Childhood Emotional Abuse and Depression Among Adolescents: Roles of Deviant Peer Affiliation and Gender

Abstract

Adolescent depression is a significant concern around the world. There is a pressing need to explore risk factors for this disorder to develop better interventions. Based on an integration of attachment theory, Bronfenbrenner’s ecological systems theory, and relational theory, the current study aimed to examine (a) whether childhood emotional abuse (CEA) would be significantly and positively related to adolescents’ depression, (b) whether deviant peer affiliation would mediate the relation between CEA and depression, and (c) whether gender would moderate the direct and indirect relations between CEA and adolescent’s depression via deviant peer affiliation. Participants were 961 Chinese adolescents (M_{_age} = 15.21 years, SD = 1.57). They completed questionnaires regarding demographics, CEA, other types of childhood maltreatment (i.e., physical abuse, sexual abuse, physical neglect, and emotional neglect), deviant peer affiliation, and depression. Results showed that CEA was positively related to adolescent depression even after controlling for other types of childhood maltreatment, and this relation was mediated by deviant peer affiliation. Furthermore, moderated mediation analyses indicated that gender moderated the relation between CEA and deviant peer affiliation, with the relation being stronger for girls than for boys. However, gender did not moderate the relation between deviant peer affiliation and depression, as well as the direct relation between CEA and depression. Results highlight that interventions aimed at reducing CEA may protect adolescents, especially girls from the risks of deviant peer affiliation and depression.

Keywords

childhood emotional abuse depression deviant peer affiliation gender

Introduction

Adolescent depression is a significant concern around the world (Platt et al., 2013; P. Wang et al., 2018). For example, it was estimated that 8% to 20% of adolescents globally are clinically depressed at some point in time before the age of 18 (Naicker et al., 2013). Narrowing the spectrum within China, the incidence of adolescent depression is as high as 28.6% (J. Li et al., 2017). Adolescent depression is linked to a wide range of psychosocial adversities, including educational failure, substance abuse, low life qualities, as well as self-harm and suicidal behaviors (Platt et al., 2013; P. Wang et al., 2018). Worse still, it is widely documented that depression has a recurrent course, and depressive symptoms in adolescence can even predict long-term maladaptive outcomes in adulthood (X. Wang, Gao, et al., 2019). Given these startling facts, a careful scrutiny of risk factors for adolescent depression is needed to develop better interventions to prevent and treat this disorder.

Among various risk factors, childhood maltreatment has been well demonstrated as a pivotal antecedent of adolescent depression (Alto et al., 2018; Paul & Eckenrode, 2015). For example, both retrospective and prospective studies have shown that the deleterious effect of childhood maltreatment on depression can persist well into adolescence (Alto et al., 2018; Paul & Eckenrode, 2015). Moreover, a meta-analysis revealed that maltreated children are approximately 2 times more likely to develop recurrent and persistent depression than those without such experience (Nanni et al., 2012). Although these research has yielded valuable information, there are at least two issues that worth further examination. First, historically, previous studies have almost exclusively focused on the impacts of “more obvious” subtypes of childhood maltreatment (e.g., physical abuse and sexual abuse) on depression; the potential relation between childhood emotional abuse (CEA) and depression has been virtually ignored (Infurna et al., 2016). This gap in the literature is problematic given that CEA has been widely viewed as the “core component” of all forms of childhood maltreatment and is far more prevalent than physical abuse or sexual abuse (Navarre, 1987). Furthermore, relative to other forms of childhood maltreatment, CEA may be more strongly associated with the development of depression (Infurna et al., 2016). Thus, there is a pressing need to explore the specific relation between CEA and adolescent depression. Second, the mediating and moderating variables that may be involved in the relation between CEA and depression remain largely unexplored. Elucidating plausible processes that may mediate or moderate the relation between CEA and depression would be necessary for clinical interventions. To clarify these gaps, the present study was designed to examine the specific relation between CEA and adolescent depression after controlling for other types of childhood maltreatment. What’s more, we also explored mediating and moderating variables in this relation to provide more detailed information about how and why these two constructs are related.

