oshri et al., 2017). Self-esteem mediates the relations between overall CM or its subtypes and multiple outcomes: wellbeing, self-efficacy, substance misuse, psychopathology, personality pathology, and suicidal ideation (Duprey et al., 2019; Greger et al., 2017). Studies with African American women confirm associations between CM subtypes and decreased self-esteem in this population (Sterk et al., 2005). They show that self-esteem mediates the link between CM and later psychosocial difficulties (Bradley et al., 2005; Lamis et al., 2014). Additional links exist between CM’s commonly comorbid factors including MDD, IPV, and post-traumatic stress disorder (PTSD) wherein MDD, IPV, and PTSD have been connected in the literature to lower self-esteem (Matheson et al., 2015; van Tuijl et al., 2020).

No studies have investigated self-esteem and overall effectiveness of resource attainment. However, studies suggest links between self-esteem and specific types of resources. There is a correlation between low self-esteem and goal attainment, health, and food acquisition in homeless individuals (Diblasio & Belcher, 1993). With regard to educational outcomes, higher academic-related self-esteem has predicted higher academic achievement (Cvencek et al., 2018). Research has shown that individuals with low self-esteem are almost twice as likely to be unemployed, even when controlling for high school graduation (Dooley & Prause, 1997), and amongst unemployed individuals, higher self-esteem correlates with positive employment outcomes (Bruster, 2009). Regarding self-esteem and income, data are mixed.

Building upon the literature, this study focuses on a low-income, high-risk sample (history of IPV and suicidal behavior) of African American women. This population is important to study because they are disproportionately impacted by interpersonal violence (CM, severe IPV) and their suicidal behavior has often been ignored or stigmatized. The study investigates: (1) the association between overall CM and its specific subtypes and effectiveness of obtaining resources, and (2) self-esteem as a mediator between CM and effectiveness in obtaining resources. It is hypothesized that: (1) overall CM and each CM subtype will correlate negatively with effectiveness in obtaining resources; (2) self-esteem will mediate the relation between overall CM and each of the CM subtypes and effectiveness in obtaining resources.

Method

Participants

The sample consists of 213 African American women, aged 18–59 (M = 36.79, SD = 11.23) who presented to a large public urban, university-affiliated hospital in the Southeastern U.S. Women were recruited from the medical and psychiatric emergency departments and outpatient clinics. Participants had a history of one or more suicide attempts and IPV exposure within one year prior to presentation. Table 1 presents sociodemographic and psychiatric history on the participants. Women were excluded if they exhibited cognitive difficulties or active psychotic symptoms. All women gave written consent for their participation in the study.

Table 1.

Demographic Characteristics of the Study Participants

Demographic characteristics (%)
Homeless 52.4
Highest Grade Completed
  0 0.5
  <12th Grade 44.8
  12th Grade 22.4
  GED 8.1
  Some college or tech school 14.8
  Technical school grad 3.8
  College grad 5.2
  Graduate school 0.5
Unemployed 87.6
Owns a Car 11.5
Receives Food Stamps 52.5
Receives SS/SSI/Disability 22.5
Receives TANF 1.0
Receives Child Support 4.9
Receives Additional Income from Parents 12.2
Receives Additional Income from Partner 14.6
Major Depressive Disorder Diagnosis 72.3
Bipolar Disorder Diagnosis 44.5
Post-Traumatic Stress Disorder Diagnosis 9.6
Takes Antidepressants 55.9
Takes Mood Stabilizers 8.5
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Note. TANF = Temporary Assistance for Needy Families; SS = Social Security; SSI = Supplemental Security Income

Psychological diagnoses (major depressive disorder, bipolar disorder, and post-traumatic stress disorder) and medications (antidepressants, mood stabilizers) are self-reported.

A power analysis performed using G*Power 3.1 software with a predicted effect size of 0.3, power of 0.8, α of 0.05, and β of 0.2 indicated a minimum sample of 64 was needed. This is consistent with requirements for mediation analyses (Fritz & MacKinnon, 2007). Thus, 213 participants exceeds the minimum requirement to achieve adequate power.

