Supplementary Material for: Sensitive periods for the effect of child maltreatment on psychopathology symptoms in adolescence

Introduction: Child maltreatment is among the strongest risk factors for mental disorders. However, little is known about whether there are ages when children may be especially vulnerable to its effects. We sought to identify potential sensitive periods when exposure to the 2 most common types of maltreatment (neglect and harsh physical discipline) had a particularly detrimental effect on youth mental health. Methods: Data came from the Future of Families and Child Wellbeing Study (FFCWS), a birth cohort oversampled from “fragile families” (n=3,474). Maltreatment was assessed at 3, 5, and 9 years using an adapted version of the Parent-Child Conflict Tactics Scales (CTS-PC). Using least angle regression, we examined the relationship between repeated measures of exposure to maltreatment on psychopathology symptoms at age 15 (Child Behavior Checklist; CBCL/6-18). For comparison, we evaluated the strength of evidence to support the existence of sensitive periods in relation to an accumulation of risk model. Results: We identified sensitive periods for harsh physical discipline, whereby psychopathology symptom scores were highest among girls exposed at age 9 (r2=0.67 internalizing symptoms; r2=1% externalizing) and among boys exposed at age 5 (r2=0.41%). However, for neglect, the accumulation of risk model explained more variability in psychopathology symptoms for both boys and girls. Conclusion: Child maltreatment may have differential effects based on the child’s sex, type of exposure, and the age it occurs. These findings provide additional evidence for clinicians assessing the benefits and drawbacks of screening efforts and point towards mechanisms driving increased vulnerability to psychopathology.引言：儿童虐待（Child maltreatment）是引发精神障碍的最强危险因素之一。然而目前学界对于儿童是否存在特定年龄阶段会更易受其影响这一问题仍知之甚少。本研究旨在明确，当儿童暴露于两种最常见的虐待类型——忽视（neglect）与严厉体罚（harsh physical discipline）时，是否存在对青少年心理健康产生尤为有害影响的潜在敏感期。 方法：本研究数据取自《家庭与儿童福祉未来研究》（Future of Families and Child Wellbeing Study, FFCWS），这是一项针对脆弱家庭的出生队列研究，共纳入3474名研究对象。研究在儿童3岁、5岁及9岁时，采用修订版亲子冲突解决策略量表（Parent-Child Conflict Tactics Scales, CTS-PC）对虐待情况进行评估。本研究采用最小角回归（least angle regression），分析了15岁时（通过儿童行为量表CBCL/6-18评估）的精神病理症状与重复测量的虐待暴露水平之间的关联。为进行对照，我们针对风险累积模型，评估了支持敏感期存在的证据强度。 结果：本研究明确了严厉体罚的敏感期：9岁时遭受虐待的女孩，其精神病理症状得分最高（内化症状的决定系数r²=0.67；外化症状的r²=1%）；5岁时遭受虐待的男孩得分最高（r²=0.41%）。但对于儿童忽视而言，风险累积模型能够更好地解释男、女孩的精神病理症状变异程度。 结论：儿童虐待的影响可能因儿童性别、虐待类型及发生年龄而异。本研究结果为临床医师评估筛查工作的利弊提供了更多证据，并为揭示精神病理易感性升高的潜在机制指明了方向。