CEA and Adolescent Depression

CEA, as a persistent pattern of emotional ill treatment, refers to any humiliating or demeaning behaviors toward children by caregivers (Banducci et al., 2017). According to attachment theory (Bowlby, 1980), children form internal working models of the world mainly based on their relationships with primary caregivers. Specifically, when children receive sensitive and appropriate caregiving, they are inclined to develop a more positive model of the world. Whereas, experiences of CEA will make them perceive the self as unlovable, unworthy, and incompetent and view others as unreliable, untrustworthy, and unsupportive. These negative internal working models are particularly potent risk factors for depression (Paredes & Calvete, 2014). Although far less numerous, there has been a growing interest in the role that CEA plays in diagnoses of adolescent depression. For instance, adolescents who experienced high levels of parental phubbing (a form of parental rejection) are more likely to be depressed than those without such experiences (X. Wang, Gao, et al., 2019). In addition, both retrospective and prospective research has consistently found that CEA is positively related to elevated depression levels among adolescents (Paredes & Calvete, 2014; Paul & Eckenrode, 2015). More importantly, a meta-analytic review indicated that survivors of CEA have almost double risks of suffering from depression across life span than survivors of childhood physical abuse, which indicates the unique contribution of CEA to depression (Norman et al., 2012).

Deviant Peer Affiliation as a Mediator

Deviant peer affiliation refers to the selective affiliation with peers who engage in delinquent behaviors, such as cheating, stealing, fighting, and substance abuse (Rudolph et al., 2014; Zhu et al., 2015). In the current study, we propose it as a possible mediator in the relation between CEA and depression. That is, adolescents with CEA experiences are more likely to develop affiliations with deviant peers. It is in turn related to adolescents’ depressive mood. This expectation can be grounded in Bronfenbrenner’s (1986) ecological systems theory, which postulates that families and peer groups as two interactional microsystems can exert positive or negative effects on the development of adolescents. Specifically, negative family environments may drift adolescents toward adverse peer contexts (Zhu et al., 2017), which will ultimately result in high levels of depression (Connell & Dishion, 2006). Consistent with this theoretical framework, a growing number of studies have revealed the mediating role of deviant peer affiliation in the relation between family factors (e.g., corporal punishment, maladaptive parenting, and parent–adolescent relationship) and maladaptive outcomes (e.g., physical aggression and internet game addiction; Zhu et al., 2015, 2017). Thus, although not yet directly tested, it is reasonable to speculate that deviant peer affiliation can mediate the relation between CEA and adolescent depression. Two specific reasons underlie this argument.

First, adolescents who experienced CEA may increasingly choose to affiliate with deviant peers for obtaining a sense of belonging. Drawing from social network theory (Sijtsema et al., 2010), victimized adolescents generally select into deviant peer groups through two processes. The first one is “homophily selection,” which means that adolescents actively seek affiliations with peers who have similar characteristics with them. As adolescents with CEA experiences tend to have more internalizing or externalizing problems at school (T. Lewis et al., 2019; Paul & Eckenrode, 2015), they may voluntarily affiliate with peers who are like them through similarity-based selection (Sijtsema et al., 2010). The second one is “default selection,” which occurs when adolescents passively affiliate with deviant peers due to a lack of viable alternatives. Given that family is the first place where adolescents learn to behave appropriately in interpersonal relationships, those who experienced CEA may lack basic social skills required for maintaining conventional peer relationships (Fergusson & Horwood, 1999). Therefore, they are more likely to be rejected by mainstreaming peers and have no choices but to self-organize into deviant peer groups (Rudolph et al., 2014). In line with this theory, research has consistently found that adverse family environments consisting of harsh parenting or low-quality parent–child relationships are related to enhancing affiliations with deviant peers (Zhu et al., 2015, 2017). More importantly, a 12-year longitudinal study identified that lower levels of emotional responsiveness from parents at age 3 can significantly predict higher levels of deviant peer affiliation at age 15, and this relation still holds even after controlling for other theoretically relevant variables (Fergusson & Horwood, 1999).