Measures

Childhood Trauma Questionnaire-Short Form (CTQ-SF)

The CTQ-SF, developed from the Childhood Trauma Questionnaire (Bernstein et al., 1994), assesses CM. It covers a range of traumatic experiences using 28 questions. It is comprised of five subscales related to the CM subtypes: Physical Abuse (items 9, 11, 12, 15, 17), Sexual Abuse (items 20, 21, 23, 24, 27), Emotional Abuse (items 3, 8, 14, 18, 25), Physical Neglect (items 1, 2 4, 6, 26), and Emotional Neglect (items 5, 7, 13, 19, 28). It has good validity and reliability across studies and within community samples (Bernstein et al., 1994; Kongerslev et al., 2019, Scher et al., 2001). Each question begins with the statement, “When I was growing up, …” and follows with an item targeting one of the five subscales. For example, “People in my family hit me so hard that it left me with bruises or marks.” Each item is scored using a 5-point Likert scale; 1 indicates never true and 5 indicates very often true. CTQ-SF questions 2, 5, 7, 13, 19, 26 and 28 are reverse coded. The mean of each subscale is calculated based on the items associated with the subtype. The CTQ-SF demonstrated good internal consistency reliability in this sample (α = 0.91 for the overall measure, α = 0.85 for emotional abuse, α = 0.88 for physical abuse, α = 0.85 for emotional neglect, α = 0.76 for physical neglect, α = 0.93 for sexual abuse). Consistent with previous research, physical neglect had the lowest internal consistency, and sexual abuse had the highest (Bernstein & Fink, 1994; Scher et al., 2001).

Effectiveness in Obtaining Resources (EOR)

The EOR (Sullivan et al., 1992) measures effectiveness of obtaining 11 categories of resources: housing, material goods and resources (clothing, food), education, employment, health, childcare, transportation, social support, legal assistance, finances, and issues regarding the children. Women responded to the 11 items based on their attempts at obtaining each of the community resources. Each item begins with the statement, “How effective have your efforts been (how successful have you been) in accomplishing your goals in the following areas?” The EOR is rated using a 4-point Likert scale from 1 indicating very ineffective, to 4 indicating very effective. The mean of all items is calculated and recorded as the overall score; higher numbers indicate higher perceived EOR, with a possible range from 11 to 44. Internal consistency reliability of the original scale was 0.64, however, data obtained using our sample yielded stronger internal consistency reliability, α = 0.86.

Beck Self-Esteem Scale (BSE)

The 18-item BSE (Beck et al., 2001) assesses self-esteem. For each item, a pair of adjectives is placed on opposite ends of a line anchored with values from 1 to 10. Participants are asked to place an X on the line between the adjectives. Examples of adjective pairs are successful-unsuccessful and lovable-unlovable. The women filled out the scale twice, once describing beliefs about themselves and the other describing how others perceive them. In this study, only self-rating data were used. The BSE was recoded by subtracting each item from 11 and scored by summing the results from all 18 items. Higher scores indicate higher levels of self-esteem with a possible range from 18 to 180. The BSE has been shown to have good reliability, internal consistency, and construct validity for assessing self-esteem (Beck et al., 2001). The scale yielded good internal consistency reliability (α = 0.92) for the current sample.

Procedure

Statistical analyses were performed using SPSS with de-identified data. We assessed demographic characteristics (see Table 1) and reliability for each scale. 196 participants had complete data, and missing data for the remaining participants were addressed via listwise deletion. We tested skewness and kurtosis to check the normality of the data. Skewness ranged from −0.43 to 0.80 and kurtosis ranged from −1.40 to −0.23, indicating normality was adequate for our analyses (Gravetter & Wallnau, 2014). Variance inflation factor was performed to assess multicollinearity and the values were all below the suggested cutoff value of 2.5 (Allison, 1999); therefore, multicollinearity was not a concern.

