Psychology, 2010, 1, 143-150
doi:10.4236/psych.2010.12019 Published Online June 2010 (
Copyright © 2010 SciRes. PSYCH
Does Child Maltreatment Mediate Family
Environment and Psychological Well-Being?
Michael Galea
University of Malta, and L.S.E.—University of London, External Program, Malta.
Received February 19th, 2010; revised April 8th, 2010; accepted April 10th, 2010.
This study tried to establish if childhood maltreatment mediates the established relationship between family environ-
ment and psychological well-being, in a sample of Maltese university students (N = 312). However, our analysis sug-
gested partial mediation only. Mo reover, results indicated that abusive families are less lovin g, socially integrated, or-
ganized, and more conflicted. Family environment contributed positively, albeit limited, to cognitive well-being after
controlling fo r child abuse history. In particula r, cohesion, do add unique variance to subjective well-being , after con-
trolling for child abuse. This study replicates classic research on the important role that family environment plays in
children’s holistic development.
Keywords: Childhood Maltreatment, Family Enviro nment, Well-Being
1. Introduction
The past focus on human deficiencies has only served to
present a “half-baked” psychology [1]. Psychology needs
to start getting seriously concerned with the qualities and
experiences that make life most worthwhile. Gillham and
Seligman [1] point at the sterling work of Rachman [2,3]
who helped launch a systematic science of human str-
engths, in view of his experience with various clients
with debilitating emotional disorders and past traumas.
Positive psychology requires such strides to balance what
has been a one-sided view of human being.
Life’s crises challenge our deepest beliefs and as-
sumptions: that good people are somehow immune of
bad things, that life always makes sense, and that we are
in control in whatever happens. Calhoun and Tedeschi [4]
found that for most people, life’s crisis ultimately lead to
what he calls “post-traumatic growth”. After one’s basic
assumptions are shattered, a new framework is con-
structed. Campbell, Brunch, & Foster [5] call this phe-
nomena “ego shock”. Such negative events could poten-
tially evaporate instantly our old habits, self-perceptions
and assumptions, leaving only the raw experience of the
One such crisis is childhood maltreatment. Research
consistently indicates a complex and difficult reality for
victims of such trauma. To fully understand the impact of
child abuse, key variables need be taken into considera-
tion and evaluated for their contribution. Most impor-
tantly, this paper looks at family environment, the inci-
dence, reality, and impact of childhood abuse in Malta,
and the consequences of such trauma on one’s subjective
1.1 Family Environment and Psycho-Social
Studies suggest that a key variable for a child’s normal
development is family environment. Family environment
is not just the physical aspect under which children live
and grow, but also other relevant factors that affect one’s
developmental process, such as parental styles and dy-
namics. Finkelhor and Browne [6] found that the family
environment was the context where most of the reported
child abuse cases occur. Moreover, Finkelhor [7,8]
showed that not only is the family context part of such
trauma, but that the perpetrator is often known to the
Scarr [9] stressed that except in extreme cases of
abused and at-risk children, environmental experiences
play a minimal role in influencing children’s cognitive and
socio-emotional development. To the contrary, Baumrind
[10] found that the environment does have an important
role in children’s development. Thus parents should not
be punitive or aloof, but promote their children with con-
sistent rules along with considerable affection. Baum-
rind’s argument is credible in light of attachment re-
Does Child Maltreatment Mediate Family Environment and Psychological Well-Being
Bowlby [11,12] and Ainsworth [13] spoke of the im-
portance of secure attachment in infancy for normal de-
velopment. Staying in physical proximity to the primary
caregiver helps the child satisfy essentials for survival,
such as nourishment and self-defense. They further cha-
racterized the importance of reliable care-givers during
infancy in two respects: a safe haven in times of distress
and a secure base for exploring one’s environment. This
safety zone helps the child to develop and face life’s
challenges positively. The contact comfort received from
such a secure environment helps the child to develop the
resiliency that is critical for survival [14]. Darling and
Steinberg [15] also stressed the important implications of
parenting styles. Research classifies parenting styles in
two directions: 1) a combination of warmth, nurturance,
acceptance and responsiveness, defined by parental em-
pathy and closeness, and 2) a demand and control family
dynamic, defined by parental neglect and indifference
[10]. The first parenting style is the optimal one [16].
