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Mindfulness as Mediator and Moderator of Post-traumatic Symptomatology in Adolescence Following Childhood Sexual Abuse or Assault

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Abstract

Childhood sexual abuse or assault (CSA) is a non-specific risk factor for psychopathology such as post-traumatic stress disorder or depression. However, the impact of CSA greatly varies among individuals. Mediating mechanisms and moderating factors have been proposed to explain how the effects of CSA translate into varied symptoms. Mindfulness is one of the potential variables linked to the diversity of outcomes of CSA. As mindfulness-based interventions are increasingly being used among adolescents and those sexually abused or assaulted in childhood, it is essential to know more about the mechanisms by which it influences post-traumatic symptoms in these populations. This study’s aim is to assess whether mindfulness mediates and moderates the relationship between self-reported exposure to CSA and post-traumatic symptoms in adolescence. A sample of 246 adolescents (48 % female) reported their exposure to CSA and completed the Child Acceptance and Mindfulness Measure and the Trauma Symptoms Checklist for Children. The relation between CSA, mindfulness and post-traumatic symptoms was investigated using mediation and moderation regression models from the Process script. Results reveal that mindfulness acted as a mediator of post-traumatic symptoms, as CSA was associated with lower levels of mindfulness, which in turn were associated with more post-traumatic symptoms. On the other hand, mindfulness only acted as a moderator of CSA for anger and anxiety but not in the expected direction. Further investigation is needed to shed light on the moderator role of mindfulness in sexually abused youth.

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References

  • A-Tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30–36. doi:10.1159/000365764.

    Article  PubMed  Google Scholar 

  • Banks, K., Newman, E., & Saleem, J. (2015). An overview of the research on mindfulness-based interventions for treating symptoms of posttraumatic stress disorder: a systematic review. Journal of Clinical Psychology, Online prepublication, doi:10.1002/jclp.22200

  • Barth, J., Bermetz, L., Heim, E., Trelle, S., & Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. International Journal of Public Health, 58(3), 469–483. doi:10.1007/s00038-012-0426-1.

    Article  PubMed  Google Scholar 

  • Bauer, D. J., & Curran, P. J. (2005). Probing interactions in fixed and multilevel regression: inferential and graphical techniques. Multivariate Behavioral Research, 40(3), 373–400. doi:10.1207/s15327906mbr4003_5.

    Article  PubMed  Google Scholar 

  • Bolduc, R., Bigras, N., Godbout, N., Hébert, M., & Daspe, M.-È. (2014). L’effet de la pleine conscience et de la dissociation sur la relation entre le trauma cumulatif et la dépression: Modèle d’équations structurelles. Paper presented at the Rencontre annuelle du CRIPCAS, Trois-Rivièves, October 2014

  • Brabant, M.-E., Hébert, M., & Chagnon, F. (2014). Predicting suicidal ideations in sexually abused female adolescents: a 12-month prospective study. Journal of Child Sexual Abuse, 23(4), 387–397. doi:10.1080/10538712.2014.896842.

    Article  PubMed  Google Scholar 

  • Briere, J. (1996). Trauma symptom checklist for children (TSCC): professional manual. Odessa: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Briere, J., & Scott, C. (2015). Complex trauma in adolescents and adults. Psychiatric Clinics, 38(3), 515–527. doi:10.1016/j.psc.2015.05.004.

    PubMed  Google Scholar 

  • Broderick, P. C., & Jennings, P. A. (2012). Mindfulness for adolescents: a promising approach to supporting emotion regulation and preventing risky behavior. New directions for youth development, 2012, 111–126. doi:10.1002/yd.20042.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Seal, B. N., & Rellini, A. (2012). Pilot study of a brief cognitive behavioural versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. Journal of Sex & Marital Therapy, 38(1), 1–27. doi:10.1080/0092623X.2011.569636.

