Child abuse and negative explicit and automatic self-associations: The cognitive scars of emotional maltreatment

Linear and curvilinear association of pain tolerance and social anxiety symptoms among youth with different subgroups of childhood trauma

BACKGROUND

Social anxiety is a common symptom that occurs after exposure to childhood trauma (CT), and pain tolerance is a protective factor against social anxiety in generic populations with CT. However, few studies have investigated whether and how this association varies across different CT subgroups. Thus, this study aimed to investigate (1) the effects of pain tolerance on social anxiety symptoms among youth with different subgroups of CT; (2) the nonlinear relationship between pain tolerance and social anxiety symptoms among different CT categories.

METHODS

In this study, 15,682 college or university students with experiences of CT were identified in a large sample and divided into five CT subgroups. Linear and quadratic regression models were conducted to explore the association between pain tolerance and social anxiety symptoms among youth with different CT subgroups.

RESULTS

The results of model revealed a linear relationship between pain tolerance and social anxiety symptoms among youth with most CT subgroups. Notably, an inverted U-shaped curve was found between pain tolerance and social anxiety symptoms in youth with emotional abuse. Social anxiety symptoms increased gradually with pain tolerance scores between 0 and 16, and then sharply decreased when scores reached above 16.

LIMITATIONS

Limited by self-report measurements, the results of this study focused only on perceived pain tolerance and ignored behavioral pain tolerance.

CONCLUSION

These findings highlight the importance of assessing pain tolerance thresholds in youth with emotional abuse and improving pain tolerance to prevent social anxiety symptoms in youth with different subgroups of CT.

The role of explicit and implicit self-esteem in the relationship between childhood trauma and adult depression and anxiety

BACKGROUND

Self-esteem is an important psychological concept that can be measured explicitly (reflective processing) and implicitly (associative processing). The current study examined 1) the association between childhood trauma (CT) and both explicit and implicit self-esteem, and 2) whether self-esteem mediated the association between CT and depression/anxiety.

METHODS

In 1479 adult participants of the Netherlands Study of Depression and Anxiety, CT was assessed with a semi-structured interview, depression/anxiety symptoms with self-report questionnaires and explicit and implicit self-esteem with the Rosenberg Self-Esteem Scale and Implicit Association Test, respectively. ANOVAs and regression analyses determined the association between CT (no/mild/severe CT), its subtypes (abuse/neglect) and self-esteem. Finally, we examined whether self-esteem mediated the relationship between CT and depression/anxiety.

RESULTS

Participants with CT reported lower explicit (but not lower implicit) self-esteem compared to those without CT (p < .001, partial η2 = 0.06). All CT types were associated with lower explicit self-esteem (p = .05 for sexual abuse, p < .001 for other CT types), while only emotional neglect significantly associated with lower implicit self-esteem after adjusting for sociodemographic characteristics (p = .03). Explicit self-esteem mediated the relationship between CT and depression/anxiety symptoms (proportion mediated = 48-77 %).

LIMITATIONS

The cross-sectional design precludes from drawing firm conclusions about the direction of the proposed relationships.

CONCLUSIONS

Our results suggested that the relationship between CT and depression/anxiety symptoms can at least partly be explained by explicit self-esteem. This is of clinical relevance as it points to explicit self-esteem as a potential relevant treatment target for people with CT.

Emotional abuse mediated by negative automatic thoughts impacts functional connectivity during adolescence

Background

Emotional abuse during childhood and adolescence is thought to be associated with the brain; however, the neural mechanism underlying the cognitive process remains unknown. Therefore, we aimed to investigate the mediating effect of negative automatic thoughts on the relationship between emotional abuse and resting-state functional connectivity (rsFC) during adolescence.

Method

Our community sample included 54 adolescents aged 13-17 years in the statistical analysis. Resting-state functional and structural magnetic resonance imaging (MRI) was performed, while emotional abuse and negative automatic thoughts were assessed using self-reported scales. A mediation analysis was used to assess the contributions of early traumatic events and negative automatic thoughts to resting functional connectivity.

Result

Higher negative automatic thoughts were associated with lower connectivity in the context of greater emotional abuse (i.e., suppression effect). Thus, the relationships between emotional abuse and connectivity in the precuneus (pCun)-medial prefrontal cortex, parahippocampal cortex-extrastriate cortex, and temporal cortex-temporal pole were decreased by negative automatic thoughts. In contrast, functional connections in the pCun-pCun, pCun-precuneus/posterior cingulate cortex, and nucleus accumbens-somatomotor areas were strongly mediated when emotionally abused adolescents reported a high tendency for negative automatic thoughts.

Conclusion

Negative automatic thoughts strengthened the relationship between emotional abuse and rsFC. These findings highlight the underlying cognitive processing of the traumatic event-neural system, supporting the use of cognitive therapy for post-traumatic symptoms.

Day-to-day affect fluctuations in adults with childhood trauma history: a two-week ecological momentary assessment study

BACKGROUND

Childhood trauma (CT) may increase vulnerability to psychopathology through affective dysregulation (greater variability, autocorrelation, and instability of emotional symptoms). However, CT associations with dynamic affect fluctuations while considering differences in mean affect levels across CT status have been understudied.

METHODS

346 adults (age = 49.25 ± 12.55, 67.0% female) from the Netherlands Study of Depression and Anxiety participated in ecological momentary assessment. Positive and negative affect (PA, NA) were measured five times per day for two weeks by electronic diaries. Retrospectively-reported CT included emotional neglect and emotional/physical/sexual abuse. Linear regressions determined associations between CT and affect fluctuations, controlling for age, sex, education, and mean affect levels.

RESULTS

Compared to those without CT, individuals with CT reported significantly lower mean PA levels (Cohen's d = -0.620) and higher mean NA levels (d = 0.556) throughout the two weeks. CT was linked to significantly greater PA variability (d = 0.336), NA variability (d = 0.353), and NA autocorrelation (d = 0.308), with strongest effects for individuals reporting higher CT scores. However, these effects were entirely explained by differences in mean affect levels between the CT groups. Findings suggested consistency of results in adults with and without lifetime depressive/anxiety disorders and across CT types, with sexual abuse showing the smallest effects.

CONCLUSIONS

Individuals with CT show greater affective dysregulation during the two-week monitoring of emotional symptoms, likely due to their consistently lower PA and higher NA levels. It is essential to consider mean affect level when interpreting the impact of CT on affect dynamics.

Emotion-Focused Psychodynamic Interview for People with Chronic Musculoskeletal Pain and Childhood Adversity: A Randomized Controlled Trial

Childhood adversity and emotional conflicts are associated with the presence and severity of chronic musculoskeletal pain (CMP), yet common treatments for CMP do not address such risk factors. We developed a single session, emotion-focused psychodynamic interview, based on Emotional Awareness and Expression Therapy and Intensive Short-term Psychodynamic Therapy, and we tested the interview's effects on pain-related outcomes and potential psychological mediators in a randomized, controlled trial. Adults (N = 91; ages 21-70, M = 44.64; 87.9% women) reporting CMP and at least 3 adverse childhood experiences completed measures at baseline and 6-week follow-up. Participants were randomized to immediate interview or waitlist control conditions. The 90-minute interview was conducted via videoconference, and the interviewer elicited disclosure of adversities and conflicts, linked these with pain, and encouraged the experience and expression of adaptive emotions. Analyses indicated that conditions did not differ significantly on change in pain severity; however, compared to control, the interview led to a significantly greater reduction in pain interference (P = .016, ηp2 = .05) and a similar trend for anxiety (P = .058, ηp2 = .04). The interview also significantly changed several potential mediators: pain-related anxiety (P = .008, ηp2 = .06), pain controllability (P = .016, ηp2 = .06), and psychological (P < .001, ηp2 = .15) and brain attributions (P = .022, ηp2 = .05) for pain. Participants viewed the interview as very valuable. We conclude that addressing childhood adversities and conflicts in a psychodynamic interview is beneficial for people with CMP. PERSPECTIVE: This study found that, compared to waitlist control, a 90-minute, remotely-administered, emotion-focused, psychodynamic interview improved pain interference, and anxiety among adults with chronic musculoskeletal pain and childhood adversity. Intensive emotional work can be done in a single session to the benefit of patients with chronic musculoskeletal pain.

