Child Maltreatment

17(4) 306-317
Cumulative Childhood Maltreatment and ª The Author(s) 2012
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Depression Among Incarcerated Youth: DOI: 10.1177/1077559512466956
http://cmx.sagepub.com
Impulsivity and Hopelessness as Potential
Intervening Variables

Sonya G. Wanklyn1, David M. Day1, Trevor A. Hart1,2, and

Todd A. Girard1

Abstract
Youth involved in the juvenile justice system are at high risk for mental health problems, particularly depression. Furthermore,
these youth often present with a history of childhood maltreatment. Despite research consistently demonstrating a link between
childhood maltreatment and depression, our understanding of intervening factors of this relationship remains limited. This study
examined impulsivity, hopelessness, and substance use as potential explanatory variables in the relationship between cumulative
childhood maltreatment and depression severity among 110 incarcerated youth. The data were analyzed using path analysis. As
hypothesized, cumulative maltreatment maintained a strong direct relation with depression severity in the context of the
additional variables in the final model. Cumulative maltreatment also had an indirect relation with depression severity through
both impulsivity and hopelessness. Contrary to expectation, substance use was not an explanatory variable in the model.
These findings suggest that impulsivity and hopelessness might be important factors to consider in future studies on the
relation between childhood maltreatment and depression symptoms among incarcerated youth.

Keywords
childhood maltreatment, depression, incarcerated youth, adolescent offenders

Youth involved in the juvenile justice system represent one of
the largest concentrations of adolescents presenting with
depression (Colins, Vermeiren, Schuyten, & Broekaert, 2009;
Teplin, Abram, McClelland, Dulcan, & Mericle, 2002).
Research suggests that 47% of incarcerated youth have
moderate or severe depression (Domalanta, Risser, Roberts,
& Risser, 2003), with as many as 13% of incarcerated youth
meeting criteria for major depressive disorder (Teplin et al.,
2002), compared to 5% of youth in the general population
(Shaffer et al., 1996). Depression and depressive symptoms
in adolescence can result in significant impairment in school
performance and social functioning, compromising an individ-
ual’s overall health and well-being and putting a young person
at heightened risk for suicide (Coyle et al., 2003; Hauenstein,
2003; Spirito & Esposito-Smythers, 2006). Furthermore,
depression symptoms are among the most consistent and
strongest predictors of youth violence, alongside delinquent
peer associations and antisocial personality traits (Ferguson,
San Miguel, & Hartley, 2009). As a result, it is imperative that
potential explanatory variables for adolescent depression are
identified to prevent or address negative psychological
outcomes. The investigation of the potential causes of
depression among juvenile offenders remains a particularly
understudied area.
Although the etiology of depression in young people is
multifaceted (Tao, Moore, Mayes, & Emslie, 2007), childhood
maltreatment has been consistently identified as an important
risk factor (Brown, Cohen, Johnson, & Smailes, 1999;
Harkness, Bruce, & Lumley, 2006). Theorists have long held
that depression severity in adolescence and adulthood is
precipitated by childhood maltreatment (e.g., Bowlby, 1980).
Moreover, research suggests cumulative maltreatment may
lead to more detrimental mental health functioning than
exposure to only one subtype of childhood maltreatment. For
instance, the number of maltreatment subtypes experienced
in childhood has been associated with poorer mental health
outcomes, including increased depression severity, among both
men and women (Edwards, Holden, Felitti, & Anda, 2003;
Salazar, Keller, & Courtney, 2011).
1
Department of Psychology, Ryerson University, Toronto, ON, Canada
2
University of Toronto, Toronto, ON, Canada
Corresponding Author:
David M. Day, Department of Psychology, Ryerson University, 350 Victoria
Street, Toronto, ON, Canada, M5B 2K3
Email: dday@psych.ryerson.ca
Wanklyn et al.
With respect to the youth involved in the juvenile justice
system and childhood maltreatment, incarcerated youth are
more likely to report childhood maltreatment histories than
nonincarcerated youth (Stevenson, 2009). Childhood maltreat-
ment is, in fact, widely recognized as a risk factor for involve-
ment in criminal activity, whereby a history of abuse or neglect
in childhood has been reported to increase the likelihood of
antisocial and delinquent behavior (Malinosky-Rummell &
Hansen, 1993; Verrecchia, Fetzer, Lemmon, & Austin,
2010). Without intervention, these maltreated youth are more
likely to commit a violent offense (Widom, 1992), have an
earlier onset for the initiation of delinquent behaviors (Rivera
& Widom, 1990), and are at a higher risk for criminal recidi-
vism and for involvement in the adult criminal justice system
(Visher, Lattimore, & Linster, 1991). Furthermore, this effect
is cumulative; youth are at increased risk for delinquency when
multiple forms of maltreatment are experienced (Ford, Elhai,
Connor, & Frueh, 2010), and those who are repeatedly
maltreated for an extended period of time are more likely to
re-offend (Chang, Chen, & Brownson, 2003).
Adolescent offenders who have experienced childhood
maltreatment report a higher prevalence of depression and
severity of depression symptoms compared to nonmaltreated
youth (Bender, 2010). However, relatively few studies have
examined the effects of cumulative childhood maltreatment
on depression severity and other indicators of mental health
functioning. Multiple factors might explain the relation
between childhood maltreatment and depression. Here we
focus on the role of three such dynamic factors that may offer
insight into future research informing the development of more
targeted intervention and prevention strategies.
Hopelessness, Impulsivity, and Substance Use as
Potential Intervening Factors in the Relation Between
Childhood Maltreatment and Depression
Hopelessness. Numerous theories have posited a relationship
between depression and persistent negative expectancies and
cognitions. According to Beck’s cognitive theory of depression
(1987), dysfunctional negative cognitions are the primary
antecedents of depression symptoms. This theory has stimulated
considerable interest and numerous studies have generated
support for a relationship between hopelessness, as a negative
cognition, and depression severity (e.g., Alloy & Abramson,
1999).
Beck’s theory further postulates that negative events in the
formative years can contribute to the development of persistent
and maladaptive negative cognitions later on. Nonetheless, few
empirical investigations have examined childhood maltreat-
ment history as a potential precursor to hopelessness. Rose and
Abramson (1992) hypothesized that individuals who infer
negative self-characteristics and stable global causes from
negative life events are vulnerable to the development of
hopelessness and subsequent depression. In the case of
childhood maltreatment, it is suggested that the child attempts
307
to understand why the event occurred in order to avoid its
recurrence. These inferences are initially hopeful and attributed
to unstable and specific characteristics. However, with chronic
maltreatment these inferences are continuously disconfirmed
and eventually the child begins to make hopeless attributions
that can generalize to other negative events (e.g., Gibb, Alloy,
Abramson, & Marx, 2003). As such, negative cognitive styles,
including hopelessness, could be expected to influence the rela-
tionship between childhood maltreatment and depression
severity (DuRant, Getts, Cadenhead, Emans, & Woods, 1995).
Impulsivity. Early experiences of maltreatment might consti-
tute an environmental risk factor for the development of impul-
sivity, which might, in turn, increase depression severity.
Impulsivity has been described as a consequence of traumatic
events, such as childhood maltreatment, by undermining the
individual’s capacity to inhibit behavior and modulate emo-
tions (Braquehais, Oquendo, Baca-Garcı́a, & Sher, 2010).
Relatedly, the appraisal theory of emotional states posits that
sadness arises when our potential for coping with a negative
event is compromised (Scherer, 2001). Therefore, compared
to their nonimpulsive counterparts, impulsive adolescents may
have increased depression severity because they are more
likely to employ inappropriate strategies for coping with child-
hood maltreatment (e.g., d’Acremont & Van der Linden, 2007).
This proposition is further supported by neurobiological
evidence regarding alterations in brain development associated
with childhood maltreatment (Gerra et al., 2007; Lovallo,
1997). One neurochemical mechanism for this association may
relate to serotonergic function. That is, chronic or persistent
maltreatment can lead to lower levels of central serotonin.
Moreover, low serotonin function has been associated with
impulsive behaviors. Reduced availability of serotonin leads
to decreased ability of the central nervous system to dampen
emotional responses to stressors (Braquehais et al., 2010). This
offers one potential neurochemical explanation for the associ-
ation between impulsivity and depression severity (e.g., Gerra
et al., 2007). While these interrelations deserve further
investigation, on the whole, research suggests that impulsivity
precedes depression (d’Acremont & Van der Linden, 2007).
Substance use. The association between substance use and
depression is well established, with many studies reporting
greater depression severity in drug users than nondrug users
(e.g., Sumnall & Cole, 2005). Several studies also have
reported substance use to be a strong predictor of depression
(e.g., Davidson, 1995; Swanson, Linskey, Quinero-Salinas,
Pumariega, & Holzer, 1992). With respect to traumatic
experiences, research has suggested that childhood maltreat-
ment increases the risk for substance use disorders and misuse
among adolescents (Gerra et al., 2007). The positive associa-
tion between childhood maltreatment and substance use has
been recorded across diverse samples, including incarcerated
adolescents (Hawke, Jainchill, & DeLeon, 2000).
In light of the above mentioned relationships, it is possible
that impulsivity and hopelessness, arising from childhood
308 Child Maltreatment 17(4)

