Difficulties with emotion regulation as a transdiagnostic mechanism linking child maltreatment with the emergence of psychopathology

Shadows of the past - Hierarchical regression analyses on the role of childhood maltreatment experiences for postpartum depression

BACKGROUND

Postpartum depression (PPD) is one of the most common mental disorders in parents after birth. To develop tailored preventive programs, it is necessary to identify risk factors for PPD in parents. This study aimed to examine the impact of parental childhood maltreatment (CM) as a risk factor for PPD.

METHODS

Data from a German study comprising n = 349 mothers and n = 46 fathers were used. Hierarchical regression models were performed to examine CM, educational background, single parenthood, emotion regulation and attachment style as predictors of symptoms of PPD. In exploratory analyses, potential mediators (i.e., parenting stress and emotion regulation) were investigated via a path model.

RESULTS

CM, low level of education, difficulties in emotion regulation, and attachment anxiety were significant predictors for maternal PPD [R2 = 0.52, F (6, 305) = 57.99, p < .001]. For fathers, difficulties in emotion regulation were identified as a predictor [R2 = 0.43, F (6, 24) = 4.78, p < .01]. In exploratory analyses, emotion regulation served as a mediator for the link between CM and PPD as well as for the link between CM and parenting stress.

LIMITATIONS

The study design is cross-sectional and based on self-report questionnaires. Despite our attempts, only few fathers participated in the study, resulting in an underpowered sample for the regression analyses.

CONCLUSIONS

The study confirmed the assumption that CM experiences represent a risk factor for the development of maternal PPD. Emotion regulation might provide a pivotal target for interventions with parents at-risk.

The Role of Psychopathology and Emotion Regulation in the Intergenerational Transmission of Childhood Abuse: A Family Study

Previous studies have shown that parents with a history of childhood abuse are at increased risk of perpetrating child abuse. To break the cycle of childhood abuse we need to better understand the mechanisms that play a role. In a cross-sectional extended family design including three generations (N = 250, 59% female), we examined the possible mediating role of parental psychopathology and emotion regulation in the association between a history of childhood abuse and perpetrating child abuse. Parents' own history of childhood abuse was associated with perpetrating abuse toward their children, and externalizing (but not internalizing) problems partially mediated this association statistically. Implicit and explicit emotion regulation were not associated with experienced or perpetrated abuse. Findings did not differ across fathers and mothers. Findings underline the importance of (early) treatment of externalizing problems in parents with a history of childhood abuse, to possibly prevent the transmission of child abuse.

The association between childhood adversity and hippocampal volumes is moderated by romantic relationship experiences

Reduced hippocampal volumes are a feature of many mental disorders. Childhood maltreatment is a known risk factor for the development of psychopathology and has consistently been linked to hippocampal volume reductions in adults, but not in children and adolescents. We propose that maltreatment-related difficulties in coping with developmental tasks in adolescence and young adulthood might underlie the delayed emergence of hippocampal volume reductions in maltreated individuals. In a study with 196 healthy young adults (mean age [years]: 24.0 ± 3.2, 50% female, 20.6% living with a partner (missings: n = 2)), we investigated the interaction between childhood maltreatment (Childhood Trauma Screener) and the breakup of a steady romantic relationship (List of Threatening Experiences Questionnaire) on hippocampal magnetic resonance imaging grey matter volumes. The experience of a romantic relationship breakup moderated the association between childhood maltreatment and bilateral hippocampal volumes, revealing more negative associations with hippocampal volumes in participants with at least one breakup compared to those with no breakup experience (right hippocampus: β = - 0.05 ± 0.02, p = 0.031, p (FDR) = 0.031; left hippocampus: β = -0.06 ± 0.02, p = 0.005, p (FDR) = 0.009). Moreover, our findings provide some evidence that childhood maltreatment is related to smaller bilateral hippocampal volumes only in those adults who suffered from a relationship breakup (right hippocampus: β = -0.23 ± 0.10, p = 0.018, p (FDR) = 0.018; left hippocampus: β = -0.24 ± 0.10, p = 0.016, p (FDR) = 0.018;). Our study highlights the interaction of adult social bonds with early adversity on vulnerability to psychopathology.

Looking out for danger: Theoretical and empirical issues in translating human attention bias tasks to assess animal affective states

Understanding animal emotional (affective) state is highly relevant to various disciplines (e.g., animal welfare, neuroscience, comparative psychology), and has been significantly advanced by translating affect-induced cognitive bias paradigms rooted in human psychology to non-human animal studies. Attention bias (i.e., preferential attention allocation, AB) tests are increasingly used as more practical substitutes to commonly used judgement bias tests. Yet, evidence that AB reflects affective valence in animals is still limited. We review in-depth the concept of attention and AB described in humans and discuss utilising human-derived AB paradigms for measuring animal affective states. We describe key concepts and functions of attention in humans, before concentrating on the relationship between AB to threat detection and human anxiety. We critically review animal AB studies, discuss methodological discrepancies in such studies, and highlight the need for further experimental refinements. This includes identifying appropriate species-specific test designs and stimuli, modes of presentation (e.g., real-life vs. artificial stimuli), and consideration of subject-related factors (e.g., personality, age). We conclude that experimental limitations currently hamper the validity of AB as a proxy of animal affect and hope that the knowledge gaps highlighted in our review will encourage further research.

Changes in emotion regulation strategies during the pandemic: prospective pathways to adolescent depressive symptoms

BACKGROUND

Emotion regulation (ER) is considered central in adolescent psychopathology, and ER strategies may change during challenging times, such as a global pandemic. Despite this, there remains a limited understanding of individual differences in ER mechanisms and their associations with psychopathology. This study examined whether and how cognitive reappraisal, expressive suppression, and self-compassion changed over COVID-19 and how these changes uniquely predicted adolescents' depressive symptoms.

METHODS

A total of 2,411 adolescents (58.6% females; Mage = 18.51, SD = 0.80) completed the Emotional Regulation Questionnaire, the Self-compassion Scale, and the Symptom Checklist-90 before COVID-19 (in 2019) and during COVID-19 (in 2020). The predictive associations between each ER strategy and depressive symptoms were tested with latent change score models.

