Childhood Interpersonal Trauma Research Articles

Childhood Interpersonal Trauma and Relationality Among Profiles of Mindfulness Facets

Childhood Interpersonal Trauma and Relationality Among Profiles of Mindfulness Facets

Cumulative Childhood Trauma, Communication Patterns, and Intimate Partner Violence Perpetrated by Men Seeking Help.

Intimate partner violence (IPV) is a complex and multifactorial public health problem associated with important physical and psychological repercussions. Recent studies suggest that cumulative childhood trauma (CCT) may be related to higher IPV perpetration through dysfunctional communication patterns, but to our knowledge, no study has tested this proposition in a clinical population. This study aimed to explore the direct and indirect links between CCT and perpetrated IPV through dysfunctional communication patterns among 577 men seeking help from community centers specializing in IPV. Prior to receiving services, participants completed a battery of questionnaires including validated brief measures of CCT (sexual, physical, and psychological abuse; physical and psychological neglect; witnessing of physical and psychological parental violence; bullying), communication patterns (demand/demand, partner demands/man withdraws, man demands/partner withdraws), and IPV (psychological, physical, coercive control). Results from a path analysis reveal that having sustained a higher number of different forms of childhood trauma is directly related to men's higher risk of perpetrating psychological IPV. CCT is also indirectly related to higher perpetrated psychological and physical IPV and coercive control through a higher report of the demand/demand communication pattern and a higher report of the man demands/partner withdraws communication pattern. The tested model explains 23% of the variance in psychological IPV, 6% of the variance in physical IPV, and 12% of the variance in coercive control. Results highlight the importance of assessing, in therapy, both distal and proximal variables associated with IPV, including the accumulation of many forms of childhood interpersonal trauma, and to tailor trauma-informed interventions that promote constructive communication strategies.

Trauma and psychosis: The mediating role of premorbid adjustment and recent stressful events in a 3-year longitudinal study

BackgroundSome of the most-studied environmental factors that can contribute to the development of psychosis are the adversities experienced at an early age. Among these, childhood interpersonal trauma (CIT) has been considered especially influential in the onset of the disease. The aim of the study was to explore the relationship between CIT and the first episode of psychosis (FEP), as well as the relationship between CIT and clinical and functional outcomes 3 years after illness onset. MethodsA total of 278 patients with a FEP and 52 healthy controls were studied. Logistic regression analysis was carried out to examine the explained variation by CIT at the beginning of psychosis. Recent stressful events and premorbid adjustment related to CIT, were introduced in path analyses to determine their mediating effects between CIT and the disease and its clinical and functional results. ResultsMediation analyses showed that CIT was indirectly associated with belonging to the FEP group through recent stressful events (Effect = 0.981; SE = 0.323; CI = 0.485 to 1.761). Premorbid academic adjustment in late adolescence mediated the relationship between CIT and clinical and functional outcomes, specifically in the measurements of the Scales for Assessment of Positive and Negative Symptoms, in the Brief Psychiatric Rating Scale, and in the Disability Assessment Scale. ConclusionsThese findings suggest that early traumatic experiences play an important role in the FEP. Early intervention that promotes good academic adjustment during adolescence and/or avoids retraumatisation could positively impact both the onset and the course of psychotic illness.

Native Hawaiian wellbeing and transdiagnostic trauma symptoms: The protective role of physical activity in dissociation

ObjectivesNative Hawaiians (NH) report higher rates of interpersonal trauma in childhood or adolescence (ITCA) as well as higher rates of chronic physical illness and psychopathology. Given that physical activity (PA) has positive impacts on physical and mental health, it may also serve as a protective factor in the development of poor health outcomes in adulthood following ITCA. The present study investigated what factors contribute to wellbeing and transdiagnostic posttraumatic sequelae for individuals with exposure to ITCA using a dataset from a longitudinal study cohort (n = 989) of ethnically diverse older individuals (mean age = 60) in Hawaiʻi. MethodsFive univariate general linear models were used to explore the unique effects of: PA; ITCA level; NH status; interactions with ITCA level; and interactions with NH status on the dependent variables: posttraumatic sequelae (i.e., dissociation, avoidance, interpersonal difficulty) and aspects of wellbeing (i.e., satisfaction with life [SWL], self-rated health). ResultsPA was a significant predictor of SWL, self-rated health, and dissociation, while exposure to ITCA predicted SWL. NH group status interacted with PA to uniquely predict dissociation. Exposure to ITCA differentially predicted SWL. ConclusionsFindings support prior evidence that processes in posttraumatic experience are significantly associated with poor health-promoting behaviors (e.g., PA). Additionally, for NHs, PA may reduce dissociation, or levels of dissociation already present in the NH group may play a role in disengagement from PA. Future research should consider whether PA holds benefits across trauma types (e.g., historical trauma), or if culturally based PA is differentially more protective.