Table 1. Demographics and Offense Characteristics of the Sample investigation. The present study tested a theoretical model of the
relationship between childhood maltreatment and depression
Males Females Total sample
Demographics n (%) n (%) N (%)
severity by examining hopelessness, impulsivity, and substance
use as potential explanatory factors in a sample of incarcerated
Sexual orientation juvenile offenders. Moreover, we also examined the potential
Heterosexual 66 (98.5) 26 (60.5) 92 (83.6) intervening role of substance use in the relations between both
Bisexual 0 (0.0) 17 (39.5) 17 (15.5) hopelessness and impulsivity with depression. Based on the exist-
Highest completed level of education
ing literature, it was hypothesized that higher levels of cumulative
 Grade 8 6 (9.0) 15 (34.9) 21 (19.1)
Grade 9 14 (20.9) 8 (18.6) 22 (20.0) maltreatment would be related to higher depression severity. This
Grade 10 19 (28.4) 11 (25.6) 30 (27.3) relation was expected to be partially explained by impulsivity,
Grade 11 20 (29.9) 8 (18.6) 28 (25.5) hopelessness, and substance use such that higher levels of these
Grade 12 6 (9.0) 0 (0.0) 6 (5.5) intervening factors would account for some of the variance
First-year college/ 2 (3.0) 1 (2.3) 3 (2.7) explained by cumulative maltreatment. Furthermore, it was
university expected that the relations between impulsivity and hopelessness
Ethnicity
on depression severity would be partially explained by substance
African/Caribbean 50 (74.6) 11 (25.6) 61 (55.5)
Aboriginal 1 (1.5) 8 (18.6) 9 (8.2) use, whereby higher levels of substance use would account for
White 8 (11.9) 26 (60.5) 34 (30.9) some of the variance explained by impulsivity and hopelessness.
Other 12 (17.9) 14 (32.6) 26 (23.6)
Offense characteristics
Current charges or convictions Method
Property 19 (28.4) 20 (46.5) 39 (35.5) The original study sample comprised 116 juvenile offenders
Violent 55 (82.1) 20 (46.5) 75 (68.2)
(70 males and 46 females) recruited from one secure-custody and
Drug 15 (22.4) 3 (7.0) 18 (16.4)
Other 16 (23.9) 30 (69.8) 46 (41.8) five open-custody facilities in Ontario. Data collection took place
Previous charges or convictions between July 2009 and August 2010. Eligibility criteria were
Property 27 (40.3) 30 (69.8) 57 (51.8) (a) being between the ages of 12 to 24 years; (b) fluent in English;
Violent 45 (67.2) 32 (74.4) 77 (70.0) and (c) in custody at a youth justice facility under the supervision
Drug 20 (29.9) 6 (14.0) 26 (23.6) of the Ministry of Children and Youth Services (MCYS) at the
Other 27 (40.3) 26 (60.5) 53 (48.2) time of the interview. Due to incomplete data from six youth
Lifetime charges or convictions
across the measures, all analyses for this study examined a sample
Property 35 (52.2) 35 (81.4) 70 (63.6)
Violent 62 (92.5) 38 (88.4) 100 (90.9) of N ¼ 110 (n ¼ 67 males and n ¼ 43 females).
Drug 26 (38.8) 9 (20.9) 35 (31.8) The average age of participants at the time of the interview
Other 35 (52.2) 36 (83.7) 71 (64.5) was 16.78 years (standard deviation [SD] ¼ 1.07) and 91.8% of
participants were between the ages of 16 and 19 years. Males
Note. The variation in sample size in sexual orientation is due to missing data for
one male participant. Percentages add up to more than 100% for ethnicity and
were on average 17.10 years of age (SD ¼ 1.08) and females
charges or convictions because some youth identified more than one. were on average 16.28 years of age (SD ¼ 0.85). Table 1 shows
the demographic and offense characteristics for the sample.
Descriptive information on sample characteristics and path
maltreatment, predicts substance use, which, in turn, could
variables for females alone, males alone, and the entire sample
explain depression severity. In support of this contention,
are provided to give further information about sample sex
impulsivity has been found to be a vulnerability factor for both
differences. Although not a focus of the current study, these
the acquisition and escalation of substance use disorders (Perry
sex-specific details are included to inform future larger scale
& Carroll, 2008; Wills & Stoolmiller, 2002) and hopelessness
studies in this area, particularly given the inconsistent findings
has been identified as an important determinant of substance
regarding sex differences with respect to the relation between
use behaviors (Bolland, 2003).
maltreatment and depression severity (e.g., Arata, Langhin
richsen-Rohling, Bowers, & O’Brien, 2007; Powers, Ressler,
& Bradley, 2009). Eighty-nine youth (80.9%) had completed
The Present Study at least 1 year of high school. The sample was diverse in terms
It is widely held that childhood maltreatment is a precipitating of their ethnicity and sexual orientation. With respect to offense
factor for depression. However, the potential intervening characteristics, violent offenses were most often reported as
factors between these variables are not well understood, partic- precipitating incarceration and half the sample reported a
ularly among incarcerated adolescents. Given their high rate of previous period of incarceration. The majority of the youth
depression, understanding the possible intervening factors (60.0%) was sentenced to serve time at the facility for their
between maltreatment and depression among incarcerated most recent offense and the remainder was in custody while
youth may reveal critical areas to target for intervention. Thus, awaiting sentencing (i.e., in detention). Although recruitment
empirical research focusing on the dynamic factors of was based on self-initiated interest in participating, and there-
hopelessness, impulsivity, and drug use is an important area for fore not necessarily representative of the entire population of
Wanklyn et al.
youth within the facilities, offense characteristics appear
comparable to the entire population of Canadian incarcerated
youths. For instance, violent offenses accounted for the largest
proportion of incarcerations (Calverley, Cotter, & Halla, 2010).
Procedure
A flyer describing the study was posted at each site in a visible
