Maltreatment is a pervasive global problem known to have cascading consequences that persist long after exposure subsides (Masten and Cicchetti, 2010). Maltreatment is often co-occurring, involving exposure to multiple types. Cumulative maltreatment, or exposure to multiple types of neglect and abuse, is proposed to be of critical importance for developmental psychopathology. However, a cumulative approach to studying maltreatment provides little insight into the developmental processes whereby it exerts its effects on health. Thus, we employed both a cumulative approach and a multidimensional approach to facilitate our comprehensive understanding of maltreatment experiences related to behavioral development. Given the high prevalence of maltreatment, it is important to cultivate a greater understanding of the processes linking maltreatment and health and to identify developmental periods of vulnerability to its deleterious effects. The present study uses a longitudinal design and a multidimensional approach to examine the effects of maltreatment on delay discounting and health-promoting and health-demoting behaviors during adolescence and across the transition from adolescence to young adulthood. The study sample includes 167 adolescents (aged 13–14 at Time 1; 53% male) who participated across 5 time points over 6 years. At Time 5, adolescents provided retrospective reports of their exposure to maltreatment during adolescence across ages 13–18. Delay discounting, substance use, and body mass index (BMI) were assessed at each time point. We used a developmental cascade model with autoregressive, cross-lagged, and cross-sectional associations to examine the longitudinal multivariate change processes and indirect effects from maltreatment exposure during adolescence to delay discounting and health-promoting and health-demoting behaviors during adolescence and across the transition to young adulthood. Our results indicate that cumulative maltreatment affects health-demoting behavior via its effects on delay discounting and that maltreatment of omission but not commission drives this effect. Furthermore, the findings identify adolescents exposed to maltreatment of omission as being especially vulnerable to marijuana use via elevated delay discounting. Identifying mediating processes linking maltreatment exposure to health-promoting and health-demoting behaviors may be instrumental for preventing deleterious developmental cascades and interrupting related health problems during adolescence and across the transition from adolescence to young adulthood. / Doctor of Philosophy / Maltreatment is a pervasive global problem that casts a long shadow, often involving exposure to multiple types of abuse or neglect. Cumulative maltreatment involves exposure to different types of neglect and abuse and is especially problematic for adjustment and health. However, a cumulative approach to studying maltreatment provides little insight into the developmental processes whereby it exerts its effects on health. We took a cumulative approach and a multidimensional approach to improve our understanding of how maltreatment experiences relate to health in adolescence and young adulthood. Given the high prevalence of maltreatment, it is important to understand how maltreatment and health are related and to identify developmental periods of vulnerability to maltreatment. The present study includes 167 adolescents (aged 13–14 at the study outset; 53% male) who participated across 6 years. At ages 17–18, adolescents provided reports of their exposure to maltreatment during adolescence (across ages 13–18). Delay discounting, substance use, and body mass index (BMI) were gathered at each assessment. We examined the cascading effects of cumulative maltreatment, abuse, and neglect on delay discounting and health behaviors over time. Our results indicate that cumulative maltreatment affects health-demoting behavior via delay discounting and that maltreatment of omission but not commission drives this effect. Furthermore, the findings identify adolescents exposed to maltreatment of omission as being especially vulnerable to marijuana use via elevated delay discounting. These findings may inform prevention and intervention efforts aimed at mitigating risks for adolescents exposed to neglect during adolescence and across the transition from adolescence to young adulthood.

This study reported an Outcome Mediation Cascade evaluation of the Changing Lives Program (CLP), a positive youth intervention. This study examined the effects of participation in the CLP on positive outcomes (Personal Expressiveness and Well-Being) and negative outcomes (Internalizing and Externalizing problem behaviors) as mediated by Identity Distress. 137 females and 101 males comprised the sample of this study, which draws from archival data of adolescents in alternative high schools in Miami. Findings indicated that the hypothesized model fit the data (χ2 (11) = 14.544, p = .020; RMSEA = .04; CFI = .995; SRMR = .028). Findings also provided preliminary evidence consistent with the hypothesis that in addition to having effects on targeted positive outcomes, PYD interventions are likely to have progressive cascading effects on untargeted problem outcomes.