Early Emotional Abuse Research Articles

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 Trauma and Suicide: The Mediating Effect of Stress and Sleep

This study aimed to investigate the relationship between suicide risk, perceived stress, and sleep quality through a structural equation modeling approach. This study used convenience sampling to survey 780 undergraduate and graduate students aged 18–30 years. Students were invited to participate in the online questionnaires, which included the Beck Scale for Suicide Ideation, the Suicidal Behaviors Questionnaire-Revised, the Perceived Stress Scale, the Childhood Trauma Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. The results showed that suicide ideation and suicidal behavior were positively correlated with childhood trauma, stress, and sleep. A well-fitted structural equation model (χ2 = 1.52, df = 1, χ2/df = 1.52, RMSEA = 0.03, CFI = 1.00, NFI = 1.00) was constructed in this study. The hierarchical regression test showed significance in all the path coefficients of the model. The total effect of emotional abuse on suicide behaviors was 49.5%. The mediating effects accounted for 73.7% of the total effects of emotional abuse on suicidal behaviors. The results demonstrate efforts targeting stress and poor sleep might mitigate the risk of suicidal behaviors among individuals with early emotional abuse experiences.

Psychological maltreatment and self-compassion - the mediating role of shame and perspective-taking

IntroductionPsychological maltreatment such as emotional abuse or neglect is a serious risk factor for poorer mental and somatic health outcomes in life. A higher rate of psychological maltreatment experienced in childhood is a predictor of aversive emotional states such as shame, and can negatively influence factors of mentalization such as perspective-taking capacity in adulthood. However, emotional abuse or neglect are also negative predictors of self-compassion.ObjectivesThe purpose of the study was to test two mediating models. We hypothesized, that reduced perspective-taking capacity, as well as higher levels of shame due to psychological maltreatment can be causally linked to lower levels of self-compassion.MethodsWe collected data from 120 healthy subjects (mean age=29.46, SD = 7.55) from Hungary We used Experience of Shame Scale, Interpersonal Reactivity Index, Childhood Trauma Scale, and the Self-Compassion Scale in our cross-sectional questionnaire study.ResultsPsychological maltreatment is a significant negative predictor of self-compassion (b=-0,712; p<0.05), and shame seems to play a mediating role in this relationship (effect size= 0.231; p<0.05). Psychological maltreatment was not a statistically significant predictor of perspective-taking.ConclusionsOur results highlight that shame has a central role between childhood traumatization and psychological well-being. In the case of early emotional maltreatment we have to focus on shame for higher levels of self-compassion and effective healing in psychotherapy.DisclosureNo significant relationships.

Mentalizing mediates the association between emotional abuse in childhood and potential for aggression in non-clinical adults

BackgroundEmotional abuse in childhood has been linked to a higher expression of aggressive behavior in adulthood. The identification of protective factors that mitigate this association is needed. Mentalizing—the capacity to understand behavior in terms of intentional mental states—appears to be a promising candidate factor that possibly modifies maladaptive consequences of early emotional abuse. ObjectiveThis study investigated associations between the history of emotional abuse, aggressive behavior in adulthood and mentalizing capacities in a non-clinical sample of adults. Methods214 healthy adults completed questionnaires measuring retrospectively rated experiences of emotional abuse in childhood, mentalizing capacities and aggressive behavior in a cross-sectional design. ResultsResults indicated associations between emotional abuse in childhood, uncertainty about mental states, and aggressive behavior in adulthood. Moreover, certainty about mental states counteracted the negative effect of emotional abuse and partially mediated the associations between emotional abuse and aggressive behavior in adulthood. ConclusionThis study extends current research and sheds further light on the relationship between emotional abuse in childhood, the health-promoting capacity of mentalizing, and aggressive behavior in non-clinical adults.

Building Resilience: The Invisible Childhood Emotional Neglect

Early Emotional Maltreatment (EEM) is a major risk factor for impairments in social functioning and mental health. EEM is one of the emotional neglects and it constitutes a major public health concern with devastating consequences to the individual and society as a whole. Based on this background the study adopted a qualitative approach and data was collected using unstructured interviews. The sample consisted participants from different social economic backgrounds aged between 10 to 46 years old. The study findings established that the emotional neglect occurs as parental rejection, feeling unloved, violence in the family, discrimination, emotionally unavailable parents, discovering the existence of a step family, separation/divorce just to mention a few. The EEM manifest in the individual’s daily life though unconsciously as anger outburst, resentment/hatred, bitterness, poor relations with the peers and parents, low self-confidence, cannot handle criticism, rebellion, poor academic performance, loneliness, mistrust, fear, feelings of inadequacy, drug and substance abuse and in extreme cases hopelessness, depression and suicidal tendencies. The study recommends empowerment of the children to accept themselves, express their thoughts and feelings, and create awareness among parents and caregivers to be responsive to children’s thoughts and feelings therefore promote holistic growth.