area accessible to the youth, directing interested youth to an
on-site contact person. This contact person was a unit or facility
manager not involved in the provision of clinical services or
directly involved in the research. In this regard, a facility manager
served as a liaison between the study coordinator and participants
in order to minimize the involvement and knowledge of other
staff regarding participation, to respect the privacy of youth’s
identities, and to minimize any perceived pressure to participate.
When youth 16 years of age and older expressed an interest
in participating in the study, the on-site contact person con-
tacted the research coordinator to schedule a time to meet the
youth. In-person and prior to testing, a formal consent protocol
was read to youth by the research coordinator. For youth less
than 16 years of age, the on-site contact person obtained
consent from a parent, guardian, or the youth’s social worker
(in the case of the youth being a crown ward) before a meeting
was scheduled with the research coordinator to obtain assent
from the youth and to complete the measures.
Each interview took approximately 50–60 min and was con-
ducted individually in a quiet room on-site. For the majority of the
interviews, the youth completed the questionnaires on their own
in the presence of the study coordinator. For 15 youth (13.4%),
upon request of the participant, the study coordinator read the
questions aloud to the youth. No differences on the variables of
interest for this study were found between participants who read
the questionnaire and those who had the questionnaires read to
them. Youth received $15.00 as reimbursement. Approval for this
study was obtained from Ryerson University’s ethics board and
the (Ontario) Ministry of Community Safety and Correctional
Services (MCSCS)/Ministry of Children and Youth Services
(MCYS) Youth Justice Research Committee.
Measures
Childhood maltreatment. Childhood maltreatment was
measured with the Childhood Trauma Questionnaire–Short
Form (CTQ-SF; Bernstein et al., 2003; Bernstein & Fink,
1998). The CTQ-SF is a 28-item self-report retrospective inven-
tory assessing childhood experiences of maltreatment. The cen-
tral constructs underlying the inventory are emotional neglect
and abuse, physical neglect and abuse, and sexual abuse. These
subscales each contain 5 items that begin with the stem "When I
was growing up," and items are summed to yield a total subscale
score, with higher scores indicating greater severity of childhood
maltreatment. Respondents rate the frequency of a particular
incident on a 5-point Likert-type scale ranging from never true
(1) to very often true (5). The CTQ-SF has been well validated
with both adolescent and adult populations, and there is good
309
support for the convergent and discriminant validity of the mea-
sure (Bernstein et al., 2003; Bernstein & Fink, 1998). Internal
consistencies for subscales are good, with Cronbach’s as ranging
from .81 to .95 for the abuse and emotional neglect subscales
(Bernstein et al., 2003). The physical neglect subscale typically
yields the lowest reliability across studies, ranging from .61 to
.83 (Bernstein et al., 2003; Burton, 2008).
For the present study, a cumulative childhood maltreatment
score was calculated by first dichotomizing each of the five
maltreatment subscales, based on the CTQ-SF manual subscale
cutoffs indicative of "moderate" to "extreme" childhood
maltreatment having occurred or not, then summing the dichot-
omized variables to create a count score from 0 (experienced no
maltreatment) to 5 (experienced each form of maltreatment). A
count variable was chosen over running separate models for
each type of childhood maltreatment primarily due to high inter-
scale correlations. Cronbach’s as for this study were consistent
with prior research (e.g., Bernstein et al., 2003; Burton, 2008):
.96 (sexual abuse), .88 (physical abuse), .91 (emotional abuse),
.76 (physical neglect), and .90 (emotional neglect).
Hopelessness. Severity of hopelessness was measured with
the Beck Hopelessness scale (BHS; Beck, Weissman, Lester,
& Trexler, 1974). This self-report measure consists of 20
true–false statements designed to assess the extent of negative
and positive expectations about the future. Each statement is
scored as a 0 or 1, and a total score is calculated by summing
pessimistic responses for each of the items. Higher scores
indicating a greater degree of hopelessness during the
preceding week, with scores over 8 indicating a moderate to
severe level of hopelessnes as defined by the instrument
authors. The instrument has high internal reliability and
test–retest reliability across diverse populations, including non-
clinical and substance abusing adolescents (Osman, Barrios,
Guitierrez, Williams, & Bailey, 2008; Subramaniam, Harrell,
Huntley, & Tracy, 2009). The predictive validity of the BHS
has been well established (e.g., Chapman, Specht, & Cellucci,
2005). Cronbach’s a for the BHS in this study was .79.
Impulsivity. The Barratt Impulsiveness scale, Version 11 (BIS-
11; Patton, Stanford, & Barratt, 1995) is a widely used, 30-item
self-report questionnaire. This measure is designed to assess
impulsivity as a stable trait characteristic, taking into consider-
ation the multifaceted nature of the construct. Each item consists
of a statement (e.g., ‘‘I plan tasks carefully’’), and participants
are asked to indicate how often they act or think in that particular
way based on a 4-point scale from 1 to 4 (rarely/never, occasion-
ally, often, almost always/always). A total score out of 120 is
obtained by summing all items. The BIS has been used across
a range of contexts and samples, including adolescents (e.g., Spi-
nella, 2007). Cronbach’s as have ranged in previous studies from
.79 to .83 (Patton et al., 1995). Reliability for the BIS-11 in this
study was good (Cronbach’s a ¼ .86).
Substance use. Substance use was measured using drug-
related questions from the Ontario Student Drug Use and
310
Health Survey (OSDUHS) developed by the Centre for Addic-
