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Results

Our study results show that the psychologically maltreated group had significantly higher scores on the widely used and well-validated Child Behavior Checklist: Internalizing (CBCL-Int), (Achenbach & Rescorla, 2004) than either the physically abused group or the sexually abused group. In addition, the psychologically maltreated group had significantly higher Child Behavior Checklist: Externalizing (CBCL-Ext.) scores (Achenbach & Rescorla, 2004) than the sexually abused group. We also found no significant differences between the psychologically maltreated versus the physically abused or sexually abused groups on Post-traumatic Stress Disorder-Reaction Index (PTSD-RI) scores. Finally, although the psychologically maltreated group had marginally lower CBCL-Ext. scores than the group with positive histories of both physical and sexual abused, the two groups had similar CBCL-Int. and PTSD-RI (Steinberg et al., 2004) scores.

Our study revealed that the psychologically maltreated group had similar or higher frequencies than both the physically abused and sexually abused groups on 21 of 27 indicators of risk behaviors, behavioral problems, functional impairments, symptoms and disorders.

Compared with the physically abused group, the psychologically maltreated group had significantly higher odds on five indicators: behavior problems at home, attachment problems, depression, acute stress disorder and generalized anxiety disorder. The psychologically maltreated group also had marginally higher odds than the physically abused group on two indicators: skipping school or day care and self-injurious behaviors.

Compared with the sexually abused group, the psychologically maltreated group had higher frequencies on the majority of outcomes (17 of 27). The psychologically maltreated group had significantly lower frequencies on only these study indicators compared with both the physically abused group (conduct disorder, general behavior problems and attention deficit hyperactivity) and the sexually abused group (sexualized behaviors, PTSD and, marginally, suicidality).

In addition, we found that the psychologically maltreated group had significantly lower odds on only two indicators compared with the combined physically and sexually abused group: sexualized behaviors and PTSD. The psychologically maltreated group had significantly higher odds on these indicators: substance abuse disorder, generalized anxiety disorder, depression and acute stress disorder.

The study also found that compared with the physically abused group, the combined psychologically maltreated and physically abused group had significantly higher CBCL-Int. scores and PTSD-RI scores. In contrast, the two groups reported similar CBCL-Ext. scores. Further, compared with the sexually abused group, the combined psychologically maltreated and sexually abused group had significantly higher scores on the CBCL-Ext., as well as marginally higher scores on the PTSD-RI.

Compared with the sexually abused group, the psychologically maltreated and sexually abused group had significantly higher odds on the majority of indicators (18 of 27).

Similarly, compared with the physically abused group, the combined psychologically maltreated and physically abused group had significantly higher odds on the majority of indicators (17 of 27).

It is important to note that our results were from the models adjusted for gender and age at baseline, and these model covariates were significantly associated with some of the measures and indicators of interest. Male status was associated with significantly higher mean scores on the CBCL-Ext. subscale, as well as a significantly higher frequency of a subset of respondent and clinician-rated indicators (8 of 27). Female status was associated with significantly higher PTSD-RI scores and with a significantly higher frequency of a different subset of clinician-rated indicators (7 of 27).

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