Childhood Emotional Abuse Research Articles

LIFE COURSE TIMING OF ADVERSITY AND DIURNAL CORTISOL IN LATER LIFE

Abstract Exposure to adversity is believed to alter stress sensitive biological processes. One manifestation of this, flatter diurnal cortisol slopes, has been linked to cardiometabolic problems. Questions remain about whether the timing of adversity within the life course influences its effect on cortisol slopes in later life. Two longitudinal cohort studies (Cardiac Rehabilitation and The Experience [CREATE], Tracking Risk Identification for Adult Diabetes [TRIAD]) with identical measures were merged for analysis (merged N = 175, Mage 60.8) using multilevel modeling. Measures included retrospective self-report of childhood trauma (CTQ), major life stressors in adulthood (number and recency of stressful events, affected domains, everyday discrimination), and peak-to-bedtime cortisol slopes (≤12 collected over 15 months). Report of any moderate and severe childhood adversity was not associated with adult cortisol slopes (p>.05). When we probed specific types, emotional abuse was associated with cortisol slopes (b=.006, SE=.003, p=.015). For adult adversity, total number of stressful events (b=.001, SE=.0002, p=.009) and recent stressful events (b=.003, SE=.001, p=.041) were associated with cortisol slopes. When simultaneously modeling all measures of adversity over the life course, number of stressful events in adulthood (b=. 001, SE=.0002, p=.018) and childhood emotional abuse (b=.007, SE=.004, p=.064) were the strongest predictors of flatter diurnal cortisol slopes in adulthood. Given that those reporting childhood adversity were also more likely to have experienced adulthood adversity (r=.08-.39), early life adversity may be an important risk factor for flattened cortisol slopes and associated cardiometabolic outcomes in later life via multiple pathways. Implications for intervention will be discussed.

Different epistemic stances for different traumatic experiences: implications for mentalization.

Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.

Resilience in the face of adversity: The role of impermanence in mitigating the effects of childhood emotional abuse and everyday stress on depressive symptoms.

Resilience in the face of adversity: The role of impermanence in mitigating the effects of childhood emotional abuse and everyday stress on depressive symptoms.

Pathways to suicidal risk in patients with OCD: The role of childhood abuse, cognitive vulnerabilities, OCD symptomology, and depression

Childhood maltreatment (CM) and its associated cognitive vulnerabilities, such as early maladaptive schemas (EMSs), have been identified as dysfunctional and risk factors for obsessive-compulsive disorder (OCD) and its related clinical outcomes, including obsessive-compulsive (OC) symptoms, depression, and suicidality. However, the combined effects of these variables on suicidal risk have not been investigated yet. This study aimed to examine the relationships between CM and suicidal risk through the paths of EMS domains, OCD symptoms, and depression in patients with OCD (n = 300). Participants completed a series of self-report scales assessing the psychological and clinical variables. The results showed a significant relationship between childhood emotional abuse and suicidal ideation, which was mediated by the paths of disconnection/rejection, unacceptable obsessional thoughts, and depression. These findings suggest that individuals with OCD who have experienced childhood emotional abuse may exhibit heightened levels of disconnection/rejection, frequent repugnant obsessions, and depressive mood, possibly contributing to an increased risk of suicide. Therefore, it is crucial for therapeutic settings, such as schema therapy, to carefully assess and monitor these risk factors in order to prevent suicidal risk in individuals with OCD.

Developmental Trajectories of Childhood Emotional Maltreatment and Smartphone Addiction in Primary School Children: Based on a Three-Year Longitudinal Study

ABSTRACT Primary school children are in a critical period of growth, and childhood emotional maltreatment (CEM) can have a tremendous negative impact, leading to smartphone addiction (SPA). Considering developmental trajectories has significant implications for understanding the relationship between CEM and SPA. This study was conducted with 208 Chinese primary school children to investigate the developmental trajectories of SPA and CEM during children’s development, the relationship between the two developmental trajectories, and the influence of gender on the two developmental trajectories through a three-year, three-wave longitudinal study. The study found a linear increase with age in both SPA and CEM in primary school children. Further, the initial level of SPA was significantly higher in boys than girls. Finally, the developmental trajectory of CEM positively predicted the developmental trajectory of SPA. This study contributes to understanding the developmental trajectory of SPA and CEM in the child population. It provides theoretical support and practical guidance for preventing and intervening SPA in children from the perspective of the family environment.

