Pathways From Child Maltreatment to Proactive and Reactive Aggression: The Role of Posttraumatic Stress Symptom Clusters

Objective: Childhood aggression is related to a myriad of negative concurrent and long-term outcomes. To mitigate the risks associated with childhood aggression, it is important to understand risk factors that might predispose 1 to aggressive behaviors. One risk factor commonly associated with aggression is the experience of child maltreatment. A common outcome associated with child maltreatment is the development of posttraumatic stress symptoms (PTSS). Several prevailing theoretical models of both posttraumatic stress and aggression indicate that these constructs have similar underlying cognitive, behavioral, and emotional mechanisms. Therefore, the present study examined the relations between and among child maltreatment, PTSS clusters, and proactive and reactive aggression in children. Method: Children between the ages of 6 and 14 who were enrolled in a residential treatment program completed self-report measures to evaluate variables of interest. These variables were included as multiple outcomes in a path analysis model in which individual PTSS clusters were examined as potential multiple mediators of the relations between child maltreatment and proactive and reactive aggression. Results: Direct effects of child maltreatment and PTSS clusters on aggression were observed. Significant indirect effects of the intrusion PTSS cluster on the relation between child maltreatment and reactive aggression was found. Conclusions: Findings suggest that symptoms associated with these specific PTSS clusters might help explain the relation between child maltreatment and reactive aggression and therefore present important implications for clinical practice and future research. Clinical Impact Statement The current study sheds light on the need to potentially broaden our conceptualization of trauma-related responses in children and adolescents and evaluate the need for a trauma-informed treatment approaches even when diagnostic criteria for PTSD is not clearly met. It may be that children with a history of maltreatment engage in more impulsive and externalizing behaviors secondary to experiencing PTSS symptoms and to properly address underlying processes, a treatment model supported for PTSD may be appropriate.