RESULTS

Adolescents' use of expressive suppression and self-compassion strategies both increased during COVID-19. More increases in expressive suppression predicted more depressive symptoms, whereas more increases in self-compassion predicted fewer depressive symptoms. Although, on average, cognitive reappraisal did not change, it did show significant variations within the sample - increases (vs. decreases) in cognitive appraisal predicted fewer depressive symptoms.

CONCLUSIONS

The study indicates how adolescents' ER strategies changed during the unprecedented global pandemic. It underscores protective roles of increased cognitive reappraisal and self-compassion, as well as the adverse consequence of heightened expressive suppression on adolescents' depressive symptoms. Findings offer insights for targeted interventions aimed at addressing specific ER strategies.

Cognitive and affective links between childhood adversity and psychological adjustment in emerging adults with chronic medical conditions

OBJECTIVE

Childhood adversity has been linked to poor psychological adjustment and decreased emotion regulation (ER) abilities. The extended process model of ER outlines the pivotal role of cognitive appraisals in the generation and expression of emotion as well as the pursuit of ER. The aim of the current study is to examine whether illness-related cognitive appraisals (i.e., illness uncertainty and illness intrusiveness) and emotion dysregulation serially mediate the relationship between childhood adversity and psychological adjustment for emerging adults with chronic medical conditions (CMCs).

METHODS

Participants included 557 undergraduate college students (Mage= 19.53 years, SD = 1.34) enrolled in a Midwestern public university with self-reported CMCs. Participants completed measures of adverse childhood experiences (ACEs), illness uncertainty, illness intrusiveness, emotion dysregulation, anxious symptoms, and depressive symptoms. A path analysis was conducted examining ACEs → cognitive appraisals (i.e., illness uncertainty, illness intrusiveness) → emotion dysregulation → depressive and anxious symptoms.

RESULTS

The overall model was significant and predicted 63.5% of the variability in anxious symptoms and 60.2% of the variability in depressive symptoms. All anticipated direct and indirect paths were significant.

CONCLUSIONS

The current study indicates that greater childhood adversity is indeed associated with negative appraisals of one's CMC, such as greater perceived uncertainty and intrusiveness. Negative illness-related cognitive appraisals thus may limit one's ability to effectively employ adaptive strategies to regulate emotions, which could contribute to greater depressive and anxious symptoms.

What Emotion Regulation Strategies are Associated with a General Psychopathology Factor (p) in Adolescence? Identifying Possible Transdiagnostic Targets for Intervention

Mental health problems in adolescence are increasing and there is an urgent call for transdiagnostic interventions, as most adolescents experience problems across multiple domains. Research has identified a general psychopathology factor (p) capturing the shared variance across mental health problems. In parallel, there is empirical support for the transdiagnostic nature of emotion regulation. In the current study, we explore the associations between p and emotion regulation strategies to identify which strategies may be promising targets for intervention. Data from the population-based Youth and Mental Health Study (YAMHS) (N = 2,464, mean age 13.7 years, SD 0.6) was used. The fit of different structural models of emotion regulation and psychopathology were compared, and latent factors from the final models were included in multiple regression analyses to explore the associations between p and emotion regulation strategies. A bifactor exploratory structural equation model (B-ESEM) showed best fit for modelling p. For emotion regulation strategies, an ESEM model showed best fit, including Rumination, Reactive Impulsivity, Distraction, Non-Acceptance, Problem Solving, Social Support, and Proactive Behavior. Results showed that a higher score on p was predicted by higher scores on the emotion regulation strategies Rumination (β = .38, p < .001) and Reactive Impulsivity (β = .35, p < .001), and lower scores on Problem Solving (β = -.15, p < .001). The results indicate that Rumination and Reactive Impulsivity have the strongest associations with p and may be promising targets for mental health interventions for adolescents.

Adverse childhood experiences (ACEs) and emotion dysregulation phenotypes: An intersectional analysis of race/ethnicity and gender in a nationally representative U.S. sample

BACKGROUND

Adverse childhood experiences (ACEs) are strong, preventable risk factors for emotion dysregulation in adolescence, but whether ACEs-emotion dysregulation associations differ by race/ethnicity or gender remains unclear.

OBJECTIVE

We examined (a) how race/ethnicity and gender jointly impact latent ACEs classes and emotion dysregulation phenotypes, and (b) how these ACEs classes in childhood (by age 9) transition to latent emotion dysregulation phenotypes in adolescence (at age 15).

PARTICIPANTS AND SETTING

Participants were 3,273 children from two waves of data from the Future of Families and Child Wellbeing Study, a large, nationally representative cohort. The sample consisted of 26.6% non-Hispanic (NH) Black boys, 25.4% NH Black girls, 12.9% Hispanic boys, 12.6% Hispanic girls, 11.8% NH White boys, and 10.7% NH White girls.

METHOD

We estimated latent class models to identify ACEs patterns across ten indicators and dysregulation phenotypes across affective, attentional, and behavioral domains. Latent transition analysis was used to examine how ACEs classes transitioned into dysregulation phenotypes from childhood into adolescence.

RESULTS

The findings revealed significant variation in the number and nature of latent classes of both ACEs and emotion dysregulation across the intersection of race/ethnicity and gender. NH Black and Hispanic children were more likely to be in the Poverty and Parental Separation class than NH White children. Hispanic boys had the highest prevalence of Severe Dysregulation (16%), whereas NH White boys had the highest prevalence of Low Symptoms (52%). Individuals in the Poverty and Parental Separation class had a higher probability of transitioning to the Low Symptoms class. In contrast, those in the Abuse and Family Dysfunction class were more likely to transition to the Severe Dysregulation class, with NH White girls showing the highest probability (.34), nearly twice that of NH Black girls (.19). These gender differences in these transition probabilities were observed for Whites but not Blacks.

CONCLUSIONS

These findings thus highlight the need for adopting an intersectional, person-centered approach when studying the effects of ACEs on adolescent development.

