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 of age 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 years (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 years (r2 = 0.67 internalizing symptoms; r2 = 1% externalizing symptoms) and among boys exposed at age 5 years (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 at which it occurs. These findings provide additional evidence for clinicians assessing the benefits and drawbacks of screening efforts and point toward possible mechanisms driving increased vulnerability to psychopathology.

1.
Grummitt
LR
,
Kreski
NT
,
Kim
SG
,
Platt
J
,
Keyes
KM
,
McLaughlin
KA
.
Association of childhood adversity with morbidity and mortality in US adults: a systematic review
.
JAMA Pediatr
.
2021
;
175
(
12
):
1269
78
.
2.
Evans
GW
,
Li
D
,
Whipple
SS
.
Cumulative risk and child development
.
Psychol Bull
.
2013
;
139
(
6
):
1342
96
.
3.
Schilling
EA
,
Aseltine
RH
,
Gore
S
.
The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations
.
Soc Sci Med
.
2008
;
66
(
5
):
1140
51
.
4.
Shonkoff
JP
,
Boyce
WT
,
McEwen
BS
.
Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention
.
JAMA
.
2009
;
301
(
21
):
2252
9
.
5.
Bailey
DB
,
Bruer
JT
,
Symons
FJ
,
Lichtman
JW
, editors.
Critical thinking about critical periods
Baltimore, MD
Paul H. Brookes Publishing Company
2001
.
6.
Knudsen
EI
.
Sensitive periods in the development of the brain and behavior
.
J Cogn Neurosci
.
2004
;
16
(
8
):
1412
25
.
7.
Dunn
EC
,
McLaughlin
KA
,
Slopen
N
,
Rosand
J
,
Smoller
JW
.
Developmental timing of child maltreatment and symptoms of depression and suicidal ideation in young adulthood: results from the National Longitudinal Study of Adolescent Health
.
Depress Anxiety
.
2013
;
30
(
10
):
955
64
.
8.
Dunn
EC
,
Busso
DS
,
Raffeld
MR
,
Smoller
JW
,
Nelson
CA
,
Doyle
AE
.
Does developmental timing of exposure to child maltreatment predict memory performance in adulthood? Results from a large, population-based sample
.
Child Abuse Negl
.
2016
;
51
:
181
91
.
9.
Schaefer
JD
,
Cheng
TW
,
Dunn
EC
.
Sensitive periods in development and risk for psychiatric disorders and related endpoints: a systematic review of child maltreatment findings
.
Lancet Psychiatry
.
2022
;
9
(
12
):
978
91
. in press.
10.
Duprey
EB
,
Oshri
A
,
Caughy
MO
.
Childhood neglect, internalizing symptoms and adolescent substance use: does the neighborhood context matter
.
J Youth Adolesc
.
2017
;
46
(
7
):
1582
97
.
11.
Kaplow
JB
,
Widom
CS
.
Age of onset of child maltreatment predicts long-term mental health outcomes
.
J Abnorm Psychol
.
2007
;
116
(
1
):
176
87
.
12.
Keiley
MK
,
Howe
TR
,
Dodge
KA
,
Bates
JE
,
Pettit
GS
.
The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems
.
Dev Psychopathol
.
2001
;
13
(
4
):
891
912
.
13.
Kia
R
,
Kelly
L
,
Sison-Young
RLC
,
Zhang
F
,
Pridgeon
CS
,
Heslop
JA
.
MicroRNA-122: a novel hepatocyte-enriched in vitro marker of drug-induced cellular toxicity
.
Toxicol Sci
.
2015
;
144
(
1
):
173
85
.
14.
Thornberry
TP
,
Ireland
TO
,
Smith
CA
.
The importance of timing: the varying impact of childhood and adolescent maltreatment on multiple problem outcomes
.
Dev Psychopathol
.
2001
;
13
(
4
):
957
79
.
15.
Kaplow
JB
,
Dodge
KA
,
Amaya-Jackson
L
,
Saxe
GN
.
Pathways to PTSD, part II: sexually abused children
.