  • Caldwell, J. G., & Shaver, P. R. (2015). Promoting attachment-related mindfulness and compassion: a wait-list-controlled study of women who were mistreated during childhood. Mindfulness, 6(3), 624–636. doi:10.1007/s12671-014-0298-y.

    Article  Google Scholar 

  • Ciesla, J., Reilly, L., Dickson, K., Emanuel, A., & Updegraff, J. (2012). Dispositional mindfulness moderates the effects of stress among adolescents: rumination as a mediator. Journal of Clinical Child and Adolescent Psychology, 41(6), 760–770. doi:10.1080/15374416.2012.698724.

  • Cotton, S., Luberto, C. M., Sears, R. W., Strawn, J. R., Stahl, L., Wasson, R. S., et al. (2015). Mindfulness-based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: a pilot trial. Early Intervention in Psychiatry, 1–9. doi:10.1111/eip.12216.

  • Daigneault, I., Tourigny, M., & Cyr, M. (2004). Description of trauma and resilience in sexually abused adolescents: an integrated assessment. Journal of Trauma Practice, 3(2), 23–47.

    Article  Google Scholar 

  • Daigneault, I., Cyr, M., & Tourigny, M. (2007a). Exploration of recovery trajectories in sexually abused adolescents. Journal of Aggression Maltreatment and Trauma, 14(1/2), 165–184. doi:10.1300/J146v14n01_09.

  • Daigneault, I., Hébert, M., & Tourigny, M. (2007b). Personal and interpersonal characteristics related to resilient developmental pathways of sexually abused adolescents. Child and Adolescent Psychiatric Clinics of North America, 16(2), 415–434. doi:10.1016/j.chc.2006.11.002.

  • Daigneault, I., Dion, J., Hébert, M., McDuff, P., & Collin-Vézina, D. (2013). Psychometric properties of the Child and Youth Resilience Measure (CYRM-28) among samples of French Canadian youth. Child Abuse and Neglect, 37, 160–171. doi:10.1016/j.chiabu.2012.06.004.

  • de Bruin, E. I., Zijlstra, B. J. H., & Bogels, S. M. (2014). The meaning of mindfulness in children and adolescents: further validation of the child and adolescent mindfulness measure (CAMM) in Two independent samples from the Netherlands. Mindfulness, 5(4), 422–430. doi:10.1007/s12671-013-0196-8.

    Google Scholar 

  • Domhardt, M., Münzer, A., Fegert, J. M., & Goldbeck, L. (2014). Resilience in survivors of child sexual abuse: a systematic review of the litterature. Trauma, Violence, & Abuse, 1–18. doi:10.1177/1524838014557288.

  • Earley, M. D., Chesney, M. A., Frye, J., Greene, P. A., Berman, B., & Kimbrough, E. (2014). Mindfulness intervention for child abuse survivors: a 2.5-year follow-up. Journal of Clinical Psychology, 70(10), 933–941. doi:10.1002/jclp.22102.

  • English, L. (2012). Investigating childhood emotional maltreatment, adult attachment, and mindfulness as predictors of internalizing symptoms and emotional processing. Ontario: University of Guelph.

    Google Scholar 

  • Fergusson, D. M., Horwood, J. L., & Lynskey, M. T. (1996). Childhood sexual abuse and psychiatric disorder in young adulthood: II. Psychiatric outcomes of childhood sexual abuse. Journal of American Academy of Child & Adolescent Psychiatry, 34(10), 1365–1374.

    Article  Google Scholar 

  • Fergusson, D. M., Boden, J. M., & Horwood, L. (2008). Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse & Neglect, 32(6), 607–619. doi:10.1016/j.chiabu.2006.12.018.

  • Finkelhor, D., & Browne, A. (1985). The traumatic impact of child sexual abuse: a conceptualization. American Journal of Orthopsychiatry, 55(4), 530–541.

