The sequelae of childhood maltreatment: a multi-level longitudinal investigation of brain structure, symptomatology and social support

Childhood maltreatment is associated with a wide range of adverse outcomes across the lifespan, including significant relationships with poor physical health, educational attainment, economic outcomes, and most notably an increased risk towards the emergence of psychopathology in adolescence and adulthood. Not all individuals who have experienced maltreatment will go on to develop psychopathology/elevated psychiatric symptomatology, as the pathway from maltreatment is probabilistic and not deterministic. Understanding the multifinality of maltreatment is vital for academics and clinicians to provide targeted, effective, and preventative interventions for this group at high-risk of poor outcomes. Developmental psychopathologists have called for the inclusion of ‘multi-level investigations’ which meaningfully integrate multiple levels of functioning, such as on a neural, behavioural and social level, to understand the risk and resilience factors that may characterise these pathways. Social support is one of a number of factors that is proposed to engender resilience against poor outcomes following maltreatment. Three hypotheses have been proposed that attempt to explain how social support interacts with the experience of maltreatment: as a direct protective factor, as a moderator, and as a mediator. However, the existing literature within this domain has been reported to be ambiguous and in some cases contradictory. This thesis aims to investigate the sequalae of childhood maltreatment and further characterise the multifinality of maltreatment across multiple levels of functioning and risk and resilience factors.