Poly-victimization and its association with protective and vulnerability variables in adolescence: The mediating role of self-esteem

Interpersonal victimization is widely acknowledged to be a significant stressor and psychologically damaging factor for both children and adolescents. Despite the large number of studies that report a clear association between specific kinds of victimization and psychiatric disorders, little research to date has accounted for the full spectrum of victimization to which adolescents can be exposed. The current thesis aims to analyse the mental health aftermath of victimization, taking into account the wide range of victimizations to which adolescents are exposed, and highlighting the higher vulnerability of those who can be considered “poly-victims”. It also aims to study the role that variables like self-esteem may play in buffering the negative effects of victimization. This thesis is based on four studies (Soler, Paretilla, Kirchner, & Forns, 2012; Soler, Kirchner, Paretilla & Forns, 2013; Soler, Segura, Kirchner, & Forns, 2013; Soler, Forns, Kirchner, & Segura, 2014). Overall, the results highlight the high burden of victimization to which Spanish adolescents are exposed, and show that youth rarely suffer single victimizing events but are more likely to endure rather multiple victimization experiences. Similarly, very few adolescents reported victimization in only one area (e.g., only sexual victimization); rather, they tend to report a combination of different areas. Moreover, it was found that the impact of individual areas of victimization on mental health tends to decrease and even become irrelevant when the combination of different areas is taken into account, showing that it is probably the combination of victimization areas, and not single areas, that is truly important for adolescents’ mental health. Overall, girls at adolescent ages showed higher psychological distress than boys. Moreover, although in general boys and girls reported equivalent amounts of victimization (i.e., total kinds of victimization), girls reported twice as much child maltreatment and sexual victimization as boys. Boys and girls in the poly-victim condition were the ones that reported the most psychopathological symptoms (e.g., PTSS, suicidal behaviours) and lower self-esteem, highlighting the cumulative effect of increasing stressors (Cloitre et al., 2009). A gender-specific psychopathologic response linked to the cumulative pattern of interpersonal victimization was found, with boys showing increased distress in the poly-victim condition and girls showing increased distress even in mild levels of victimization. This signals that victimization may play an important role in producing the gender differences in mental health that are found in the general population, and highlights females’ greater vulnerability to victimization. Experiencing multiple kinds of victimization or poly-victimization was found to affect adolescents’ self-evaluation as worthy social beings (i.e., self-liking), but it did not seem to make them question their self-efficacy (i.e., self-competence). Also, self-liking was found to be a partial mediator of the relationship between victimization and certain mental health variables (e.g., internalizing symptoms) in both boys and girls, whereas self-competence was found to be a mediator of this relationship only in girls. These findings may be of help to clinicians and health practitioners since they suggest that working on adolescents’ sense of personal value (self-liking) and girls’ sense of ability to meet personal goals (self-competence) may help them to build up resilience in the face of adversity.La victimización interpersonal ha sido ampliamente considerada una importante fuente de estrés y de malestar psicológico tanto para niños como para adolescentes. A pesar de que la literatura contiene numerosos estudios que demuestran una clara asociación entre distintos tipos de victimización y algunos trastornos psiquiátricos, pocos son los que han tenido en cuenta el amplio abanico de victimizaciones al que niños y adolescentes pueden verse expuestos. La presente tesis pretende analizar las consecuencias del sufrimiento de victimización interpersonal en términos de salud mental, tomando en cuenta el amplio abanico de victimización al que los adolescentes pueden verse expuestos y subrayando la mayor vulnerabilidad de aquellos considerados poli-víctimas. En general, los resultados subrayan la importante carga de victimización a la que los adolescentes españoles se ven sometidos y muestran que rara vez los jóvenes experimentan un único episodio de victimización de forma aislada. Las chicas adolescentes presentaron más malestar psicológico que los chicos y el doble de maltrato infantil y de victimización sexual. Los adolescentes en la condición de poli-víctimas fueron los que presentaron más síntomas psicopatológicos y menos autoestima. En este sentido, se encontró que la respuesta psicológica vinculada al patrón acumulativo de victimización interpersonal es diferente según el género. Mientras que los chicos mostraron significativamente más malestar únicamente en la condición de poli-victimas, las chicas lo mostraron incluso en la condición de víctimas. Esto subraya la mayor vulnerabilidad de las chicas ante la victimización e indica que ésta puede estar jugando un papel importante sobre las diferencias de género que se encuentran en la población general a nivel de salud mental. Por último, los resultados mostraron que el hecho de experimentar múltiples tipos de victimización o poli-victimización afecta más la autovaloración que los adolescentes hacen de su propia valía como seres sociales (self-liking) que su percepción de auto-eficacia (self-competence). Los resultados de la presente tesis pueden ser útiles para clínicos y otros profesionales de la salud mental ya que, por un lado, subrayan la importancia de considerar los distintos tipos de victimización a los que los adolescentes se ven expuestos, y por el otro, indican que para ayudar a los adolescentes a desarrollar resiliencia frente a la adversidad sería recomendable trabajar principalmente la visión que tienen sobre su propia valía (self-liking)