A Hierarchical Cluster Analysis of Childhood Interpersonal Trauma and Dispositional Mindfulness: Heterogeneity of Sexual and Relational Outcomes in Adulthood

ABSTRACT The current mixed-method study aimed to 1) identify different childhood interpersonal trauma (CIT) and dispositional mindfulness (DM) profiles in an adult sample; 2) illustrate these profiles with qualitative data documenting childhood sexual abuse (CSA) and CIT survivors’ perceptions of their own DM; and 3) examine profile differences on sexual and relational outcomes. Participants were 292 adults who completed an online questionnaire. A subsample of participants having reported a history of CSA (n = 51) also completed semi-structured interviews. Hierarchical cluster, comparison, and content analyses were performed. Analyses yielded three profiles: 1) Lower victimization, high mindfulness; 2) Psychological victimization, low mindfulness; and 3) Multi-victimization, low mindfulness. Participants in profile 1 presented the lowest frequency of CIT experiences and the highest levels of DM and sexual and relational well-being. Profile 2 participants presented higher sexual and relational well-being (i.e., higher sexual satisfaction, lower sexual depression, and fewer interpersonal conflicts) than those in profile 3. By documenting distinct CIT and DM profiles and tying them to different levels of relational and sexual well-being, this study could guide practitioners in designing tailored interventions.

Neural correlates of acute post-traumatic dissociation: a functional neuroimaging script-driven imagery study.

Current neurobiological models of post-traumatic stress disorder (PTSD) assume excessive medial frontal activation and hypoactivation of cortico-limbic regions as neural markers of post-traumatic dissociation. Script-driven imagery is an established experimental paradigm that is used to study acute dissociative reactions during trauma exposure. However, there is a scarcity of experimental research investigating neural markers of dissociation; findings from existing script-driven neuroimaging studies are inconsistent and based on small sample sizes. The current aim was to identify the neural correlates of acute post-traumatic dissociation by employing the script-driven imagery paradigm in combination with functional magnetic resonance imaging. Functional neuroimaging data was acquired in 51 female patients with PTSD with a history of interpersonal childhood trauma. Blood-oxygen-level-dependent response during the traumatic (versus neutral) autobiographical memory recall was analysed, and the derived activation clusters were correlated with dissociation measures. During trauma recall, enhanced activation in the cerebellum, occipital gyri, supramarginal gyrus and amygdala was identified. None of the derived clusters correlated significantly with dissociative symptoms, although patients reported increased levels of acute dissociation following the paradigm. The present study is one of the largest functional magnetic resonance imaging investigations of dissociative neural biomarkers in patients with PTSD undergoing experimentally induced trauma confrontation to elicit symptom-specific brain reactivity. In light of the current reproducibility crisis prominent in neuroimaging research owing to costly and time-consuming data acquisition, the current (null) findings highlight the difficulty of extracting reliable neurobiological biomarkers for complex subjective experiences such as dissociation.

Mindfulness in Survivors of Cumulative Childhood Interpersonal Trauma: a Buddhist Conceptualization of Suffering and Healing

Mindfulness in Survivors of Cumulative Childhood Interpersonal Trauma: a Buddhist Conceptualization of Suffering and Healing

Cumulative childhood interpersonal trauma and parenting stress: The role of self-capacities disturbances among couples welcoming a newborn