Second, deviant peer affiliation is a significant risk factor for adolescent depression. As mentioned above, adolescents with CEA experiences tend to acquire intimacy and recognition from peer relationships (Fergusson & Horwood, 1999). Nevertheless, deviant friendships are usually of low quality and less rewarding. Therefore, it is ill-equipped to provide necessary emotional support for adolescents (Brendgen et al., 2000; Connell & Dishion, 2006). What’s more, as deviant behavior itself is strongly related to depressive symptomatology (Klostermann et al., 2016), adolescents affiliating with deviant peers may become more depressed through peer contagion (Zalk et al., 2010) and co-rumination (Schwartz-Mette & Smith, 2018). Empirical studies have supported this notion. For example, Brendgen et al. (2000) found that adolescents with deviant peers consistently reported more depressive feelings than those with nondeviant peers. Similarly, some longitudinal studies indicated that deviant peer affiliation can predict higher levels of depression at 9 months later (Connell & Dishion, 2006), 1 year later (Vitaro et al., 2005), and even 5 years later (Fergusson et al., 2003). In particular, Vitaro and colleagues (2005) explored trajectories of deviant peer affiliation from childhood to adolescence and their respective effects on adolescent depression. Results showed that compared with participants who never affiliate with deviant peers or affiliate with deviant peers in childhood, those affiliating with deviant peers during adolescence reported an especially rapid increase in depressive symptoms.

Gender as a Moderator

Although CEA may be related to depression via deviant peer affiliation, not all adolescents with CEA experiences equally affiliate with deviant peers and suffer from depression. Heterogeneity of results may originate from individual characteristics that moderate the effect of CEA on depression via deviant peer affiliation, for example, gender. Indeed, gender differences have been one of the most frequently reported topics in the research of depression. Much evidence has indicated that adolescent girls usually exhibit more internalizing problems, such as depression, anxiety, and nonsuicidal self-injury than boys (Bresin & Schoenleber, 2015; Derdikman-Eiron et al., 2011). Some theorists claim that the female predominance of adolescent depression may generally result from a combination of biological changes and psychosocial vulnerabilities (A. J. Lewis et al., 2015). For instance, the interaction between stressful events and the serotonin transporter gene (5-HTTLPR) is significantly related to depression only for girls but not for boys (Hammen et al., 2010). Moreover, adolescent girls tend to be more sensitive to negative events, possess higher levels of rumination, and have lower levels of positive thinking than boys, all of which are significantly related to depression (Bakker et al., 2010; Nolen-Hoeksema & Jackson, 2001).

What’s more, gender may moderate the relation between CEA and depression via deviant peer affiliation, with the relation being much stronger for girls than for boys. There are several reasons for this speculation. First, as relational theory (Portman et al., 2010) puts, adolescent girls appear to possess a more pronounced interpersonal orientation than boys (Bakker et al., 2010). They are uniquely sensitive to relationship losses and rely heavily on close relationships as a source of self-worth (Rudolph & Conley, 2005). In this regard, CEA may exert more deleterious effects on girls than on boys because it just occurs within an interpersonal context. Second, compared with boys, girls usually hold themselves more responsible for the quality of relationships (Nolen-Hoeksema & Jackson, 2001). When suffering from CEA, they are more prone to make a self-blaming attribution for the events, which may in turn result in poorer psychological outcomes, including depression (Swannell et al., 2012). Third, a growing body of research has posited that interpersonal difficulties contribute to higher prevalence of depression among girls than among boys (Bakker et al., 2010; Kendler & Gardner, 2014). More notably, a recent study has examined the moderating role of gender in the link between emotional closeness with parents and depression in adolescence. The result confirmed a significant gender by emotional closeness interaction, with girls showing more susceptible to the quality of parent–child relationships (A. J. Lewis et al., 2015). On the strength of the above literature, it is quite plausible to expect a gender difference in the relation between CEA and depression via deviant peer affiliation.

The Current Study

The aims of the present study were threefold: (a) to explore whether CEA would be positively related to adolescents’ depression, (b) to examine whether deviant peer affiliation would mediate the relation between CEA and depression, and (c) to test whether the relation between CEA and depression through deviant peer affiliation would vary as a function of gender. These research hypotheses were examined by a moderated mediation model (Figure 1) among Chinese adolescents. In addition, to account for the potential confounding effects, our study included other types of childhood maltreatment as controlled variables. Specifically, we proposed three hypotheses as follows:

Hypothesis 1: CEA would be positively linked to adolescents’ depression.