Linking childhood emotional abuse and adult depressive symptoms: The role of mentalizing incapacity

BackgroundAccumulated evidence suggests that childhood emotional abuse is particularly related to adulthood depression. However, this connection demands further explanation regarding potential intermediate factors. ObjectiveThis study aims to disentangle the independent effects of emotional abuse on adulthood depressive symptoms by statistically controlling for other forms of childhood maltreatment, and to examine mentalizing incapacity (i.e., hypermentalizing, hypomentalizing) as a potential mediator in this relationship. ParticipantsA general sample of 205 adults were assessed online. MethodParticipants completed a set of self-report measures assessing childhood maltreatment history, mentalizing and depression symptoms. Hierarchical multiple regression was employed to assess the independent effect of emotional abuse on depression. Bootstrap analysis was used to test mediation models. ResultsEmotional abuse continued to exert a significant effect on adulthood depression after controlling for other forms of childhood maltreatment and mentalizing incapacity. A mediation effect between childhood emotional abuse and adulthood depression symptoms via mentalizing incapacity, both hypermentalizing (b = 2.02, 95 % CI [0.96, 3.25]) and hypomentalizing, (b = 1.26, 95 % CI [0.59, 1.99]), was established. ConclusionsThis study provided preliminary evidence for hypermentalizing and hypomentalizing as mechanisms whereby early emotional abuse can lead to later depression. A normal to high level of mentalizing capacity might serve as a protective factor to suspend the pathway from childhood maltreatment to subsequent depression and become a promising target in psychological treatments. As cross-sectional data does not allow conclusions to be drawn on causal relationships, longitudinal data in a more representative sample is needed to capture relevant context and further examine our findings.

T3. METACOGNITIVE BELIEFS IN SEVERE MENTAL DISORDERS

BackgroundAffective dysregulation and psychotic experiences or symptoms often co-occur in the general population as well as in bipolar and psychotic disorders, suggesting a complex interplay. Early trauma is hypothesised to be important for the aetiology of both, and individuals with early traumatic experiences often develop disorders characterised by an admixture of affective and psychotic symptoms. Early emotional abuse seems to be particularly relevant for both disorders. Studies of common factors associated with affective dysregulation and psychosis in bipolar and psychotic disorders could help further theoretical understanding and tailor therapeutic interventions. Metacognitive beliefs – beliefs that outline the importance or consequence of thoughts – have been proposed as one possible common factor. Compared to healthy controls, patients with affective or psychotic disorders hold higher levels of metacognitive beliefs that could be maladaptive. Metacognitive beliefs have been linked to affective and/or psychotic diagnoses and symptoms in these disorders, and to early trauma in general. However, little is known about the specific relationships between symptoms of bipolar/psychotic disorders, early emotional abuse, and metacognitive beliefs.This project had three objectives: (1) to examine the prevalence of metacognitive beliefs in bipolar and psychotic disorders, compared to controls; (2) explore whether illness-related factors were linked to metacognitive beliefs; (3) examine if symptomatic responses (depression or positive symptoms) to early emotional abuse were mediated by metacognitive beliefs.MethodsPatients with a bipolar or psychotic disorder, and healthy controls, were included through the on-going Thematically Organised Psychosis (TOP) Study in Oslo, Norway. Analyses included t-tests for group comparisons, regression analyses, and regression based mediation pathway analyses where the indirect effects were tested with bootstrapped confidence intervals.ResultsPatients with bipolar or psychotic disorders reported higher levels of metacognitive beliefs compared to controls. Metacognitive beliefs were significantly related to depression for all patients. Higher levels of metacognitive beliefs were also related to illness-factors related to a poorer long-term outcome, specifically an earlier age at onset of affective disorder in bipolar disorders, and poorer premorbid social adjustment in psychotic disorders. Metacognitive beliefs significantly mediated the relationship between early emotional abuse and depression. The combination of metacognitive beliefs and depression significantly mediated the relationship between early emotional abuse and positive symptoms. The mediation models explained a moderate amount of the variance in symptoms (R2 = .21 and .29) compared to direct models of early emotional abuse impacting on symptomatic responses directly (R2 = .04 and .03)DiscussionOur results show that patients with bipolar or psychotic report higher levels of metacognitive beliefs compared to controls, and that such beliefs relate to current symptoms of depression in both patient groups. Our results also suggest that metacognitive beliefs relate to factors present before or at the onset of illness, which are often linked to a poorer long-term outcome in the disorders. Further, our findings suggest that in regards to early emotional abuse, metacognitive beliefs could play a role in an affective pathway to psychosis. Metacognitive beliefs could thus be relevant treatment targets in regards to depression and positive symptoms in bipolar and psychotic disorders.