Assessment of Adverse Childhood Experiences, Adverse Professional Experiences, Depression, and Burnout in USPhysicians.

To assess associations of adverse childhood experiences (ACEs) and adverse occupational experiences (AOEs) with depression and burnout in US physicians. We performed a secondary analysis of data from a representative sample survey of US physicians conducted between November 20, 2020, and March 23, 2021, and from a probability-based sample of other US workers. The ACEs, AOEs, burnout, and depression were assessed using previously published measures. Analyses included data from 1125 of the 3671 physicians (30.6%) who received a mailed survey and 6235 of 90,000 physicians (6.9%) who received an electronic survey. The proportion of physicians age 29-65 who had lived with a family member with substance misuse during childhood (673 of 5039[13.4%]) was marginally lower (P <.001) than that of workers in other professions (448 of 2505 [17.9%]). The proportion of physicians age 29-65 who experienced childhood emotional abuse (823 of 5038 [16.3%]) was similar to that of workers in other professions (406 of 2508 [16.2%]). The average physician depression T-score was 49.60 (raw score ± SD, 6.48±3.15), similar to the normed US average. The AOEs were associated with mild to severe depression, including making a recent significant medical error (odds ratio [OR], 1.64; 95% CI, 1.33 to 2.02, P<.001), being named in a malpractice suit (OR, 1.30; 95% CI, 1.07 to 1.59, P=.008), and experiencing one or more coronavirus disease 2019-related AOEs (OR, 1.76; 95% CI, 1.56 to 1.99, P<.001). Having one or more ACEs was associated with mild to severe depression (OR, 1.58; 95% CI, 1.38 to 1.79, P<.001). The ACEs, coronavirus disease 2019-related AOEs, and medical errors were also associated with burnout. Assessing ACEs and AOEs and implementing selective primary prevention interventions may improve population health efforts to mitigate depression and burnout in physicians.

Transdiagnostic Ecological Momentary Intervention for Improving Self-Esteem in Youth Exposed to Childhood Adversity

Targeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorders. Ecological momentary interventions (EMIs) allow for the delivery of youth-friendly, adaptive interventions for improving self-esteem, but robust trial-based evidence is pending. To examine the efficacy of SELFIE, a novel transdiagnostic, blended EMI for improving self-esteem plus care as usual (CAU) compared with CAU only. This was a 2-arm, parallel-group, assessor-blinded, randomized clinical trial conducted from December 2018 to December 2022. The study took place at Dutch secondary mental health services and within the general population and included youth (aged 12-26 years) with low self-esteem (Rosenberg Self-Esteem Scale [RSES] <26) exposed to childhood adversity. A novel blended EMI (3 face-to-face sessions, email contacts, app-based, adaptive EMI) plus CAU or CAU only. The primary outcome was RSES self-esteem at postintervention and 6-month follow-up. Secondary outcomes included positive and negative self-esteem, schematic self-beliefs, momentary self-esteem and affect, general psychopathology, quality of life, observer-rated symptoms, and functioning. A total of 174 participants (mean [SD] age, 20.7 [3.1] years; 154 female [89%]) were included in the intention-to-treat sample, who were primarily exposed to childhood emotional abuse or neglect, verbal or indirect bullying, and/or parental conflict. At postintervention, 153 participants (87.9%) and, at follow-up, 140 participants (80.5%), provided primary outcome data. RSES self-esteem was, on average, higher in the experimental condition (blended EMI + CAU) than in the control condition (CAU) across both postintervention and follow-up as a primary outcome (B = 2.32; 95% CI, 1.14-3.50; P < .001; Cohen d-type effect size [hereafter, Cohen d] = 0.54). Small to moderate effect sizes were observed suggestive of beneficial effects on positive (B = 3.85; 95% CI, 1.83-5.88; P < .001; Cohen d = 0.53) and negative (B = -3.78; 95% CI, -6.59 to -0.98; P = .008; Cohen d = -0.38) self-esteem, positive (B = 1.58; 95% CI, 0.41-2.75; P = .008; Cohen d = 0.38) and negative (B = -1.71; 95% CI, -2.93 to -0.48; P = .006; Cohen d = -0.39) schematic self-beliefs, momentary self-esteem (B = 0.29; 95% CI, 0.01-0.57; P = .04; Cohen d = 0.24), momentary positive affect (B = 0.23; 95% CI, 0.01-0.45; P = .04; Cohen d = 0.20), momentary negative affect (B = -0.33; 95% CI, -0.59 to -0.03, P = .01, Cohen d = -0.27), general psychopathology (B = -17.62; 95% CI, -33.03 to -2.21; P = .03; Cohen d = -0.34), and quality of life (B = 1.16; 95% CI, 0.18-2.13; P = .02; Cohen d = 0.33) across postintervention and follow-up. No beneficial effects on symptoms and functioning were observed. A transdiagnostic, blended EMI demonstrated efficacy on the primary outcome of self-esteem and signaled beneficial effects on several secondary outcomes. Further work should focus on implementing this novel EMI in routine public mental health provision. Dutch Trial Register Identifier:NL7129(NTR7475).

Associations between abnormal electroencephalogram microstates and childhood emotional abuse in adolescent depression.

Childhood traumatic experiences greatly influenced the brain network activities of patients with depression, and there is an urgent need to explore the temporal dynamics for these changes. This study aims to investigate the abnormalities of resting-state electroencephalogram (EEG) microstates in eye-open state of depressed adolescents and to explore the correlations between their EEG microstates and the childhood traumatic experience. Using resting-state EEG microstate analysis, we explored the temporal dynamics of brain activity in patients with adolescent depression. This study selected 66 adolescents with depression as a patient group, and 27 healthy adolescents as a healthy control group. A modified k-means clustering algorithm was used to classify the 64-channel resting-state EEG data into different microstates. Independent sample t-tests were used to compare the microstate parameters between the 2 groups and further assciations between these parameters and childhood traumatic experience in patients were explored via using Spearman correlation. In this study, significant differences were observed in the occurrence and transition probabilities of EEG microstates between the healthy control and the patient group. Notably, there was a statistically significant difference (P<0.05) in the occurrence of microstate A across 2 groups, exhibiting a negative correlation with the emotional abuse component within the childhood trauma scores (Spearman's rho=-0.31, P=0.013). Furthermore, patient-specific, non-random transitions from microstate B to A (Spearman's rho=-0.30, P=0.015) and C to A (Spearman's rho=-0.31, P=0.013) were inversely associated with the scores of emotional abuse factors from childhood trauma in the patient group, showing statistically significant differences when comparing to the healthy controls (P<0.05). Upon stratification into quartiles based on the emotional abuse factor scores, the occurrence of microstate A, as well as the transition rates from microstates B to A and C to A, retained statistical significance following adjustment for multiple comparisons (all P<0.05). The abnormal temporal dynamics in brain networks of adolescents with depression are linked to childhood emotional abuse. Those who have suffered severe emotional abuse may show greater impairments in the brain's visual and central executive networks. EEG microstate analysis could be a potential tool for detecting adolescent depression with severe childhood trauma.