Hypothesis 2: Deviant peer affiliation would mediate the link between CEA and depression.

Hypothesis 3: Gender would moderate the link between CEA and depression via deviant peer affiliation, with the link being stronger for girls than for boys.

Figure 1.

The proposed moderated mediation model.

Method

Participants

This study was conducted in 2018 at a middle and a high school in Henan province, China. Initially, a total of 991 adolescents attending seventh, eighth, 10th, and 11th grades were recruited by cluster sampling. After data cleansing (we excluded participants who did not complete the measure of interested variables or answered questionnaires regularly), the final sample size was reduced to 961. Among them, 48.80% were boys and 51.20% girls. Adolescents’ age ranged from 11 to 20, with a mean age of 15.21 years (SD = 1.57). Moreover, 52.30% of the participants reported being urban residents; 26.90% of the participants were only children. After informed consent was obtained from both students and their teachers, students completed questionnaires regarding demographics, CEA, other types of childhood maltreatment, deviant peer affiliation, and depression.

Measures

CEA and other types of childhood maltreatment

CEA and other types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire–Short Form (CTQ-SF; Bernstein et al., 2003), a 28-item self-report inventory measuring five categories of childhood maltreatment: emotional abuse, physical abuse, sexual abuse, physical neglect, and emotional neglect. Respondents were asked to rate each item on a 5-point Likert-type scale from 1 (never true) to 5 (very often true). High scores indicate high levels of childhood maltreatment. A representative item for CEA is “People in my family called me things like ‘stupid,’ ‘lazy,’ or ‘ugly’.” The measure has demonstrated good reliability and validity among Chinese adolescents (X. Wang, Yang, et al., 2019). In the current study, Cronbach’s α for emotional abuse, physical abuse, sexual abuse, physical neglect, and emotional neglect were .86, .78, .77, .82, and .79, respectively.

Deviant peer affiliation

Deviant peer affiliation was measured using eight-item Deviant Peer Affiliation Questionnaire (D. Li et al., 2013). The scale assessed various peers’ deviant behaviors, such as smoking, drinking, cheating, stealing, and misbehaving. Participants indicated how many of their friends had performed each of the eight deviant behaviors during the prior year. Each item was rated from 1 (none) to 5 (almost all), with higher scores indicating greater deviant peer affiliation. An example item is “How many of your friends got drunk in the last year?” The measure has sound psychometrical criterion in previous studies (D. Li et al., 2013). In this study, its Cronbach’s α was .77.

Depression

The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) was adopted to test adolescents’ levels of depression. It consists of 20 items, such as “I felt depressed.” Participants responded how many days they had experienced the emotion or thought in the statement during the past week. Each item was rated from 1 (less than 1 day) to 4 (5–7 days), with higher scores representing more severe depressive symptoms. The CES-D has been used in Chinese samples with good reliability and validity (e.g., P. Wang et al., 2018). Cronbach’s α was .89 for the current study.

Procedure

Ethical approval was granted by Ethics Committees at the first author’s University. Following the standardization of the data collection progress, the first author conducted the research with the help of teachers. To better protect adolescents from potential research risks, informed consents were obtained from both students and their teachers before completing the measures. All participants were told that they are free to withdraw from the study at any time, and because the questionnaires were anonymous, they did not have to place their names on the measures. Participants completed the paper-based questionnaires regarding CEA, other types of childhood maltreatment, deviant peer affiliation, depression, and demographics variables in quiet classrooms. It took about 15 min to complete all questionnaires.

Data Analyses

According to the criteria proposed by Curran et al. (1996), the skewness and kurtosis of deviant peer affiliation and depression fell within the acceptable range (skewness cutoff of 2.0 and kurtosis cutoff of 7.0). However, the distributions of CEA were somewhat skewed (skewness = 2.10). Thus, we used the bootstrapping method to calculate estimators, because it is an approach for implementing statistical tests and constructing confidence intervals (CIs) without considering the data distribution (Preacher & Hayes, 2008).