tion and Mental Health (CAMH, 2009). The OSDUHS is a
widely used measure by government, educational, and health
officials and assesses substance use across a variety of drugs
based on 12-month prevalence. This self-report survey is admi-
nistered across Ontario, Canada, every 2 years since 1977 to
over 150 elementary and secondary schools, by employing a
regionally stratified design. For the present study, respondents
indicated the frequency of use over the 12 months prior to
incarceration for 16 drugs, including cannabis, heroin, methy-
lenedioxy-methamphetamine (MDMA), methamphetamine,
phencyclidine (PCP), lysergic acid diethylamide (LSD), other
hallucinogens, and cocaine as well as sedatives and tranquili-
zers without a prescription. Consistent with CAMH documen-
tation (Paglia-Boak, Mann, Adlaf, & Rehm, 2009), participants
who indicated that they did not know about a given drug were
considered nonusers of that substance, and their data were
retained for analyses. The 16-item scale had good reliability
(Cronbach’s a ¼ .83). For purposes of analysis, we measured
the variety of substances used by dichotomizing each item (0
¼ have not used drug, 1 ¼ have used drug) and summing all
responses to provide equal weighting across items.
Depression. The Center for Epidemiological Studies Depres-
sion scale for Children (CES-DC; Faulstich, Carey, Ruggiero,
Enyart, & Gresham, 1986) is a 20-item self-report depression
inventory on a 4-point scale from 0 (not at all) to 3 (a lot), with
a total score obtained by summing all items. Respondents are
asked to indicate how frequently over the past week they have
experienced a variety of symptoms of depression. Higher CES-
DC scores are indicative of higher depression severity, with
scores over 15 indicating a clinically significant level of
depression as defined by the instrument authors. Test–retest
reliability, internal consistency, and concurrent validity were
shown to be adequate, with good psychometric properties for
adolescents (Faulstich et al., 1986). The total score out of 60
was used for analysis and the reliability coefficient for the
CES-DC in this sample was excellent (Cronbach’s a ¼ .91).
Data Analytic Strategy
Descriptive analyses were performed using PASW 18.0. Pre-
dicted relations among childhood maltreatment, impulsivity,
hopelessness, substance use, and depression severity were
examined with path analyses using the software program, Anal-
ysis of Moment Structures (AMOS), Version 18.0 (Arbuckle,
2009) with maximum likelihood estimation (MLE). The
sample size of N ¼ 110 was appropriate based on the recom-
mended minimum rules of thumb (Hoyle, 1995; Kline, 2005).
We employed a model-trimming approach beginning with the
just-identified model (Kline, 2005) and including a direct
relation between childhood maltreatment and depression
severity as well as indirect relations including impulsivity,
hopelessness, and substance use. The nonsignificant path with
the lowest standard estimate was constrained to zero, which
generated an overidentified model that was used as a base of
Child Maltreatment 17(4)
comparison for subsequent nested models that were generated
using the same method of path removal. To identify the most
parsimonious model fitting the data reasonably well, these steps
were repeated until either the model retained only those vari-
ables demonstrating significance or the model fit was found to
be significantly poorer than the previous model.
Determination of the adequacy of the models in representing
the data was evaluated using established critical values of
goodness-of-fit indicators. These included a nonsignificant
model chi-square statistic (w2; Byrne, 2010), normed
chi-square statistic (w2/df) < 2 (Tabachnick & Fidell, 2007),
standardized root mean square residual (SRMR)  .08 (Jöres-
kog & Sörbom, 1996), comparative fit index (CFI) and Tucker-
Lewis coefficient (TLI)  .95 (Hu & Bentler, 1999). General
use of the TLI and CFI have been recommended with MLE
because they are sensitive to model misspecification and not
sensitive to sample size (Hu & Bentler, 1999). The root mean
square error of approximation (RMSEA) also was included
as it has been recognized as one of the most informative fit
indices in path analysis, taking the error of approximation in
the population and the number of estimated parameters into
account (Byrne, 2010). For this study, the precision of the
RMSEA was estimated with its 90% confidence interval (CI)
and a significance test for closeness of fit (PCLOSE). RMSEA
values of .06 or less signify a good fit between the data and the
hypothesized model, while standard interpretation of the
PCLOSE value dictates values greater than .05, indicating the
fit of the model is close (Hu & Bentler, 1999).
Data Preparation for Path Analyses
Univariate and multivariate normality was assessed before
performing the analyses. Several variables were not normally
distributed, with critical ratios of skew above three and/or
kurtosis above four (Kline, 2005). As a result, bootstrapping
was employed to estimate model parameters via nonparametric
resampling of the data (2000 pseudosamples), along with
corresponding confidence intervals (CIs) and statistical signif-
icance. In terms of the overall model fit, a nonsignificant
Bollen-Stine corrected p value (Bollen & Stine, 1993) reflects
a good fit of the model to the data. Mardia’s (1970) normalized
estimate of multivariate kurtosis was <5.00, indicating multi-
variate normality for the model (Bentler, 2005). Table 2 shows
that first-order correlations among the five measured variables
used in the path analysis were not greater than .60, indicating
multicollinearity was not a problem (Kline, 2005). With the
exception of the association between hopelessness and
substance use, all variables were significantly and positively
correlated with one another.
Results
Rates of Childhood Maltreatment and Depression
Means and SDs for the model variables appear in Table 3. In
terms of cumulative maltreatment of moderate to extreme
severity, 13.6% of participants (n ¼ 15) endorsed a history of
Wanklyn et al. 311