The relationship between childhood emotional abuse and borderline personality disorder: the mediating role of difficulties in emotion regulation among Lebanese adults

ObjectiveThe present study investigates the mediating effect of difficulties in emotion regulation in the association between childhood emotional abuse and Borderline Personality Disorder (BPD) among Lebanese adults.MethodThis cross-sectional study, involving 411 participants, was conducted between March and August 2022. Lebanese individuals from all governorates of the country were recruited using the Snowball Sampling technique. Three self-report scales were utilized to complete this research; the ‘Difficulties in Emotion Regulation Scale—Brief Version (DERS-16)’ which evaluates the difficulties in emotion regulation of individuals, the ‘Childhood Trauma Questionnaire—Short Form (CTQ-SF)’ which grants a subjective evaluation of the general childhood environment of the participants, as well as the ‘Borderline Personality Questionnaire (BPQ)’ which measures Borderline Personality Disorder traits, that demonstrate significant convergence with the disorder.ResultsThe results indicate that DERS-16 played an indirect effect role between childhood emotional abuse scores and Borderline Personality Disorder. Higher emotional abuse scores were significantly associated with higher DERS-16 scores, which in turn was significantly associated with higher BPQ scores. Moreover, childhood emotional abuse was directly associated with higher BPQ scores.ConclusionThis work suggests that, among the different forms of childhood abuse, emotional abuse may have a role in the development of Borderline Personality Disorder. Training on emotion regulation strategies would potentially benefit individuals in preventing BPD development and facilitating therapeutic processes.

Childcare Subsidy Employment and Copayment Requirements and Child Maltreatment.

Economic support programs for low-income families may play an important role in preventing child abuse and neglect. In the United States, childcare subsidies are provided to low-income families who meet certain requirements to offset the high cost of childcare. States have flexibility in setting many policies related to the provision of childcare subsidies, which results in a great deal of variation in how the programs operate between states. One policy dimension on which states vary is the number of employment hours required to receive childcare subsidies. A small body of work has begun to investigate the ways in which these state policy variations might relate to child maltreatment. Using 11years of administrative data from the United States, the current study sought to estimate the relationship between two sources of variation in childcare subsidy policies: employment requirements and copayment size; and child neglect, physical abuse, and emotional abuse substantiations. The study found a nuanced relationship between required employment and neglect substantiations. Specifically, requiring some level of work was not associated with neglect substantiations, but requiring 30 hours of employment was associated with higher rates. The study did not find a relationship between copayment size and maltreatment substantiations.

Childhood emotional abuse and gamebullying among Chinese youths: The mediating roles of mindfulness and Machiavellianism

This study investigated the relationship between childhood emotional abuse and gamebullying among youths, and the roles of mindfulness and Machiavellianism in that relationship. The study sample comprised 504 Chinese youths (female = 51.2%) who completed the Childhood Emotional Abuse Scale, Gamebullying Scale, Mindful Attention Awareness Scale, and Machiavellianism Scale. Path analysis results indicated a history of childhood emotional abuse to predict gamebullying. Mindfulness mediated the relationship with childhood emotional abuse to predict gamebullying to be lower. Machiavellianism mediated the relationship between childhood emotional abuse and gamebullying to be higher. In our sample, demographic variables, including gender and education, did not predict gamebullying. Younger youths had lower levels of gamebullying than older youths. These findings indicate a need to reduce gamebullying among youths with a history of adverse childhood events. Mindfulness healing can be used to lower the negative effects of gamebullying.