BackgroundThe birth of a child is a life-defining event which tends to widen the gap between parents' resources and the demands they face, generating parenting stress. In this regard, individuals who experienced childhood trauma, particularly cumulative childhood interpersonal trauma (CCIT), appear more vulnerable, with higher rates of parenting stress. However, dyadic studies are lacking and the mechanisms explaining the association between CCIT and parenting stress remain unknown, limiting the promotion of resilience in parental couples. ObjectiveBased on the Self-Trauma Model and the Actor-Partner Interdependence Model, this study examined the role of self-capacities disturbances (i.e., affect dysregulation, identity impairment and interpersonal conflicts) in the association uniting CCIT and parenting stress. Participants and settingsA randomly selected sample of 421 parental couples of an infant. MethodsParticipants completed self-reported measures online. ResultsPath analyses revealed that CCIT was associated to greater parenting stress through affect dysregulation and identity impairment, in both mothers and fathers (R2 = 22.4%; 20.7%). APIM modeling revealed a dyadic association between mothers' proneness to interpersonal conflicts and fathers' parenting stress, in addition to indirect effects involving all three self-capacities in the associations between one parent's CCIT and their partner's parenting stress. ConclusionsCCIT-exposed individuals may experience parenting stress through difficulties with self-capacities at the individual and dyadic level, highlighting these capacities as promising intervention targets during the postpartum period, and emphasizing the need to involve both parents since intricate dyadic patterns may be at play.

The role of attachment and dissociation in the relationship between childhood interpersonal trauma and negative symptoms in psychosis.

Negative symptoms have an adverse impact on quality of life and functioning in psychosis. Service users with psychosis have identified negative symptoms as a priority for their recovery. Despite this, there is a lack of effective and targeted psychological interventions for negative symptoms and their underlying mechanisms remain poorly understood. Childhood trauma is a robust risk factor for positive symptoms in psychosis, but the association with negative symptoms is less well established. Our aim was to examine the association between childhood interpersonal trauma and negative symptoms and the psychological mediators of this relationship. Two hundred and forty participants experiencing psychosis completed validated self-report measures of childhood trauma, attachment, dissociation, compartmentalization, and symptoms. Mediation analyses showed that disorganized attachment and dissociative experiences mediated the association between childhood trauma and negative symptoms, when analysed individually and in a combined model. Models adjusted for age and positive and depressive symptoms. Avoidant attachment and compartmentalization were independently associated with negative symptoms but not childhood trauma and thus were not significant mediators. Childhood trauma was not independently associated with negative symptoms. This paper is the first to present empirical data to support a model implicating attachment and dissociation as important psychological processes in the link between childhood trauma and negative symptoms. These exploratory findings suggest that it may be beneficial to consider these relationships in trauma-informed formulations and interventions. Further longitudinal research is required to establish causality and test theoretical models of mechanisms in the pathway to negative symptoms.

Childhood interpersonal trauma and paranoia in psychosis: The role of disorganised attachment and negative schema

Paranoia is associated with significant distress and is associated with childhood trauma. Understanding the mechanisms responsible for this association is important for informing psychological interventions. Theoretical proposals suggest that negative schema and insecure attachment may be important mechanisms in the development of paranoia. Disorganised attachment may be particularly relevant. The current study is the first to examine whether the relationship between childhood interpersonal trauma and paranoia is mediated by disorganised attachment, and the impact of disorganised attachment on negative self and negative other schema.A large online sample of 242 people with self-reported psychosis completed measures of childhood trauma, attachment, self and other schema, paranoia and psychosis symptomatology.Path analysis indicated that childhood interpersonal trauma was associated with disorganised attachment, which in turn was associated with negative self-schema, negative other schema, and paranoia. Negative schema about others, but not self, was associated with paranoia. Disorganised attachment and negative other schema fully mediated the relationship between trauma and paranoia. Negative other schema partially mediated the association between disorganised attachment and paranoia. Results were found when controlling for depression, hallucinations and age.Results suggest that interventions that aim to modify disorganised attachment patterns and negative schema about others can potentially alleviate the impact of trauma on paranoia. Findings provide justification for longitudinal studies to confirm the direction of effects, and intervention studies that aim to manipulate disorganised attachment and negative schema about others and observe the impact of this on paranoia.

Therapeutic alliance and childhood interpersonal trauma: The role of attachment, cultural humility, and therapeutic presence

AbstractThis study aimed to assess the role of insecure attachment style, cultural humility, and therapeutic presence in the development of therapeutic alliance in a sample of adults with a history of childhood interpersonal trauma (N = 251). Multiple regression analyses indicated that cultural humility, therapeutic presence, and lower levels of attachment anxiety together accounted for 66.6% of the variance in therapeutic alliance. Implications for counselors, limitations, and directions for future research are provided.