The data analyses proceeded in three steps. First, we calculated descriptive statistics and bivariate associations among interested variables. Second, Hayes’s (2013) PROCESS macro for SPSS (Model 4) was used to examine the mediating role of deviant peer affiliation in the link between CEA and depression. Third, Hayes’s PROCESS macro for SPSS (Model 59) was adopted to test the moderating effect of gender in the link between CEA and depression via deviant peer affiliation. In our study, all variables were standardized prior to analyses.

Results

Preliminary Analyses

Means, standard deviations, and correlations for all study variables were presented in Table 1. As expected, CEA was positively correlated with deviant peer affiliation and depression. Thus, Hypothesis 1 was supported. In addition, deviant peer affiliation was positively related to depression and gender (girls = 0, boys = 1), indicating that boys are more inclined to affiliate with deviant peers. Furthermore, all other four types of childhood maltreatment were positively related to CEA, deviant peer affiliation, and depression. Physical abuse and sexual abuse were also positively related to gender. Thus, these four types of childhood maltreatment were included as covariates in subsequent analyses.

Table 1.

Descriptive Statistics and Correlations Among Variables (N = 961).

Variables	M	SD	1	2	3	4	5	6	7	8
1. CEA	1.39	.49	1
2. Physical abuse	1.14	.35	.45**	1
3. Sexual abuse	1.09	.32	.30**	.31**	1
4. Physical neglect	1.71	.57	.35**	.32**	.15**	1
5. Emotional neglect	2.14	.85	.38**	.28**	.11**	.56**	1
6. Deviant peer affiliation	1.56	.61	.35**	.25**	.18**	.19**	.19**	1
7. Depression	1.77	.49	.48**	.30**	.18**	.37**	.42**	.37**	1
8. Gender	0.49	.50	.04	.09**	.12**	.03	.05	.09**	−.004	1

Note. Gender was dummy coded such that 0 = girls and 1 = boys. CEA = childhood emotional abuse.

p < .01.

Testing for Mediation Effect

In Hypothesis 2, we assumed that deviant peer affiliation would mediate the relation between CEA and depression. We examined this hypothesis with Model 4 of the PROCESS macro (Hayes, 2013). As shown in Table 2, CEA was positively associated with deviant peer affiliation (β = .28, p < .001), which in turn was positively associated with depression (β = .21, p < .001). More importantly, the indirect relation between CEA and depression via deviant peer affiliation was significant (indirect effect = .06, 95% CI = [.04, .09]). The mediation effect accounted for 17.14% of the total effect. Therefore, Hypothesis 2 was supported.

Table 2.

Testing the Mediation Effect of CEA on Depression (N = 961).

Predictors	Model 1 (Deviant Peer Affiliation)				Model 2 (Depression)
Predictors	β	SE	LLCI	ULCI	β	SE	LLCI	ULCI
CEA	.28***	.04	.21	.36	.29***	.03	.22	.36
Deviant peer affiliation					.21***	.03	.15	.27
R ²	.15				.35
F	32.70***				84.97***

Note. Each column is a regression model that predicts the criterion at the top of the column. CEA = childhood emotional abuse; LLCI = lower limit of the 95% confidence interval; ULCI = upper limit of the 95% confidence interval.

***

p < .001.

Testing for Moderated Mediation

In Hypothesis 3, we expected that gender would moderate the indirect link between CEA and depression via deviant peer affiliation. We tested this assumption with Model 59 of PROCESS macro (Hayes, 2013). According to Hayes (2013), moderated mediation was established if either or both of two patterns exist: (a) the link between CEA and deviant peer affiliation was moderated by gender and/or (b) the link between deviant peer affiliation and depression was moderated by gender.