    Article  PubMed  Google Scholar 

  • Follette, V. M., Palm, K. M., & Pearson, A. N. (2006). Mindfulness and trauma: implications for treatment. Journal of Rational Emotive & Cognitive Behavior Therapy, 24(1), 45–61. doi:10.1007/s10942-006-0025-2.

  • Follette, V. M., Briere, J., Rozelle, D., Hopper, J. W., & Rome, D. I. (2015). Mindfulness-oriented interventions for trauma: integrating contemplative practices. In Mindfulness-oriented interventions for trauma: integrating contemplative practices (p. xi, 372). New York: Guilford Press.

    Google Scholar 

  • Godbout, N., Bigras, N., & Dion, J. (2016). Présence attentive et traumas interpersonnels en enfance [Mindfulness and interpersonnal trauma in childhood]. In S. Grégoire, L. Lachance, & L. Richer (Eds.), La présence attentive : état des connaissances théoriques, empiriques et pratiques (pp. 229–246). [Mindfulness: current theoretical, empirical and practical knowledge]. Montreal: Presses de l’Université du Québec (PUQ).

    Google Scholar 

  • Greco, L. A., Baer, R. A., & Smith, G. T. (2011). Assessing mindfulness in children and adolescents: development and validation of the Child and Adolescent Mindfulness Measure (CAMM). Psychological Assessment, 23(3), 606–614. doi:10.1037/a0022819.

  • Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12. doi:10.1016/j.cpr.2015.01.006.

    Article  PubMed  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation and conditional process analysis: a regression-based approach (Vol. 1 april 2014). New York: The Guildford Press.

    Google Scholar 

  • Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior research methods, 41(3), 924–936.

    Article  PubMed  Google Scholar 

  • Hébert, M., Lavoie, F., & Blais, M. (2014). Post traumatic stress disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors. Ciência & Saúde Coletiva, 19(3), 685–694.

    Article  Google Scholar 

  • Herman, J. L. (1992). Trauma and recovery. New-York: Basic Books.

    Google Scholar 

  • Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190.

    Article  PubMed  Google Scholar 

  • Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological Bulletin, 113(1), 164–180. doi:10.1037/0033-2909.113.1.164.

  • Kimbrough, E., Magyari, T., Langenberg, P., Chesney, M., & Berman, B. (2010). Mindfulness intervention for child abuse survivors. Journal of Clinical Psychology, 66(1), 17–33.

    PubMed  Google Scholar 

  • King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A. M., Robinson, E., et al. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression and Anxiety, 30(7), 638–645. doi:10.1002/da.22104.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuby, A., McLean, N., & Allen, K. (2015). Validation of the Child and Adolescent Mindfulness Measure (CAMM) with Non-Clinical Adolescents. Mindfulness, 1–8. doi:10.1007/s12671-015-0418-3.

  • Langer, E. J., Blank, A., & Chanowitz, B. (1978). The mindlessness of ostensibly thoughtful action: the role of “ placebic” information in interpersonal interaction. Journal of Personality and Social Psychology, 36(6), 635.

    Article  Google Scholar 

  • Langevin, R., Hébert, M., & Cossette, L. (2015). Emotion regulation as a mediator of the relation between sexual abuse and behavior problems in preschoolers. Child Abuse & Neglect, 46, 16–26. doi:10.1016/j.chiabu.2015.02.001.

  • Lanktree, C. B., Briere, J., Godbout, N., Hodges, M., Chen, K., Trimm, L., et al. (2012). Treating multitraumatized, socially marginalized children: results of a naturalistic treatment outcome study. Journal of Aggression, Maltreatment & Trauma, 21(8), 813–828. doi:10.1080/10926771.2012.722588.

    Article  Google Scholar 

  • Lebowitz, L., Harvey, M. R., & Herman, J. L. (1993). A stage-by-dimension model of recovery from sexual trauma. Journal of Interpersonal Violence, 8(3), 378–391.

    Article  Google Scholar 

  • Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: a critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. doi:10.1111/1467-8624.00164.