Am J Psychiatry
.
2005
;
162
(
7
):
1305
10
.
16.
Jaffee
SR
,
Maikovich-Fong
AK
.
Effects of chronic maltreatment and maltreatment timing on children’s behavior and cognitive abilities
.
J Child Psychol Psychiatry
.
2011
;
52
(
2
):
184
94
.
17.
Yoon
S
.
Child maltreatment characteristics as predictors of heterogeneity in internalizing symptom trajectories among children in the child welfare system
.
Child Abuse Negl
.
2017
;
72
:
247
57
.
18.
U.S. Department
Of health and human services, administration on children youth and families. Child maltreatment 2015
Washington, DC
U.S. Government Printing Office
2017
.
19.
Straus
MA
,
Hamby
SL
,
Finkelhor
D
,
Moore
DW
,
Runyan
D
.
Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: development and psychometric data for a national sample of American parents
.
Child Abuse Negl
.
1998
;
22
(
4
):
249
70
.
20.
Bender
HL
,
Allen
JP
,
McElhaney
KB
,
Antonishak
J
,
Moore
CM
,
Kelly
HOB
.
Use of harsh physical discipline and developmental outcomes in adolescence
.
Dev Psychopathol
.
2007
;
19
(
1
):
227
42
.
21.
MacKenzie
MJ
,
Nicklas
E
,
Waldfogel
J
,
Brooks-Gunn
J
.
Spanking and child development across the first decade of life
.
Pediatrics
.
2013
;
132
(
5
):
e1118
25
.
22.
Straus
MA
,
Paschall
MJ
.
Corporal punishment by mothers and development of children’s cognitive ability: a longitudinal study of two nationally representative age cohorts
.
J Aggression, Maltreat Trauma
.
2009
;
18
(
5
):
459
83
.
23.
Gershoff
ET
,
Grogan-Kaylor
A
.
Spanking and child outcomes: old controversies and new meta-analyses
.
J Fam Psychol
.
2016
;
30
(
4
):
453
69
.
24.
Abbasi
J
.
American Academy of Pediatrics says no more spanking or harsh verbal discipline
.
JAMA
.
2019
;
321
(
5
):
437
9
.
25.
Sege
RD
,
Siegel
BS
Council On Child Abuse And Neglect
Committee On Psychosocial Aspects Of Child And Family Health
.
Effective discipline to raise healthy children
.
Pediatrics
.
2018
;
142
(
6
):
e20183112
.
26.
Dunn
EC
,
Soare
TW
,
Raffeld
MR
,
Busso
DS
,
Crawford
KM
,
Davis
KA
.
What life course theoretical models best explain the relationship between exposure to childhood adversity and psychopathology symptoms: recency, accumulation, or sensitive periods
.
Psychol Med
.
2018
;
48
(
15
):
2562
72
.
27.
Reichman
NE
,
Teitler
JO
,
Garfinkel
I
,
McLanahan
SS
.
Fragile families: sample and design
.
Child Youth Serv Rev
.
2001
23
4–5
303
26
.
28.
Public data documentation | the future of families and child wellbeing study ffcws.princeton.edu
The Future of Familes and Child Wellbeing Study
2023
[Available from: https://ffcws.princeton.edu/data-and-documentation/public-data-documentation.
29.
Gilbert
R
,
Widom
CS
,
Browne
K
,
Fergusson
D
,
Webb
E
,
Janson
S
.
Burden and consequences of child maltreatment in high-income countries
.
Lancet
.
2009
;
373
(
9657
):
68
81
.
30.
Koenen
KC
,
Roberts
A
,
Stone
D
,
Dunn
EC
.
The epidemiology of early childhood trauma
. In:
Lanius
R
,
Vermetten
E
, editors.
The hidden epidemic: the impact of early life trauma on health and disease
New York, NY
Oxford University
2010
. p.
13
24
.
31.
Coleman
DL
,
Dodge
KA
,
Campbell
SK
.
Where and how to draw the line between reasonable corporal punishment and abuse
.