Emerging adult college students' descriptions of exposure to childhood emotional abuse and associated factors: A qualitative exploration

BackgroundGrowing evidence on the long-term deleterious impacts of emotional abuse highlights the need to further understand childhood emotional abuse and its context to strengthen prevention efforts. ObjectiveTo describe emerging adults' experiences of emotional abuse in their childhoods and the household context surrounding that abuse. Participants and settingFifty-eight interviews were conducted with emerging adults, ages 18–25, recruited from four 2- and 4-year institutions of higher education. MethodsThematic analysis was conducted to identify and describe patterns in the data. A cyclical approach to codebook development and data analysis was followed by a team of four coders. ResultsThemes related to participants' experiences of emotional abuse included: inability to meet parent expectations; parent attacks on the child's character; parent negative comparisons to siblings and others; parent invalidation of the child's emotions and mental health needs; and evolution over time in the parent-child relationship. Aspects of childhood family environments contemporaneous with the childhood emotional abuse included: financial stress; parent mental illness; parent divorce, separation, or volatile relationship; parent adversity or trauma; physical abuse; and young parent age. Many participants identified these aspects of their family environment, most of which could potentially be improved with sufficient support, as playing causal roles in the emotional abuse they experienced. ConclusionThis descriptive qualitative study provides additional insight into child emotional abuse and its associated factors, providing invaluable insights that can enhance current measurement and intervention approaches.

여자 청소년의 정서적 학대 피해와 사이버 언어폭력 가해의 관계: 내현적 자기애와 피해자 정의민감성의 매개효과

여자 청소년의 정서적 학대 피해와 사이버 언어폭력 가해의 관계: 내현적 자기애와 피해자 정의민감성의 매개효과

Suicidal behaviors and adverse childhood experiences: A cross-diagnostic study in persistent depressive disorder and borderline personality disorder

Adverse childhood experiences (ACE) constitute a known risk factor for suicidality. There is a research gap regarding differential patterns of associations between variants of suicidal ideations and behaviors (SIB) and characteristics of ACE in severe mental disorders. This cross-diagnostic study investigates whether SIB are related to ACE subtypes in two high-risk conditions, i.e., persistent depressive disorder (PDD) and borderline personality disorder (BPD). Inpatients with PDD (n = 117; age 40.2 years ± 12.3) and BPD (n = 74; age 26.2 ± 7.9) were assessed with the Columbia-Suicide Severity Rating Scale for suicidal ideations (SI), suicidal behaviors (SB) and actual suicide attempts (SA); ACE were recorded with the Childhood Trauma Questionnaire. In PDD, SI and SA were associated with childhood physical abuse (ORs 7.2 and 2.3, respectively). In BPD, SA were associated with severe experiences of physical abuse (OR 6.5). Weaker yet significant associations were found for childhood emotional abuse in PDD with SB (including SA), and in BPD with SA. Recall of childhood physical abuse may be clinically relevant information for identifying particular risks of SIB. Future studies should investigate these differential patterns in more depth and in terms of causality.

Looking into troubled waters: Childhood emotional maltreatment modulates neural responses to prolonged gazing into one's own, but not others', eyes.

One of the most prevalent nonverbal, social phenomena known to automatically elicit self- and other-referential processes is eye contact. By its negative effects on the perception of social safety and views about the self and others, childhood emotional maltreatment (CEM) may fundamentally affect these processes. To investigate whether the socioaffective consequences of CEM may become visible in response to (prolonged) eye gaze, 79 adult participants (mean [M]age = 49.87, standard deviation [SD]age = 4.62) viewed videos with direct and averted gaze of an unfamiliar other and themselves while we recorded self-reported mood, eye movements using eye-tracking, and markers of neural activity using fMRI. Participants who reported higher levels of CEM exhibited increased activity in ventromedial prefrontal cortex to one's own, but not to others', direct gaze. Furthermore, in contrast to those who reported fewer of such experiences, they did not report a better mood in response to a direct gaze of self and others, despite equivalent amounts of time spent looking into their own and other peoples' eyes. The fact that CEM is associated with enhanced neural activation in a brain area that is crucially involved in self-referential processing (i.e., vmPFC) in response to one's own direct gaze is in line with the chronic negative impact of CEM on a person's self-views. Interventions that directly focus on targeting maladaptive self-views elicited during eye gaze to self may be clinically useful.