Early Parental Abuse and Daily Assistance to Aging Parents With Disability: Associations With the Middle-Aged Adults' Daily Well-being.

The current study examined the within-person association between providing daily assistance to aging parents with disability and adult children's daily mood in the context of early relationship with parents. We used data from 782 participants and 5,758 daily interviews from the Midlife in the United States (MIDUS) Refresher, with 248 people self-reported providing daily assistance ranging from 1 to 8 days out of the entire daily-interview period. Multilevel models were fit to examine the moderating effect of physical and emotional abuse from parents in early life on the associations between daily assistance to parents today and yesterday and daily mood. Additional analyses were conducted to examine whether the moderating effect of parental abuse remained when the assistance was provided for other family members and friends. Providing assistance today and yesterday to parents had immediate and lagged associations with higher negative affect when adult children experienced childhood emotional abuse from parents. No significant findings were found for daily positive affect. The moderating effect of parental abuse became nonsignificant when the assistance was provided to other family members or friends. Daily assistance to parents with disability needs to be examined in the context of the relationship history with parents. The impact of childhood abuse can linger long after the actual incident. Frequent early emotional abuse from parents was associated with greater distress when the middle-aged provided daily assistance to their aging parents.

Metacognitive beliefs mediate the effect of emotional abuse on depressive and psychotic symptoms in severe mental disorders.

Early trauma is linked to higher symptom levels in bipolar and psychotic disorders, but the translating mechanisms are not well understood. This study examines whether the relationship between early emotional abuse and depressive symptoms is mediated by metacognitive beliefs about thoughts being uncontrollable/dangerous, and whether this pathway extends to influence positive symptoms. Patients (N = 261) with psychotic or bipolar disorders were assessed for early trauma experiences, metacognitive beliefs, and current depression/anxiety and positive symptoms. Mediation path analyses using ordinary least-squares regressions tested if the effect of early emotional abuse on depression/anxiety was mediated by metacognitive beliefs, and if the effect of early emotional abuse on positive symptoms was mediated by metacognitive beliefs and depression/anxiety. Metacognitive beliefs about thoughts being uncontrollable/dangerous significantly mediated the relationship between early emotional abuse and depression/anxiety. Metacognitive beliefs and depression/anxiety significantly mediated the relationship between early emotional abuse and positive symptoms. The models explained a moderate amount of the variance in symptoms (R 2 = 0.21-0.29). Our results indicate that early emotional abuse is relevant to depression/anxiety and positive symptoms in bipolar and psychotic disorders, and suggest that metacognitive beliefs could play a role in an affective pathway to psychosis. Metacognitive beliefs could be relevant treatment targets with regards to depression/anxiety and positive symptoms in bipolar and psychotic disorders.

Early maternal relational traumatic experiences and psychopathological symptoms: a longitudinal study on mother-infant and father-infant interactions.

Early maternal relational traumas and psychopathological risk can have an impact on mother-infant interactions. Research has suggested the study of fathers and of their psychological profiles as protection or risk factors. The aim of the paper is to assess the quality of parental interactions during feeding in families with mothers with early traumatic experiences. One hundred thirty-six (N = 136) families were recruited in gynecological clinics: Group A included families with mothers who experienced early sexual/physical abuse; Group B was composed of families with mothers who experienced early emotional abuse or neglect; and Group C comprised healthy controls. The subjects participated in a 10-month longitudinal protocol [at the fourth month of pregnancy (T0), 3 months after child birth (T1), and 6 months after child birth (T2)] that included an observation of mother-infant and father-infant interactions during feeding (Scala di Valutazione dell’Interazione Alimentare [SVIA]) and a self-reporting 90-item Symptom Checklist-Revised (SCL-90-R). Maternal higher rates of depression and early traumatic experiences of neglect and emotional abuse predicted more maladaptive scores on the affective state of the dyad SVIA subscale. Paternal anxiety predicted more severe levels of food refusal in the child during feeding.

