Child maltreatment and depressive symptomatology among adolescents in out-of-home care: The mediating role of self-esteem

Compared with the general population, adolescents in out-of-home care are at greater risk of having higher rates of mental health problems including depressive symptomatology. Although child maltreatment is the main reason for entering the out-of-home care system, only a few studies explored the association between child maltreatment and depressive symptomatology among youth in out-of-home care. In addition, although selfesteem may be a potential mediator linking child maltreatment and depressive symptomatology, this has not yet been evaluated with adolescents in out-of-home care. The aim of this study was to investigate the role of selfesteem as a mediator in the association between different types of child maltreatment (i.e., physical abuse, physical neglect, emotional abuse) and depressive symptomatology among a sample of adolescents in out-of-home care. The sample consisted of 404 (226 males, 178 females) adolescents derived from the Mental Health Service Use of Youth Leaving Foster Care study. Depressive symptomatology was assessed at age 18 using the Depression-Arkansas Scale. Three types of child maltreatment (physical abuse, physical neglect, emotional abuse) were assessed at age 17 using the Childhood Trauma Questionnaire. Self-esteem was assessed at age 18 using the Rosenberg Self-Esteem Scale. A path analysis was conducted to test the mediating role of self-esteem in the association between child maltreatment types and depressive symptomatology. Physical neglect was directly associated with depressive symptomatology. Emotional abuse was indirectly related to depressive symptomatology via self-esteem. The findings suggest that self-esteem may be a powerful mediator linking emotional abuse and depressive symptomatology for adolescents in out-of-home care. For emotionally abused adolescents in out-of-home care, interventions that help them promote self-esteem could reduce depressive symptomatology.