1.2 Child Abuse and Related Variables
Abuse may lead to people engaging in various defense
mechanisms, repressing the trauma for example so that
life can move on. Dickie et al. [17] found that worse ef-
fects seem to occur when the abuser is the primary
care-giver/parent. Children need to find ways to make
sense of their trauma. They may internalize their guilt
and feel rejected, sinful, unclean, or even ignored by a
Using Bowlby’s attachment theory [11], in which in-
dividuals are not passive but active in constructing and
maintaining close relationships, Kirkpatrick and Shaver
[18,19] indicated that God may serve as a “perfect” sub-
stitute attachment figure for people with histories of
avoidant attachment. Child abuse may be a potential
reason for such avoidance. They speculated that the need
for attachment is life-long. Kane, Cheston and Greer [20]
considered this element important in that “transference
might easily occur in a child’s mind from father the ab-
user to God the Father”. In related studies, spirituality but
not religiosity predicted subjective well-being [21,22].
Besides attachment and spirituality, two key and re-
lated variables are family conflict and cohesion. Meyer-
son, Long, Miranda, and Marx [23] found that family
conflict and cohesion are risk factors for the development
of psychological distress and depression in adolescence,
and therefore they suggest the particular study of these
two variables for a more holistic appreciation and better
understanding. Various researchers suggest the inclusion
of other important variables when focusing on childhood
maltreatment, as it never occurs in a vacuum [24,25].
Moreover, patriarchal family systems, which are pre-
valent in Western countries including Malta, are posi-
tively correlated to childhood maltreatment [26]. Other
studies suggested the negative prediction of patriarchal
systems on the well-being of family members [27,28].
This is more important in a small country like Malta,
with its closely-knit family systems, and under a strong
influence by a dominant Catholic faith [29,30].
1.3 The Reality in Malta
This study focused on the experience of childhood trau-
ma in Malta, specifically among a sample of university
students. Malta, a tiny republic island in the Mediterra-
nean Sea, with a rich history dating back to thousands of
years, has been highlighted in a recent document by the
United Nations on children’s welfare. The U.N. docu-
ment [31] called for the urgent need for a comprehensive
assessment and public policy decisions regarding this
problem. Malta does not have the necessary resources to
protect children from child abuse, nor any mandatory
reporting laws. Galea reiterates that statistics are scarce,
and child protective services are still in their infancy [22].
More awareness and research is required for better and
timely response.
Galea et al. [29] surveyed Maltese university students
on various aspects of childhood trauma and found that
almost 11% qualified as severely abused. Interestingly,
he indicated that spirituality may serve also as a potential
resource in treating victims of childhood maltreatment.
To help further clarify the reality of childhood trauma,
this study seeks to know whether family environment
gives any additional value to well-being, after controlling
other key variables, among Maltese students. The pur-
pose of this study, therefore, was to measure the rela-
tionship and the interplay between childhood maltreat-
ment with relevant variables, such as family environment,
subjective well-being and others. This study hypothe-
sized that the family background of victims must be
conducive to abuse. Thus, such environments would cor-
relate to high family conflict and low cohesion. More-
over, this study sought to clarify the exact nature of rela-
tionships between the key variables at play. Finally, this
study intended to seek any possible mediator variable
effect/s among the key variables, predicting subjective
Given the lack of relevant studies on this reality in
Malta, this study could serve to further related studies
among the general population, intended to highlight the
incidences and relationships among such important vari-
ables to one’s psycho-social well-being after trauma. As
an overall summary therefore, this chapter looked at re-
search findings on the potential implications of early
attachment and family dynamics on the psycho-social
well-being of young individuals.