Table 2. Pearson Correlation Matrix for Path Variables (n ¼ 110)

Variable 1 2 3 4 5 6 7 8 9

1. Depression 1
2. Substance use .28** 1
3. Hopelessness .51** .12 1
4. Impulsivity .59** .44** .54** 1
5. Cumulative maltreatment .46** .25** .32** .40** 1
6. EA .46** .32** .22* .46** .82** 1
7. PA .31** .15 .20* .26** .76** .67** 1
8. SA .48** .33** .20* .29** .64** .62** .57** 1
9. EN .31** .10 .31** .34** .77** .65** .51** .36** 1
10. PN .32** .03 .29** .35** .76** .57** .50** .33** .75**
Note. Cumulative maltreatment based on experiencing moderate to extreme severity of maltreatment. EA ¼ emotional abuse; PA ¼ physical abuse; SA ¼ sexual
abuse; EN ¼ emotional neglect; PN ¼ physical neglect.
*Correlation is significant at p ¼ .05
**Correlation is significant at p ¼ .01

Table 3. Descriptive Statistics for Path Variables

Males Females Total sample

Variable
M SD Range M SD Range M SD Range

Cumulative Maltreatment 1.13 1.39 0–5 2.35 1.82 0–5 1.61 1.68 0–5
Impulsivity * 64.42 11.09 42– 90 76.82 12.39 53– 104 69.27 13.06 42– 104
Hopelessness 4.18 2.86 0 – 12 5.72 4.33 0 – 17 4.78 3.57 0 – 17
Substance use* 1.49 1.44 0–7 4.35 3.01 0 – 11 2.61 2.59 0 – 11
Depression* 17.58 9.34 2 – 42 30.46 12.88 7 – 60 22.61 12.52 2 – 60
Note. Cumulative maltreatment means and standard deviations are based on the number of subtypes of maltreatment for which participants experienced mod-
erate to extreme severity. Sex differences were assessed with a t test for normally distributed variables (i.e., impulsivity) and Mann-Whitney U tests for those with
skew critical ratios above 3.
*Sex difference p <.001. SD ¼ standard deviation.