Interpersonal trauma and its relation to childhood psychopathic traits: what does ADHD and ODD add to the equation?

BackgroundChildhood trauma has demonstrated associations with callous-unemotional traits (e.g., reflecting lack of remorse and guilt, unconcern about own performance). Less is known about associations between trauma and multiple domains of child psychopathic traits. There has also been limited focus on the role of co-occurring disorders to psychopathy traits among children, namely, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and how they interact with childhood trauma.MethodsWe examined to what degree childhood interpersonal trauma can predict parent-rated psychopathic traits in a large population based Swedish twin sample (N = 5057), using a stringent definition of interpersonal trauma occurring before age 10. Two hundred and fifty-one participants met the interpersonal trauma criteria for analysis. The study explored the additional impact of traits of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).ResultsLinear regressions demonstrated statistically significant but clinically negligible effects of interpersonal trauma on total and subscale scores of parent-rated psychopathic traits. When exploring interaction effects of ADHD and ODD into the model, the effect increased. There were interaction effects between ODD and trauma in relation to psychopathic traits, suggesting a moderating role of ODD. Having been exposed to trauma before age 10 was significantly associated with higher parent rated psychopathy traits as measured by The Child Problematic Traits Inventory-Short Version (CPTI-SV), however the explained variance was small (0.3–0.9%).ConclusionsThe results challenge the notion of association between interpersonal trauma and youth psychopathic traits. They also highlight the need to gain an improved understanding of overlap between psychopathic traits, ADHD and ODD for clinical screening purposes and the underlying developmental mechanisms.

Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis.

To what extent psychotic symptoms in first-episode psychosis (FEP) with a history of childhood interpersonal trauma (CIT) are less responsive to antipsychotic medication is not known. In this longitudinal study, we compare symptom trajectories and remission over the first 2 years of treatment in FEP with and without CIT and examine if differences are linked to the use of antipsychotics. FEP (N = 191) were recruited from in- and outpatient services 1997-2000, and assessed at baseline, 3 months, 1 and 2 years. Inclusion criteria were 15-65 years, actively psychotic with a DSM-IV diagnosis of psychotic disorder and no previous adequate treatment for psychosis. Antipsychotic medication is reported as defined daily dosage (DDD). CIT (<18) was assessed with the Brief Betrayal Trauma Survey, and symptomatic remission based on scores from the Positive and Negative Syndrome Scale. CIT (n = 63, 33%) was not associated with symptomatic remission at 2 years follow-up (71% in remission, 14% in relapse), or time to first remission (CIT 12/ no-CIT 9 weeks, p = 0.51). Those with CIT had significantly more severe positive, depressive, and excited symptoms. FEP with physical (N = 39, 20%) or emotional abuse (N = 22, 14, 7%) had higher DDD at 1 year (p < 0.05). Mean DDD did not excerpt a significant between-group effect on symptom trajectories of positive symptoms. Results indicate that antipsychotic medication is equally beneficial in the achievement of symptomatic remission in FEP after 2 years independent of CIT. Still, FEP patients with CIT had more severe positive, depressive, and excited symptoms throughout.

Complex PTSD in Chinese Adolescents Exposed to Childhood Trauma: A Latent Profile Analysis.

Although numerous studies have supported the idea that complex posttraumatic stress disorder (CPTSD) is a distinct disorder from posttraumatic stress disorder (PTSD) and demonstrated that childhood interpersonal trauma is an important risk factor for CPTSD, few studies have examined the validity of CPTSD in adolescents, especially in non-Western contexts. Moreover, the question of which form of child maltreatment plays the most important role in predicting CPTSD, and how CPTSD is associated with psychological health, physical health, and social function among adolescents, is not clear. The present study used a Chinese high school student sample with childhood trauma experiences (N = 395) to address these questions. Latent profile analysis indicated that there were four subgroups in our sample: Low symptoms (54.43%), Disturbance of self-organization (DSO, 18.99%), PTSD (15.95%), and CPTSD (10.63%). Further analysis revealed that emotional abuse was an important risk factor for CPTSD. In addition, the CPTSD class showed the highest levels of depression, anxiety, and stress, as well as the lowest levels of life satisfaction and physical health. This study revealed that CPTSD is a distinct disorder from PTSD in Chinese adolescents exposed to childhood trauma. It provides evidence that emotional abuse might be an important risk factor for CPTSD, and demonstrates that CPTSD is accompanied by serious psychological and physical consequences in adolescents. We suggest that parents and educators should focus more on adolescents' emotional needs, avoid using negative ways such as verbal violence to express love, and pay more attention to adolescents' DSO symptoms in parenting, teaching practices and clinical interventions.

