Studies have documented the co-occurrence and cumulative impact of multiple types of child maltreatment on later psychosocial difficulties. Other research suggests that child abuse characteristics indicative of severity may also increase risk of later adjustment problems. However, little effort has been made to examine the co-occurrence of both multiple types of maltreatment and abuse severity within a single study. The present investigation examines self-reported child maltreatment and adult functioning in a geographically diverse sample of 1,396 undergraduate students. Results indicate that experiencing multiple types of maltreatment is positively associated with more severe abuse. Although increased maltreatment types and more severe abuse are each associated with greater trauma symptomatology, abuse severity is the stronger of the two predictors. Finally, number of maltreatment types and severity of maltreatment interact to predict greater levels of trauma symptomatology. These results highlight the importance of considering both co-occurring abuse types and severity in research and clinical work with adult victims.Keywords: child maltreatment, child abuse, long-term effects, multiple abuse, trauma A ccording to the U.S. Department of Health and Human Services (2006), 872,000 children were the victims of confi rmed child abuse and neglect reported to state child protective services in 2004. Of these cases, 60% involved neglect, 18% physical abuse, 10% sexual abuse, and 7% emotional maltreatment. Not only is abuse prevalent, but child maltreatment in its various forms has been associated with a host of immediate and long-term adverse outcomes including depressive symptoms (Danielson, De Arellano, Kilpatrick, Saunders, & Resnick, 2005), partner relationship problems (DiLillo & Long, 1999), adult sexual victimization (Messman-Moore & Brown, 2004), substance abuse (Brown & Anderson, 1991), aggression (Herrenkohl, Egolf, & Herrenkohl, 1997), and poor school performance (Kendall-Tackett & Eckenrode, 1996). Trauma symptomatology is one of the most commonly studied outcomes in the child maltreatment literature. In fact, studies have documented consistent relationships between child sexual and physical abuse and adult posttraumatic stress symptoms (e.g., Boney-McCoy & Finkelhor, 1996;Schaaf & McCanne, 1998). Recently, emotional maltreatment has been included as an additional abuse type in examinations of child maltreatment and adult trauma symptoms (Rich, Gidycz, Warkentin, Loh, & Weiland, 2005). Given the widespread prevalence of child maltreatment and the deleterious outcomes that often result, it is not surprising that this problem has captured the attention of social science researchers during the past 30 years.
Co-Occurrence of Multiple Forms of Child MaltreatmentAlthough researchers have traditionally studied single types of maltreatment, it is becoming increasingly clear than many individuals experience more than one form of child maltreatment, a phenomenon referred to as multitype abuse (Higgins & Mc...