The effect of parenting behaviours on adolescents' rumination: a systematic review of longitudinal studies

Rumination is an emotional regulation mechanism strongly associated with the development and maintenance of internalising psychopathology in adolescence and adulthood. Parenting behaviours (PBs) play a pivotal role in the development of rumination in children and adolescents. Nonetheless, the specific PBs that can either protect against or increase the risk of rumination development remain poorly understood. This systematic review aimed to explore the (1) temporal associations between PBs and adolescents' rumination and (2) potential moderators influencing these associations. We conducted a comprehensive search across Web of Science, Scopus, PubMed, Academic Search Complete and Eric databases, adhering to PRISMA reporting guidelines. Out of 1,868 abstracts screened, 182 articles underwent full-text examination, with nine meeting the inclusion criteria for the systematic review. Overall, the studies indicated that PBs characterised by criticism, rejection and control were positively associated with the development of rumination in adolescents, whilst PBs marked by authoritative practises exhibited a negative association with rumination. Gender, temperament, environmental sensitivity and pubertal timing emerged as significant moderators in the effects of PBs on rumination. However, conclusions were limited due to the studies' methodological heterogeneity. Future studies on PBs and rumination should address various dimensions of PBs and different moderators to identify factors that can modify the development of rumination across adolescence. Findings may inform family-based prevention programmes to promote emotion regulation in adolescents as a protective factor against internalising psychopathology across adulthood.

Positive Childhood Experiences and the Indirect Relationship With Improved Emotion Regulation in Adults With ADHD Through Social Support

OBJECTIVE

To identify direct and indirect associations between PCEs and social support to emotion regulation outcomes in adults with ADHD.

METHOD

Adults with ADHD (n = 81) reported PCEs, current social support, and emotion regulation. Conditional effects modeling examined the direct and indirect relationships between PCEs and emotion dysregulation through social support.

RESULTS

Higher PCEs were indirectly related to improved emotion regulation through increased social support generally (β = -.70, 95% CI [-1.32, -0.17], and specifically through belonging (β = -.43, 95% CI [ -0.87, -0.05], self-esteem (β = -.61, 95% CI [-1.08, -0.27], and tangible social support (β = -.50, 95% CI [-1.07, -0.02].

CONCLUSIONS

PCEs may protect emotion regulation in adults with ADHD through social support, possibly through facilitating social connections, increasing access to social support, and sustaining emotion regulation strategies.

Augmenting mindfulness training through neurofeedback: a pilot study of the pre-post changes on resting-state functional connectivity in typically developing adolescents

Background

Mindfulness training has been shown to promote positive mental health outcomes and related changes in neural networks such as the default mode network, which has a central node in the posterior cingulate cortex (PCC). Previous work from our group reported on the impact of a novel, neurofeedback augmented mindfulness training (NAMT) task on regulation of PCC hemodynamic activity in typically developing adolescents. The present pilot study aimed to expand on this finding by examining the pre-post changes of the NAMT task on resting-state functional connectivity of the PCC.

Methods

Thirty-one typically developing adolescents (14.77 ± 1.23 years; 45% female) underwent a resting-state functional magnetic resonance imaging scan both before and after completing the NAMT task. A linear mixed effects model was used to assess for changes in functional connectivity of the PCC across the two resting-state runs.

Results

Data did not support the hypothesized decrease in connectivity between the PCC seed and other DMN regions from pre- to post-NAMT task. However, we observed a significant increase in functional connectivity between the PCC and a cluster encompassing the left hippocampus and amygdala following completion of the NAMT task (run 1 Fisher's Z = 0.16; run 2 Fisher's Z = 0.26).

Conclusion

Although preliminary, this finding suggests NAMT has the potential to strengthen connectivity between default mode and salience regions. We speculate that such changed connectivity may facilitate enhanced self-referential and emotional processing in adolescents.

Clinical trial registration

https://clinicaltrials.gov/, identifier NCT04053582.

The role of caregiver emotion regulation in youth mental health during the COVID-19 pandemic: A longitudinal study

The COVID-19 pandemic has presented youth and families with a broad spectrum of unique stressors. Given that adolescents are at increased risk for mental health and emotional difficulties, it is critical to explore family processes that confer resilience for youth in the face of stress. The current study investigated caregiver emotion regulation (ER) as a familial factor contributing to youth ER and risk for psychopathology following stressful life events. In a longitudinal sample of 224 youth (M age = 12.65 years) and their caregivers, we examined whether caregiver and youth engagement in ER strategies early in the pandemic mediated the associations of pandemic-related stress with youth internalizing and externalizing symptoms six months later. Leveraging serial mediation analysis, we demonstrated that caregiver and youth rumination, but not expressive suppression or cognitive reappraisal, mediated the prospective associations of pandemic-related stress with youth internalizing and externalizing symptoms. Greater exposure to pandemic-related stressors was associated with greater caregiver rumination, which, in turn, related to greater rumination in youth, and higher levels of youth internalizing and externalizing symptoms thereafter. Family interventions that target caregiver ER, specifically rumination, may buffer against the consequences of stress on youth engagement in maladaptive ER strategies and risk for psychopathology.

Alexithymia: A Defense of the Original Conceptualization of the Construct and a Critique of the Attention-Appraisal Model

Objective

Our goal was to compare the original conceptualization of the alexithymia construct with the attention-appraisal model, focusing primarily on the removal of the reduced imaginal activity component, a seminal aspect of the construct in the original model. We also examined associations between alexithymia and emotional distress and emotion regulation, attachment, and trauma, and whether alexithymia is a transdiagnostic risk factor. We discuss differences between the models in the treatment of alexithymia and also differences in measurement.

Method

We conducted a narrative review of the scientific literature validating the original model of alexithymia and examined the comparatively few empirical studies evaluating the attention-appraisal model. Articles describing contemporary theoretical ideas about the relationship between imagination and emotion were reviewed, as well as studies exploring associations between alexithymia and imaginal activity.