Stigma as a barrier to addressing childhood trauma in conversation with trauma survivors: A study in the general population.

Victims of childhood trauma report shame and anticipation of stigma, leading to non-disclosure and avoidance of help. Stigma is potentially aggravating the mental health consequences of childhood trauma. So far there is no comprehensive study examining stigma toward adult survivors of various forms of childhood trauma, and it is unclear whether stigma interferes with reaching out to affected individuals. In a vignette study based on a representative sample of the German general population (N = 1320; 47.7% male) we randomly allocated participants to brief case vignettes pertaining to past childhood sexual/physical abuse or accidents, and adult physical abuse. Stigma was elicited by applying the Social Distance Scale, assessing respondents' attitudes/stereotypes toward the persons in the vignette and their reluctance to address the specific trauma in conversation. While one aim was to establish the prevalence of stigma toward persons with CT, we hypothesized that attitudes differ according to type of trauma. Of the respondents, 45% indicated they were unlikely to reach out to a victim of childhood sexual abuse, 38% to a victim of childhood physical abuse, 31% to someone reporting a childhood accident and 25% to someone reporting adult physical abuse. Contrary to our expectations, childhood sexual abuse did not consistently elicit more stigma than childhood physical abuse in Krukall-Wallis tests. Equally, childhood interpersonal trauma did not consistently elicit more stigma than childhood accidental trauma. Structural equation modeling revealed social distance as mediator of the relationship between negative stereotypes and reluctance to address childhood trauma in conversation. Our analyses further revealed an ambiguous role of negative stereotypes in addressing childhood trauma in conversation with trauma victims, which has yet to be examined. There is evidence for stigma associated with having survived childhood trauma, which is interfering with offering help.

50.7 History of Interpersonal Trauma as a Risk Factor for Psychiatric Rehospitalization Among Children and Adolescents: A Narrative Review

Childhood and adolescent psychiatric rehospitalizations are prevalent and overtaxing for patients, their families, and healthcare systems and can in themselves be traumatic to all parties involved. Understanding their causes is crucial to reduce this burden. This narrative literature review investigates the growing evidence identifying history of interpersonal trauma—defined as a type of trauma that occurs between people by acts of commission or omission, such as abuse, neglect, and bullying—as a risk factor for psychiatric rehospitalization among children and adolescents. The literature review was conducted on PubMed with the following key terms: (childhood OR adolescent OR children) AND (readmission OR rehospitalization) AND ([(interpersonal OR mental OR psychiatric) AND trauma)] OR PTSD). Three independent reviewers screened for eligible studies that discussed interpersonal trauma and psychiatric rehospitalization risk in patients aged 0 to 18 years. PubMed queries yielded 63 records with the key terms. After 3 independent reviews, 4 eligible records were found. Among the 4 retrospective studies with sample sizes between 100 and 783, three studies reported that children and adolescents who experienced neglect, bullying, physical abuse, or sexual abuse had higher psychiatric rehospitalization rates than those without. The fourth study found no significant association between interpersonal trauma and psychiatric rehospitalization but stated that underreporting of childhood interpersonal trauma may attribute to this lack of significance. All 4 studies focused on diagnosis of PTSD to account for trauma, while some, but not all, took into consideration family structure, history of abuse, and further mental health diagnosis. Current literature is limited but supports the interpretation that interpersonal trauma history is a risk factor for psychiatric rehospitalization among children and adolescents. However, the degree to which various factors, such as age, number of traumas, and types of interpersonal trauma experienced, impact this relationship remains unknown. Therefore, further studies are warranted to explore and elaborate on such elements in this emerging association.

