FIGURE 1.
FIGURE 2.
FIGURE 3.
Bootstrapped point estimate for direct and indirect effects and 95% confidence intervals for predicting PTSD and DSO symptoms by sums of exposure to adverse childhood experiences through defense mechanisms levels and coping styles dimensions_
| Estimates of standardized regression weights | Estimates of unstandardized regression weights | BCa 95% CI (lower, upper) | p | |
|---|---|---|---|---|
| PTSD symptoms | ||||
| Direct effect of exposure to ACEs | .30 | .44 | (.34, .54) | .001 |
| Indirect effect via mature defense mechanisms | .04 | .02 | (−.26, .30) | .28 |
| Indirect effect via neurotic defense mechanisms | .04 | .02 | (−.02, .06) | .26 |
| Indirect effect via immature defense mechanisms | .06 | .24 | (−.09, .57) | .16 |
| Indirect effect via rational coping | .17 | .33 | (.19, .47) | .001 |
| Indirect effect via emotional coping | .31 | .55 | (.42, .68) | .001 |
| Indirect effect via detachment coping | −.13 | −.17 | (−.27, −.07) | .01 |
| Indirect effect via avoidance coping | .07 | .05 | (−.02, .12) | .14 |
| DSO symptoms | ||||
| Direct effect of exposure to ACEs | .24 | .33 | (.25, .41) | .001 |
| Indirect effect via mature defense mechanisms | −.02 | −.04 | (−.26, .18) | .70 |
| Indirect effect via neurotic defense mechanisms | .04 | .02 | (−.02, .06) | .26 |
| Indirect effect via immature defense mechanisms | .26 | .44 | (.17, .71) | .001 |
| Indirect effect via rational coping | .04 | .03 | (−.03, .09) | .39 |
| Indirect effect via emotional coping | ,45 | .35 | (.30, .40) | .001 |
| Indirect effect via detachment coping | −.08 | −.10 | (−.19, −.01) | .04 |
| Indirect effect via avoidance coping | .02 | .02 | (−.03, .07) | .57 |
Items representing PTSD and DSO symptoms_
| Cluster | Test items |
|---|---|
| PTSD symptoms | HTQ 2. Feeling as though the event is happening again |
| HTQ 3. Recurrent nightmares | |
| HTQ 6. Being jumpy or easily startled | |
| HTQ 9. Feeling on guard | |
| HTQ 11. Avoiding activities that remind you of the traumatic or hurtful event | |
| HTQ 15. Avoiding thought or feelings associated with the traumatic or hurtful events | |
| DSO symptoms | TSC 16. Temper outburst that you could not control |
| TSC 14. Crying easily | |
| TSC 28. Feelings of inferiority or insecurity | |
| TSC 29. Blaming yourself | |
| TSC 6. Feeling isolated from other people | |
| HTQ 27. Feeling that you have no one to rely upon |
Adverse childhood events according to exposure_
| Event | Count (%) |
|---|---|
| Traffic accident | 115 (16.7) |
| Other serious accidents | 80 (11.6) |
| Physical assault | 66 (9.6) |
| Rape | 28 (4.1) |
| Witnessed other people injured or killed | 66 (9.6) |
| Came close to being injured or killed | 87 (12.7) |
| Threats of violence | 217 (31.6) |
| Near-drowning | 150 (21.8) |
| Attempted suicide | 68 (9.9) |
| Robbery/theft | 94 (13.7) |
| Pregnancy /abortion | 21 (3.1) |
| Serious illness | 88 (12.8) |
| Death of someone close | 362 (52.7) |
| Divorce | 90 (13.1) |
| Sexual abuse | 35 (5.1) |
| Physical abuse | 50 (7.3) |
| Severe childhood neglect | 34 (4.9) |
| Bullying | 207 (30.1) |
| Absence of a parent | 101 (14.7) |
| Other events | 48 (7.0) |
Correlation matrix of study variables-
| Variables | 1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. |
|---|---|---|---|---|---|---|---|---|---|---|
| 1. Exposure to ACE | - | –.03 | –.04 | .22*** | .12** | .28*** | .08 | .08 | .36*** | .37*** |
| 2. MDM | - | .48*** | .49*** | .44*** | .08* | .35*** | .36*** | .13** | .08* | |
| 3. NDM | - | .41*** | .36*** | .18*** | .20*** | .34*** | .20*** | .20*** | ||
| 4. IDM | - | .35*** | .42*** | .19*** | .37*** | .33*** | .41*** | |||
| 5. Rational coping | - | .35*** | .55*** | .48*** | .28*** | .26*** | ||||
| 6. Emotional coping | - | .09* | .42*** | .45*** | .65*** | |||||