Results

The attention-appraisal model of alexithymia is theoretically derived and examined empirically in studies using correlation/measurement-based methods that employed self-report measures with mostly non-clinical samples and conducted primarily by researchers led by developers of the model. The original model of alexithymia is derived from observations of patients in clinical settings; its validity is supported by findings from hundreds of empirical investigations spanning nearly four decades with nonclinical and a variety of clinical samples using both correlation-based and experimental studies and methods of measurement other than self-report, and by independent teams of researchers. The reduced imaginal activity component of the alexithymia construct is mostly supported by these studies.

Conclusions

Because of the dearth of studies with clinical samples, the absence of investigations by independent researchers, and the limited range of methods and measurements to evaluate and assess the model, there is insufficient evidence to warrant removal of the imaginal activity component of the alexithymia construct and for replacing the original conceptualization of the construct with the attention-appraisal model.

Self-Compassion and Emotion Dysregulation Mediate the Effect of Stress Appraisals on Elder Abuse and Neglect Behaviors in Dementia Family Caregiving

OBJECTIVES

The purpose of this paper is to evaluate the mechanistic process by which family caregivers' situational stress appraisals of behavioral symptoms of dementia (BSD) increase the likelihood of a caregiver engaging in abusive and neglectful behaviors toward their care recipient with dementia. We test the hypotheses that (1) the effect of daily BSD stress appraisals on elder abuse and neglect (EAN) is mediated by the caregivers' emotion dysregulation (2) and the mediation path is moderated by self-compassion.

METHODS

This study employed a multitime series design in which participants (N = 453) completed traditional longitudinal surveys at enrollment followed by 21 sequential days of diary surveys (n = 9,513). The hypothesized moderated mediation path was evaluated through a multilevel structural equation model.

RESULTS

Hypotheses were supported. At the within-person level, daily BSD stress appraisal has a significant direct effect on daily EAN. At the between-person level, the path was no longer significant implying a full mediation of emotion dysregulation. The main effect of self-compassion and the interaction term (emotion dysregulation × self-compassion) were also statistically significant indicating the path between emotion dysregulation and EAN is moderated by self-compassion.

DISCUSSION

This study significantly advances the field by empirically showing a mechanistic pathway for a theoretical explanation of EAN. These findings represent a breakthrough for the field and identify modifiable intervention targets for future behavioral interventions to prevent EAN. Emotion (dys)regulation and self-compassion are modifiable traits and skills that can be learned, with robust evidence bases of efficacious interventions that can be adapted for context to dementia family caregiving.

Reduced positive attentional bias in patients with borderline personality disorder compared with non-patients: results from a free-viewing eye-tracking study

BACKGROUND

Attentional processes are important for regulating emotional states and coping with stressful events. Orientation of attention acts as filter for subsequent information processing. So far, only few eye-tracking studies have examined attentional processes during emotion perception in borderline personality disorder (BPD). In these studies, gaze behaviour was analysed during simultaneous or delayed evaluation of single stimuli. The objective of the present eye-tracking study was to investigate early and late attention allocation towards emotional facial expressions in patients with BPD and non-patients (NPs) based on a free-viewing paradigm, which allows to examine processes of self-generated attention deployment.

METHODS

In a multiple-stimulus free-viewing task with facial expressions, i.e. happy, angry, sad, and neutral faces, presented simultaneously early and late attentional allocation was analysed in 43 patients with BPD and 43 age- and sex-matched NPs. We assessed study participants' trait anxiety, depressive symptoms, level of alexithymia, traumatic childhood experiences, and borderline symptoms. Entry time was used to measure initial gaze orientation, whereas dwell time was calculated as an index of late attention allocation.

RESULTS

As could be expected, patients with BPD reported more anxiety, depressive symptoms, experiences of childhood maltreatment, and showed higher levels of alexithymia than NPs. Patients differed from NPs in dwell time on happy facial expressions but not in dwell time on angry, sad, and neutral expressions. Contrary to our hypothesis, patients did not differ from NPs concerning entry times on angry facial expressions.

CONCLUSIONS

According to our results, patients with BPD show a reduced attentional preference for happy facial expression during free viewing compared to NPs. A decreased positive attentional bias at a late processing stage could be part of emotion regulation impairments and add to the vulnerability for negative affects in BPD, which represent core symptoms of the disorder. In contrast to previous eye-tracking research in BPD examining attention during evaluative processing, our dwell time data could be more indicative of self-generated, endogenously controlled attentional processes in emotion perception. The present data do not support an early vigilance for threatening social information in BPD.

general psychopathology factor in Chinese adolescents and its correlation with trans-diagnostic protective psycho-social factors

BACKGROUND

Comorbidity in mental disorders is prevalent among adolescents, with evidence suggesting a general psychopathology factor ("p" factor) that reflects shared mechanisms across different disorders. However, the association between the "p" factor and protective factors remains understudied. The current study aimed to explore the "p" factor, and its associations with psycho-social functioning, in Chinese adolescents.

METHODS

2052 students, aged 9-17, were recruited from primary and secondary schools in Shanghai, China. Multiple rating scales were used to assess psychological symptoms and psycho-social functioning. Confirmatory factor analysis was conducted to verify the fit of models involving different psychopathology domains such as externalizing, internalizing, and the "p" factor. Subsequently, structural equation models were used to explore associations between the extracted factors and psycho-social functioning, including emotion regulation, mindful attention awareness, self-esteem, self-efficacy, resilience, and perceived support.

RESULTS

The bi-factor model demonstrated a good fit, with a "p" factor accounting for 46 % of symptom variation, indicating that the psychological symptoms of Chinese adolescents could be explained by internalizing, externalizing, and the "p" factor. Psychologically, a higher "p" was positively correlated with emotion suppression and negatively correlated with mindful attention awareness, emotion reappraisal, self-esteem, and resilience. Socially, a higher "p" was associated with decreased perceived support.

LIMITATIONS

Only common symptoms were included as this study was conducted at school. Furthermore, the cross-sectional design limited our ability to investigate causal relationships.

CONCLUSIONS

A "p" factor exists among Chinese adolescents. Individuals with higher "p" factor levels were prone to experience lower levels of psycho-social functions.

Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study

BACKGROUND

Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth.

METHODS

The sample includes 170 youths aged 10-13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later.