As illustrated in Table 3, the relation between CEA and deviant peer affiliation was moderated by gender (β = –.21, p < .001). For descriptive purpose, we plotted predicted deviant peer affiliation against CEA, separately for boys and girls (Figure 2). Simple slop tests revealed that the positive relation between CEA and deviant peer affiliation was stronger for girls (β_simple= .45, p < .001) than for boys (β_simple= .24, p < .001). Nevertheless, gender did not moderate the relation between CEA and depression (β = –.002, p = .979) or the relation between deviant peer affiliation and depression (β = .04, p = .533). The bias-corrected percentile bootstrap results further indicated that the indirect relation between CEA and depression via deviant peer affiliation was moderated by gender. Compared with boys with CEA experiences (β = .04, SE = .02, 95% CI = [.02, .08]), girls with similar experiences are more likely to be depressed via affiliating deviant peers (β = .08, SE = .02, 95% CI = [.04, .12]). Given that gender only moderated the first stage of the mediation process, we called this a “first-stage-moderated mediation model.” Thus, Hypothesis 3 was partially supported.

Table 3.

Testing the Moderated Mediation Effect of CEA on Depression (N = 961).

Predictors	Model 1 (Deviant Peer Affiliation)				Model 2 (Depression)
Predictors	β	SE	LLCI	ULCI	β	SE	LLCI	ULCI
CEA	.39***	.05	.30	.48	.29***	.05	.20	.38
Gender	.14*	.06	.03	.25	−.11*	.05	−.21	−.005
CEA × Gender	−.21***	.06	−.33	−.10	−.002	.06	−.12	.12
Deviant peer affiliation					.20***	.04	.12	.28
Deviant peer affiliation × Gender					.04	.06	−.08	.15
R ²	.16				.35
F	26.43***				57.25***

Note. Each column is a regression model that predicts the criterion at the top of the column. Gender as dummy coded such that 0 = girls and 1 = boys. CEA = childhood emotional abuse; LLCI = lower limit of the 95% confidence interval; ULCI = upper limit of the 95% confidence interval.*p < .05. ***p < .001.

Figure 2.

Gender moderates the relation between CEA and deviant peer affiliation.

Discussion

Although the detrimental effect of CEA on adolescents’ depression has garnered some empirical support (e.g., Paredes & Calvete, 2014; Paul & Eckenrode, 2015), questions regarding the mediating and moderating mechanisms underlying this association remain largely unanswered. Thus, we formulated and examined a moderated mediation model based on an integration of existing theories. Our results indicated that CEA was significantly and positively related to adolescents’ depression even after controlling for the relevant third variables such as physical abuse, sexual abuse, physical neglect, and emotional neglect, and this relation can be explained in part by deviant peer affiliation. Moreover, the indirect relation between CEA and depression via deviant peer affiliation was stronger for girls than for boys. We discussed all these findings in the following sections.

The Relation Between CEA and Depression

We first examined the relation between CEA and depression among Chinese adolescents. As expected, CEA is significantly and positively related to adolescent depression. Although previous studies have identified childhood maltreatment as a risk factor of adolescent depression (Alto et al., 2018; Nanni et al., 2012; Paul & Eckenrode, 2015), limited research has explored the unique relation between CEA and depression after controlling for other types of childhood maltreatment. This finding highlights the important role of CEA in shaping adolescents’ depressive symptoms. It is consistent with attachment theory (Bowlby, 1980) and previous empirical studies which indicated that poor parent–child relationships have critical influences on the development of depression among adolescents (Alto et al., 2018; Paul & Eckenrode, 2015; X. Wang, Gao, et al., 2019). A possible explanation is that adolescents with CEA experiences have a strong feeling of being rejected and not worthy of love, which eventually contribute to the increase in their depression.

The Mediating Role of Deviant Peer Affiliation

Consistent with Bronfenbrenner’s ecological systems theory, we found that deviant peer affiliation mediated the relation between CEA and adolescents’ depression. In other words, deviant peer affiliation is one of the explanatory factors for why adolescents with CEA experiences are more likely to be depressed. Although researchers have uncovered some distinct mechanisms underlying the association between CEA and depression, they have so far limited the focus on individual-level mediators, such as cognitive vulnerabilities (Paredes & Calvete, 2014), insecure attachment styles (Schierholz et al., 2016), and altered emotion regulation strategies (Schierholz et al., 2016). Neither the peer-level nor the school-level mediators have been explored. To our knowledge, the current study is the first to document that deviant peer affiliation is a crucial mechanism in the association between CEA and adolescent depression. Thus, the importance of parent–child relationships and peer relationships on the adolescents’ development cannot be stressed enough. Actually, in the past research on depression, family psychologists emphasized the adverse effect of CEA, whereas school psychologists focused on the negative influence of deviant peer affiliation. However, these two fields have developed largely independently of each other without considering the possible link between CEA and deviant peer affiliation. To fill this gap, we innovatively integrated studies from both fields to unpack adolescents’ depression. Our integrated model showed that adolescents with CEA experiences are more likely to affiliate with deviant peers, which in turn is related to high depression.