We examined the mediating effect of self-esteem on each of the independent variable’s prediction of effectiveness in obtaining resources. Mediation analysis allowed us to analyze the total effect, direct effect, and indirect effect. In these analyses, the predictor variables were overall CM and its subtypes, the outcome was the EOR score, and the mediator was self-esteem. We estimated the total effect of CM and its five subtypes on effectiveness in obtaining resources before separating the total effect into the direct and indirect effects using regression-based mediation analysis. We used the PROCESS SPSS extension for regression-based mediation analysis with bootstrapping (5000 samples and 95% confidence intervals [CI]), which allowed us to analyze data without assuming that the data fit a normal distribution (Hayes & Rockwood, 2017; Preacher & Hayes, 2004).

Results

Descriptive Statistics

Table 2 provides means and standard deviations for each of the measures.

Table 2.

Means (M) and Standard Deviations (SD) of Study Variables

Scale M SD
Overall CM 2.82 0.81
Emotional Abuse 3.34 1.24
Physical Abuse 2.78 1.34
Sexual Abuse 3.32 1.51
Emotional Neglect 2.97 1.15
Physical Neglect 2.06 0.97
Self-Esteem 116.71 36.06
EOR 24.05 7.78
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Note. CM = Childhood Maltreatment; EOR = Effectiveness in Obtaining Resources.

Total Effects

To address the first study aim, we examined the total effect pathway (Figure 1; path c), without accounting for the mediating variable. These analyses supported two of the six hypotheses, with significant associations between both emotional abuse and emotional neglect and effectiveness in obtaining resources. Consistent with what was hypothesized, higher levels of emotional abuse and emotional neglect correlated with lower levels of resource attainment.

Figure 1. Simple Mediation Model.

Figure 1

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Note. This figure demonstrates an example of a simple mediation analysis model in which: a represents the path from independent variable (IV) to the mediating variable (MV), b represents the path from MV to the dependent variable (DV) controlling for the IV, c represents the path from IV to DV (total effect), and c’ represents the path from IV to DV controlling for the MV (direct effect). Indirect effect is calculated by multiplying a and b or subtracting c’ from c. Results are shown in Table 3.

Mediational Effects

Overall CM and four of its subtypes (emotional abuse, physical abuse, emotional neglect, and physical neglect) were independently associated with decreased resource attainment through the effect of decreased self-esteem. This supported all but one of the hypotheses associated with the second study aim (see Table 3). These findings indicate that among women who report experiencing maltreatment during childhood, effectiveness in obtaining resources is impacted via decreased self-esteem. In other words, increased CM (overall, emotional abuse, physical abuse, emotional neglect, and/or physical neglect) was associated with decreased self-esteem, which subsequently relates to decreased effectiveness in obtaining resources. Sexual abuse was not directly or indirectly associated with resource attainment.

Table 3.

Path Coefficients for Simple Mediation Analysis of Self-Esteem in the Relation Between CM and EOR

Childhood Maltreatment a b c c’ Indirect Effect [CI]
Overall −0.26** 0.34** −0.13 −0.04 −0.09 [−0.15, −0.04]
Emotional Abuse −0.26** 0.33** −0.16* −0.08 −0.09 [−0.15, −0.04]
Physical Abuse −0.18* 0.34** −0.14 −0.08 −0.06 [−0.12, −0.01]
Sexual Abuse −0.10 0.35** −0.03 0.01 −0.04 [−0.09, 0.01]
Emotional Neglect −0.30** 0.34** −0.16* −0.06 −0.10 [−0.17, −0.05]
Physical Neglect −0.27** 0.36** −0.06 0.04 −0.10 [−0.16, −0.04]
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Note. See Figure 1 for an example mediation model. Results are reported as standardized coefficients.

Indirect effect significance is based on 95% confidence intervals (CI). Bolded font indicates the confidence intervals do not include zero, suggesting a significant indirect effect. All others reported as p values.

*

p < 0.05.

**

p < 0.01.