A Meta-Analytic Review of the Impact of Child Maltreatment on Self-Esteem: 1981 to 2021

An increasing number of studies have examined the relationship between child maltreatment and self-esteem. In this study, we assess the magnitude of this association through a meta-analytic approach. Four English databases (PubMed, PsycINFO, PsycARTICLES, and Web of Science), three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu), and grey literature were systematically searched. A total of 254 independent studies, including 550 effect sizes, met the inclusion criteria for this meta-analysis. Child maltreatment was significantly and negatively associated with self-esteem (P C C ¯  = -0.24, p < .001); emotional abuse and neglect were associated with decreased self-esteem (P C C ¯  = -0.23, p < .01; P C C ¯  = -0.22, p < .01, respectively) at a moderate level; and physical abuse, sexual abuse, and physical neglect were negatively associated with self-esteem (P C C ¯  = -0.14, p < .01; P C C ¯  = -0.14, p < .01; P C C ¯  = -0.17, p < .001, respectively) at a small level. Furthermore, the meta-regression results suggested that the aggregated associations between child maltreatment and self-esteem were not inflated by publication bias, but they were moderated by age and culture. General and subtypes of child maltreatment are associated with decreased self-esteem. Evidence-based and culturally sensitive child maltreatment prevention and intervention programs should be developed and implemented as early as possible.

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.

The influence of childhood emotional maltreatment on cognitive symptoms, rumination, and hopelessness in adulthood depression

Childhood emotional maltreatment (CEM) is a risk factor for the pathogenesis of depressive disorders. However, it is not clear whether CEM is more strongly related to specific symptoms of depression and whether specific traits or cognitive states may mediate the association between CEM and depressive symptoms. In our cross-sectional study, including 72 patients with a current depressive episode, we investigated if CEM is specifically related to cognitive symptoms of depression. In addition, we evaluated whether CEM also influences the extent of rumination and hopelessness in adult depression. Using multiple regression analyses, we tested if CEM and rumination could predict cognitive symptoms and hopelessness. A structural equation model (SEM) was used to examine if rumination mediates the relationship between CEM and cognitive symptoms. Correlational analyses revealed that CEM was related to cognitive symptoms, rumination, and hopelessness. The regression analyses showed that only rumination was a significant predictor for cognitive symptoms and hopelessness, whereas CEM could not significantly predict the two constructs. SEM revealed that the association between CEM and cognitive symptoms in adult depression was mediated by rumination. Our results thereby suggest that CEM is a risk factor particularly for the development of cognitive symptoms as well as rumination and hopelessness in adult depression. However, the influence on cognitive symptomatology seems to be indirectly regulated by rumination. These findings may contribute to a better understanding of processes that promote depression, as well as provide guidance for more targeted treatment options.

Gender-specific associations between types of childhood maltreatment and major depressive disorder: A matched case-control study

INTRODUCTION

Major depressive disorder (MDD) has been found to be nearly twice as prevalent in females as in males. One hypothesis proposed that abused females were particularly prone to MDD. We aim to examine the sex-specific associations between various types of childhood trauma and MDD.

METHODS

In this study, 290 outpatients diagnosed with MDD were recruited from Beijing Anding Hospital, and 290 healthy volunteers were recruited from neighborhoods nearby the hospital, with sex, age, and family history matched. Childhood Trauma Questionnaire-Short Form (CTQ-SF) developed by Bernstein et al. was used to assess the severity of five different types of childhood abuse and neglect. McNemar's test and conditional logistic regression models with potential confounders (i.e., marital status, educational level, and body mass index) controlled were used to explore the sex-specific associations between different types of childhood maltreatment and MDD.

RESULTS

In the full sample, patients with MDD showed a significant higher rate of any childhood maltreatment (i.e., emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect). Among females, all types of childhood abuse were statistically significant. For males, significant differences were only found in emotional abuse and in emotional neglect.

CONCLUSION

It would appear that MDD in the outpatients is associated with any type of childhood trauma in women and emotional abuse or neglect in men.

Child abuse and wellbeing: Examining the roles of self-compassion and fear of self

INTRODUCTION

Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and sequelae of abuse supporting gender-specific analyses. To assist in circumventing poor outcomes associated with child abuse, this study examined fear of self (FoS) and self-compassion (SC) as risk and protective factors between child abuse and well-being.

METHOD

Australian women (N = 1302, M_age = 47.28 [13.63]) completed an online assessment of childhood abuse, psychological distress, perceived quality of life, SC, FoS. Moderated-moderation examined the different abuses as predictors of psychological distress and quality of life (QoL) and FoS and SC as primary and secondary moderators, respectively.

RESULTS

Physical abuse did not predict psychological distress or QoL. FoS and SC were independent predictors of distress and QoL. Similarly, childhood sexual abuse was not found to predict distress or QoL. FoS and SC were independent predictors of distress and QoL. There was also an interaction between childhood sexual abuse and SC in predicting QoL. A moderated-moderation was found for the relationship between child sexual abuse and distress. Psychological abuse predicted distress and QoL, and FoS and SC both moderated this relationship. Moreover, a moderated-moderation was observed for the relationship between psychological abuse and QoL.

CONCLUSIONS

Greater FoS is associated with poorer outcomes for child abuse survivors; SC may mitigate this impact. Psychological abuse was the strongest predictor of well-being. Interventions that increase SC and raise awareness of psychological abuse and its impacts are needed.

Effects of Childhood Maltreatment on Self-Compassion: A Systematic Review and Meta-Analysis

BACKGROUND

This systematic review aims to estimate the extent to which childhood maltreatment influences self-compassion in later life.

METHOD

Four English databases (Web of Science, PsycINFO, PubMed, and PsycARTICLES) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu) were systematically searched. We extracted data related to the associations between child maltreatment and self-compassion and pooled them using random effect models.

FINDINGS

A total of 20 eligible studies were included involving 6,877 participants in the analyses. Overall child maltreatment was negatively related to self-compassion (r = -.28, p < .001); emotional abuse and neglect were negatively related to self-compassion (r = -.28, p < .01; r = -.31, p < .01, respectively) at a moderate level; and physical abuse, sexual abuse, and physical neglect were negatively related to self-compassion (r = -.12, p < .01; r = -.10, p < .01; and r = -.22, p < .001, respectively) at a small level.

CONCLUSION

The results indicate that overall and subtypes of maltreatment are associated with decreased self-compassion, and child intervention programs focused on self-compassion should be designed to protect the well-being of individuals with a history of childhood maltreatment.

Association between the behavioral response during social exclusion and recalled childhood maltreatment

Social exclusion is a critical event for mental health. Patients with interpersonal dysfunction, e.g., with borderline personality disorder (BPD) or persistent depressive disorder (PDD), are particularly vulnerable, often based on their experiences of early adversity in life. The etiological pathways from childhood maltreatment (CM) to current behavior during social exclusion are still underexplored. This cross-diagnostic study investigated the relationship between self-reported CM and behavioral reaction to social exclusion in an experimental paradigm (Cyberball). Data from 140 subjects including patients with BPD and PDD as well as healthy controls were analyzed. The effect of CM (Childhood Trauma Questionnaire, CTQ) on behavior to social exclusion during Cyberball (ball tossing behavior) was analyzed including rejection sensitivity (RS) as a mediator. In the whole sample, the CTQ score (B = -.004, p < .05) as well as the emotional neglect subscore (B = -.016, p < .01) were associated with a reduced ball tossing behavior towards the excluder. There were no significant indirect effects involving RS. These current findings support the relationship between CM and an altered interpersonal response in critical interpersonal situations. Larger cohorts with multidimensional data in social domains are warranted to further investigate the link between CM and current interpersonal dysfunction.

Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample

BACKGROUND

While the psychopathological sequalae of childhood maltreatment are widely acknowledged, less is known about the underlying pathways by which childhood maltreatment might lead to an increased risk for mental health problems. Recent studies indicated that impaired personality functioning might mediate this relationship. The aim of the present paper was to extend the current literature by investigating the mediating effect of impaired personality functioning between different types of childhood maltreatment and self-reported mental health problems in a high-risk sample.

METHODS

Overall, 173 young adults (mean age = of 26.61 years; SD = 3.27) with a history of residential child welfare and juvenile justice placements in Switzerland were included in the current study. The Childhood Trauma Questionnaire (CTQ-SF), Semi-structured Interview for Personality Functioning DSM-5 (STiP-5.1) and the self-report questionnaires of the Achenbach System of Empirically Based Assessment scales (ASEBA) were used. Mediation analyses were conducted through structural equation modeling.

RESULTS

Overall, 76.3% (N = 132) participants indicated at least one type of childhood maltreatment, with emotional neglect being most commonly reported (60.7%). A total of 30.6% (N = 53) participants self-reported mental health problems. Emotional abuse (r = 0.34; p < .001) and neglect (r = 0.28; p < .001) were found to be most strongly associated with mental health problems. In addition, impaired personality functioning was fond to be a significant mediator for overall childhood maltreatment (β = 0.089; p = 0.008) and emotional neglect (β = 0.077; p = 0.016). Finally, impaired self-functioning was found to be a significant mediator when both self-functioning and interpersonal functioning were included as potential mediators in the relationship between overall childhood maltreatment (β1 = 0.177, p1 = 0.007) and emotional neglect (β1 = 0.173, p1 = 0.003).

CONCLUSION

Emotional neglect may be particularly important in the context of childhood maltreatment, personality functioning, and mental health problems and, therefore, should not be overlooked next to the more "obvious" forms of childhood maltreatment. Combining interventions designed for personality functioning with trauma-informed practices in standard mental health services might counteract the psychopathological outcomes of maltreated children and adolescents.

Harsh and Inconsistent Parental Discipline Is Associated With Altered Cortical Development in Children

BACKGROUND

A growing body of evidence suggests that parenting behaviors may affect child mental health via altering brain development. There is a scarcity of research, however, that has investigated associations between parenting behavior and brain structure using longitudinal magnetic resonance imaging. This study aimed to investigate associations between parenting behaviors and structural brain development across the transition from childhood to adolescence.

METHODS

Participants were 246 children who provided 436 magnetic resonance imaging datasets covering the age range from 8 to 13 years. Parents (94% mothers) completed self-report measures of parenting behavior, and both children and parents reported on child mental health. Factor analysis was used to identify dimensions of parental behavior. Linear mixed-effects models investigated associations between parenting behaviors and age-related change in cortical thickness and surface area and subcortical volume. Mediation models tested whether brain changes mediated associations between parenting behaviors and changes in internalizing/externalizing symptoms.

RESULTS

Hypothesized associations between parenting and amygdala, hippocampal, and frontal trajectories were not supported. Rather, higher levels of parent harsh/inconsistent discipline were associated with decreases in surface area in medial parietal and temporal pole regions and reduced cortical thinning in medial parietal regions. Some effects were present in female but not male children. There were no associations between these neurodevelopmental alterations and symptoms.

CONCLUSIONS

This study provides insight into the links between parenting behavior and child neurodevelopment. Given the functions of implicated regions, findings may suggest that parental harsh/inconsistent discipline affects the development of neural circuits subserving sensorimotor and social functioning in children.

Child Neglect and Life Satisfaction among Left-behind Children in Rural China: The Roles of Self-compassion and Gratitude

Child neglect is a social problem that causes great concern and affects the long-term well-being of left-behind rural Chinese children against the backdrop of their parents having to leave them in the care of others for extended periods while they have to go and work in cities. However, previous studies have disproportionally focused on the negative processes through which child neglect may influence their life satisfaction. Guided by positive psychology, this study examined the role of self-compassion and gratitude on the association between child neglect and life satisfaction. Our research questionnaire Likert survey used a sample of 1,091 left-behind children and 754 non left-behind children from Shanxi Province and Hunan Province. The results indicated that left-behind children reported a higher level of child neglect, and that child neglect was negatively associated with left-behind children's life satisfaction through decreased self-compassion and gratitude. The implications of these findings are that policy measures and interventions that focus on increasing the self-compassion and gratitude of neglected left-behind children may have a positive effect on their life satisfaction.

Childhood trauma and its impact on depressive and anxiety symptomatology in adulthood: A 6-year longitudinal study

BACKGROUND

Childhood trauma (CT) is a risk factor for depressive and anxiety disorders. However, whether CT is more strongly linked to specific clinical features of these disorders remains inconclusive. The current study comprehensively examined cross-sectional and longitudinal associations between CT and depressive/anxiety symptomatology in a large adult sample with current and remitted depressive and/or anxiety disorders.

METHODS

Baseline (n = 1803), 2-year (n = 1735), 4-year (n = 1585), and 6-year follow-up (n = 1475) data from the Netherlands Study of Depression and Anxiety were used. CT (emotional neglect, emotional/physical/sexual abuse) was assessed at baseline, while depressive/anxiety symptomatology with relevant dimensions (e.g., mood/cognitive, melancholic, general distress, and somatic depression) was assessed at each wave using self-reported questionnaires. Linear regressions and linear mixed models determined cross-sectional and longitudinal associations.

RESULTS

Individuals with CT, especially, severe CT, compared to those without CT, had significantly higher scores in overall depressive symptomatology (Cohen's d = 0.674), mood/cognitive depression (d = 0.691), melancholic depression (d = 0.587), general distress (d = 0.561), and somatic depression severity (d = 0.549). Differences were lower, but still highly significant for anxiety (d = 0.418), worry (d = 0.362), and fear/phobic symptomatology (d = 0.359). Effects were consistent across CT types and maintained over six years.

LIMITATIONS

Retrospectively-reported CT.

CONCLUSIONS

CT is a risk factor for depressive and anxiety symptomatology across all dimensions and enduring over multiple years. Screening for CT is essential to identify individuals at risk for more severe and chronic manifestations of affective disorders.

Effects of maltreatment during childhood on benign and malicious envy in adulthood: Psychological resilience as a moderator

We explored the effect of two forms of maltreatment of children (emotional and physical) on two kinds of envy in adulthood (benign and malicious), and the moderating role of psychological resilience in these associations. Participants were 676 Chinese undergraduates who completed the Childhood Trauma Questionnaire, the Benign and Malicious Envy Scale, and the Connor-Davidson Resilience Scale. The results indicate that of the two types of childhood maltreatment, only emotional maltreatment negatively predicted benign envy and positively predicted malicious envy. Psychological resilience played a moderating role in the childhood emotional maltreatment–benign/malicious envy link and childhood physical maltreatment–malicious envy link. These results reveal the direct relationships between different types of childhood maltreatment and benign/malicious envy and the moderating effect of psychological resilience in these associations. Our findings have theoretical and practical implications for cultivating psychological resilience to inhibit malicious envy and promote benign envy in adults.