Peripartum dissociation, sense of control, postpartum posttraumatic stress disorder and emotional adjustment to motherhood in adult survivors of childhood maltreatment.

Survivors of childhood maltreatment (CM) may experience difficulties in the peripartum period and in adjustment to motherhood. In this study we examined a model wherein CM is associated with maternal self-efficacy and maternal bonding three months postpartum, through mediation of peripartum dissociation and reduced sense of control during childbirth and postpartum-posttraumatic-stress disorder (P-PTSD). Women were recruited in a maternity ward within 48h of childbirth (T1, N = 440), and contacted three-months postpartum (T2, N = 295). Participants completed self-report questionnaires: peripartum dissociation, sense of control (T1), and CM, P-PTSD, postpartum-depression, maternal self-efficacy and bonding (T2). Obstetrical data were collected from medical files. Structural equation modeling was conducted to test the hypothesized model, controlling for mode of delivery and postpartum-depression. Reported CM included child emotional neglect (CEN; 23.5%), child emotional abuse (CEA; 16.3%), child sexual abuse (CSA; 12.9%) and child physical abuse (CPA; 7.1%). CM was positively associated with peripartum dissociation and P-PTSD (p < .001). Peripartum dissociation was positively associated with P-PTSD (p < .001). P-PTSD was negatively associated with maternal self-efficacy (p < .001) and maternal bonding (p < .001). Association between CM and maternal self-efficacy and bonding was serially mediated by peripartum dissociation and P-PTSD, but not by sense of control. Findings remained significant after controlling for mode of delivery and postpartum-depression. CM is a risk factor for adjustment to motherhood, owing to its effects on peripartum dissociation and P-PTSD. Implementation of a trauma-informed approach in obstetric care and recognition of peripartum dissociative reactions are warranted.

Differentiating between intrapsychic symptoms and behavioral expressions of borderline personality disorder in relation to childhood emotional maltreatment and emotion dysregulation: an exploratory investigation

ABSTRACT Background: Borderline personality disorder (BPD) is a severe mental disorder, characterized by pronounced instability in emotions, self-image, and interpersonal relationships. Experiences of childhood maltreatment are among the risk factors for BPD. While self-damaging and aggressive acts often occur, not every person with the disorder shows markedly dysregulated behaviour. Internalized symptoms, such as shame, loneliness, and self-disgust tend to be more pervasive and persist after clinical remission. Objective: Here we investigated associations between BPD symptom severity, childhood maltreatment, and emotion regulation difficulties. We further explored if the Borderline Symptom List (BSL) could potentially be used to differentiate between internalized symptoms (intrapsychic strain) and externalized symptoms (dysregulated behaviours) in future research. Method: 187 women with at least mild BPD symptoms (65% having a diagnosis of BPD) completed the BSL 23 including its 11-item supplement (BSL-S), the Childhood Trauma Questionnaire (CTQ), and Difficulties in Emotion Regulation Scale (DERS). Participants further underwent a semi-structured clinical interview to assess BPD criteria (International Personality Disorder Examination, IPDE). Multivariate models and regression-based bootstrapping analyses were performed to test direct and indirect effects. Results: Childhood trauma severity, especially emotional abuse, positively predicted BPD symptom severity. A significant indirect effect through emotion regulation difficulties was found (k 2=.56). When exploring associations with BPD criteria (IPDE), the BSL-23 mean significantly correlated with separation anxiety, identity and mood problems, chronic emptiness, suicidal ideation, and dissociation, while the BSL-S correlated with self-harming impulsive behaviour and anger outbursts. Conclusions: Findings complement previous research, highlighting the role of childhood maltreatment and emotion regulation difficulties in BPD. While our findings need to be seen as preliminary and interpreted with caution, they suggest that the BSL may be used to differentiate between internalized symptoms and behavioural expressions of BPD in future research. Such a distinction might help to deepen the understanding of this complex heterogenous disorder.