In the mediational analyses, the directionality of pathways a and b was consistent with current descriptive statistics. Overall CM and four of its five subtypes (excluding sexual abuse) were associated with decreased self-esteem (Figure 1; path a) and increased self-esteem was significantly correlated with increased effectiveness in obtaining resources in all mediation analyses (Figure 1; path b). For example, the indirect effect of emotional abuse on EOR through self-esteem (coefficient = −0.09, [95% CI: −0.15, −0.04]) was statistically significant, and the two paths linked to the indirect effect were significant as well. In other words, higher levels of emotional abuse predicted lower self-esteem (coefficient = −0.26, p-value < 0.01), and lower self-esteem predicted decreased ability to acquire resources (coefficient = 0.33, p-value < 0.01).

Discussion

This research advances our understanding of one potential mechanism through which experiences of childhood abuse and neglect may determine low-income African American women’s ability to access needed community resources. Results highlight the powerful role self-esteem plays in explaining the link between CM and effectiveness of obtaining resources in this population; self-esteem mediated the association between both overall CM and four of its subtypes (emotional abuse, physical abuse, emotional neglect, physical neglect) and effectiveness of obtaining resources. These findings, combined with prior research, support the conclusion that CM decreases self-esteem, and decreased self-esteem renders individuals less able to secure community resources (Choi et al., 2016; Duprey et al., 2019). Self-esteem did not mediate the childhood sexual abuse – adult effectiveness of attaining resources link. Given that low-income African American women endorse higher rates of CM exposure than women from other ethno-racial and social class backgrounds (Kim & Drake, 2018; Mersky & Janczewski, 2018; U.S. Department of Health & Human Services, 2020), we must determine factors that influence their psychosocial adjustment, as these can serve as key intervention targets.

The results obtained build upon and extend the literature and underscore the major role self-esteem may play in the lives of individuals maltreated during childhood (Choi et al., 2016; Duprey et al., 2019; Greger et al., 2017; Oshri et al., 2017), including African American females (Bradley et al., 2005; Lamis et al., 2014; Sterk et al., 2005). This dearth of attention to self-esteem among African American women is concerning given that their experiences of multiple forms of oppression, such as racism and discrimination, may be associated with a racial context that influences their levels of self-esteem (Johnson, 2020).

It is the first time self-esteem has been examined with regard to resource attainment. A focus on overall community resources is critical given the discrepancy in the well-being of individuals with and without such resources (Huegaerts et al., 2017; Nagata et al., 2019). Particularly relevant is the finding that African American women with a history of IPV are less likely to become suicidal if they perceive themselves as effective at obtaining resources (Thompson et al., 2002). Moreover, among women with a history of IPV, those who participate in an advocacy intervention designed to increase their ability to access community resources report a higher quality of life (Bybee & Sullivan, 2002). Thus, ability to obtain community resources is an essential skill for high-risk populations, such as low-income African American women with a history of IPV and suicidal behavior. Participants’ histories of IPV and suicide attempt(s) are important to consider when analyzing outcomes. These factors did not confound the outcomes of interest given their uniformity amongst all participants. However, these comorbidities impact the generalizability of the conclusions. Further studies investigating the association between CM, self-esteem, and resource attainment in samples that do not have uniform exposure to IPV and suicide attempts would shed light on the extent to which these variables may influence the findings.

Although the findings largely supported the hypothesized mediational associations, this was not true when sexual abuse was considered. Moreover, sexual abuse was not correlated with effectiveness of obtaining resources. This is consistent with prior research that failed to show an association between sexual abuse and negative outcomes (Curry, 2017).

Despite the strength of these findings, several study limitations warrant discussion. First, this research was conducted with a demographically homogenous sample. In addition, it is a specific subpopulation of low-income African American women, namely those who experienced IPV and attempted suicide. This is a population that has experienced significant oppression and discrimination associated with the intersectionality of their gender and race. Thus, results may not generalize to other demographic groups. The second concern relates to the assessment tools. The accuracy of the retrospective reporting of CM and validity of the resource attainment data may be questionable. However, the CTQ has been published in multiple studies, providing evidence for convergent validity in assessing CM (e.g. Bernstein et al., 2003; Kongerslev et al., 2019). Yet, the EOR has not been widely used and has only 11 questions, so it is not a robust measure of the construct. Further study is needed to determine its psychometric properties. The third limitation relates to the cross-sectional design. Although it is not feasible to conclude a causal relation with cross-sectional survey data, the nature of CM implies a chronological association between CM as the predictor and EOR as the outcome. Practically, this allows us to infer that changes in effectiveness of obtaining resources in adulthood come after the period in which an individual would be subjected to CM. All participants were older than age 18, yet the CTQ focused on adverse interpersonal experiences during childhood. This implies that CM preceded adulthood effectiveness of resource attainment.