two subtypes of maltreatment, 14.5% (n ¼ 16) endorsed Model Specification

three subtypes, 12.7% (n ¼ 14) endorsed four subtypes, and
Table 5 presents the standardized regression estimates for the
5.5% (n ¼ 6) of participants endorsed experiencing all five
just-identified and final nested cumulative maltreatment mod-
subtypes of childhood maltreatment. Table 3 shows that this
els. Analysis of the just-identified model revealed that the path
sample was also characterized by elevated rates of depres-
from substance use to depression severity was the weakest and
sion, with female reporting greater severity of depression
nonsignificant (b ¼ .04, p ¼ .61, 95% confidence interval [CI]
than male youth (U ¼ 606.50, z ¼ 5.11, p < .001). In
¼ [0.12, 0.22]). This demonstrated that, despite a significant
addition, 66.4% of participants reported depression scores
bivariate correlation, substance use no longer accounted for
within the clinical range, whereby 37 females (86.0%) and
any substantial variance in depression in the context of child-
36 males (53.7%) had scores above 15 on depression sever-
hood maltreatment, impulsivity, and hopelessness in the model.
ity, and this difference was statistically significant, w2(1,
Therefore, this path was constrained to zero to form the initial
N ¼ 110) ¼ 12.25, p < .001. Sex differences were also
Model A for subsequent comparisons. Model A demonstrated a
identified for impulsivity, t(108) ¼ 5.47, p < .001, and
good fit to the data, w2(1) ¼ 0.28, p ¼ .59, Bollen-Stine p ¼ .63,
substance use (U ¼ 611.50, z ¼ 5.35, p < .001), with
w2/df ¼ 0.28, CFI ¼ 1.00, TLI ¼ 1.05, SRMR < 0.01, RMSEA
lower scores for male compared to female youth. Table 4
< 0.01, 90% CI ¼ [0.00, 0.21], PCLOSE ¼ .64. However,
shows the frequency of childhood maltreatment types for
nonsignificant paths remained in the model, suggesting the
the level of severity for the total sample and by biological
complexity of the model could be reduced further. Thus, we
sex. Almost 60% (n ¼ 64) of our sample endorsed a history
eliminated the weakest path from cumulative maltreatment to
of moderate to extreme childhood maltreatment. This per-
substance use in Model A (b ¼ .11, p ¼ .32, 95% CI ¼
centage increases to 77.3% (n ¼ 85) when considering the
[0.09, 0.29]) to create Model B. All criteria for Model B indi-
CTQ-SF manual cutoff for any maltreatment (i.e., low
cated a good fit: w2(2) ¼ 1.63, p ¼ .44, Bollen-Stine p ¼ .51;
through extreme severity). As presented in Table 4, a
w2/df ¼ 0.81, CFI ¼ 1.00, TLI ¼ 1.01, SRMR ¼ 0.03, RMSEA
greater proportion of female than male participants endorsed
< 0.01 (90% CI ¼ [0.00, 0.18], PCLOSE ¼ .53. Moreover,
extreme subtypes of emotional, physical, and sexual abuse.
312 Child Maltreatment 17(4)

Table 4. Severity of Childhood Maltreatment

Frequency of childhood maltreatment severity by subtype

None Low Moderate Extreme

n (%) n (%) n (%) n (%)

Males

Emotional abuse 42 (62.7) 14 (20.9) 8 (11.9) 3 (4.5)

Physical abuse 32 (47.8) 12 (17.9) 10 (14.9) 13 (19.4)
Sexual abuse 54 (80.6) 4 (6.7) 7 (10.4) 2 (3.0)
Emotional neglect 36 (53.7) 16 (23.9) 7 (10.4) 8 (11.9)
Physical neglect 38 (56.7) 11 (16.4) 9 (13.4) 9 (13.4)

Females

Emotional abuse 14 (32.6) 5 (11.6) 7 (16.3) 17 (39.5)

Physical abuse 19 (44.2) 4 (9.3) 2 (4.7) 18 (41.9)
Sexual abuse 23 (53.5) 1 (2.3) 7 (16.3) 12 (27.9)
Emotional neglect 15 (34.9) 10 (23.3) 7 (16.3) 11 (25.6)
Physical neglect 19 (44.2) 4 (9.3) 9 (20.9) 11 (25.6)

Total sample

Emotional abuse 56 (50.9) 19 (17.3) 15 (13.6) 20 (18.2)

Physical abuse 51 (46.4) 16 (14.5) 12 (10.9) 31 (28.2)
Sexual abuse 77 (70.0) 5 (4.5) 14 (12.7) 14 (12.7)
Emotional neglect 51 (46.4) 26 (23.6) 14 (12.7) 19 (17.3)
Physical neglect 57 (51.8) 15 (13.6) 18 (16.4) 20 (18.2)

Note. CTQ-SF manual cutoff scores for none, low, moderate, and extreme severity of childhood maltreatment: emotional abuse, 8, 9–12, 13–15, 16; physical
abuse, 7, 8–9, 10–12, 13; sexual abuse, 5, 6–7, 8–-12, 13; emotional neglect, 9, 10–14, 15–17, 18; physical neglect, 7, 8–9, 10–12, 13. Chi-square
statistics for extreme maltreatment by biological sex: emotional abuse, w2(1, N ¼ 110) ¼ 21.64, p < .001; physical abuse, w2(1, N ¼ 110) ¼ 6.53, p ¼ .011; sexual
abuse, w2(1, N ¼ 110) ¼ 14.65, p < .001; emotional neglect, w2(1, N ¼ 110) ¼ 3.41, p ¼ .065; physical neglect, w2(1, N ¼ 110) ¼ 2.60, p ¼ .107. CTQ-SF ¼ Child-
hood Trauma Questionnaire–Short Form.