The Rating of Emotional Abuse in Childhood (REACH) Questionnaire: A new self-report measure assessing history of childhood emotional abuse

BackgroundA history of childhood emotional abuse (CEA) is prevalent among adults with affective disorders; therefore, a comprehensive measure of it is vital. The Rating of Emotional Abuse in Childhood Questionnaire (REACH) was developed to assess history of CEA in relation to parental behaviours of threat, ignoring, humiliation/denigration, scapegoating, antipathy, and overcontrol/conditionality in a single measure. This paper investigated the psychometric properties of REACH in a community sample and proposes values for classifying individuals as high-risk for CEA. MethodA convenience sample of N = 483 adults (Female, 78.3%) was recruited to complete questionnaires that included the REACH alongside measures of mental health, insecure attachment, emotion regulation, and childhood abuse. A subset of participants (n = 198) completed the REACH 7 days later. ResultsFactor analysis indicated a 2-factor model provided a good fit. Factors were named ‘threatening’ and ‘devaluing’. A total scale score of CEA was also recommended. The threatening, devaluing, and total scales demonstrated strong psychometric properties with high internal consistency, test-retest reliability, and convergent validity, while cutoff values for identifying a high-risk CEA group demonstrated good discriminant utility. ConclusionsThe results support REACH as a valid measure and suggest a history of CEA should be measured in relation to threatening and devaluing CEA as they represent unique dimensions of CEA even though they often co-occur.

Childhood maltreatment, alexithymia and eating disorder psychopathology: A mediation model

BackgroundThe relationship between childhood maltreatment and eating disorder psychopathology has been under-investigated. ObjectiveThe purpose of this study was to investigate the role of alexithymia in mediating the relationship between childhood maltreatment experiences and eating disorder (ED) symptoms. Participants and settingOne-hundred-forty-three women with anorexia nervosa, 110 women with bulimia nervosa and 108 healthy women filled in the Eating Disorder Inventory-2, the Childhood Trauma Questionnaire and the Toronto Alexithymia Scale-20 (TAS-20). MethodsA mediator path model including childhood trauma types as predictors, the subscales of the TAS-20 as mediators and ED specific symptoms as dependent variables was conducted in individuals with EDs and in healthy women. ResultsIn women with EDs emotional abuse was directly associated with body dissatisfaction and was associated to drive to thinness, bulimia and body dissatisfaction through the mediation of difficulties to identify emotions. In healthy women, physical neglect was directly associated to drive to thinness and bulimia, but no significant mediation effect through alexithymia emerged. ConclusionImpaired emotion recognition mediates the association between childhood emotional abuse and ED symptoms. Individuals with early emotional abuse may experience ED symptoms to manage confused emotional perceptions. Improving emotional understanding and acceptance may be a treatment target in early maltreated individuals with EDs.

Childhood emotional abuse and depression: The mediating roles of emotion regulation and resilience

Childhood adverse experiences are associated with an increased susceptibility to low psychopathology. Childhood emotional abuse (CEA) is a widespread adversity, known to be associated with depression. Yet, the underlying mechanisms contributing to the relationship remain unclear. The present study aimed to explore the association between CEA and depression and identify potential mediating factors, focusing specifically on emotion regulation and resilience. Participants (N = 110) completed an online survey assessing experiences of CEA, depression levels, emotional regulation strategies, and resilience levels. A mediation analysis found that CEA has a direct influence on the onset of depression. Interestingly, only the expressive suppression emotional regulation strategy and resilience were found to mediate the relationship between CEA and depression. Cognitive reappraisal was not a mediator. The results add to the growing literature emphasising the association between CEA and depression. The implications for clinicians would be to explore the emotional regulation strategies and resilience in clients with known CEA. In the future, when assessing the outcome of CEA, it is critical to consider all aspects of the effects of CEA. Rather than primarily focusing on the presence of depression, clinicians should consider the fact that CEA often hinders one’s social, cognitive, and emotional development.