Despite these challenges, the findings suggest several clinical implications. First, it is important when assessing women to screen for both overall CM and experiences with CM subtypes because different subtypes of CM have different impacts on outcomes. Second, interventions with African American women with a history of CM should target enhancing self-esteem if it is deemed to be low on assessment. Psychotherapies must be tailored to prioritize bolstering the self-esteem of individuals with CM (Norwood et al., 2011; Rigby & Waite, 2006), which ultimately should increase effectiveness of obtaining resources. This is critical given that women who present in healthcare settings secondary to IPV and/or a suicide attempt may be able to process and recover to a greater degree from their traumas if provided interventions that strengthen their self-esteem. For such interventions to be culturally relevant, they must incorporate spirituality; empowerment techniques based on Afrocentric theory and African proverbs; a focus on public African American figures, personal mentors, and role models in the African American community; and culturally informed coping strategies (Zhang et al., 2013). Third, more attention needs to be given to interventions with this population to increase their capacity to acquire community resources. Although resource attainment often is not the focus in traditional psychotherapy, it is necessary to address in this population. This must be done in part through targeting ways in which to increase resource attainment, including self-esteem, as evidenced by this study. Finally, given that this study adds to the mounting evidence of the negative psychosocial effects of CM within this population, culturally competent prevention programs must be designed, implemented, and evaluated.

Future research is warranted to elucidate further the implications of self-esteem as a factor to consider in understanding the challenges that individuals with a history of CM experience with securing community resources. This should include studying more diverse populations and developing and utilizing more robust measures of resource acquisition. Investigations should be undertaken to ascertain additional factors to self-esteem, such as related mental health conditions (MDD, PTSD, anxiety, personality disorders), that affect resource attainment in women with a history of CM. When examining the mediating role of self-esteem in the CM-resource attainment link among low-income African American women, attention should be paid to culturally relevant mediators and moderators, such as racial identity (Tyrell et al., 2019). In addition, culturally- and trauma- informed interventions should be designed, implemented, and evaluated that aim to bolster the self-esteem of individuals with a history of CM to increase their capacity to access the requisite community resources.

Clinical Impact Statement.

When low-income African American women seek mental health services, they should be asked about their history of childhood maltreatment (CM) including their experiences with each subtype of abuse (emotional, physical, sexual) and neglect (emotional, physical) because these differentially impact their self-esteem and ability to acquire needed community resources. Interventions with this population, especially if they report CM, should prioritize bolstering their self-esteem, as this can increase their effectiveness in obtaining various resources from their community. Given the deleterious effects of CM in this community, culturally-informed prevention programs must be developed, and community resources must be more available and accessible.

Acknowledgments

This research was supported by a grant from the National Institute of Mental Health (1R01MH078002-01A2, Group interviews for abused, suicidal Black women) awarded to the last author (Kaslow). The authors are grateful to Dr. Dorian Lamis for providing feedback on the early ideas for this paper.

Appendix

Although a number of studies using this database have explored childhood maltreatment, none of them explore the association between childhood maltreatment and effectiveness in obtaining resources. The submitted manuscript differs from prior research on this dataset, which is part of a larger data collection. Childhood maltreatment will be referred to as variable 1 with self-esteem labeled variable 2 and effectiveness in obtaining resources variable 3. Published manuscripts (MS) 1–9 all focused on variable 1, while MS 5 also includes variable 2. To date, this is the first manuscript from this database that has investigated variable 3 in addition to variables 1 and 2. This combination of variables has not yet been investigated nor is currently under investigation using the same database beyond the scope of the current study.

Footnotes

The authors have no known conflicts of interest to disclose with respect to the research, authorship, and/or publication of this article.

