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However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: neuroendocrine, autonomic, affective, and emotion regulation. Female adolescents (<jats:italic>N<\/jats:italic>= 110; age range = 14\u201319) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed 18 months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed.<\/jats:p>","DOI":"10.1017\/s0954579415000905","type":"journal-article","created":{"date-parts":[[2015,11,4]],"date-time":"2015-11-04T14:46:36Z","timestamp":1446648396000},"page":"1503-1514","source":"Crossref","is-referenced-by-count":18,"title":["Symptoms of major depressive disorder subsequent to child maltreatment: Examining change across multiple levels of analysis to identify transdiagnostic risk pathways"],"prefix":"10.1017","volume":"27","author":[{"given":"Chad E.","family":"Shenk","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda M.","family":"Griffin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran J.","family":"O'Donnell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,11,4]]},"reference":[{"key":"S0954579415000905_ref29","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/145219"},{"key":"S0954579415000905_ref70","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.114.4.627"},{"key":"S0954579415000905_ref67","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.40.3.879"},{"key":"S0954579415000905_ref77","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579400001036"},{"key":"S0954579415000905_ref89","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.1.49"},{"key":"S0954579415000905_ref9","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10m06409blu"},{"key":"S0954579415000905_ref75","article-title":"Contamination in the prospective study of child maltreatment and female adolescent health","author":"Shenk","year":"2015","journal-title":"Journal of Pediatric Psychology"},{"key":"S0954579415000905_ref65","doi-asserted-by":"publisher","DOI":"10.1177\/1745691611419672"},{"key":"S0954579415000905_ref83","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579409990332"},{"key":"S0954579415000905_ref91","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2010.61.8.796"},{"key":"S0954579415000905_ref64","volume-title":"From discovery to cure: Accelerating the development of new and personalized interventions for mental illnesses","year":"2010"},{"key":"S0954579415000905_ref86","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.54.6.1063"},{"key":"S0954579415000905_ref41","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.09091379"},{"key":"S0954579415000905_ref36","doi-asserted-by":"publisher","DOI":"10.1023\/B:JOBA.0000007455.08539.94"},{"key":"S0954579415000905_ref60","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1217750110"},{"key":"S0954579415000905_ref58","doi-asserted-by":"publisher","DOI":"10.1016\/S0018-506X(02)00024-7"},{"key":"S0954579415000905_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-009-0132-z"},{"key":"S0954579415000905_ref57","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.12.1.23"},{"key":"S0954579415000905_ref38","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579400006313"},{"key":"S0954579415000905_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2011.10.006"},{"key":"S0954579415000905_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(04)80036-4"},{"key":"S0954579415000905_ref3","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"S0954579415000905_ref71","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-010-1879-7"},{"key":"S0954579415000905_ref28","first-page":"367","volume-title":"A guide to treatments that work","author":"Franklin","year":"2002"},{"key":"S0954579415000905_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62129-1"},{"key":"S0954579415000905_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.22"},{"key":"S0954579415000905_ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000348451"},{"key":"S0954579415000905_ref46","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199504000-00020"},{"key":"S0954579415000905_ref50","doi-asserted-by":"publisher","DOI":"10.1177\/1754073910361986"},{"key":"S0954579415000905_ref43","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579411000289"},{"key":"S0954579415000905_ref84","unstructured":"US Department of Health and Human Services. 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