L Contemp Probl
.
2010
;
73
(
2
):
107
66
.
32.
Font
SA
,
Berger
LM
.
Child maltreatment and children's developmental trajectories in early to middle childhood
.
Child Dev
.
2015
;
86
(
2
):
536
56
.
33.
Kang
J
.
Instrumental social support, material hardship, personal control and neglectful parenting
.
Child Youth Serv Rev
.
2013
;
35
(
9
):
1366
73
.
34.
Slack
KS
,
Berger
LM
,
DuMont
K
,
Yang
M-Y
,
Kim
B
,
Ehrhard-Dietzel
S
.
Risk and protective factors for child neglect during early childhood: a cross-study comparison
.
Child Youth Serv Rev
.
2011
;
33
(
8
):
1354
63
.
35.
Jimenez
ME
,
Wade
R
Jr.
,
Lin
Y
,
Morrow
LM
,
Reichman
NE
.
Adverse experiences in early childhood and kindergarten outcomes
.
Pediatrics
.
2016
;
137
(
2
):
e20151839
.
36.
Achenbach
TM
,
Dumenci
L
,
Rescorla
LA
Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR
Burlington, VT
University of Vermont
2001
.
37.
Lussier
AA
,
Hawrilenko
M
,
Wang
M-J
,
Choi
KW
,
Cerutti
J
,
Zhu
Y
.
Genetic susceptibility for major depressive disorder associates with trajectories of depressive symptoms across childhood and adolescence
.
J Child Psychol Psychiatry
.
2021
;
62
(
7
):
895
904
.
38.
Hawrilenko
M
,
Masyn
KE
,
Cerutti
J
,
Dunn
EC
.
Individual differences in the stability and change of childhood depression: a growth mixture model with structured residuals
.
Child Dev
.
2021
;
92
(
4
):
e343
63
.
39.
Chilcoat
HD
,
Breslau
N
.
Does psychiatric history bias mothers’ reports? An application of a new analytic approach
.
J Am Acad Child Adolesc Psychiatry
.
1997
;
36
(
7
):
971
9
.
40.
Ringoot
AP
,
Tiemeier
H
,
Jaddoe
VWV
,
So
P
,
Hofman
A
,
Verhulst
FC
.
Parental depression and child well-being: young children’s self-reports helped addressing biases in parent reports
.
J Clin Epidemiol
.
2015
;
68
(
8
):
928
38
.
41.
Dunn
EC
,
Gilman
SE
,
Willett
JB
,
Slopen
NB
,
Molnar
BE
.
The impact of exposure to interpersonal violence on gender differences in adolescent-onset major depression: results from the National Comorbidity Survey Replication (NCS-R)
.
Depress Anxiety
.
2012
;
29
(
5
):
392
9
.
42.
Gaub
M
,
Carlson
CL
.
Gender differences in ADHD: a meta-analysis and critical review
.
J Am Acad Child Adolesc Psychiatry
.
1997
;
36
(
8
):
1036
45
.
43.
Nolen-Hoeksema
S
,
Girgus
JS
.
The emergence of gender differences in depression during adolescence
.
Psychol Bull
.
1994
;
115
(
3
):
424
43
.
44.
Smith
ADAC
,
Heron
J
,
Mishra
G
,
Gilthorpe
MS
,
Ben-Shlomo
Y
,
Tilling
K
.
Model selection of the effect of binary exposures over the life course
.
Epidemiology
.
2015
;
26
(
5
):
719
26
.
45.
Smith
AD
,
Hardy
R
,
Heron
J
,
Joinson
CJ
,
Lawlor
DA
,
Macdonald-Wallis
C
.
A structured approach to hypotheses involving continuous exposures over the life course
.
Int J Epidemiol
.
2016
;
45
(
4
):
1271
9
.
46.
Mishra
G
,
Nitsch
D
,
Black
S
,
De Stavola
B
,
Kuh
D
,
Hardy
R
.
A structured approach to modelling the effects of binary exposure variables over the life course
.