1

ACEs are broader than CM and include violence against a child’s mother; living with substance users; or having a household member who was mentally ill, suicidal, or imprisoned.

References

  1. Allison PD (1999). Multiple regression: A primer. Pine Forge Press. [Google Scholar]
  2. Beck AT, Brown GK, Steer RA, Kuyken W, & Grisham J (2001). Psychometric properties of the Beck Self-Esteem Scales. Behaviour Research and Therapy, 39(1), 115–124. [DOI] [PubMed] [Google Scholar]
  3. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, & Ruggiero J (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151(8), 1132–1136. [DOI] [PubMed] [Google Scholar]
  4. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, & Zule W (2003). Development and Validation of a Brief Screening Version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. [DOI] [PubMed] [Google Scholar]
  5. Bowlby J (1958). The nature of the child’s tie to his mother. International Journal of Psycho-Analysis, 39, 350–373. [PubMed] [Google Scholar]
  6. Bradley R, Schwartz AC, & Kaslow NJ (2005). Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors: Self-esteem, social support, and religious coping. Journal of Traumatic Stress, 18(6), 685–696. [DOI] [PubMed] [Google Scholar]
  7. Bruster BE (2009). Transition from welfare to work: Self-esteem and self-efficacy influence on the employment outcome of African American women. Journal of Human Behavior in the Social Environment, 19(4), 375–393. [Google Scholar]
  8. Bybee DI, & Sullivan CM (2002). The process through which an advocacy intervention resulted in positive change for battered women over time. American Journal of Community Psychology, 30(1), 103–132. [DOI] [PubMed] [Google Scholar]
  9. Choi K, Englander E, Woo Y, Choi J, Kim J, & Kim H (2016). A comparison of attributions, self-esteem, anxiety, and parental attachment in sexually abused and non-abused Korean children. Journal of Child Custody, 13(2–3), 219–239. [Google Scholar]
  10. Curry SR (2017). Childhood experiences and housing insecurity in adulthood: The salience of childhood emotional abuse. Children and Youth Services Review, 82, 301–309. [Google Scholar]
  11. Cvencek D, Fryberg SA, Covarrubias R, & Meltzoff AN (2018). Self‐concepts, self‐ esteem, and academic achievement of minority and majority north American elementary school children. Child Development, 89(4), 1099–1109. [DOI] [PubMed] [Google Scholar]
  12. Diblasio FA, & Belcher JR (1993). Social work outreach to homeless people and the need to address issues of self-esteem. Health & Social Work, 18(4), 281–287. [DOI] [PubMed] [Google Scholar]
  13. Dooley D, & Prause J (1997). Effect of students’ self-esteem on later employment status: Interactions of self-esteem with gender and race. Applied Psychology: An International Review, 46(2), 175–198. [Google Scholar]
  14. Duprey EB, Oshri A, & Liu S (2019). Childhood maltreatment, self-esteem, and suicidal ideation in a low-SES emerging adult sample: The moderating role of heart rate variability. Archives of Suicide Research, 23(2), 333–352. [DOI] [PubMed] [Google Scholar]
  15. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, & Marks JS (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. [DOI] [PubMed] [Google Scholar]
  16. Fletcher JM (2010). Adolescent depression and educational attainment: Results using sibling fixed effects. Health Economics, 19, 855–871. [DOI] [PubMed] [Google Scholar]
  17. Fritz MS, & MacKinnon DP (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Gravetter FJ & Wallnau LB (2014). Essentials of statistics for the behavioral sciences (8th ed.). Cengage Learning. [Google Scholar]
  19. Gottman JM, Katz LF, & Hooven C (1997). Meta-emotion: How families communicate emotionally. Lawrence Erlbaum Associates, Inc. [Google Scholar]
  20. Greger HK, Myhre AK, Klöckner CA, & Jozefiak T (2017). Childhood maltreatment, psychopathology and well-being: The mediator role of global self-esteem, attachment difficulties and substance use. Child Abuse & Neglect, 70, 122–133. [DOI] [PubMed] [Google Scholar]