Early trauma, negative affect, and anxious attachment: the role of metacognition

Background and Objectives: Metacognition is linked to the etiology and maintenance of negative emotions and psychological disorder in the Self-Regulatory Executive Function Model. Although there is significant evidence supporting the model, little is currently known about the situational factors for developing dysfunctional metacognitions. The current study explored the hypothesis that early aversive experiences might be important and also tested if metacognitions could mediate the relationship between such experiences and psychological symptoms. Design and Methods: Three hundred and fifty non-clinical adults completed a retrospective early trauma measure, as well as measures of current metacognitive beliefs, negative affect, and anxious attachment. Results: Early emotional abuse positively and significantly correlated with several metacognitive belief dimensions but other forms of early trauma did not. Metacognition fully mediated the relationship between emotional abuse and negative affect. Anxious attachment was also positively and significantly associated with metacognitive beliefs and specific relationships remained after controlling for early emotional abuse and current negative affect. Conclusions: Findings are consistent with the ideas that: (i) early negative experiences, and emotional abuse in particular, could be a factor in the formation of problematic metacognitions and (ii) these metacognitions may be important in determining the effects of abuse on subsequent psychological symptoms.

Salivary oxytocin mediates the association between emotional maltreatment and responses to emotional infant faces

Childhood emotional maltreatment has been associated with a higher risk for maltreating one's own offspring. In the current study, we explored a possible role of oxytocin in mediating the association between childhood emotional maltreatment and participants' interpretation of infant facial expressions. Oxytocin levels were measured in 102 female participants using saliva samples. They rated the mood of thirteen infants with happy, sad and neutral facial expressions. Emotional maltreatment indirectly influenced responses to happy infant faces by modulating oxytocin levels: higher self-reported emotional maltreatment was related to higher levels of salivary oxytocin which were in turn related to a more positive evaluation of happy infant expressions, but not to the evaluation of sad infant expressions. Oxytocin receptor polymorphism rs53576 did not moderate the relation between maltreatment experiences and salivary oxytocin levels. Early emotional maltreatment might indirectly affect emotional information processing by altering the oxytonergic system.

Initial evidence for sex-specific effects of early emotional abuse on affective processing in bipolar disorder

PurposeThis study investigates the effect of sex and childhood trauma on affective processing in bipolar disorder (BPD) patients. MethodsIn a sample of fifty-six BPD patients, we administered the Childhood Trauma Questionnaire (CTQ), and the Iowa Gambling Task (IGT) and the Affective Go/No-Go (AGNG) to measure affective processing. Analysis of Variance (ANOVA) was used to evaluate the effect of sex and childhood trauma on IGT; Repeated-Measures ANOVAs to measure accuracy and bias measures across conditions on the AGNG. ResultsIn the context of childhood abuse, females evidenced a more conservative cognitive style than males by selecting fewer cards from the disadvantageous decks [F(1, 49)=14.218; P<0.001] and showed an improvement throughout the task, as noted in a normal learning curve [F(1.49)=4.385; P=0.041)]. For the AGNG, an interaction specific to the negative valence stimuli on response bias measures was found. Abused females scored higher (mean=8.38; SD=6.39) than abused males (mean=0.69; SD=1.19) [F(1.46)=6.348; P=0.015]. ConclusionSeverity of childhood trauma was significantly different between sexes. In the context of a history of emotional abuse, male bipolar patients tended toward a more risk-taking behavior compared to female. Further investigations are needed to elucidate potential pathophysiological mechanisms underlying this interaction.

Stressful Life Events and Depression Symptoms: The Effect of Childhood Emotional Abuse on Stress Reactivity

Stressful life events are associated with an increase in depressive symptoms and the onset of major depression. Importantly, research has shown that the role of stress changes over the course of depression. The present study extends the current literature by examining the effects of early life stress on emotional reactivity to current stressors. In a multiwave study (N = 281, mean age = 18.76; 68% female), we investigated the proximal changes that occur in depressive symptoms when individuals are faced with life stress and whether a history of childhood emotional abuse moderates this relationship. Results support the stress sensitivity hypothesis for early emotional abuse history. Individuals with greater childhood emotional abuse severity experienced greater increases in depressive symptoms when confronted with current dependent stressors, controlling for childhood physical and sexual abuse. This study highlights the importance of emotional abuse as an indicator for reactivity to stressful life events.