2. Methods
2.1 Participants
The participants in this study were undergraduate stu-
Copyright © 2010 SciRes. PSYCH
Does Child Maltreatment Mediate Family Environment and Psychological Well-Being 145
dents from the Mediterranean island of Malta. Overall,
the study sampled 800 students. From a response rate of
39%, there were 214 female (69%), and 98 male respon-
dents (31%). The age of the participants ranged from 18
to 25 years old (Mean = 20.45, SD = 2.37). The religious
orientation of the respondents consisted of: 97.1% Ro-
man Catholic, 0.6% Protestant, and 2.2% no religion
2.2 Measurements
The Family Environment Scale (FES). Developed by
Moos and Moos [32], this is a 90-item, True-False in-
strument, paper and pencil measure intended to look at
the social and environmental characteristics of families.
The FES is based on a three-dimensional conceptualiza-
tion of families, with related subscales: 1) Relationship, 2)
Personal growth, and 3) System-Maintenance dimension.
The Relationship dimension consisted of Cohesion, the
degree of commitment, help, and support family mem-
bers provide for one another (e.g., “Family members re-
ally help and support one another”); Expressiveness, the
extent to which family members are encouraged to ex-
press their feelings directly (e.g., “We say anything we
want to around home”); and Conflict, the amount of
openly expressed anger and conflict among family
members (e.g., “We fight a lot in our family”).
The Personal Growth dimension consisted of Inde-
pendence, the extent to which family members are asser-
tive and self-sufficient, (e.g., “We think things out for
ourselves in our family”); Achievement orientation, how
much activities are cast into an achievement-oriented or
competitive framework (e.g., “We feel it is important to
be the best at whatever you do”); Intellectual-Cultural
orientation, the level of interest in political, intellectual,
and cultural activities (e.g., “We often talk about political
and social problems”); Active-Recreational orientation,
the amount of participation in social and recreational
activities (e.g., “Friends often come over for dinner or to
visit”); and Moral-Religious emphasis, the emphasis on
ethical and religious values (e.g., “We don’t say prayers
in our family”). The System Maintenance dimension
consisted of Organization, the degree of importance of
clear organization and structure in planning family ac-
tivities and responsibilities (e.g., “We are generally very
neat and orderly”); and Control, how much set rules and
procedures are used to run family life (e.g., “There are
very few rules to follow in our family”).
In this sample, alpha reliabilities for the scales consti-
tuting the three dimensions of Relationship, Personal
Growth, and System Maintenance ranged from: 0.63 to
0.74, 0.34 to 0.66, and 0.56 to 0.63, respectively. Due to
the low alphas of Personal Growth and System Mainte-
nance dimensions in this analysis, they were removed
from this study, despite their benefit in other related stu-
dies [33].
Internal consistency reliability estimates presented in
the manual ranged from 0.61 to 0.78. As for normative
values, the inter-correlations among the 10 subscales
ranged from –0.53 to 0.45, suggesting that different fam-
ily characteristics are measured with reasonable consis-
tency [34]. Test-retest reliabilities were found reasonably
stable across three intervals within one-year period. Face
and content validity of the instrument are supported by
the clear statements relating to the 10 subscale domains.
Construct validity was also found through comparative
descriptions of distressed and normal family samples, as
shown in the manual.
Satisfaction with Life scale (SWLS). Well-being was
examined from the cognitive well-being component. The
Satisfaction with Life Scale (SWLS), developed by Die-
ner, Emmons, Randy and Griffin [35], is a 5-item simple
scale that measures life satisfaction and cognitive well-
being. Pavot and Diener [36] have consistently found the
internal consistencies of the SWLS and alpha coefficients
as exceeding 0.80. Test-retest correlation coefficients
were found at 0.89. The alpha reliability of the Maltese
sample was found to be at 0.95.