RESULTS

Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms.

CONCLUSIONS

Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.

Diverging Effects of Violence Exposure and Psychiatric Symptoms on Amygdala-Prefrontal Maturation During Childhood and Adolescence

BACKGROUND

Violence exposure during childhood and adolescence is associated with increased prevalence and severity of psychopathology. Neurobiological correlates suggest that abnormal maturation of emotion-related brain circuitry, such as the amygdala-prefrontal cortex (PFC) circuit, may underlie the development of psychiatric symptoms after exposure. However, it remains unclear how amygdala-PFC circuit maturation is related to psychiatric risk in the context of violence.

METHODS

In this study, we analyzed individual differences in amygdala-PFC circuit maturity using data collected from the PNC (Philadelphia Neurodevelopmental Cohort) (n = 1133 youths). Neurodevelopment models of amygdala-PFC resting-state functional connectivity were built using deep learning and trained to predict chronological age in typically developing youths (not violence exposed and without a psychiatric diagnosis). Using the brain age gap estimate, an index of relative circuit maturation, patterns of atypical neurodevelopment were investigated.

RESULTS

Violence exposure was associated with delayed maturation of basolateral amygdala (BLA)-PFC circuits, driven by increased BLA-medial orbitofrontal cortex functional connectivity. In contrast, increased psychiatric symptoms were associated with advanced maturation of BLA-PFC functional connectivity, driven by decreased BLA-dorsolateral PFC functional connectivity.

CONCLUSIONS

Delayed frontoamygdala maturation after exposure to violence suggests atypical, but adaptive, development of threat appraisal processes, potentially reflecting a greater threat generalization characteristic of younger children. Advanced circuit maturation with increasing symptoms suggests divergent neurodevelopmental mechanisms underlying illness after emotion circuits have adapted to adversity, exacerbated by preexisting vulnerabilities to early maturation. Disentangling the effects of adversity and psychopathology on neurodevelopment is crucial for helping youths recover from violence and preventing illness from continuing into adulthood.

The relationship between general psychopathology in young people with family functioning and engagement with psychotherapy

OBJECTIVE

to examine whether an underlying general psychopathology factor (p factor) existed in children and adolescents attending psychodynamic psychotherapy and whether this general psychopathology factor was associated with family functioning and engagement with psychotherapy.

METHOD

Participants were 1976 children and adolescents, and their families, who sought psychodynamic psychotherapy from a community-based clinic in Southern Brazil. The Child Behavior Checklist and the Family Adaptability and Cohesion Evaluation Scales for assessing symptoms and family functioning were used, with treatment engagement data available through linked records. Confirmatory factor analytic methods examined psychopathology and regression models were constructed to examine associations.

RESULTS

A general psychopathology factor and specific internalizing and externalizing factors were identified. Higher general psychopathology scores at assessment were associated with an increased likelihood of dropout and poorer attendance compared to completing treatment. Father's educational level, living with both parents, lack of family adaptability and cohesion, and maltreatment experience were related to increased p factor severity.

CONCLUSION

General psychopathology severity seems to contribute to child and adolescent psychotherapy outcomes, increasing the risk of non-adherence and dropout. Family difficulties and traumatic experiences may increase p factor severity. Identifying general psychopathology routinely can be crucial for developing effective treatment plans.

Childhood maltreatment and transdiagnostic connectivity of the default-mode network: The importance of duration of exposure

Childhood maltreatment (CM) has been demonstrated to be associated with changes in resting-state functional connectivity of the default-mode network (DMN) across various mental disorders. Growing evidence regarding severity of CM is available but transdiagnostic research considering the role of both severity and duration of CM for DMN connectivity at rest is still scarce. We recruited a sample of participants with varying levels of CM suffering from three disorders in which a history of CM is frequently found, namely, post-traumatic stress disorder, major depressive disorder, or somatic symptom disorder, as well as healthy volunteers to examine DMN connectivity in a transdiagnostic sample. We expected to find changes in inter-network connectivity of the DMN related to higher self-reported levels of CM severity and duration. Resting-state functional magnetic resonance imaging scans of 128 participants were analyzed focusing on regions of interest (ROI-to-ROI approach) and whole-brain Seed-to-Voxel analyses with retrospectively assessed CM as predictor in a regression model. Changes in connectivity between nodes of the DMN and the visual network were identified to be associated with CM duration but not severity. CM duration showed associations with increased connectivity of the precuneus and visual regions, as well as sensory-motor regions. The observed changes in connectivity could be interpreted as an impairment of information transfer between the transmodal DMN and unimodal visual and sensory-motor regions with impairment increasing with duration of exposure to CM.

Cigarette Smoking in Women Victims of Police-Reported Intimate Partner Violence: The Role of Childhood Maltreatment, Type of Partner Abuse, and Psychological Distress Symptoms

Existing research on the relationship between intimate partner violence (IPV) and cigarette smoking primarily involves low-risk, physical IVP-focused studies on community women. As a result, the risks associated with cigarette smoking in women victims of severe IPV have not been fully explored. This study examined the association between exposure to different forms of childhood maltreatment, exposure to physical, psychological, and sexual IPV, and current psychological distress symptoms with cigarette smoking in a high-risk sample of women victims of police-reported severe IPV. Participants included 162 women victims of police-reported severe IPV recruited in shelters for domestic violence and Child Protective Services in Portugal. Participants provided self-reports on childhood maltreatment physical, psychological, and sexual violence), physical, psychological, and sexual IPV, psychological distress symptoms (anxiety, depressive, somatic, and posttraumatic stress disorder symptoms), and daily cigarette consumption. Results revealed significant associations between daily cigarette consumption and exposure to IPV, physical abuse during childhood, psychological IPV, and anxiety symptoms in women experiencing police-reported severe IPV. Childhood maltreatment may increase vulnerability for emotion dysregulation, promoting addictive behaviors to regulate distress. Smoking can be an unhealthy regulating strategy to reduce the distress related to chronic exposure to psychological IPV. Future effective health promotion interventions in women facing severe forms of IPV may target emotional regulation and incorporate a trauma-focused approach.