Furthermore, each of the independent links in this mediation model is worth discussing. For the first stage, CEA is positively linked to deviant peer affiliation. Our finding is consistent with prior studies that unsupportive parent–child relationships consisting of CEA can result in difficulties in developing positive peer relationships in school (Fergusson & Horwood, 1999; Zhu et al., 2017). Actually, a high quality of parent–child relationship can shape adolescents’ ability to resist peer influence (Smorti et al., 2014) and thus reduce the chance to engage in deviant peer groups. Nevertheless, adolescents who experienced CEA tends to develop poor parent–child relationships and have poor social skills to interact with conventional peers (Rudolph et al., 2014). Therefore, they may undergo more social rejection and isolation by both their parents and mainstreaming peers, which will in turn amplify the possibility of affiliating with deviant peers (Rudolph et al., 2014; Sijtsema et al., 2010; Zhu et al., 2015).

For the second stage, deviant peer affiliation is positively linked to depression. This result supports the notion that adolescence is a period during which peers, especially those who are involved in deviant behaviors, exert paramount effects on adolescent development (Connell & Dishion, 2006). Moreover, the current study showed that compared with family factors, deviant peer affiliation tends to have a more direct and proximal relation with adolescent depression. Surprisingly, prior studies have mainly focused on the linkages between deviant peer affiliation and externalizing behaviors (e.g., Jiang et al., 2016; Zhu et al., 2015, 2017), only a small body of research has linked deviant peer affiliation to internalizing problems (e.g., Connell & Dishion, 2006; Vitaro et al., 2005). In this regard, our study expanded prior research by identifying that deviant peer affiliation is also a risk factor for adolescent depressive symptomatology. Therefore, although the involvement in deviant peer groups alleviates adolescents’ sense of isolation and rejection temporarily, it may increase the level of depression in the long run.

Gender as a Moderator

As relational theory puts, the extent to which negative events affect adolescent depression may vary as a function of gender (Bakker et al., 2010; Kendler & Gardner, 2014; A. J. Lewis et al., 2015). Based on this view, we investigated the moderating role of gender in the relation between CEA and depression via deviant peer affiliation. Results confirmed that gender does moderate this indirect link, with the effect being much stronger for girls than for boys. However, it should be noted that gender only moderated the first stage of the mediation model, such that the relation between CEA and deviant peer affiliation was stronger for girls than for boys. This may be due to the different influences of interpersonal relationships on boys and girls (Kendler & Gardner, 2014). Specifically, compared with boys, girls value more highly on interpersonal relationships and are particularly sensitive to social exclusion (Bakker et al., 2010; Jiang et al., 2016). When suffering from CEA, they are especially eager to develop other interpersonal relationships to contend with isolation (Jiang et al., 2016). Therefore, girls are more likely to affiliate with peers to gain a feeling of belonging and relatedness without considering whether the peer group is deviant or not. In contrast, boys do not rely so heavily on interpersonal relationships to acquire self-worth and have a relatively low desire for relationship building (Bakker et al., 2010; Jiang et al., 2016). They may not view seeking other interpersonal relationships as a priority when suffering from CEA. Thus, for adolescent boys, the relation between CEA and deviant peer affiliation became much weaker.

Contrary to our speculation, both the relation between deviant peer affiliation and depression and the relation between CEA and depression were not moderated by gender. One possible explanation is that relatedness is one of the most universal needs for all human beings (Deci & Ryan, 2000), and once this fundamental need is not met, people tend to be depressed regardless of their gender. In the current study, CEA undoubtedly implies the rejection from parents and includes a direct denial of self-worth. Similarly, deviant peer affiliation is usually an unwilling choice when excluded by mainstreaming peers. It is less rewarding in nature and is less likely to provide emotional support when necessary (Brendgen et al., 2000; Connell & Dishion, 2006). In this regard, both CEA and deviant peer affiliation are detrimental to the satisfaction of relatedness. Consequently, adolescents with these experiences are prone to be depressed no matter whether they are girls or boys.

