Childhood Adversity and PTSD Experiences: Testing a Multiple Mediator Model Siobhan Murphy University of Ulster, Magee Campus Mark Shevlin University of Ulster, Magee Campus, and University of Southern Denmark Cherie Armour University of Ulster, Coleraine Campus Ask Elklit University of Southern Denmark and University of Ulster, Magee Campus Mogens N. Christoffersen The Danish National Centre for Social Research, Copenhagen, Denmark The association between childhood adversity and posttraumatic stress disorder (PTSD) symptomatology has been argued to be both directly and indirectly explained through a number of psychological mechanisms. This study builds on recent findings from an analysis of childhood adversity co-occurrence that revealed 4 groups: emotional abuse, sexual abuse, and multiple (overall) abuse and a no-abuse group to investigate the relationship between PTSD experiences. Data was analyzed using a Danish stratified probability survey that included 2980 interviews of 24-year-olds. A multiple mediator model was conducted to assess the role of self-esteem, social support, and being bullied at school on the abuse types and PTSD experiences. Results indicated that the 3 mediating variables were all statistically significant with low social support exerting the strongest influence in the association between childhood adversity and PTSD experiences. Low self-esteem, however, was only associated with sexual abuse. The current study supports that there are direct and indirect effects between childhood adversity and PTSD experi- ences but suggests there may be additional mechanisms underlying this relationship. Further exploration into underlying mechanisms will promote and inform intervention and treatment programs. Keywords: bullying, childhood adversity, PTSD experiences, self-esteem, social support Childhood adversity, such as physical, sexual and psycho- logical abuse has consistently been shown to predict negative outcomes, for example, posttraumatic stress disorder (PTSD; Shenk, Putnam, & Noll, 2012), general psychopathology (Kes- sler et al., 2010), psychotic disorders (Read, Fink, Rudegeair, Felitti, & Whitfield, 2008; Varese et al., 2012), and higher health care utilization (Chartier, Walker, & Naimark, 2010). Childhood adversity has further been associated with poorer psychological adjustment, peer related problems, and interper- sonal variables such as low self-regard, poor self-esteem and perceived social support (Kendall-Tackett, 2002; Turner, Finklehor, & Comrod, 2010). The prevalence of PTSD follow- ing childhood adversity varies across studies but it is estimated that between 25% and 62% of victims of childhood abuse subsequently develop PTSD (Albach & Everaerd, 1992; Chu & Dill, 1990). Ackerman, Newton, McPherson, Jones, and Dyk- man, (1998) investigated the prevalence of PTSD in three groups of abused children. The abuse groups in this study were sexual abuse (n = 127), physical abuse (n = 43), and both sexual and physical abuse (n = 43). Using both child and caregiver ratings the prevalence of PTSD as measured by the Diagnostic Interview for Children and Adolescents (Reich & Weluer, 1988) was reported as 36% and 30%, respectively. It is evident from these studies that there is variability in the prev- alence of PTSD following childhood adversity. There could be many reasons that explain the variability between studies, for example, sample composition, time since the abuse, type of abuse, and the measurement of PTSD. Underlying this variabil- ity within studies is that not everyone who has experienced childhood adversity develops PTSD. This indicates that there may be additional mediating variables that may indirectly ex- plain the transition to PTSD symptomatology. This article was published Online First June 16, 2014. Siobhan Murphy, School of Psychology, University of Ulster, Magee Campus; Mark Shevlin, School of Psychology, University of Ulster, Magee Campus, and National Centre for Psychotraumatology, University of Southern Denmark; Cherie Armour, School of Psychology, University of Ulster, Coleraine Campus; Ask Elklit, National Centre for Psychotrauma- tology, University of Southern Denmark, and School of Psychology, Uni- versity of Ulster, Magee Campus; Mogens N. Christoffersen, The Danish National Centre for Social Research, Copenhagen, Denmark. We thank The Egmont Foundation and The Danish National Research Foundation for generous research support. Correspondence concerning this article should be addressed to Mark Shevlin, Psychology Research Institute, Faculty of Life and Health Sci- ences, University of Ulster at Magee Campus, L’Derry BT48 7JL, North- ern Ireland. E-mail: m.shevlin@ulster.ac.uk This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Traumatology © 2014 American Psychological Association 2014, Vol. 20, No. 3, 225–231 1085-9373/14/$12.00 http://dx.doi.org/10.1037/h0099838 225