Investigating the impact of rumination and adverse childhood experiences on resting-state neural activity and connectivity in depression

BACKGROUND

Both ruminative thought processes and adverse childhood experiences (ACEs) are well-established risk factors for the emergence and maintenance of depression. However, the neurobiological mechanisms underlying these associations remain poorly understood.

METHODS

We examined resting-state functional magnetic resonance imaging data (3 T Tim Trio MR scanner; Siemens, Erlangen) of 44 individuals diagnosed with an acute depressive episode. Specifically, we focused on investigating functional brain activity and connectivity within and between three large-scale neural networks associated with processes affected in depression: the default mode network (DMN), the salience network (SN), and the central executive network (CEN). Correlational and regression-based analyses were performed.

RESULTS

Our regions of interest analyses revealed that region-specific spontaneous neural activity in the anterior DMN was associated with self-reported trait rumination, specifically, the pregenual anterior cingulate cortex (pgACC). Furthermore, using a liberal statistical threshold, we found that spontaneous neural activity of the ventromedial prefrontal cortex and the pgACC were associated with depression symptom severity. Neither spontaneous neural activity in the SN and CEN nor functional connectivity within and across the investigated networks was associated with depression severity or rumination. Furthermore, there was no association between ACEs and brain activity and connectivity.

LIMITATIONS

Lack of a formal control group or low-risk group for comparison.

CONCLUSIONS

Overall, our results indicate network-specific changes in spontaneous brain activity, that are linked to both depression severity and rumination. Findings underscore the crucial role of the pgACC in depression and contribute to a dimensional and symptom-based understanding of depression-related network imbalances.

Predictors of the rate and course of reactive attachment disorder and disinhibited social engagement disorder symptoms in foster children during the first year of placement

BACKGROUND

Due to adverse care experiences, foster children are at risk for developing symptoms of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED).

OBJECTIVE

This study investigated the factors influencing rate and course of RAD and DSED symptoms during the first year of placement in long-term foster care.

PARTICIPANTS AND SETTING

The sample consisted of 55 foster children aged 1 to 6 years. Measurements were taken at placement as well as 6 and 12 months after placement.

METHODS

RAD and DSED symptoms were assessed with the Disturbance of Attachment Interview (DAI). DSED symptoms were also assessed by observation with the Rating of Infant Stranger Engagement (RISE). Foster parents and caseworkers reported on children's preplacement experiences and placement characteristics.

RESULTS

RAD symptoms were rare at Wave 1 (5.5 %) and remitted in most children within the first six months of placement, t(54) = 3.06, p = .003. A total of 30.9 % of the foster children presented DSED symptoms according to the DAI, but only 5.5 % of the children according to the RISE. Foster parents reported symptom reduction, t(54) = 3.71, p = .003, while observational data indicated symptom stability. Prior placement in emergency foster care was associated with lower levels of RAD at Wave 1, F(1.62, 80.88) = 7.80, p = .002, while later placed children presented more RAD and DSED symptoms (RRAD2 = 0.07, RDSED2 = 0.08, RRISE2 = 0.12). Psychopathology of the biological parents (RRAD2 = 0.07, RDSED2 = 0.08) and visitation with the biological parents (RRISE2 = 0.14) predicted symptom stability.

CONCLUSION

A substantial number of foster children present persistent DSED symptoms indicating a need for evidenced based interventions.

Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis

Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0%) than paternal (19.5-56.0%) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.

Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences

BACKGROUND

Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored.

OBJECTIVE

To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample.

METHODS

A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire.

RESULTS

ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels.

CONCLUSIONS

This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.

Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents

BACKGROUND

Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts.

OBJECTIVE

The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents.

PARTICIPANTS AND SETTING

A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey.

METHODS

Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems.

RESULTS

CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives.

CONCLUSIONS

The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.

Threat, Emotion Dysregulation, and Parenting in a Clinical Sample of Children with Disruptive Behaviour

Early-life adversity is associated with the development of internalizing and externalizing problems in children. Despite this, there is a need to understand the mechanisms linking these experiences to psychopathology, especially in clinical samples. This cross-sectional study tested emotion dysregulation as a mechanism linking early-life threat to psychopathology in a clinical sample of children with disruptive behavior problems. We also explored parental positive reinforcement as a protective factor in these pathways. A clinical sample of 606 children aged 6-12 years, referred to a mental healthcare hospital, were included. Parent-reported child threat, and parent- and teacher-reported child emotion dysregulation and psychopathology, were collected. Path analysis was used to explore the mediating effect of emotion dysregulation in the relation between threat and psychopathology. The moderating effects of parental positive reinforcement were explored through moderated-mediation analyses. Emotion dysregulation partially mediated the association between threat and both internalizing (β = .18, P = .006) and externalizing (β = .19, P = .002) problems. Positive reinforcement did not buffer the association between threat and emotion dysregulation (β = .09, P = .62) or the association between emotion dysregulation and internalizing (β = - .003, P = .20) or externalizing (β = - .002, P = .35). Poor emotion regulation may be a transdiagnostic mechanism linking early-threat with internalizing and externalizing problems in clinic-referred children with disruptive behaviors. Factors aside from parental positive reinforcement should be explored as protective factors in these pathways, including those directly implicated in the purported mechanisms linking these factors over time.

Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis

Introduction

Victims of child abuse have an elevated risk of developing mental health issues later in life. Several variables have been suggested as mediators of this correlation, but little is known about the possible influence of alexithymia. Alexithymia is a sub-clinical personality trait that manifests as difficulties recognizing and verbalizing emotions.

Methods

In this study, two separate meta-analyses were conducted using questionnaire data, and Pearson correlations for overall effects were estimated.

Results

The correlation between child abuse and alexithymia showed to be significant (r = .26), as did the correlation between alexithymia and general psychopathology (r = .44). Further analyses revealed no indication for possible publication bias. When investigating differences between various subtypes of child maltreatment, each subtype significantly correlated with alexithymia. Emotional abuse, emotional neglect, and physical neglect had stronger correlations than physical and sexual abuse.