Intergenerational transmission of trauma from mother to infant: the mediating role of disrupted prenatal maternal representations of the child

ABSTRACT Data from a multi-method, longitudinal study involving a community sample (N = 120) of pregnant women aged 18–42 were used to examine disrupted maternal representations of the child as a mechanism of the transmission of trauma from mother to infant. Using structural equation modeling, the best fitting model indicated that severity of mothers’ childhood interpersonal trauma was associated with severity of disruption in prenatal representations of the child, which in turn was associated with less secure infant-mother attachment at 1 year of age. There was a significant indirect effect of maternal childhood interpersonal trauma on infant-mother attachment insecurity via disrupted prenatal maternal representations. Findings highlight an important mechanism of trauma transmission that could be targeted in interventions with mother-infant dyads.

Childhood interpersonal trauma and premorbid social adjustment as predictors of symptom remission in first episode psychosis

BackgroundChildhood interpersonal trauma (CIT) and premorbid adjustment are both associated with poor outcome in psychosis. In this study we investigate the relative impact of CIT and premorbid adjustment on symptom remission in first episode psychosis (FEP) over two years. MethodA total of 232 participants with FEP were recruited through the early detection program of the The early detection and Intervention in Psychosis (TIPS)-2 study and followed up after two years. Symptom remission was according to consensus criteria. CIT was assessed with the semi-structured interview Freyd Goldberg Brief Betrayal Trauma Survey, and premorbid adjustment with the Premorbid Adjustment Scale. Generalized estimating equations and multivariate models were used to analyze the associations between remission, symptom levels over time, CIT and premorbid adjustment; and a path analysis of mediation effects of CIT through premorbid adjustment on remission. ResultsIn this sample with 57% males and a mean age of 26.6 years (SD 10.2), a third of participants had experienced CIT. The participants with CIT had poorer premorbid adjustment compared to those without. Statistical analyses found independent effects of CIT and an interaction effect of CIT with premorbid adjustment on remission after two years, suggesting that CIT moderates the effect of premorbid adjustment. However contrary to expectations, premorbid adjustment did not mediate the effect of CIT. ConclusionOur findings indicate a complex interplay between effects of interpersonal trauma and premorbid social adjustment on remission in psychosis. CIT appeared to moderate the effect of premorbid adjustment such that individuals with CIT and who had poor social functioning in childhood are at greater risk of non-remission. Findings indicate that better premorbid social relations could provide a buffer for the effects of trauma on symptom course.

Interpersonal Trauma in the Lives of Nurses and Perceptions of Nursing Work.

The purpose of this study was to explore associations between trauma experiences among nurses and nursing perceptions of risk for involuntary job loss and standing in society. This observational study used 2001 data from the Nurses' Health Study II (N = 53,323 female nurses). The outcome variables were nurses' perceptions of their risk for involuntary job loss and their social standing in the United States and within their own community. The exposure variables were childhood and adulthood interpersonal trauma. Nurses reported high levels of emotional (60% childhood; 44% adulthood), physical (45% childhood, 23% adulthood), and sexual trauma (15% childhood, 11% adulthood). Emotional trauma was associated with perception of higher risk for involuntary job loss, but also higher perception of nurse societal standing. Nurses experience high rates of interpersonal trauma, which may influence how they perceive their profession.

Relationships Between Childhood Interpersonal Trauma, Religious Coping, Post-traumatic Stress Symptoms, and Resilience.

Positive and negative religious coping strategies have been linked to symptom trajectories following adult interpersonal trauma. However, the interactions between childhood interpersonal trauma, religious coping, and psychological outcomes are less clear. This study examined whether aspects of religious coping moderated the associations between cumulative childhood interpersonal trauma and mental health outcomes, such as post-traumatic stress symptoms (PTSS) and resilience. Participants included 525 undergraduates from two universities (Mage = 20.04, SD = 1.71; range = 18-24; 57.7% White; 82.1% female). In both the positive and negative religious coping models, cumulative childhood interpersonal trauma was related to PTSS (b = 6.66; b = 6.10, respectively). While positive religious coping was not associated with PTSS (b = .01), it was linked to resilience (b = .69). Negative religious coping was significantly related to PTSS (b = .75) but not resilience (b = -.20). No significant interactions were identified between aspects of religious coping and cumulative childhood interpersonal trauma. While religious coping was directly related to both positive and negative mental health outcomes, it may not be associated with the relationships between childhood interpersonal trauma exposure and clinical outcomes. Such findings offer valuable information on malleable factors that may contribute to adaptive and maladaptive functioning following childhood adversity.