Childhood Trauma Questionnaire. The Childhood
Trauma Questionnaire (CTQ) is a 28-item Likert-scale,
which captures a history of child abuse and neglect
across multiple dimensions [37]. Five subscales form the
CTQ: emotional abuse, physical abuse, sexual abuse,
emotional neglect, and physical neglect. The alpha reli-
abilities for the Maltese sample are 0.82, 0.77, 0.93, 0.83,
and 0.46 respectively.
For the purpose of this study, an overall composite
abuse index score was created based on the total scores
of the five sub-scales. This composite score was then
reciprocally transformed to meet the assumptions of
normal distribution. In this sample 11% of respondents
fell in the severe abuse and neglect range while 25%
qualified as moderately abused. These percentages are
highly similar to rates in the United States based on the
studies that validated the CTQ [38].
2.3 Procedure
The questionnaires were mailed to participants who were
randomly selected from among a pool of students who
volunteer for such surveys.
3. Results
3.1 Hypothesis Testing
Table 1 presents the means, standard deviations, and
alpha reliabilities for the study variables. Pearson r cor-
relations suggested that abusive families tend to be low
on cohesion, expressiveness, intellectual-cultural empha-
sis, organization, and on moral-religiousness. These fam-
ily environments seem also to be exposed to high conflict,
as was hypothesized.
Copyright © 2010 SciRes. PSYCH
Does Child Maltreatment Mediate Family Environment and Psychological Well-Being
Copyright © 2010 SciRes. PSYCH
Table 1. Descriptive statistics for study variables
Variable M SD Range
Age 20.45 02.37 18-25
well-being 23.66 06.59 06-35
Positive effect 3.14 1.32 0-5
Negative effect 2.37 1.57 0-5
Total abuse 21 72 0-5
Cohesion 21.52 15.36 04-65
Expressiveness 46.85 04.47 38-58
Conflict 62.58 10.77 33-80
Independence 24.43 13.06 03-53
Achievement 35.50 10.47 16-65
Intellectual 41.56 12.57 19-69
Active-reactive 47.04 10.72 23-69
Moral 42.75 09.30 27-66
Organizational 37.05 10.80 21-69
Control 51.30 11.07 27-76
N = 312
What about the family profile of a person with a his-
tory of child abuse? Abuse negatively correlated with
cohesion (r (310) = –0.40, p < 0.001), expressiveness (r
(310) = –0.30, p < 0.001), intellectual-cultural orientation
(r (310) = –0.20, p < 0.001), moral-religious emphasis (r
(310) = –0.22, p < 0.001), and a sense of organization (r
(310) = –0.23, p < 0.001). As expected, abuse correlated
positively with conflict (r (310) = 0.41, p < 0.001). There-
fore, results suggest a family profile with a history of
child abuse as being: low in cohesion and expressiveness,
and high in conflict. These indicate a family dysfunction
which evidently is not a promising and positive environ-
ment for the normal psycho-emotional development of
children, let alone for those already scarred by abuse.
3.2 Mediator Variable Effect
The next step in our analysis concerned the main hy-
pothesis of the study, that of the possibility of a mediator
variable effect. One typically looks for mediators if there
already is a strong relation between a predictor and an
outcome and one wishes to explore the mechanisms be-
hind that relation. More specifically, a mediator is de-
fined as a variable that explains the relation between a
predictor and an outcome [39]) variable. The mediator is
the mechanism through which a predictor influences an
outcome variable [39]. According to this method, there
are four steps (performed with three regression equations)
in establishing that a variable (e.g., child abuse) mediates
the relation between a predictor variable (e.g., family)
and an outcome variable (e.g., well-being).
Baron & Kenny [39] explain that a variable functions
as a mediator when it meets certain conditions, namely:
(a) the independent variable (IV) impacts the mediator
variable (MV) in the first equation (path a), (b) the IV
impacts the dependent variable (DV) in the second equa-
tion (path c), (c) the MV impacts the DV in the third eq-
uation (path b), (d) if (a), (b), and (c) all hold in the pre-
dicted direction, then the effect of the IV on the DV must
be less in the third equation than in the second (path c’).