| 7. Detachment coping | - | .39*** | .06 | .05 | ||||||
| 8. Avoidance coping | - | .28*** | .29*** | |||||||
| 9. PTSS | - | .54*** | ||||||||
| 10. DSOS | - |
Description of coping styles and defense mechanisms_
| Coping styles | Description | Example |
|---|---|---|
| Emotion-focused | Attempt to escape from the emotional distress associated with the stressor |
|
| Problem-focused or rational | Deliberate and rational approach, in which individuals make conscious efforts to cope with stressful circumstances |
|
| Engagement | Confrontation of the stressor and/or related emotions/thoughts |
|
| Disengagement | Seeking to avoid the threat and/or related emotions/thoughts |
|
Bootstrapped point estimate for direct and indirect effects and 95% confidence intervals for predicting PTSD and DSO symptoms by sums of exposure to adverse childhood experiences through immature defense mechanisms levels and coping styles
| Estimates of standardized regression weights | Estimates of unstandardized regression weights | BCa 95% CI (lower, upper) | p | |
|---|---|---|---|---|
| PTSD symptoms | ||||
| Direct effect of exposure to ACEs | .29 | .43 | (.20, .66) | .02 |
| Indirect effect via IDM | .10 | .35 | (.07, .63) | .02 |
| Indirect effect via rational coping | .06 | ,12 | (−.01, .25) | .08 |
| Indirect effect via emotional coping | .26 | .21 | (.14, .28) | .001 |
| Indirect effect via detachment coping | −.04 | −.04 | (−.12, .04) | .31 |
| Indirect effect via avoidance coping | .02 | .04 | (−.09, .17) | .50 |
| Indirect effect via IDM and rational coping | .43 | 2.10 | (1.76, 2.44) | .001 |
| Indirect effect via IDM and emotional coping | .41 | 1.97 | (1.67, 2.27) | .001 |
| Indirect effect via IDM and detachment coping | −.13 | −.18 | (−.29, −.07) | .01 |
| Indirect effect via IDM and avoidance coping | .08 | .06 | (−.01, .13) | .07 |
| DSO symptoms | ||||
| Direct effect of exposure to ACEs | .23 | .32 | (.24, .40) | .001 |
| Indirect effect via IDM | .17 | ,58 | (.34, .82) | .001 |
| Indirect effect via rational coping | .04 | .04 | (−.01, .09) | .13 |
| Indirect effect via emotional coping | .23 | .34 | (.29, .39) | .001 |
| Indirect effect via detachment coping | .04 | .04 | (−.08, .16) | .18 |
| Indirect effect via avoidance coping | .04 | .03 | (−.02, .08) | .25 |
| Indirect effect via IDM and rational coping | .37 | 1.34 | (1.11, 1.57) | .001 |
| Indirect effect via IDM and emotional coping | .42 | 2.07 | (1.77, 2.37) | .001 |
| Indirect effect via IDM and detachment coping | −.10 | −.10 | (−.19, −.01) | .04 |
| Indirect effect via IDM and avoidance coping | .02 | .04 | (−.02, .08) | .50 |
Sample demographic characteristics
| Female (n= 353) | Male (n = 334) | Total (N = 687) | |
|---|---|---|---|
| Age | |||
| 13 years | 7 (2.0%) | 13 (3.9%) | 20 (2.9%) |
| 14 years | 177 (50.1%) | 179 (53.6%) | 356 (51.8%) |
| 15 years | 167 (47.3%) | 137 (41.0%) | 304 (44.3%) |
| 16 years | 2 (0.6%) | 5 (1.5%) | 7 (1.0%) |
| Mean (SD) | 14.5 (SD=0.5) | 14.4 (SD=0.6) | 14.4 (SD=0.6) |
| Living with | |||
| Both parents | 290 (82.2%) | 272 (81.4%) | 562 (81.8%) |
| One of their parents | 58 (16.4%) | 53 (15.9%) | 111 (16.2%) |
| Other arrangements* | 5 (1.4%) | 9 (2.7%) | 14 (2.0%) |
| Father education | |||
| Did not report | 34 (9.6%) | 46 (13.8%) | 80 (11.6%) |
| Primary school | 86 (24.4%) | 59 (17.7%) | 145 (32.8%) |
| High school | 42 (11.9%) | 62 (18.6%) | 104 (15.1%) |
| College | 112 (31.7%) | 80 (24.0%) | 192 (27.9%) |
| University | 79 (22.4%) | 87 (26.0%) | 166 (24.2%) |
| Mother education | |||
| Did not report | 32 (9.1%) | 46 (13.8%) | 78 (11.4%) |
| Primary school | 74 (21.0%) | 68 (20.4%) | 142 (20.7%) |
| High school | 121 (34.3%) | 112 (33.5%) | 233 (33.9%) |
| College | 81 (22.9%) | 64 (19.2%) | 145 (21.1%) |
| University | 45 (12.7%) | 44 (3.2%) | 89 (13.0%) |