Child maltreatment is a potent relational pathogen that alters functioning across diverse developmental domains, and has been shown to increase risk for a host of mental health problems, including internalizing disorders. Similarities in the neuroendocrine profiles of individuals who develop internalizing symptoms and individuals who have been maltreated are striking, and suggest a role of neuroendocrine functioning, specifically the hypothalamic-pituitary-adrenal (HPA) axis, in the pathogenesis of internalizing disorders following child maltreatment. Risk and protective genetic factors, particularly relevant to HPA axis functioning, have been discovered, further highlighting involvement of the HPA axis and offering ideas about how some maltreated children may evade the biological impact of maltreatment. There has been movement in the field toward identifying mediators and moderators at multiple levels of analysis to best inform developmental mechanisms, which may ultimately aid in the treatment and prevention of deleterious outcomes following child maltreatment. Utilizing a large, ethnically homogenous sample, the current study employed exploratory and confirmatory factor analysis and structural equation modeling to examine associations among child maltreatment, risk across multiple HPA-related genes, daytime cortisol patterns, and internalizing symptoms in effort to clarify biological mechanisms. Results revealed that experiences of maltreatment prior to age 5 were most predictive of internalizing symptoms in African American youth, whereas maltreatment occurring at or after age 5 was most predictive of HPA axis dysregulation in the form of blunted diurnal decrease of cortisol. Genetic factors did not alter the relationship between maltreatment and cortisol, nor were genetic risk patterns reflected in HPA functioning. There was no mediation of the relationship between maltreatment and internalizing symptoms by HPA dysfunction. Results are interpreted through a developmental psychopathology lens, emphasizing the principle of equifinality, whereby children follow multiple pathways toward internalizing symptoms. Implications for future research, particularly the need for longitudinal studies in this area, are discussed.
University of Minnesota Ph.D. dissertation. 2017. Major: Child Psychology. Advisors: Dante Cicchetti, Bonnie Klimes-Dougan. 1 computer file (PDF); 133 pages.
The Effects of Child Maltreatment, Genetic Factors, and HPA Axis Functioning on Internalizing Symptoms in African American Children: A Moderated Mediation Model.
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