Table 5. Standardized Regression Estimates for Nested Cumulative Model C demonstrated a nonsignificant difference from
Maltreatment Models Model B (w2D2 ¼ 2.44, p ¼ .12, TLID ¼ 0.39). Moreover,
Just-identified Model C fit the data well, w2(3) ¼ 4.07, p ¼ .25,
Model A Final Model C Bollen-Stine p ¼ .31, w2/df ¼ 1.36, CFI ¼ 0.99, TLI ¼ 0.97,
SRMR ¼ 0.04, RMSEA ¼ 0.06, 90% CI ¼ [0.00, 0.18],
Path b SE p b SE p PCLOSE ¼ .37, and all remaining paths were significant. Thus,
Maltreatment ! impulsivity .40 0.08 .001 .40 0.08 .001 Model C was considered the cumulative maltreatment final
Maltreatment ! hopelessness .32 0.09 .001 .32 0.09 .001 model. Notably, this final model accounted for 44% of the
Maltreatment ! substance use .11 0.10 .323 – – – variance in depression severity (see Figure 1).
Maltreatment ! depression .23 0.10 .012 .27 0.10 .011
Impulsivity ! substance use .49 0.09 .001 .44 0.08 .001
Impulsivity ! depression .35 0.10 .005 .24 0.09 .001 Direct and Indirect Relations Between Childhood
Hopelessness ! substance use –.18 0.11 .099 – – – Maltreatment and Depression
Hopelessness ! depression .24 0.09 .013 .24 0.09 .016
Substance use ! depression .04 0.09 .614 – – – AMOS assesses the strength and significance of indirect
relations within the model via bootstrapping confidence limits
Note. SD ¼ standard deviation.
(Arbuckle, 2009). Bootstrapping is preferred over more
classical tests (e.g., Sobel), particularly in the case of multiple
Model B represented a nonsignificant change in model fit intervening variables, smaller samples, or deviation from
(w2D2 ¼ 1.34, p ¼ .25, TLID ¼ 0.04), further supporting that the normality (Bollen & Stine, 1990; Preacher & Hayes, 2008).
path from cumulative maltreatment to substance use did not Cumulative maltreatment maintained a strong direct relation
substantially contribute to the model. with depression severity in the context of the additional
The direct path from hopelessness to substance use also variables in the final model (impulsivity, hopelessness,
failed to reach significance (b ¼ .16, p ¼ .16, 95% substance use). Cumulative maltreatment also had direct rela-
CI ¼ [.36, .06]). Therefore, in the interest of parsimony, a tions with impulsivity and hopelessness and an indirect relation
Model C was created that constrained this path to zero. with depression severity through impulsivity and hopelessness
Wanklyn et al.
2
R = .16
Impulsivity
.40
.47
Cumulative
Maltreatment
2
R = .10
.32
Hopelessness
Figure 1. Significant standardized parameter estimates for the final trimmed cumulative childhood maltreatment model. Note the intervening
roles of impulsivity and hopelessness on the relations of abuse with substance use and depression. Dotted paths indicate paths that were
constrained to zero due to nonsignificance. Overall, cumulative maltreatment, impulsivity, and hopelessness explained 44% of the variance in
depression severity.
(b ¼ .22, p < .01, 95% CI ¼ [0.11, 0.36]). Regarding substance
use, only the direct relation with impulsivity was significant
(and retained in the model) and supported an indirect relation
with cumulative maltreatment (b ¼ .17, p < .01, 95%
CI ¼ [0.09, 0.28]). In summary, the model depicted in Figure
1 suggests that a substantial proportion of the relation between
cumulative maltreatment and depression in this sample of juve-
nile offenders is linked to impulsivity and hopelessness. In the
context of these variables, however, substance use failed to
account for any additional variance in depression.
Discussion
Childhood maltreatment was associated with the severity of
incarcerated adolescents’ depression through a variety of
pathways. The present study extends past research by examining
the relative roles of impulsivity, hopelessness, and substance use
in the relationship between cumulative childhood maltreatment
and depression severity. The final model fit well and supported
the intervening roles of hopelessness and impulsivity in the rela-
tion between maltreatment and depression severity. However, no
support was found for the intervening role of substance use.
Consistent with other studies (e.g., Edwards et al., 2003),
childhood maltreatment was positively associated with severity
of depression. Results supported a direct role of cumulative
maltreatment on depression over and above the role of
impulsivity and hopelessness. With respect to hopelessness,
results supported the association between negative events,
hopeless cognitions, and symptoms of depression, as reported
in the literature (e.g., DuRant et al., 1995). According to Rose
and Abramson (1992; see also Cole & Turner, 1993) negative
life events, and ensuing negative attributions about the future,
leave individuals vulnerable to developing depression. For
instance, negative attributions about the future might follow
from childhood maltreatment and interfere with an individual
deriving pleasure from positive events that others would find
313
.37
.44
2 2
R = .19 R = .44
Substance Depression
Use Severity
.24
.27
enjoyable. Notably, the clinical presentation of hopelessness
may differ depending on the severity of the depressive symp-
toms. In the presence of severe clinical depression, the individ-
ual may be incapacitated by their symptoms and be unable to
function. The results of the current study indicate that cumula-
tive maltreatment during childhood is related to higher levels of
hopelessness, which, in turn, is associated with depression
severity. One possibility supported by our structural covariance
model is that maltreatment in the context of hopelessness may
lead to the development of depressive symptoms.
Regarding impulsivity, the findings of the present investiga-
tion accord with other studies that show that childhood
maltreatment puts adolescents at higher risk to react without
thinking about potential consequences, which increases the risk
of depression severity. As suggested by Gerra et al. (2007),
neurobiological impairment could explain the link between
traumatic events, impulsivity, and depression by way of
hypothalamic–pituitary–adrenal axis dysfunction. Another
explanation for this relationship is borrowed from the appraisal
theory of emotional states. If depression is the result of compro-
mised coping from traumatic events (Scherer, 2001) and
childhood maltreatment increases the risk for impulsivity and
inappropriate coping (e.g., catastrophizing, blaming others;
d’Acremont & Van der Linden, 2007), impulsivity could at
least partially explain the relationship between cumulative
maltreatment and depression severity in incarcerated youths.
If impulsivity is an intervening variable, then behavioral and
pharmacological interventions that target impulsivity also may
alleviate the depression.
Contrary to expectation, results did not support the hypothe-
sized relationships between substance use and cumulative
childhood maltreatment and depression severity. It is important
to clarify in this respect that the bivariate relations among these
variables were significant, but these direct relations became
negligible in the context of the model with intervening paths
incorporating hopelessness and impulsivity. It is also of
314
potential interest that the bivariate relations between maltreat-
ment subtypes and substance use were specific to emotional
and sexual abuse (Table 2). Future research could explore pos-
sible moderating variables, such as biological sex. For exam-
ple, in a longitudinal study across adolescence and early
adulthood (Lansford, Dodge, Pettit, & Bates, 2010), physical
abuse was found to predict substance use for females but not
males. It is also possible that underreporting of substance use
underestimated its relations with depression and maltreatment.