  21. Hayes AF, & Rockwood NJ (2017). Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behaviour Research and Therapy, 98, 39–57. [DOI] [PubMed] [Google Scholar]
  22. Hetling A, Postmus JL, & Kaltz C (2016). A randomized controlled trial of a financial literacy curriculum for survivors of intimate partner violence. Journal of Family and Economic Issues, 37, 672–685. [Google Scholar]
  23. Huegaerts K, Puig-Barrachina V, & Vanroelen C (2017). The mental health of unemployed Brussels youth: The role of social and material resources. Archives of Public Health, 75:19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Hussey JM, Chang JJ, & Kotch JB (2006). Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics, 118(3), 933–942. [DOI] [PubMed] [Google Scholar]
  25. Johnson AJ (2020). Examining associations between racism, internalized shame, and self-esteem among African Americans. Cogent Psychology, 7(1), 1757857. [Google Scholar]
  26. Kaiser Family Foundation. (2019). Poverty rate by race/ethnicity. https://www.kff.org/other/state-indicator/poverty-rate-by-raceethnicity/
  27. Kazemi A, Ardabili HE, & Solokian S (2010). The association between social competence in adolescents and mothers’ parenting style: A cross sectional study on Iranian girls. Child and Adolescent Social Work Journal, 27(6), 395–403. [Google Scholar]
  28. Kim H, & Drake B (2018). Child maltreatment risk as a function of poverty and race/ethnicity in the USA. International Journal of Epidemiology, 47(3), 780–787. [DOI] [PubMed] [Google Scholar]
  29. Kongerslev MT, Bach B, Rossi G, Trauelsen AM, Ladegaard N, Løkkegaard SS, & Bo S (2019). Psychometric validation of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in a Danish clinical sample. Child Abuse & Neglect, 94, 104026. [DOI] [PubMed] [Google Scholar]
  30. Lamis DA, Wilson CK, Shahane AA, & Kaslow NJ (2014). Mediators of the childhood emotional abuse–hopelessness association in African American women. Child Abuse & Neglect, 38(8), 1341–1350. [DOI] [PubMed] [Google Scholar]
  31. Leeb RT, Paulozzi L, Melanson C, Simon T, & Arias I (2008). Child maltreatment surveillance: uniform definitions for public health and recommended data elements. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www.cdc.gov/violenceprevention/pdf/CM_Surveillance-a.pdf
  32. Matheson FI, Daoud N, Hamilton-Wright S, Borenstein H, Pederson C, & O’Campo P (2015). Where did she go? The transformation of self-esteem, self-identity, and mental well-being among women who have experienced intimate partner violence. Women’s Health Issues, 25(5), 561–569. [DOI] [PubMed] [Google Scholar]
  33. McMahon K, Hoertel N, Wall MM, Okuda M, Limosin F, & Blanco C (2015). Childhood maltreatment and risk of intimate partner violence: A national study. Journal of Psychiatric Research, 69, 42–49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Mersky JP, & Janczewski CE (2018). Racial and ethnic differences in the prevalence of adverse childhood experiences: Findings from a low-income sample of U.S. women. Child Abuse & Neglect, 76, 480–487. [DOI] [PubMed] [Google Scholar]
  35. Metzler M, Merrick MT, Klevens J, Ports KA, & Ford DC (2017). Adverse childhood experiences and life opportunities: Shifting the narrative. Children and Youth Services Review, 72, 141–149. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Nagata JM, Palar K, Gooding HC, Garber AK, Whittle HJ, Bibbins-Domingo K, & Weiser SD (2019). Food insecurity is associated with poorer mental health and sleep outcomes in young adults. Journal of Adolescent Health, 65(6), 805–811. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Norman RE, Byambaa M, De R, Butchart A, Scott J, & Vos T (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9(11), e1001349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Norwood SJ, Murray M, Nolan A, & Bowker A (2011). Beautiful from the inside out: A school-based programme designed to increase self-esteem and positive body image among preadolescents. Canadian Journal of School Psychology, 26(4), 263–282. [Google Scholar]