A perfect mediation is said to occur when this is reduced
to zero. Otherwise, it is a partial mediation. The mediator
variable, then, serves to clarify the nature of the rela-
tionship between the independent and dependent vari-
ables. Results are shown in Table 2.
Table 2 shows the results of the conditions sought to
establish mediation. In the first equation, the independent
variable (family environment) affected the mediator va-
riable (child abuse): r (310) = 0.18, p < 0.001. In the
second equation, family environment impacted the out-
come or dependent variable (cognitive well-being): r
(310) = –0.28, p < 0.001. Child abuse impacted the out-
Table 2. Testing mediator effects using multiple regression
Testing steps in mediation model B SE B 95% CI β
Testing Step 1 (Path a)
Outcome: child abuse
Predictor: family environment 0.05 0.01 0.02 0.07 0.18**
Testing Step 2 (Path c)
Outcome: cognitive well-being
Predictor: family environment –0.19 0.04 –0.27 –0.12 –0.28***
Testing Step 3 (Path b and c’)
Outcome: cognitive well-being
Mediator: child abuse
Predictor: family environment –0.16 0.04 –0.23, –0.09 –0.23***
Note. CI = Confidence Interval; ** p < 0.01, *** p < 0.001
Does Child Maltreatment Mediate Family Environment and Psychological Well-Being 147
come variable (cognitive well-being): r (310) = –0.23, p
< 0.001. Results thus indicate only a partial mediation.
The Statistical Mediation Model is shown in Figure 1.
The partial drop from –0.19 to –0.16 (i.e. from path c
to c’) could explain that child abuse partially mediates
the relation between well-being and family. In terms of
causation, a fairly strong argument can be made that
family environment (predictor variable) preceded both
child abuse (mediator variable) and well-being (outcome
variable). However, it could be the case that individuals
who are suffering from poor well-being (outcome vari-
able) symptoms are more likely to be abused (i.e., that
the outcome causes the mediator). In fact, in testing this
alternative model, well-being also was a significant me-
diator of the relation between family and child abuse.
Thus, there are alternative models that are consistent
with the data. This study also did not control for other
factors that may be related to or cause both family envi-
ronment and child abuse, such as key personality traits
like neuroticism. Thus, all we can say at this point is that
our data are consistent with models in which child abuse
causes poor well-being, and poor well-being causes abuse.
We also must acknowledge that the mediation relations
we found might not have been evident if other variables
that cause both family environment and child abuse had
been included in the model. In conclusion, these results
continue to indicate the relevance of family variables to
4. Discussion
Results indicated that child abuse as the mediator vari-
able partially mediates the established relationship be-
tween family environment and psychological well-being.
Thus, the main hypothesis of this study was partially ap-
Family environment contributed positively to cogni-
tive well-being after controlling for child abuse history.
In particular, cohesion does add unique variance to sub-
jective well-being, over and above the contribution of
That dysfunctional family environments are related to
childhood trauma, and to later psychological problems, is
well documented in research [40,41]. Families who score
on low cohesion, expressiveness, intellectual-cultural ori-
entation, moral-religiousness, organization, and high co-
nflict significantly correlate with child abuse and neglect.
This study replicates classic studies indicating the im-
portant role the family environment plays in children’s
development [10,42]. Moos and Moos [34] found that
abusive families are less loving, socially integrated, and
organized. This finding is consistent with the conclusions
of the present research.
Although some researchers [15] found a strong posi-
tive correlation between child abuse and a rigorous and
strictly organized family environment, this was not sup-
ported in this study. Moreover, Moos and Moos [34] also
indicated that family dysfunction defined as less suppor-
tive, socially integrated, and organized, was associated
with sexual abuse. Findings in this study indicated no
such links between sexual abuse and any of the Family
Environment Scales. On the other hand, this study does
confirm other research by Moos and Moos [34] whereby
abusive families are less loving, socially integrated, and
From a pastoral perspective, therapists who add to
their valuable resources key family variables such as
cohesion, self-expression and control, will increase their
possibilities to arrive at a more holistic evaluation of
their clients. This is well grounded in research [23,40], as
well as attachment theoretical studies [10,13], as indi-
cated previously.