Glia-Driven Brain Circuit Refinement Is Altered by Early-Life Adversity: Behavioral Outcomes

Early-life adversity (ELA), often clinically referred to as "adverse childhood experiences (ACE)," is the exposure to stress-inducing events in childhood that can result in poor health outcomes. ELA negatively affects neurodevelopment in children and adolescents resulting in several behavioral deficits and increasing the risk of developing a myriad of neuropsychiatric disorders later in life. The neurobiological mechanisms by which ELA alters neurodevelopment in childhood have been the focus of numerous reviews. However, a comprehensive review of the mechanisms affecting adolescent neurodevelopment (i.e., synaptic pruning and myelination) is lacking. Synaptic pruning and myelination are glia-driven processes that are imperative for brain circuit refinement during the transition from adolescence to adulthood. Failure to optimize brain circuitry between key brain structures involved in learning and memory, such as the hippocampus and prefrontal cortex, leads to the emergence of maladaptive behaviors including increased anxiety or reduced executive function. As such, we review preclinical and clinical literature to explore the immediate and lasting effects of ELA on brain circuit development and refinement. Finally, we describe a number of therapeutic interventions best-suited to support adolescent neurodevelopment in children with a history of ELA.

It is a family affair: individual experiences and sibling exposure to emotional, physical and sexual abuse and the impact on adult depressive symptoms

BACKGROUND

Childhood abuse and neglect often occurs within families and can have a large influence on mental well-being across the lifespan. However, the sibling concordance of emotional abuse and neglect (i.e. together referred to as emotional maltreatment; EM), physical abuse (PA) and sexual abuse (SA) and the long-term impact on the context of siblings' maltreatment experiences are unclear. To examine the influence of EM, PA and SA on adult depressive symptoms within the family framework we differentiate between (a) the family-wide (mean level of all siblings) effects and (b) the individual deviation from the mean family level of maltreatment.

METHODS

The sample (N = 636) consists of 256 families, including at least one lifetime depressed or anxious individual and their siblings. Multilevel modeling was used to examine the family-wide and relative individual effects of childhood maltreatment (CM).

RESULTS

(a) Siblings showed most similarity in their reports of EM followed by PA. SA was mostly reported by one person within a family. In line with these observations, the mean family levels of EM and PA, but not SA, were associated with more depressive symptoms. In addition, (b) depression levels were more elevated in individuals reporting more EM than the family mean.

CONCLUSIONS

Particularly in the case of more visible forms of CM, siblings' experiences of EM and PA are associated with the elevated levels of adult depressive symptoms. Findings implicate that in addition to individual maltreatment experiences, the context of siblings' experiences is another crucial risk factor for an individuals' adult depressive symptomatology.

Childhood Trauma in Adult Depressive and Anxiety Disorders: An Integrated Review on Psychological and Biological Mechanisms in the NESDA Cohort

BACKGROUND

Childhood trauma (CT) has adverse consequences on mental health across the lifespan. The understanding of how CT increases vulnerability for psychiatric disorders is growing. However, lack of an integrative approach to psychological and biological mechanisms of CT hampers further advancement. This review integrates CT findings across explanatory levels from a longitudinal adult cohort - the Netherlands Study of Depression and Anxiety (NESDA).

METHODS

We reviewed all studies (k = 37) from the NESDA cohort (n = 2981) published from 2009 to 2020 containing CT findings related to psychopathology and potential psychological and biological mechanisms of CT.

RESULTS

CT was associated with a higher risk of anxiety and depressive disorders with the strongest associations in the comorbid group. CT predicted the onset of these disorders, recurrence, and poorer outcomes (more comorbidity and chronicity). CT was associated with maladaptive personality characteristics and cognitions (e.g., higher neuroticism and negative self-associations), mild stress systems dysregulations (heightened levels of cortisol and inflammation), advanced biological aging (increased epigenetic aging and telomere attrition), poorer lifestyle (higher smoking rate and body mass index), somatic health decline (e.g., increased metabolic syndrome dysregulations), and brain alterations (e.g., reduced mPFC volume and increased amygdala reactivity).

LIMITATIONS

Literature review of one cohort using mixed analytical approaches.

CONCLUSION

CT impacts the functioning of the brain, mind, and body, which together may contribute to a higher vulnerability for affective disorders. It is essential to employ an integrative approach combining different sources of data to understand the mechanisms of CT better.

Maltreatment during childhood and risk for common mental disorders among first year university students in South Africa

PURPOSE

Childhood maltreatment elevates risk for common mental disorders (CMDs) during late adolescence and adulthood. Although CMDs are highly prevalent among university students, few studies have examined the relationship between childhood maltreatment and 12 month CMDs in a low- to middle-income countries. This paper describes the prevalence of maltreatment and the relationship between type, number and patterns of maltreatment exposure and 12 month CMDs among first-year university students in South Africa.

METHODS

Maltreatment and CMD data were collected via well-validated self-report scales (corresponding with DSM-IV diagnoses) in a web-based survey of first-year students from two large urban universities (n = 1290) in South Africa. Various multivariate modelling approaches (additive, restrictive interactive and latent class) were used to examine the relationship between maltreatment and CMDs.

RESULTS

Overall, 48.4% of participants reported childhood maltreatment, the most common type being emotional abuse (26.7%). Regardless of the modelling approach used, emotional abuse was the only type of maltreatment independently associated with 12-month diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD) or drug use disorder (DUD) even after adjusting for types and number of types of maltreatment. Similarly, students in the latent class reflecting histories of emotional abuse (either alone or combined with physical abuse) were more likely to meet criteria for 12-month MDD, GAD or DUD.

CONCLUSION

Findings confirm the high prevalence of childhood maltreatment among South African students. As this exposure elevates risk for MDD, GAD and DUD, interventions aimed at preventing and treating CMDs among first-year students should address experiences of childhood maltreatment.

Developmental consequences of emotional abuse and neglect in vulnerable adolescents: A multi-informant, multi-wave study

BACKGROUND

Extant research and theory posit that emotional abuse and emotional neglect-exposure is uniquely harmful during adolescence. Yet, these findings are mostly based on mono-informant, retrospective studies with unselected adults that examine emotional maltreatment in the aggregate. This prevents inferences concerning the unique, prospective risk emotional abuse and neglect, as reported by multiple informants, may confer within at-risk, adolescent samples.

OBJECTIVE

In response, the present study examined how emotional abuse and emotional neglect-exposure in adolescence uniquely related to psychological symptoms and social impairment.

PARTICIPANTS AND SETTING

Our aims were tested in a child welfare system (CWS)-involved sample of adolescents (N = 657; Age_M = 12.49 at baseline) who were participating in a longitudinal study.

METHODS

A multi-informant approach was used to assess emotional abuse/neglect and mental health. Physical abuse and lifetime CWS contact represented covariates in growth curve models.

RESULTS

Emotional abuse predicted symptoms within informant, such that youth-reported emotional abuse predicted youth-reported internalizing, β = 0.21, p = .001, and externalizing, β=0.35, p = .001, symptoms while parent-reported emotional abuse predicted parent-reported externalizing, β=0.30, p <  .001, and internalizing β=0.29, p <  .001, symptoms. Meanwhile, youth-reported emotional neglect predicted heightened self-reported internalizing symptoms, β=0.29, p <  .001, parent-reported externalizing symptoms, β=0.15, p = .002 and social impairment across youth, β=-0.17, p = .01 and parent, β=-0.24, p <  .001, report.

CONCLUSIONS

This study shows the importance of distinguishing between these maltreatment subtypes in adolescence and provides measurement recommendations for future maltreatment research. The manuscript concludes by discussing adolescent emotional abuse and neglect-exposure as a maintenance, as opposed to causal risk, factors.