  • Maniglio, R. (2009). The impact of child sexual abuse on health: a systematic review of reviews. Clinical Psychology Review, 29(7), 647–657. doi:10.1016/j.cpr.2009.08.003.

  • Mannarino, A. P., Cohen, J. A., Deblinger, E., Runyon, M. K., & Steer, R. A. (2012). Trauma-focused cognitive-behavioral therapy for children: sustained impact of treatment 6 and 12 months later. Child Maltreatment, 17(3), 231–241. doi:10.1177/1077559512451787.

  • Marks, A. D. G., Sobanski, D. J., & Hine, D. W. (2010). Do dispositional rumination and/or mindfulness moderate the relationship between life hassles and psychological dysfunction in adolescents? Australian and New Zealand Journal of Psychiatry, 44(9), 831–838.

    Article  PubMed  Google Scholar 

  • Marriott, C., Hamilton-Giachritsis, C., & Harrop, C. (2014). Factors promoting resilience following childhood sexual abuse: a structured, narrative review of the literature. Child Abuse Review, 23(1), 17–34.

    Article  Google Scholar 

  • Martinez, W., Polo, A. J., & Zelic, K. J. (2014). Symptom variation on the trauma symptom checklist for children: a within-scale meta-analytic review. Journal of Traumatic Stress, 27(6), 655–663. doi:10.1002/jts.21967.

  • McClure, F. H., Chavez, D. V., Agars, M. D., Peacock, M., & Matosian, A. (2008). Resilience in sexually abused women: risk and protective factors. Journal of Family Violence, 23(2), 81–88. doi:10.1007/s10896-007-9129-4.

  • Miller, J. W., Stromeyer, W. R., & Schwieterman, M. A. (2013). Extensions of the Johnson-Neyman technique to linear models with curvilinear effects: derivations and analytical tools. Multivariate Behavioral Research, 48(2), 267–300.

    Article  PubMed  Google Scholar 

  • Muckle, F., Dion, J., Daigneault, I., Ross, A., & McDuff, P. (2012). Influence de l’estime de soi, de la perception des qualités relationnelles parents-enfants, du soutien social et de l’agression sexuelle sur la résilience auprès d’adolescents autochtones et caucasiens du Québec [Influence of self-esteem, parent-child relationships, social support and sexual abuse on resilience among Aboriginal and Caucasian adolescents]. First Peoples Child & Family Review, 7, 99–117.

    Google Scholar 

  • Ost, L. G. (2014). The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behav Res Ther, 61, 105–121. doi:10.1016/j.brat.2014.07.018.

    Article  PubMed  Google Scholar 

  • Peters, J. R., Smart, L. M., Eisenlohr-Moul, T. A., Geiger, P. J., Smith, G. T., & Baer, R. A. (2015). Anger rumination as a mediator of the relationship between mindfulness and aggression: the utility of a multidimensional mindfulness model. Journal of Clinical Psychology. doi:10.1002/jclp.22189.

    PubMed  Google Scholar 

  • Putnam, F. W. (2003). Ten-year research update review: child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 42(3), 269–278. doi:10.1097/00004583-200303000-00006.

    Article  Google Scholar 

  • Rogers, E. S., Chamberlin, J., Ellison, M. L., & Crean, T. (1997). A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services, 48(8), 1042–1047.

    Article  PubMed  Google Scholar 

  • Rosenthal, M. Z., Hall, M. L. R., Palm, K. M., Batten, S. V., & Follette, V. M. (2005). Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood. Journal of Child Sexual Abuse, 14(4), 25–41. doi:10.1300/J070v14n04_02.

    Article  PubMed  Google Scholar 

  • Spaccarelli, S. (1994). Stress, appraisal, and coping in child sexual abuse: a theoretical and empirical review. Psychological Bulletin, 116(2), 340–362.

    Article  PubMed  Google Scholar 

  • Spaccarelli, S., & Kim, S. (1995). Resilience criteria and factors associated with resilience in sexually abused girls. Child Abuse & Neglect, 19(9), 1171–1182. doi:10.1016/0145-2134%2895%2900077-L.