Finally, repetitive family dysfunction highlighted by
high levels of conflict and abuse, can create an atmos-
phere of learned helplessness. Abramson, Sehgman, and
Teasdale [43] proposed that early experience of learned
helplessness leads to a cognitive set that predisposes to
later depression.
N = 312. FE = family environment (independent variable); CA = child abuse (mediator variable); WB = psychological well-being
(dependent variable). ***p < 0 .001
Figure 1. Statistical mediation model
0.18*** –0.23***
Copyright © 2010 SciRes. PSYCH
Does Child Maltreatment Mediate Family Environment and Psychological Well-Being
4.1 Limitations
This study was a sample of convenience among univer-
sity students. Participants were randomly selected by
computer, thus containing at least one aspect of partici-
pants’ self-selection. The cross-sectional nature of the
design limits causal inferences. Moreover, the study’s
reliance upon self-reported and recalled data may have
introduced sources of error. The internal reliability of the
FES, a key variable measure in this research, which was
used to measure family environment, was another limita-
tion, despite opting to use only the best and highest di-
mension, that of Relationship, which ranged from 0.63 to
On the positive side, this study had a relatively large
sample size, and was done in a country in which such
research is still in its infancy. To this end one hopes that
similar studies take the lead from this one and delve
deeper into the stark reality of childhood maltreatment.
Results from this study continue to confirm other related
studies elsewhere on the difficulties in the psycho-social
development of victims. Moreover, it continues to high-
light the input given by certain variables, which would
give a better picture when included in the equation.
4.2 Conclusions
Results from this study continue to add to the existing
literature on the importance that family variables have on
the psycho-emotional well-being and development of
young people. This becomes clearer in view of a history
of child abuse and neglect. More specifically, cohesion,
emotional self-expressiveness and conflict require par-
ticular assessment, when evaluating persons with child
abuse history, and when planning therapeutic programs
and strategies. The study strongly suggests that the inclu-
sion of family environment offers a better and more ho-
listic perspective on the reality of child abuse and its
This is the next step in the Maltese scenario. Malta has
long been grounded on cohesive families, supported by
strong traditional and religious past. However, the effects
of globalization are fast gaining pace, with not so posi-
tive consequences on such a vital cell within society.
Moreover, lack of awareness of the scope of child abuse
may further the weakening of the family structure, creat-
ing with it a conspiracy of silence that prevents timely
action and prevention [44].
Hopefully, studies such as this one may encourage
more social alertness, backed up by an appropriate legal
framework to help protect victims while preventing per-
petrators from pursuing their evil pursuits. It is therefore
hoped that this study encourages a drive towards a deeper
and more rigorous look into the aftermath of childhood
trauma in a culture, which has long been overshadowed
by complacency and silence. Specifically, stronger and
clearer legislation, mandatory reporting laws, and avail-
ability of professional assistance and education are areas
that require serious consideration. The present study can
assist in educating people as to the extent, nature, and
impact of child abuse in Malta. Besides protecting chil-
dren, related research will continue to shed more light on
the reasons and profiles of perpetrators, who should not
be ignored in order to evaluate a more objective appraisal
of the reality of child abuse.
Focusing the research among university students may
have been the easiest to reach and study as a start. How-
ever, this study opens up an immediate requirement to
further it among the general population for more ap-
praisal of this painful reality. Child abuse is a social evil,
with dire effects that shroud one’s personality and emo-
tional development. Such future research furthermore
request the inclusion of key variables such as family en-
vironment and subjective-well being, in light of their
close affinity to the trauma in focus
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