Specific emotion regulation deficits differentiate and mediate the relationship between adverse childhood experiences and internalizing psychopathology

Abstract

Adverse childhood experiences (ACEs) including maltreatment, abuse, and household dysfunction, are associated with an increased risk for poor physical health, psychopathology, and early mortality (Felitti et al., 1998). Exposure to ACEs is pervasive with two out of three Americans experiencing at least one ACE and 12 % reporting exposure to four or more ACEs (Poole et al., 2017). Increased exposure to ACEs is associated with various negative outcomes, including internalizing disorders and higher emotion dysregulation (ED, Cloitre et al., 2019; Diaz & Eisenberg, 2015; Poole et al., 2017; Soenke et al., 2010). ED is believed to be the nucleus of internalizing psychopathology (Mennin et al., 2005, Newman et al., 2013; Suveg et al., 2010; Werner & Gross, 2010), and has been linked to numerous disorders including depression, anxiety, and posttraumatic stress disorder (PTSD; Mennin et al., 2005, Newman et al., 2013; Suveg et al., 2010). ACEs are also linked to greater internalizing symptoms via emotion regulation deficits (Miu et al., 2022; Poole et al., 2017; Soenke et al., 2010; Rudenstine et al., 2018). However, studies examining the role of ED on ACES and internalizing symptoms have utilized different conceptualizations and measures of ED, making it difficult to compare the unique contribution of ED to specific symptoms and disorders despite the therapeutic and research benefits. Therefore, the goal of the current study was first, to determine whether ED mediated the relationship between ACEs and anhedonic depression, anxious arousal, and general distress. Second, to establish which emotion regulation deficits mediated the relationship between ACEs and internalizing symptoms, and whether they differed across the three outcomes.