Discussion

These results suggest that alexithymia plays a mediating role, at least in part, in the relationship between experiences of child abuse and general psychopathology in adulthood. Therefore, alexithymia may be relevant to further research and deserves attention in the prevention of and therapy for mental health issues in victims of child abuse.

Adaptive-to-maladaptive gradient of emotion regulation tendencies are embedded in the functional-structural hybrid connectome

BACKGROUND

Emotion regulation tendencies are well-known transdiagnostic markers of psychopathology, but their neurobiological foundations have mostly been examined within the theoretical framework of cortical-subcortical interactions.

METHODS

We explored the connectome-wide neural correlates of emotion regulation tendencies using functional and diffusion magnetic resonance images of healthy young adults (N = 99; age 20-30; 28 females). We first tested the importance of considering both the functional and structural connectome through intersubject representational similarity analyses. Then, we employed a canonical correlation analysis between the functional-structural hybrid connectome and 23 emotion regulation strategies. Lastly, we sought to externally validate the results on a transdiagnostic adolescent sample (N = 93; age 11-19; 34 females).

RESULTS

First, interindividual similarity of emotion regulation profiles was significantly correlated with interindividual similarity of the functional-structural hybrid connectome, more so than either the functional or structural connectome. Canonical correlation analysis revealed that an adaptive-to-maladaptive gradient of emotion regulation tendencies mapped onto a specific configuration of covariance within the functional-structural hybrid connectome, which primarily involved functional connections in the motor network and the visual networks as well as structural connections in the default mode network and the subcortical-cerebellar network. In the transdiagnostic adolescent dataset, stronger functional signatures of the found network were associated with higher general positive affect through more frequent use of adaptive coping strategies.

CONCLUSIONS

Taken together, our study illustrates a gradient of emotion regulation tendencies that is best captured when simultaneously considering the functional and structural connections across the whole brain.

Childhood Maltreatment and Spiritual Well-Being: Intolerance of Uncertainty and Emotion Regulation as Mediators in Turkish Sample

Spiritual well-being is a phenomenon that enhances the quality of life and acts as a protective factor against stress and negative emotions. The purpose of this study was to investigate whether childhood psychological maltreatment is related to spiritual well-being and whether intolerance of uncertainty and emotion regulation serially mediate this relationship. The study sample comprised 330 participants aged between 18 and 55 years from 46 out of the 81 cities in Türkiye. The study participants completed the Psychological Maltreatment Questionnaire, Intolerance of Uncertainty Scale, Emotion Regulation Scale, and Spiritual Well-Being Scale, a scale derived from the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being that measures spiritual well-being by using the conceptualization of meaning and peace. The data obtained were analyzed using a two-step structural equation modeling approach, which indicated that childhood psychological maltreatment has an association with spiritual well-being, and this relationship is mediated by both intolerance of uncertainty and emotion regulation. The findings are discussed in the context of the literature on spiritual well-being.

Emotional reactivity linking assaultive trauma and risky behavior: Evidence of differences between cisgender women and men

Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18-55 years, M = 32.98 years, SD = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past-month risky behavior. We also explored whether this model differed for cisgender women (n = 178, 47.6%) and men (n = 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, SE = 0.03, t(369) = 3.65, p < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, SE = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: B = -0.03, SE = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.

Childhood adversity modulates structural brain changes in borderline personality but not in major depression disorder

Adverse childhood experiences (ACEs) negatively affect the function and structure of emotion brain circuits, increasing the risk of various psychiatric disorders. It is unclear if ACEs show disorder specificity with respect to their effects on brain structure. We aimed to investigate whether the structural brain effects of ACEs differ between patients with major depression (MDD) and borderline personality disorder (BPD). These disorders share many symptoms but likely have different etiologies. To achieve our goal, we obtained structural 3T-MRI images from 20 healthy controls (HC), 19 MDD patients, and 18 BPD patients, and measured cortical thickness and subcortical gray matter volumes. We utilized the Adverse Childhood Experiences (ACE) questionnaire to quantify self-reported exposure to childhood trauma. Our findings suggest that individuals with MDD exhibit a smaller cortical thickness when compared to those with BPD. However, ACEs showed a significantly affected relationship with cortical thickness in BPD but not in MDD. ACEs were found to be associated with thinning in cortical regions involved in emotional behavior in BPD, whereas HC showed an opposite association. Our results suggest a potential mechanism of ACE effects on psychopathology involving changes in brain structure. These findings highlight the importance of early detection and intervention strategies.

Szabo Y. Childhood Adversity and Adult Inflammation: Exploring the Mediating Role of Emotion Regulation in the MIDUS II Study

The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-023-00594-2.

Early life adversity and psychopathology in preschoolers: mechanisms and moderators

Developmental theories suggest that exposure to early life adversity (ELA) alters developing emotional response systems, predicting risk for psychopathology across the life span. The present study examines whether negative emotionality (NE), a trait-like measure of emotionality that develops during early childhood, mediates the association between ELA and psychopathology in a representative sample of 917 preschoolers (Mage = 3.84). Additionally, we explored whether cognitive control, which supports attentional focusing and inhibition and has been identified as a transdiagnostic protective factor, moderates the impact of heightened emotionality following adversity on psychopathology risk. We utilized parent report of adversity, psychopathology, and NE and parent report and task-based measures of cognitive control. Structural equation modeling of cross-sectional data revealed that NE partially mediated the link between ELA and psychopathology symptoms. Moreover, parent-reported cognitive control buffered this link such that the effect of ELA on psychopathology through NE was stronger in children with low versus high cognitive control. These results identify elevated NE as one mechanism linking ELA and psychopathology, specifically among children with poorer top-down control, informing our understanding of key risk and protective factors among adversity-exposed children.

Witnessing family violence and adolescent cyberbullying perpetration: A longitudinal moderated mediation model involving anger dysregulation and teacher support

BACKGROUND

Family violence has been shown to be associated with traditional adolescent bullying perpetration. However, few studies have considered the association between witnessing family violence and adolescent bullying perpetration in cyberspace.

