Developmental trajectories from childhood sexual abuse to depressive symptoms among adolescent youth involved in Child Protection Services

Childhood sexual abuse (CSA) contributes to depression in various populations and this link has been established using robust longitudinal studies. However, limited studies have examined this link using person-centered approaches, such as with cluster analysis, and longitudinally, with respect to youth who are involved in Child Protection Services (CPS). This is important because victims of CSA do not all experience or respond to CSA in the same way, especially so among youth involved in CPS who report greater co-occurring abuse and neglect, are more likely to have experienced severe CSA, and are less likely to recover from depressive symptoms. Thus, this dissertation included two studies that built upon each other using data from the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study.Study 1 explored profiles of 560 Canadian youth involved in the Ontario child welfare system based on their depressive symptoms, CSA characteristics, and co-occurring abuse and neglect histories. Cluster analysis identified two group clusters. The majority of youth in the first group reported none to minimal CSA, co-occurring abuse and neglect, and depressive symptoms. The majority of the second group were female, reported moderate to severe CSA, co-occurring abuse and neglect, and clinical depressive symptoms. It was also found that youth who reported severe CSA were five times more likely to report clinical depressive symptoms compared to youth who did not report CSA, while controlling for gender and co-occurring abuse. The results highlight the importance of screening for abuse history and severity when treating depression, especially among sexually abused youth involved in CPS.Study 2 examined longitudinal trajectories of depressive symptoms over 18-months among 135 sexually abused youth involved in CPS. Contrary to expectations, depressive symptoms significantly reduced over time. Furthermore, the changes in depressive symptoms varied by CSA severity. Specifically, it was found that reductions of depressive symptoms were significantly associated with CSA severity over time. These findings highlight the value of screening for CSA history and severity when developing targeted interventions for depressive symptoms throughout CPS involvement. As a whole, the findings from this dissertation offer unique evidence that not only should CSA be considered, but its severity and histories of other forms of abuse and neglect are also key factors for mental health screening practices among youth involved in CPS. Future longitudinal research is needed to better understand these findings across youth involved in the child welfare system and help CPS develop effective and sustainable targeted interventions that best meet the needs of its youth. Keywords: Childhood sexual abuse, CSA, depressive symptoms, child protection services, child welfare, longitudinal studies, cluster analysis

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