  • Sperry, D. M., & Widom, C. S. (2013). Child abuse and neglect, social support, and psychopathology in adulthood: a prospective investigation. Child Abuse & Neglect, 37(6), 415–425. doi:10.1016/j.chiabu.2013.02.006.

    Article  Google Scholar 

  • Stoltenborgh, M., van Ijzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79–101. doi:10.1177/1077559511403920.

  • Swart, J., & Apsche, J. (2014). Mindfulness, mode deactivation, and family therapy: a winning combination for treating adolescents with complex trauma and behavioural problems. International Journal of Behavioral Consultation and Therapy, 9(2), 9–14.

    Article  Google Scholar 

  • Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42. doi:10.1016/j.jclinepi.2006.03.012.

    Article  PubMed  Google Scholar 

  • Thompson, B. L., & Waltz, J. (2010). Mindfulness and experiential avoidance as predictors of posttraumatic stress disorder avoidance symptom severity. Journal of Anxiety Disorders, 24(4), 409–415. doi:10.1016/j.janxdis.2010.02.005.

  • Tovote, K. A., Fleer, J., Snippe, E., Peeters, A. C., Emmelkamp, P. M., Sanderman, R., et al. (2014). Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care, 37(9), 2427–2434. doi:10.2337/dc13-2918.

    Article  PubMed  Google Scholar 

  • Tyler, K. A. (2002). Social and emotional outcomes of childhood sexual abuse: a review of recent research. Aggression and Violent Behavior, 7(6), 567–589. doi:10.1016/S1359-1789%2801%2900047-7.

  • Valdez, C., & Lilly, M. (2015). Self-compassion and trauma processing Outcomes among victims of violence. Mindfulness, 1–11. doi:10.1007/s12671-015-0442-3.

  • van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., et al. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review, 37, 26–39. doi:10.1016/j.cpr.2015.02.001.

    Article  PubMed  Google Scholar 

  • Wowra, S. A., & McCarter, R. (1999). Validation of the empowerment scale with an outpatient mental health population. Psychiatric Services, 50(7), 959–961. doi:10.1176/ps.50.7.959.

    Article  PubMed  Google Scholar 

  • Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: a meta-analysis. Mindfulness, 6(2), 290–302. doi:10.1007/s12671-013-0260-4.

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Acknowledgments

All authors are members of the “Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles” (CRIPCAS) and the “Équipe violence sexuelle et santé” (ÉVISSA), both research groups on sexual abuse. This research was supported by a grant from the Université du Québec à Chicoutimi. We thank school directors, teachers and students for their generous collaboration in this project, as well as research assistants, in particular Erika Bacon, Marie-Frédéric Bouchard, François Muckle and Delphine Lagacé for their assistance in collecting data.

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Authors and Affiliations

  1. Psychology Department, Université de Montréal, P.O. Box 6128, Downtown Station, Montréal, QC, H3C 3J7, Canada

    Isabelle Daigneault & Catherine Bourgeois

  2. Health Sciences Department, Université du Québec à Chicoutimi, 555 Boulevard de l’Université, Chicoutimi, QC, G7H 2B1, Canada

    Jacinthe Dion

  3. Sexology Department, Université du Québec à Montréal, P.O. Box 8888, Downtown Station, Montréal, QC, H3C 3P8, Canada

    Martine Hébert

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  1. Isabelle Daigneault
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Correspondence to Isabelle Daigneault.

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This study was funded by a grant from the Université du Québec à Chicoutimi.

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Daigneault, I., Dion, J., Hébert, M. et al. Mindfulness as Mediator and Moderator of Post-traumatic Symptomatology in Adolescence Following Childhood Sexual Abuse or Assault. Mindfulness 7, 1306–1315 (2016). https://doi.org/10.1007/s12671-016-0571-3

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