Psychological Mediators of the Association Between Childhood Emotional Abuse and Depression: A Systematic Review

Background: A number of existing meta-analyses and narrative reviews have already addressed the relation between childhood adversity and depression, yet none of them has examined the specific link between emotional abuse and depression highlighted by previous research. It is no longer appropriate to regard childhood maltreatment as a unitary concept when considering its effects on subsequent depression; instead, subtypes of childhood maltreatment need to be scrutinized separately. This review addresses this significant gap by critically evaluating empirical studies examining psychological mediators of the relationship between childhood emotional abuse and subsequent depression. Methods: A systematic search of nine electronic databases was conducted to identify eligible studies published in English between January 1980 and January 2020. Given the heterogeneous outcomes of eligible studies and the inconsistent reporting of indirect effects, a narrative synthesis, rather than a quantitative meta-analysis, was conducted. An appraisal of methodological quality was also included. Results: We identified 34 papers, comprising 18,529 adults and 3,434 adolescents, including 888 clinical participants. Our synthesis suggests that studies on mediators in the emotional abuse-depression link have focused on five clusters of intervening variables: early maladaptive schemas, cognitive-personality variables, emotion dysregulation, interpersonal styles, and stressful negative events. Only 11 studies identified the unique contribution of emotional abuse to depression by controlling for other forms of childhood maltreatment. Conclusions: Our findings support several routes with relative consistency (e.g., early maladaptive schemas, hopelessness, negative cognitive styles, brooding rumination, overall emotion dysregulation). Because psychological mediators function as a complex interrelated system, controlling for the interrelation between them is important. The evidence for the purported mediating role of the factors identified in this review should be considered with caution given the relative dearth of large-scale, adequately powered longitudinal studies. This review proposes a comprehensive multilevel theoretical framework as a basis for future research.

Negative relationship between brain α1A-AR neurotransmission and βArr2 levels in anxious adolescent rats subjected to early life stress

Early-life stress is correlated with the development of anxiety-related behavior in adolescence, but underlying mechanisms remain poorly known. The α_1A-adrenergic receptor (AR) is linked to mood regulation and its function is assumed to be regulated by β-arrestins (βArrs) via desensitization and downregulation. Here, we investigated correlation between changes in α_1A-AR and βArr2 levels in the prefrontal cortex (PFC) and hippocampus of adolescent and adult male rats subjected to maternal separation (MS) and their relationship with anxiety-like behavior in adolescence. MS was performed 3 h per day from postnatal days 2-11 and anxiety-like behavior was evaluated in the elevated plus-maze and open field tests. The protein levels were examined using western blot assay. MS decreased α_1A-AR expression and increased βArr2 expression in both brain regions of adolescent rats, while induced reverse changes in adulthood. MS adolescent rats demonstrated higher anxiety-type behavior and lower activity in behavioral tests than controls. Decreased α_1A-AR levels in MS adolescence strongly correlated with reduced time spent in the open field central area, consistent with increased anxiety-like behavior. An anxiety-like phenotype was mimicked by acute and chronic treatment of developing rats with prazosin, an α_1A-AR antagonist, suggesting α_1A-AR downregulation may facilitate anxiety behavior in MS adolescent rats. Together, our results indicate a negative correlation between α_1A-AR neurotransmission and βArr2 levels in both adults and anxious-adolescent rats and suggest that increased βArr2 levels may contribute to posttranslational regulation of α_1A-AR and modulation of anxiety-like behavior in adolescent rats. This may provide a path to develop more effective anxiolytic treatments.

Emotional violence in childhood and health conditions, risk-taking behaviors, and violence perpetration among young adults in Nigeria

BACKGROUND

Globally, over 1 billion children are victims of violence against children annually. Studies examining the health consequences of childhood violence have mostly focused on childhood physical violence (PV) and sexual violence (SV). Recent evidence suggests that childhood emotional violence (EV) may also be deleterious to the health and wellbeing of victims.

OBJECTIVE

This study examines the independent association between EV and some health conditions, risk taking behaviors, and violence perpetration among Nigerian young adults ages 18-24 years.

PARTICIPANTS AND SETTING

Data from 2014 Nigeria Violence Against Children Survey (n = 4,203), a nationally representative cross-sectional survey of individuals ages 13-24 were used.

METHODS

Childhood EV was defined as EV victimization before age 18 perpetrated by a parent, adult caregiver or other adult relative. Logistic regression analyses assessed the association between EV in childhood and mental distress in the past 30 days, ever self-harm behaviors and history of sexually transmitted infections; risk behaviors such as having multiple sex partners in the past 12 months; and ever violence perpetration.

RESULTS

After controlling for study covariates, EV in childhood was associated with mental distress in both males and females, and self-harm behaviors in females; excessive alcohol use and infrequent condom use in males, and multiple sexual partners in females; and PV perpetration in males and SV perpetration in females.

CONCLUSION

EV in childhood is associated with some health conditions, risk taking behaviors, and violence perpetration. Implementing programs that address all forms of violence in childhood, including EV may benefit children.

Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms

BACKGROUND

Childhood maltreatment (CM) has been repeatedly linked to future problem drinking. Depression has been identified as a potential factor contributing to problematic alcohol use in maltreated individuals. However, depression has been operationalized as the presence or number of depression symptoms in the majority of previous studies. The role of other relevant measures of depression, such as depressive implicit associations, is not well understood.

OBJECTIVES

The present study addresses this gap in the literature by examining the mediating role of both depression symptoms and depressive implicit associations.

METHODS

A community sample of young adults (N = 208, mean age = 19.7, 78.4% females) completed self-report measures of CM, depression symptoms, and problem drinking. Depressive implicit associations were assessed by a computer-based implicit association test (IAT). Structural equation modeling (SEM) was used to examine the direct link between CM and problem drinking as well as indirect links through depression symptoms and depressive implicit associations.

RESULTS

CM was significantly associated with both depression symptoms (β = 0.35, p < .001) and depressive implicit associations (β = 0.36, p < .001). Additionally, CM was associated with problem drinking indirectly via depression symptoms during young adulthood (β = .06, p = .019).

CONCLUSION

Our study provides evidence for the role of depression symptoms, but not for depressive implicit associations, in linking CM and problem drinking. Treating depression in individuals with a history of CM may help to prevent problem drinking in this vulnerable population.

Can the Implicit Association Test Serve as a Valid Measure of Automatic Cognition? A Response to Schimmack (2021)

Much of human thought, feeling, and behavior unfolds automatically. Indirect measures of cognition capture such processes by observing responding under corresponding conditions (e.g., lack of intention or control). The Implicit Association Test (IAT) is one such measure. The IAT indexes the strength of association between categories such as “planes” and “trains” and attributes such as “fast” and “slow” by comparing response latencies across two sorting tasks (planes–fast/trains–slow vs. trains–fast/planes–slow). Relying on a reanalysis of multitrait–multimethod (MTMM) studies, Schimmack (this issue, p. 396) argues that the IAT and direct measures of cognition, for example, Likert scales, can serve as indicators of the same latent construct, thereby purportedly undermining the validity of the IAT as a measure of individual differences in automatic cognition. Here we note the compatibility of Schimmack’s empirical findings with a range of existing theoretical perspectives and the importance of considering evidence beyond MTMM approaches to establishing construct validity. Depending on the nature of the study, different standards of validity may apply to each use of the IAT; however, the evidence presented by Schimmack is easily reconcilable with the potential of the IAT to serve as a valid measure of automatic processes in human cognition, including in individual-difference contexts.

Varying Cognitive Scars - Differential Associations Between Types of Childhood Maltreatment and Facial Emotion Processing

Background

Distorted cognitive processing has been found among survivors of child maltreatment. However, different types of abuse and neglect may bring about differences in emotion and attention processing. The present study aimed to detect differential associations between various types of childhood maltreatment and attentional biases in facial emotion processing.

Methods

A non-clinical sample was recruited on University campus and consisted of 67 individuals with varying degrees of maltreatment. In an evaluative conditioning task, images of faces with neutral emotional expressions were either associated with short videos of intense negative statements, or associated with neutral videos. Subsequently, these faces were used as stimuli in a face in the crowd recognition task in which the familiar faces had to be recognized within a crowd of unfamiliar neutral faces.

Results

In multiple linear regression analyses controlling for the intercorrelatedness of types of maltreatment, differential relationships between types of maltreatment and attentional bias were found. While emotional abuse was associated with faster detection of negatively associated faces, emotional neglect was associated with an impaired recognition of familiar stimuli regardless of the emotional content.

Conclusion

Results indicated that interindividual differences in cognitive biases may be due to the activation of diverse cognitive schemas based on differential experiences of maltreatment.