Alternatively, the lack of findings with respect to substance use
may have resulted from a limitation of the study’s measure-
ment of substance use, although statistically reliable. That is,
future research might benefit from determining the degree of
persistence of substance use, the prevalence of substance abuse
or dependence, and/or the influence of specific types of
substances on depression severity. Nonetheless, alternative
analyses based on frequency of use yielded comparable results
(data not shown).
Limitations and Future Directions for Research
Moving forward from these findings, it is important to consider
the limitations of the present study. First, and most importantly,
although the relationship between childhood maltreatment and
the development of depression symptoms is well supported in
the literature, the findings from the current study are limited
by the cross-sectional research design, in that temporal
precedence of the variables of interest could not be established.
This precludes statements of causality concerning the potential
role of the intervening variables. Longitudinal data are
necessary to determine the timing of the maltreatment relative
to the onset of the impulsivity, hopelessness, substance use, and
depression symptomatology.
Second, although our sample size was adequate based on
established criteria (Hoyle, 1995; Kline, 2005), a larger sample
size would allow for examination of sex as a potential
moderator, given greater levels of severity among females on
the model variables (see Table 4). Although our sample size
was sufficient for the current analyses, the reliability and
complexity of a model incorporating additional factors was
questionable, and, therefore, we did not incorporate sex as a
control or moderator in this study. Furthermore, despite the
differences in means between males and females suggesting
potential moderation, it is not necessarily the case that the
covariance structure would differ between the sexes. Lending
support to this idea, we ran a post hoc multigroup analysis in
AMOS and found that allowing path coefficients to vary
between males and females failed to produce a significant
difference in model fit compared to a more parsimonious
model constraining all path coefficients to be equal between
sexes, w2D(6) ¼ 6.34, p ¼ .39. Thus, under the present
constraints, we believe that the current findings based on the
full sample are meaningful. Of particular relevance to incarcer-
ated samples, it might be important to explore the relation
between clinical variables and offending behavior. Relatedly,
this study dichotomized childhood maltreatment subtypes
Child Maltreatment 17(4)
which results in a lack of information about the frequency of
specific childhood maltreatment events and assumes equal
weighting for each of the subtypes of childhood maltreatment.
Nonetheless, initial analyses based on frequencies of individual
subtypes yielded consistent results to that of the cumulative
index model (data not shown). Future research with larger
samples might benefit from a more complex research design
employing nested models to compare model fit between mal-
treatment subtypes or the exploration of maltreatment as a
latent variable using structural equation modeling.
Third, as the current study used a Canadian sample of
juvenile offenders, the results may not generalize to offender
samples in other jurisdictions or to adult offender populations.
Fourth, common method variance may have resulted in inflated
(or deflated) correlations among the variables in the model
(Doty & Glick, 1998). Future studies should gather data from
different sources (Reio, 2010), such as from third-party respon-
dents, using different methods such as structured and
semistructured interviews. Finally, from a statistical perspective,
error associated with the measurement of intervening variables
can lead to underestimation of indirect relations and model
misspecification (Shrout & Bolger, 2002). However, each of the
measures included in this study had good psychometric
properties.
Conclusions and Implications
In considering the relative strengths and weaknesses, this study
represents a preliminary step toward understanding impulsiv-
ity, hopelessness, and substance use as potential explanatory
factors in the relation between cumulative childhood maltreat-
ment and depression. Even after accounting for the influence of
these variables, a significant relation between cumulative
maltreatment and depression remained. This indicates
additional factors should be considered when attempting to
explain why maltreatment is associated with depression among
incarcerated youths. Although further investigation is neces-
sary to determine causal relations among these variables, the
results suggest that cumulative maltreatment, impulsivity, and
hopelessness may be important factors to address in clinical
research and treatment for depression among incarcerated
youth. Proper treatments could help reduce their psychological
distress and may also have the additional benefit of reducing
their likelihood of committing future criminal acts.
The present study suggests that careful attention in the
clinical assessment and management of incarcerated juvenile
offenders who present with a history of child maltreatment,
hopelessness, and depression is warranted; particularly when
the individual also presents with a history of risky behavior and
impulsivity. Indeed, trauma-focused cognitive–behavioral
therapy (TF-CBT) might be indicated to address the sequelae
of symptoms in an individual with this clinical presentation
(Black, Woodworth, Tremblay, & Carpenter, 2012).
Depression-focused treatments may also be relevant, such as
cognitive–behavioral treatment for depressed adolescents
(e.g., Cuipers, Munoz, Clarke, & Lewinsohn, 2009), which has
Wanklyn et al.
been found to reduce depression for juvenile justice-involved
adolescents (Rohde, Clarke, Mace, Jorgensen, & Seeley, 2004).
Similar to depression severity and a history of maltreatment,
impulsivity (Herrenkohl et al., 2000) and hopelessness (Lorion
& Saltzman, 1993) have both been implicated as risk factors for
criminal offending. Because cumulative maltreatment,
impulsivity, and hopelessness might be antecedents of both
depression severity and general antisocial behavior, they may
be particularly important risk factors to address during periods
of correctional confinement where treatment programming
may be most accessible to these young people. Positive
outcomes with CBT have been demonstrated for impulsivity
(Baer & Nietzel, 1991) and hopelessness (Daniel & Goldston,
2009). When the individual presents with comorbid features, a
multifaceted approach may be warranted, including a combina-
tion of CBT, coupled with possible stimulant medication for
the impulsivity, and family-based therapy to address parental
cognitions that might be maintaining the maladaptive
behaviors (Chronis, Jones, & Raggi, 2006; Sandy & McCarty,
2005). Finally, dialectical behavior therapy appears to be a
promising approach to address suicidal ideation, self-harming
behaviors, and poor impulse control among juvenile offenders
(Quinn & Shera, 2009).
Acknowledgments
We thank Dr. Feiring and the three reviewers for their constructive
comments in revising the manuscript.
Authors’ Note
This study was conducted as a master’s thesis by the first author under
the supervision of the second author.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
Funding for this study was provided to David M. Day and Trevor A.
Hart from the Ryerson Fund for Interdisciplinary Research (RFIS).
Trevor A. Hart was supported by a New Investigator Salary Award
from the Canadian Institutes of Health Research.
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