Limitations and Future Directions

As with all research, several limitations should be considered when interpreting these findings. First, although this study is based on theoretical and empirical foundations, the cross-sectional nature of design inevitably limited the possibility of drawing causal conclusions. Further longitudinal studies are vital for better examining the validity of this moderated mediation model. Second, the data were collected only through self-report measures, which may increase the subjectivity of results. For example, adolescents are prone to overevaluate the CEA prevalence, given that they often have lots of complaints about their parents (Sun et al., 2019). It would be particularly beneficial for future studies to collect data from diverse informants. Third, it is important to note that the present study is based on a sample of adolescents in the Chinese culture. However, CEA is deeply embedded in cultural settings, such that people in different cultures often pay different attention to family relationships and have different understanding of childhood maltreatment (X. Wang, Yang, et al., 2019). Thus, the generalizability of these findings is limited. Future studies should include samples from other cultural groups and explore whether similar findings can be obtained as well. Finally, as the main aim of our study is to investigate mediating and moderating mechanisms in the relation between CEA and depression, we measured CEA as a global index without distinguishing between maternal and paternal CEA. However, there may be differential influences of maternal and paternal maltreatment on female and male participants (Godbout et al., 2019). Therefore, future studies should further explore whether maternal and paternal CEA are differently related to adolescent depression.

Implications

Despite these limitations, our research has several theoretical and practical implications for future studies. From a theoretical perspective, this research extends previous studies by confirming that adolescents with CEA experiences are more inclined to be depressed even after controlling for other types of childhood maltreatment. Therefore, the unique relation between CEA and depression deserves greater attention in future studies. Moreover, our findings shed light on the underlying mediating and moderating mechanisms in the relation between CEA and depression. It can not only uncover how CEA is related to depression, but also clarify when the relation is likely to be maximized or minimized, both of which can contribute to a further understanding of this issue.

From a practical perspective, our findings may help to design effective psychological interventions to reduce adolescents’ depression. First, as CEA is positively related to adolescent depression, it is important for parents to realize that this relatively subtle type of childhood maltreatment can also exert deleterious effects on adolescents’ mental health. Thus, parents should make efforts to develop positive parent–child relationships and prevent the occurrence of CEA. Second, considering that deviant peer affiliation is a mediator in the relation between CEA and adolescent depression, the antidepression interventions will be more effective when educators and practitioners take it into consideration and develop strategies to reduce deviant peer affiliation. Third, our results revealed that girls with CEA experiences are more likely to affiliate with deviant peers and ultimately be more depressed than boys. Thus, interventions targeted at helping adolescents remain in mainstream peer groups may be particularly effective in ameliorating depression for girls.

Conclusion

In summary, based on an integration of attachment theory, Bronfenbrenner’s ecological systems theory, and relational theory, the present study showed that CEA is positively related to adolescent depression even after controlling for other types of childhood maltreatment. Furthermore, the moderated mediation model revealed that deviant peer affiliation is a possible explanatory factor underlying this relation, and the indirect relation is stronger for girls than for boys. These findings provide us with a better understanding of how and when CEA is related to adolescent depression, which is conducive to provide appropriate interventions of depression.

Footnotes

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

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the <Outstanding Innovative Talents Cultivation Funded Programs 2018 of Renmin Univertity of China>.

ORCID iD

Guoliang Yu

Author Biographies

Sen Li is a doctoral candidate in the School of Education, Renmin University of China. Her research interests are in childhood maltreatment, social exclusion, and adolescent development.

Fengqing Zhao is a lecturer in the School of Education, Zhengzhou University, China. Her research interests are in parenting and adolescents’ mental health, positive development, and stereotypes and stereotype threat.

Guoliang Yu is a professor in the Institute of Psychology, Renmin University of China. His research interests are in mental health, parenting styles, and stereotypes and stereotype threat.

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