Traumatic experiences, family functioning, and mood disorder development in bipolar offspring

Objectives

Studies in children of patients affected with bipolar disorder (BD; bipolar offspring) are at high risk to develop mood disorders. Our aim is to investigate how environmental factors such as childhood trauma and family functioning relate to the development of mood disorders in offspring at familial risk for BD.

Design

The current study is part of a longitudinal prospective cohort study among offspring of parents with BD.

Methods

The current study is part of the Dutch Bipolar Offspring Study, an ongoing prospective cohort study among adolescent offspring of a parent with BD. Bipolar offspring were psychiatrically evaluated at baseline and at 1‐, 5‐, and 12‐year follow‐up. Complete follow‐up data over de 12‐year follow‐up were available for 102 offspring. Childhood trauma was measured with the Childhood Trauma Questionnaire (CTQ) and filled out by the offspring. Family functioning was reported by the mother with the 130‐item Questionnaire for Family Problems (QFP).

Results

Emotional maltreatment was significantly associated (HR = 1.82, CI 1.18–2.82, p = .007) with mood disorder onset in bipolar offspring. No association was found with the family functioning total score (HR = 1.04, CI 0.94–15, p = .085) nor its subscales.

Conclusions

The current study suggests that emotional maltreatment is associated with mood disorder development in bipolar offspring. Remarkably, the association of offspring‐reported emotional maltreatment and mood disorder onset was not reflected in parent‐reported family functioning (e.g., support and communication, openness or involvement). Possible explanations are discussed and warrant further study.

Practitioner points

Offspring of bipolar patients are at increased risk of developing mood disorders across the life‐time.

Emotional trauma contributes to the likelihood of developing mood disorders in bipolar offspring.

In the daily treatment of bipolar patients having children, attention should be given to parental style and difficulties.

Further research using multiple informant methods on childhood trauma an family functioning is needed to further disentangle the effects of these variables on the onset of psychopathology in bipolar offspring.

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

BACKGROUND

Accumulated evidence suggests that childhood emotional abuse is particularly related to adulthood depression. However, this connection demands further explanation regarding potential intermediate factors.

OBJECTIVE

This 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.

PARTICIPANTS

A general sample of 205 adults were assessed online.

METHOD

Participants 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.

RESULTS

Emotional 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.

CONCLUSIONS

This 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.

Cognitive mediators of the relationship between adverse childhood experiences and adult psychopathology: A systematic review

This is the first review to rigorously examine the mediating role of cognitive factors in the relationship between childhood trauma and subsequent adult psychopathology, and highlight areas for future research. A database search (Child Development & Adolescent Studies, ERIC, Global Health, PsycARTICLES, and PsycINFO) was conducted to identify empirical studies on cognitive factors, explaining the relationship between different types of adverse childhood experiences and adult psychopathology across clinical and nonclinical populations. A narrative synthesis and appraisal of the methodological quality of the studies was conducted. Ninety-eight mediation studies were identified, comprising 4,137 clinical and 28,228 nonclinical participants. Despite great variation in methodological quality of the studies, our narrative synthesis suggests that cognitive factors mediate the relationship between early trauma and later psychopathology. This finding is consistent across different measures of traumatic experiences, psychopathology, and cognitive mediators. Cognitive mediators represent potentially valuable intervention targets for (non)clinical patients who have experienced childhood adversity. Future studies are needed to (a) establish longitudinal causal connections, and (b) assess the effect of interventions that specifically target cognitive change in patients with different levels and types of pathology.

Adverse childhood experiences among Latina women and its association with mastery of stress and health

BACKGROUND

Adverse childhood experience (ACE) and intimate partner violence (IPV) have sustained, deleterious effects on physical and mental health. Few studies have examined how to help Latina survivors of ACEs and/or IPV regain control of their health.

OBJECTIVE

To inform interventions for this population, we examined whether mastery of stress and patient activation mediate the relationship between a history of ACE and/or IPV and mental and physical health.

PARTICIPANTS AND SETTING

We recruited 235 Latina women (M age = 29.6, SD = 5.75) from primary care clinics.

METHOD

For this cross-sectional study, we used linear regressions to examine the association between ACEs, history of IPV, and health, and the sobel's test to determine whether patient activation and mastery of stress mediated the relationships between ACEs, IPV, and health.

RESULTS

Most women reported at least one ACE (61.7%, n = 137) and 22.2% (n = 55) reported a history of IPV. Mastery of stress mediated the relationship between ACE and physical health (b= -3.16 p = .002) and mental health (b= -3.83, p <  .001). Mastery of stress also mediated the relationship between history of IPV and physical health (b= -2.62, p = .008) and mental health (b= -2.74, p = .006). Patient activation was not associated with a history of trauma or mental health.

CONCLUSION

While past experiences of trauma cannot be changed, results from this study suggest that improving an individual's mastery of stress may be a point of intervention for improving mental and physical health among survivors of ACEs and IPV.

Photobiomodulation rescues cognitive flexibility in early stressed subjects

Neglectful parenting is one of the most prevalent forms of child mistreatment. This early life stress leads to long-term alterations in all the psychological domains, as well as brain alterations. Animal models have been developed to emulate and further study this early life stress, and one of most widely used models is maternal separation. In both human and animal models, cognitive flexibility has been found to be altered. In this study, we performed maternal separation (10 days, 4 h per day) in rats, and in adulthood, we tested their spatial navigation and cognitive flexibility. In addition, we delivered photobiomodulation treatment (Low-level light therapy: 1064 nm, 30 mW, 60 cycles) on the rats' brains, and we tested energy oxidative metabolism using cytochrome c oxidase histochemistry. Early life stress delivered in the form of maternal separation on the first 10 postnatal days leads to cognitive flexibility impairment and a general increase in energy metabolism in adulthood. Low-level light therapy seems to be useful for treating these unwanted outcomes, because it rescued cognitive flexibility and returned the oxidative energy metabolism to balanced scores, without harming controls' brains or behavior. Photobiomodulation is a promising tool in the treatment of chronic stress-related consequences because it rescued cognitive flexibility.

Associations Among Depressive Symptoms, Childhood Abuse, Neuroticism, Social Support, and Coping Style in the Population Covering General Adults, Depressed Patients, Bipolar Disorder Patients, and High Risk Population for Depression

BACKGROUND

Exposure to childhood abuse has been identified as a salient risk factor for the development of depression. However, the mediating factors between childhood abuse and depressive symptoms have not been sufficiently elucidated. This study aims to investigate the mediating effects of neuroticism, social support, and coping style between childhood abuse and depressive symptoms in population covering general adults, depressed patients, bipolar disorder patients, and high risk population for depression.

METHODS

This is a cross-sectional study. Five validated questionnaires were used to measure the psychological outcomes (Childhood Trauma Questionnaire CTQ-SF, Eysenck Personality Questionnaire EPQR-S, Social Support Rating Scale SSRS, Simplified Coping Style Questionnaire SCSQ, and Patient Health Questionnaire-9 PHQ-9) of 312 participants. Multiple regressions and structural equation modeling (SEM) were used to conduct data analysis.

RESULTS

Multiple regression analysis and SEM showed a significant association between childhood emotional abuse and depression symptoms. Neuroticism, use of social support, and active coping style were important mediating variables of this association. The R 2 for our model was 0.456, indicating that 45.6% of the variability in depressive symptoms can be explained by the model.

CONCLUSION

This study suggested that neuroticism, active coping, and use of social support play important role in mediating the effects of childhood abuse on adult depressive symptoms.