Early maladaptive schemas in Finnish adult chronic pain patients and a control sample

Engel (1959) suggested that negative physical or emotional experiences in childhood predispose to the development of chronic pain. Studies have shown that physical and sexual abuse in early life is connected with chronic pain. Emotional adversities are much less studied causes contributing to the development of chronic pain and disability. Early emotional abuse, neglect, maltreatment and other adversities are deleterious childhood experiences which, according to Young's schema theory (1990), produce early maladaptive schemas (EMSs). The primary goal of this study was to examine whether early adversities were more common in chronic pain patients than in a control group. A total of 271 (53% women) first-visit chronic pain patients and 331 (86% women) control participants took part in the study. Their socio-demographic data, pain variables and pain disability were measured. To estimate EMSs the Young Schema Questionnaire was used. Chronic pain patients scored higher EMSs reflecting incapacity to perform independently, catastrophic beliefs and pessimism. The most severely disabled chronic pain patients showed an increase in all the EMSs in the Disconnection and Rejection schema domain, namely Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, Defectiveness/Shame and Social Isolation/Alienation EMSs. The results of the study suggested that chronic pain patients had suffered early emotional maltreatment.

Early maladaptive schemas in Finnish adult chronic male and female pain patients

Background and aims of the study The connection between chronic pain and traumatic experiences in childhood has been established in several studies. The association of emotional maltreatment with chronic pain has been studied, but to a lesser degree. Schema therapy [24] is an extension of cognitive therapy and presents the early maladaptive schema (EMS) concept. EMSs reflect early, mainly emotional maltreatment. The aim of the present study was to examine the existence of EMSs, the association between EMSs and pain variables and EMS driven patterns. Patients and measures The study consisted of 271 first visit pain patients. Their socio-demographic data, pain variables and pain disability were assessed. The presence of EMSs was measured using the Young Schema Questionnaire Short Form Extended. One hundred and three successive participants were also interviewed according to the cognitive case conceptualization. Results More than half (58.3%) of the chronic pain patients scored EMSs as meaningful. The patients with meaningful EMSs had significantly higher pain intensity, duration of pain and pain disability. The two most frequently occurring EMSs in male pain patients were Unrelenting Standards/Hypercriticalness (US) (36.2%) and Self-Sacrifice (SS) (23.6%) and in female pain patients SS (40.3%) and US (27.1%). The speech contents of five of the highest scoring US and SS male and female patients ( n = 20) were analyzed. The analyses showed schema driven behavior which exacerbated the pain situation. US and SS schemas had a stronger motivational effect on their behavior than the pain itself. Regression analyses showed that Self-Sacrifice schema in women and Emotional Deprivation schema in the total sample predicted pain disability as did pain intensity and the number of pain locations. Conclusions This study suggested that a remarkable amount of chronic pain patients may suffer from early maladaptive schemas which have an effect on their current pain situation and may reflect underlying early emotional maltreatment.

Childhood Emotional Abuse, Adult Attachment, and Depression as Predictors of Relational Adjustment and Psychological Aggression

This study examined the theoretically expected contributions of early emotional abuse, adult attachment, and depression to several aspects of romantic relationship functioning. College students in dating relationships (N = 285) completed an online survey, including measures of childhood emotional maltreatment, adult attachment style, psychological distress, and romantic relationships. Results indicated that childhood emotional maltreatment directly predicted insecure adult attachment. In the full models, emotional maltreatment contributed to dyadic adjustment, but was not a significant predictor of psychological aggression or victimization. In contrast, depression accounted for the largest proportion of variance in the models for reported psychological aggression and victimization, but was nonsignificant for dyadic adjustment. Adult attachment style emerged as an important predictor of all 3 relationship constructs.

Childhood Emotional Abuse and the Attachment System Across the Life Cycle: What Theory and Research Tell Us

The purpose of this article is to review the theoretical and empirical literature regarding the normative development of the attachment system from infancy through adulthood, and then discuss deviations from the normal developmental pathways that occur in response to emotionally abusive parenting (e.g., strong rejection, intrusive or controlling, hostile, or frightening behavior). A theoretical model grounded in attachment theory is presented describing the development of maladaptive interaction patterns in adult romantic relationships. The model proposes that early emotional abuse engenders insecure attachment, which impairs emotional regulation, fosters negative views of self and others that support maladaptive coping responses, interferes with social functioning and the capacity for intimate adult attachments, contributes to poor mental health, and consequently shapes the quality of romantic relationships.