  39. Oshri A, Carlson MW, Kwon JA, Zeichner A, & Wickrama KKAS (2017). Developmental growth trajectories of self-esteem in adolescence: Associations with child neglect and drug use and abuse in young adulthood. Journal of Youth and Adolescence, 46(1), 151–164. [DOI] [PubMed] [Google Scholar]
  40. Paras ML, Murad MH, Chen LP, Goranson EN, Sattler AL, Colbenson KM, Elamin MB, Seime RJ, Prokop LJ, & Zirakzadeh A (2009). Sexual abuse and lifetime diagnosis of somatic disorders: A systematic review and meta-analysis. JAMA, 302(5), 550–561. [DOI] [PubMed] [Google Scholar]
  41. Peterson C, Florence C, & Klevens J (2018). The economic burden of child maltreatment in the United States, 2015. Child Abuse & Neglect, 86, 178–183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Preacher KJ, & Hayes AF (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731. [DOI] [PubMed] [Google Scholar]
  43. Rigby L, & Waite S (2006). Group therapy for self-esteem, using creative approaches and metaphor as clinical tools. Behavioural and Cognitive Psychotherapy, 35(3), 361–364. [Google Scholar]
  44. Romano E, Babchishin L, Marquis R, & Fréchette S (2015). Childhood maltreatment and educational outcomes. Trauma, Violence, & Abuse, 16(4), 418–437. [DOI] [PubMed] [Google Scholar]
  45. Scher CD, Stein MB, Asmundson GJG, McCreary DR, & Forde DR (2001). The childhood trauma questionnaire in a community sample: Psychometric properties and normative data. Journal of Traumatic Stress, 14(4), 843–857. [DOI] [PubMed] [Google Scholar]
  46. Steine IM, Winje D, Krystal JH, Bjorvatn B, Milde AM, Grønli J, Nordhus IH, & Pallesen S (2017). Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse. Child Abuse & Neglect, 65, 99–111. [DOI] [PubMed] [Google Scholar]
  47. Sterk CE, Klein H, & Elifson KW (2005). Self-esteem and “at risk” women: Determinants and relevance to sexual and HIV-related risk behaviors. Women & Health, 40(4), 75–92. [DOI] [PubMed] [Google Scholar]
  48. Sullivan CM, Tan C, Basta J, Rumptz M, & Davidson WS (1992). An advocacy intervention program for women with abusive partners: Initial evaluation. American Journal of Community Psychology, 20(3), 309–332. [DOI] [PubMed] [Google Scholar]
  49. Sun J, Knowles M, Patel F, Frank DA, Heeren TC, & Chilton M (2016). Childhood adversity and adult reports of food insecurity among households with children. American Journal of Preventive Medicine, 50(5), 561–572. [DOI] [PubMed] [Google Scholar]
  50. Thompson MP, Kaslow NJ, Short LM, & Wyckoff S (2002). The mediating roles of perceived social support and resources in the self-efficacy-suicide attempts relation among African American abused women. Journal of Consulting and Clinical Psychology, 70(4), 942–949. [DOI] [PubMed] [Google Scholar]
  51. Tyrell FA, Marcelo AK, Trang DT, & Yates TM (2019). Prospective associations between trauma, placement disruption, and ethnic-racial identity among newly emancipated foster youth. Journal of Adolescence, 76, 88–98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2020). Child maltreatment 2018. https://www.acf.hhs.gov/sites/default/files/cb/cm2018.pdf
  53. van Tuijl LA, Bennik EC, Penninx BW, Spinhoven P, & de Jong PJ (2020). Predictive value of implicit and explicit self-esteem for the recurrence of depression and anxiety disorders: A 3-year follow-up study. Journal of Abnormal Psychology, 129(8), 788–798. [DOI] [PubMed] [Google Scholar]
  54. Zhang H, Neelarambam K, Schwenke TJ, Rhodes MN, Pittman DM, & Kaslow NJ (2013). Mediators of a culturally-sensitive intervention for suicidal African American women. Journal of Clinical Psychology in Medical Settings, 20(4), 401–414. [DOI] [PMC free article] [PubMed] [Google Scholar]

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