Implicit Cognition and Psychopathology: Looking Back and Looking Forward

Implicit cognitive processing is theorized to have a central role in many forms of psychopathology. In the current review, we focus on implicit associations, by which we mean evaluative representations in memory that are difficult to control and do not require conscious reflection to influence affect, cognition, or behavior. We consider definitional and measurement challenges before examining recent empirical evidence for these associations in anxiety, obsessive–compulsive, posttraumatic stress, depressive, and alcohol use disorders. This examination is framed by a brief review of the ways that prominent models of psychopathology represent biased implicit processing of disorder-relevant information. We consider to what extent models reflect more traditional automatic/implicit versus strategic/explicit dual-process perspectives or reflect more recent dynamical systems perspectives in which mental representations are iteratively reprocessed, evolving continuously. Finally, we consider the future research needed to better understand the interactive and temporal dynamics of implicit cognition in psychopathology.

Childhood Maltreatment, Self-esteem, and Suicidal Ideation in a Low-SES Emerging Adult Sample: The Moderating Role of Heart Rate Variability

Childhood maltreatment is associated with risk for suicidal ideation later in life, yet more research is needed on the indirect effects and bioregulatory protective factors in this association. The present study aimed to investigate the indirect influence of childhood maltreatment on suicidal ideation in emerging adulthood via level of self-esteem, and examine the moderating role of heart rate variability (HRV; a proxy for emotion regulation) in this indirect association. The study included a sample of 167 non-metropolitan emerging adults (M_age = 21.17, 55.8% female) of low-socioeconomic status (low-SES). HRV data were obained using an electrocardigram, whereas childhood maltreatment, suicidal ideation, and self-esteem data were obtained via self-report. Childhood maltreatment was indirectly associated with suicidal ideation via reduced self-esteem. HRV buffered this indirect association. Childhood maltreatment poses a risk for the development of suicidal ideation. Interventions that bolster self-esteem and emotion regulation may reduce suicide risk for emerging adults with a history of childhood maltreatment.

Glucocorticoid receptor alpha translational isoforms as mediators of early adversities and negative emotional states

Childhood trauma (CT) increases the risk for psychopathology through disturbed acquisition and extinction of fear. The effects of CT are mediated by abnormalities of the hypothalamic-pituitary-adrenal axis and glucocorticoid receptor (GR). Since, the alterations in GRα translational isoforms have been documented in psychiatric disorders we sought to: 1) explore whether multiple GRα isoforms in the human peripheral blood mononuclear cells of two independent cohorts (whole cell n = 40; and nuclear extracts n = 43, adult subjects) mediate the effect of CT on negative affectivity (NA) measured by Depression, Anxiety and Stress Scales (DASS), and 2) examine their role/function during fear extinction in the animal model. In multiple regression analysis, CT, nuclear 40-kDa GRα, their interactions and FKBP5 explained 22%-35% of variance in DASS scores. Structural equation modeling showed that CT had a significant direct effect on 40-kDa and DASS in both cohorts, and on the nuclear 25-kDa GRα. The association between 40-kDa and total DASS was significantly mediated by nuclear FKBP5, whereas on DASS anxiety, over FKBP5 in both cohorts and nuclear full length GRα. Nuclear 40-kDa GRα and its interaction with CT had a significant direct effect on DASS anxiety. In mice, the successful extinction learning was followed by nuclear translocation of 40-kDa GRα and induction of BDNF exon IV expression. Our data revealed that the association between CT and adult NA in non-clinical subjects is mediated by the GRα translational isoforms, in particular 40-kDa GRα, and emphasized its role in fear extinction and neural plasticity.

Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties

BACKGROUND

Childhood maltreatment, such as severe emotional, physical, and sexual abuse and neglect, has been linked to impulse control problems and dysfunctional emotional coping. In borderline personality disorder (BPD), a history of childhood maltreatment may worsen difficulties in emotion regulation, which may in turn give rise to impulsive behaviours. The aim of this self-report study was to investigate associations between childhood maltreatment severity, emotion regulation difficulties, and impulsivity in women with BPD compared to healthy and clinical controls.

METHODS

Sixty-one female patients with BPD, 57 clinical controls (CC, women with Attention Deficit Hyperactivity Disorder and/or Substance Use Disorder, without BPD), and 60 female healthy controls (HC) completed self-report scales on childhood trauma (Childhood Trauma Questionnaire, CTQ), difficulties in emotion regulation (Difficulties in Emotion Regulation Scale, DERS), and impulsivity (UPPS Impulsive Behaviour Scale). A conditional process analysis was performed to investigate whether emotion dysregulation statistically mediated the effect of childhood maltreatment severity on impulsivity depending on group (BPD vs. CC vs. HC).

RESULTS

Childhood maltreatment, particularly emotional maltreatment, was positively associated with impulsivity and emotion regulation difficulties across all groups. Difficulties in emotion regulation statistically mediated the effect of childhood maltreatment on impulsivity in BPD, but not in the other groups.

CONCLUSION

In the context of current conceptualizations of BPD and previous research, findings suggest that problems with emotion regulation may be related to a history of childhood maltreatment, which may in turn enhance impulsivity. Targeting emotion dysregulation in psychotherapy and discussing it in relation to childhood maltreatment can help decreasing impulsive behaviors in individuals with BPD. Given the correlational design of our study which does not allow causal conclusions, future studies have to employ prospective, experimental designs and include larger sample sizes to corroborate associations between childhood maltreatment, emotion dysregulation, and impulsivity.

Childhood emotional abuse characteristics moderate associations with adult psychopathology and caregiving

As the consequences of childhood maltreatment for adult adjustment become increasingly established in the literature, investigations of individual differences in these effects must evolve to examine more nuanced components of the maltreatment experience. This is particularly true for studies of childhood emotional abuse (CEA), which represents an umbrella label for numerous qualitatively different experiences. The present study examined the distinct contributions and potential interactive effects of CEA frequency and intensity on adult psychopathology, caregiving behaviors, and caregivers' representations of the caregiver-child relationship in a diverse sample of 62 female caregivers of 4-year-old children, all of whom had experienced CEA. Frequency and intensity emerged as orthogonal characteristics of CEA with differential effects on adult adaptation. Higher CEA frequency predicted increased adult psychopathology, whereas higher CEA intensity predicted increased boundary dissolution in caregivers' representations. Further, an interaction between frequency and intensity predicted negativity in caregivers' representations, such that higher frequency of high intensity, but not low intensity, CEA predicted decreased negativity. Neither frequency nor intensity of CEA predicted observed caregiving behaviors. These results provide evidence that characteristics of CEA signal important differences in its experience, with differential implications for later adjustment. The specific differences in caregiving representations associated with high vs. low intensity CEA suggest that diverging mechanisms by which these experiences eventuate in adult outcomes should also be investigated. Above all, this study suggests that the measurement of CEA, and childhood maltreatment broadly, will benefit from enhanced attention to specific characteristics of individuals' experiences.

Distribution of ADHD symptoms, and associated comorbidity, exposure to risk factors and disability: Results from a general population study

The aim of this study was to examine whether ADHD is a dimensional trait in the adult general population. We studied whether an increased number of ADHD symptoms was associated with higher comorbidity, exposure to risk factors (childhood abuse and parental psychopathology), and disability. We ascertained whether even low numbers of ADHD symptoms were associated with an increased burden of disease. Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2, N = 5303). NEMESIS-2 is a nationally representative face-to-face survey on mental health of the Dutch general population. ADHD symptoms, mental comorbidity, and disability were assessed using the Adult ADHD Self-Report Scale Screener, the Composite International Diagnostic Interview version 3.0, and the Medical Outcomes Study Short Form Health Survey, respectively. Dose-response relationships were found between the number of ADHD symptoms and Axis I and II mental disorders; exposure to risk factors; and mental and physical disability. Our study supports the notion that ADHD is a dimensional trait in the adult general population. Even low numbers of symptoms were associated with an increased burden of disease, and therefore these should be identified and treated.

Childhood adversities as predictors of improvement in psychiatric symptoms and global functioning in solution-focused and short- and long-term psychodynamic psychotherapy during a 5-year follow-up

BACKGROUND

Childhood adversities are frequent among adults who seek treatment for depression or anxiety. These disorders are commonly treated by psychotherapy. Yet it is not known if specific types or durations of psychotherapy are particularly suited for patients who have suffered various early adversities.