Int J Epidemiol
.
2009
;
38
(
2
):
528
37
.
47.
Lockhart
R
,
Taylor
J
,
Tibshirani
RJ
,
Tibshirani
R
.
A significance test for the LASSO
.
Ann Stat
.
2014
;
42
(
2
):
413
68
.
48.
Efron
B
,
Hastie
T
,
Johnstone
I
,
Tibshirani
R
.
Least angle regression
.
Ann Statist
.
2004
;
32
(
2
):
407
99
.
49.
Khan
A
,
McCormack
HC
,
Bolger
EA
,
McGreenery
CE
,
Vitaliano
G
,
Polcari
A
.
Childhood maltreatment, depression, and suicidal ideation: critical importance of parental and peer emotional abuse during developmental sensitive periods in males and females
.
Front Psychiatry
.
2015
;
6
:
42
.
50.
Teicher
MH
,
Anderson
CM
,
Ohashi
K
,
Khan
A
,
McGreenery
CE
,
Bolger
EA
.
Differential effects of childhood neglect and abuse during sensitive exposure periods on male and female hippocampus
.
Neuroimage
.
2018
;
169
:
443
52
.
51.
Wade
M
,
Fox
NA
,
Zeanah
CH
,
Nelson
CA
.
Effect of foster care intervention on trajectories of general and specific psychopathology among children with histories of institutional rearing: a randomized clinical trial
.
JAMA Psychiatry
.
2018
;
75
(
11
):
1137
45
.
52.
Schneider
W
,
Waldfogel
J
,
Brooks-Gunn
J
.
The Great Recession and risk for child abuse and neglect
.
Child Youth Serv Rev
.
2017
;
72
:
71
81
.
53.
Reh
RK
,
Dias
BG
,
Nelson
CA
3rd
,
Kaufer
D
,
Werker
JF
,
Kolb
B
Critical period regulation across multiple timescales
Proceedings of the National Academy of Sciences of the United States of America
2020
.
54.
Kuhlman
KR
,
Robles
TF
,
Bower
JE
,
Carroll
JE
.
Screening for childhood adversity: the what and when of identifying individuals at risk for lifespan health disparities
.
J Behav Med
.
2018
;
41
(
4
):
516
27
.
55.
Oh
DL
,
Jerman
P
,
Purewal Boparai
SK
,
Koita
K
,
Briner
S
,
Bucci
M
.
Review of tools for measuring exposure to adversity in children and adolescents: official publication of National Association of Pediatric Nurse Associates & Practitioners
.
J Pediatr Health Care
.
2018
;
32
:
564
83
.
56.
Bethell
CD
,
Carle
A
,
Hudziak
J
,
Gombojav
N
,
Powers
K
,
Wade
R
.
Methods to assess adverse childhood experiences of children and families: toward approaches to promote child well-being in policy and practice
.
Acad Pediatr
.
2017
17
7S
S51
69
.
57.
Choi
K
,
Boudreau
AA
,
Dunn
EC
.
Raising the bar for measuring childhood adversity
.
Lancet Child Adolesc Health
.
2023
;
7
(
2
):
81
3
.
58.
U.S. Department
Of health and human services, administration on children youth and families. Child maltreatment 2017
U.S. Government Printing Office
2019
.
59.
Assari
S
.
Diminished economic return of socioeconomic status for Black families
.
Soc Sci
.
2018
;
7
(
5
):
74
.
60.
Curtis
MA
,
Waldfogel
J
.
Fertility timing of unmarried and married mothers: evidence on variation across U.S. Cities from the fragile families and child wellbeing study
.
Popul Res Policy Rev
.
2009
;
28
(
5
):
569
88
.
61.
Kamp Dush
CM
.
Marital and cohabitation dissolution and parental depressive symptoms in fragile families
.
J Marriage Fam
.
2013
;
75
(
1
):
91
109
.
62.
Wagner
J
.
A comparison of alternative indicators for the risk of nonresponse bias
.
Public Opin Q
.
2012
;
76
(
3
):
555
75
.
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