METHODS

221 depressed and anxious adult outpatients from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire. They were randomly assigned to short- (solution-focused or psychodynamic) or long-term (psychodynamic) psychotherapy. Outcome was assessed via patient questionnaires and clinician interviews of psychiatric symptoms and global functioning during a 5-year follow-up. Linear regression analyses were conducted.

RESULTS

Less separations from caregivers expectedly predicted better outcomes in all therapies; unexpectedly, so did greater abuse. Family unhappiness and parental problems predicted faster or greater improvement when patients were assigned to a short- or long-term psychodynamic therapy model.

LIMITATIONS

As patients with psychotic, substance abuse, and severe personality disorders were screened out, findings might not generalize to these patient groups.

CONCLUSIONS

Patients with certain childhood adversities appear to respond with faster or greater improvement when the psychotherapy model is explicitly focused on working through the potential connections between past and current problems. If confirmed by in-depth studies, the findings may help match psychotherapeutic models with given patient complaints, as well as fine-tune different psychosocial interventions to individual needs for optimizing treatment outcomes.

On the Developmental Timing of Stress: Delineating Sex-Specific Effects of Stress across Development on Adult Behavior

Stress, and the chronic overactivation of major stress hormones, is associated with several neuropsychiatric disorders. However, clinical literature on the exact role of stress either as a causative, triggering, or modulatory factor to mental illness remains unclear. We suggest that the impact of stress on the brain and behavior is heavily dependent on the developmental timing at which the stress has occurred, and as such, this may contribute to the overall variability reported on the association of stress and mental illness. Here, animal models provide a way to comprehensively assess the temporal impact of stress on behavior in a controlled manner. This review particularly focuses on the long-term impact of stress on behavior in various rodent stress models at three major developmental time points: early life, adolescence, and adulthood. We characterize the various stressor paradigms into physical, social, and pharmacological, and discuss commonalities and differences observed across these various stress-inducing methods. In addition, we discuss here how sex can influence the impact of stress at various developmental time points. We conclude here that early postnatal life and adolescence represent particular periods of vulnerability, but that stress exposure during early life can sometimes lead to resilience, particularly to fear-potentiated memories. In the adult brain, while shorter periods of stress tended to enhance spatial memory, longer periods caused impairments. Overall, males tended to be more vulnerable to the long-term effects of early life and adolescent stress, albeit very few studies incorporate both sexes, and further well-powered sex comparisons are needed.

History of childhood maltreatment and symptoms of anxiety and depression in women with chronic pelvic pain

OBJECTIVE

To determine the prevalence of physical, sexual and emotional abuse and physical and emotional neglect suffered by women with chronic pelvic pain (CPP) during childhood and whether these occurrences are associated with symptoms of pain, anxiety and depression.

METHODS

A case-control study was conducted on 154 women older than 18 years, 77 of them healthy and 77 with CPP. A history of sexual, physical, and emotional abuse and physical and emotional neglect was determined using the Childhood Trauma Questionnaire (CTQ). Anxiety and depression symptoms were determined using the Hospital Anxiety and Depression (HAD) scale. Pain intensity was determined using a visual analog scale (VAS). The quantitative variables were compared by the Wilcoxon test, and the qualitative variables were compared by the Chi-square test or exact Fisher test when appropriate. Correlation between the CTQ, HAD and VAS scores was estimated by the Spearman's p coefficient. Independent association of the variables with the presence of CPP was determined by logistic multiple regression analysis.

RESULTS

The prevalence of childhood maltreatment was 77.9% and 64.9%, respectively, for women with CPP and healthy women (p = 0.07). Emotional neglect was more frequent among women with CPP than among healthy women (58.4% versus 41.5%, p = 0.04). There was a moderate correlation between anxiety and depression symptoms and CTQ scores for women with CPP. Unemployment (OR = 4.15, 95% CI 1.73-9.94; OR_adj =  3.30, 95% CI 1.26-8.55) was independently associated with the presence of CPP.

CONCLUSIONS

Women with CPP reported emotional neglect abuse more frequently than healthy women. There was a direct correlation between maltreatment scores and anxiety and depression scores. On the other hand, CPP was independently associated only with unemployment.

Child maltreatment and adult depressive symptoms: Roles of self-compassion and gratitude

Child maltreatment, including abuse (physical, emotional, and sexual) and neglect (physical and emotional), is positively associated with depressive symptoms in adulthood. However, most studies have been conducted within a psychopathological framework and focused on underlying dysfunctional processes (e.g., insecure attachment styles, maladaptive schemas, and negative attribution styles). Protective factors that affect the relationship between child maltreatment and adult depressive symptoms are underexplored. Guided by emotion regulation theory and the perspective of positive psychology, we examined the roles of self-compassion and gratitude as protective factors in the relationship between child maltreatment and adult depressive symptoms in a sample of 358 college students. Results showed that psychological maltreatment (emotional abuse and emotional neglect) was associated with adult depressive symptoms through decreased self-compassion. Neglect (emotional neglect and physical neglect) and sexual abuse were associated with adult depressive symptoms through decreased gratitude. There was no association between physical abuse and depressive symptoms through either self-compassion or gratitude. Our findings suggest that clinical practices focusing on self-compassion and gratitude might help prevent the development of adult depressive symptoms among clients with a history of maltreatment in childhood.

Grey matter volume and thickness abnormalities in young people with a history of childhood abuse

BACKGROUND

Childhood abuse is associated with abnormalities in brain structure and function. Few studies have investigated abuse-related brain abnormalities in medication-naïve, drug-free youth that also controlled for psychiatric comorbidities by inclusion of a psychiatric control group, which is crucial to disentangle the effects of abuse from those associated with the psychiatric conditions.

METHODS

Cortical volume (CV), cortical thickness (CT) and surface area (SA) were measured in 22 age- and gender-matched medication-naïve youth (aged 13-20) exposed to childhood abuse, 19 psychiatric controls matched for psychiatric diagnoses and 27 healthy controls. Both region-of-interest (ROI) and whole-brain analyses were conducted.

RESULTS

For the ROI analysis, the childhood abuse group compared with healthy controls only, had significantly reduced CV in bilateral cerebellum and reduced CT in left insula and right lateral orbitofrontal cortex (OFC). At the whole-brain level, relative to healthy controls, the childhood abuse group showed significantly reduced CV in left lingual, pericalcarine, precuneus and superior parietal gyri, and reduced CT in left pre-/postcentral and paracentral regions, which furthermore correlated with greater abuse severity. They also had increased CV in left inferior and middle temporal gyri relative to healthy controls. Abnormalities in the precuneus, temporal and precentral regions were abuse-specific relative to psychiatric controls, albeit at a more lenient level. Groups did not differ in SA.

CONCLUSIONS

Childhood abuse is associated with widespread structural abnormalities in OFC-insular, cerebellar, occipital, parietal and temporal regions, which likely underlie the abnormal affective, motivational and cognitive functions typically observed in this population.

Emotionally Abusive Behavior in Italian Middle School Teachers as Identified by Students

The aim of this article was to estimate the prevalence of psychological maltreatment in Italian middle school students by their teachers, and to test the applicability of surveying instruments for this phenomenon in Italian educational settings. The sample consisted of 105 teachers and 128 middle school students, who were asked about their experiences with emotionally abusive behaviors (i.e., demeaning, discriminating, dominating, destabilizing, distancing, and diverse) in the Italian school system. Teachers did not tend to perceive their behavior as abusive, while the students showed a very high perception of abuse (98%). Males were more likely to be victims of abuse, and they also reported lower scores in the Achievement scale. Emotional child abuse is highly present in Italian educational settings, and there is a strong need for interventions aimed at supporting teacher education, in the hopes of increasing the general well-being in schools.