OBJECTIVE

The present study aimed to reveal the mechanism explaining the association between witnessing family violence and adolescent cyberbullying perpetration by testing the mediating effect of anger dysregulation and the moderating effect of teacher support.

PARTICIPANTS AND SETTING

Participants were 751 Chinese adolescents (Mage at Time 1 = 13.25) who completed the measures of witnessing family violence, anger dysregulation, cyberbullying perpetration, and teacher support at three time points over the year.

METHODS

Structural equation modeling was used to assess the direct and indirect effects of witnessing family violence on adolescent cyberbullying perpetration through anger dysregulation as a mediator and perceived teacher support as a moderator.

RESULTS

The results showed that witnessing family violence at baseline positively predicted adolescent cyberbullying perpetration at T3, and anger dysregulation at T2 partially mediated this association. The positive relation between witnessing family violence and later anger dysregulation was stronger for adolescents who perceived higher levels of teacher support.

CONCLUSIONS

Witnessing family violence could increase the risk for adolescent cyberbullying perpetration, with anger dysregulation mediating this association. The protective effect of perceived teacher support weakens as the levels of witnessing family violence increase. These findings offer insight into the connection between witnessing family violence and adolescent bullying perpetration in the digital age, emphasizing the importance of promoting programs to prevent intrafamilial violence.

Early childhood trauma exposure and neurocognitive and emotional processes: Associations in young children in a partial hospital program

Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.

Pathways Linking Parental Care and Control to Loneliness in Breast Cancer Patients with A History of Childhood Maltreatment: Exploring the Mediating Roles of Ambivalence Over Emotional Expression and Self-Discrepancy

Childhood maltreatment is a risk factor for loneliness and is linked to breast cancer. Parental bonding experienced during one's childhood also plays a significant role in increasing or decreasing the risk of loneliness later in life. Previous research has highlighted the significance of ambivalence over emotional expression (AEE) and self-discrepancy in the psychological adaptation of breast cancer patients, particularly concerning the impact of parental care and control experienced by patients in their relationship with their parents during childhood. Nevertheless, previous studies have not examined the mediating effects of AEE and self-discrepancy on parental care and control, as well as loneliness, in breast cancer patients. This study aimed to investigate whether AEE and self-discrepancy mediate the association of childhood parental care and control with loneliness in breast cancer patients with a history of childhood maltreatment. One hundred and thirty-three breast cancer patients who were receiving chemotherapy within the first 3 months post-diagnosis were recruited from one private and three public hospitals in Tabriz, Iran, to complete questionnaires. Parental bonding, loneliness, AEE, and self-discrepancy were assessed using the Parental Bonding Instrument (PBI), University of California Los Angeles (UCLA) Loneliness Scale, Ambivalence over the Expression of Emotion Questionnaire (AEQ), and Self-Discrepancies Scale (S-DS). Mediation models were tested using structural equation modeling. Effects of parental care (β = -.17, p < .05) and control (β = .21, p < .001) on loneliness were significant. Furthermore, both AEE (β = .19, p < .05) and self-discrepancy (β = .23, p < .01) significantly predicted loneliness. The pathway between parental care and AEE was significant (β = -.21, p < .001), as was the direct effect of parental control on self-discrepancy (β = .19, p < .05). Bootstrapping results showed that AEE significantly mediated the relationship between parental care and loneliness (95% confidence interval [CI] [-0.09, -0.01]). In addition, there was a significant indirect effect from parental control to loneliness via self-discrepancy (95% CI [0.11, 0.01]). These findings suggest that AEE and self-discrepancy could potentially be utilized in preventing or addressing loneliness in breast cancer patients who have a history of childhood maltreatment. Future research could, for example, assess whether integrating psychosocial interventions focusing on these variables as part of medical care can improve the mental health status of this subgroup of breast cancer patients who have experienced childhood maltreatment.

Emotional Regulation as a Transdiagnostic Process of Emotional Disorders in Therapy: A Systematic Review and Meta-Analysis

CONTEXT

Several studies have shown that emotional regulation (ER) is a transdiagnostic construct of emotional disorders. Therefore, if therapy improves ER, it would improve psychological distress.

OBJECTIVE

This review assesses and compares the changes in ER due to psychological treatment in different therapies.

METHODS

A systematic review and meta-analysis of RCTs published in the databases PubMed, PsycINFO and Web of Science was performed. It was registered in PROSPERO under the number CRD42023387317. Two independent experts in the field reviewed the articles.

RESULTS

A total of 18 articles met the criteria for inclusion in the review. Analysis of these studies suggests that in unified protocol (UP), cognitive behaviour therapy, dialectical behaviour therapy (DBT) and mindfulness, there is evidence to support that a moderate effect occurs during treatment. Furthermore, in mindfulness and DBT, the effect was moderate in the follow-up period, while in UP, it was high.

LIMITATIONS

Given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution.

CONCLUSIONS

UP, cognitive behaviour therapy, DBT and mindfulness can improve ER after therapy, while UP, DBT and mindfulness in the follow-up period. Other therapies, such as SKY or Flotation REST, require more research.

Childhood maltreatment and suicidal ideation among Chinese adolescents: Moderated mediation effect of perceived social support and maladaptive cognitive emotion regulation strategies

BACKGROUND

Although previous studies have shown that childhood maltreatment is a risk factor for adolescent suicidal ideation, less is known about the mediating and moderating mechanisms underlying this association.

OBJECTIVE

The current study aimed to investigate the relationship between childhood maltreatment and suicidal ideation among adolescents, as well as the mediating role of maladaptive cognitive emotion regulation strategies (maladaptive CERSs) and the moderating role of perceived social support.

METHODS

In a cross-sectional design, 4005 adolescents (Mage = 14.24 years, SD = 1.53; 49.0 % males) completed self-report questionnaires regarding childhood maltreatment, maladaptive CERSs, perceived social support and suicidal ideation, along with their basic information.

RESULTS

After controlling for gender, family location, family structure, and depression, childhood maltreatment was positively related to adolescent suicidal ideation, and maladaptive CERSs were found to mediate this association. Moderated mediation analyses revealed that perceived social support buffered the associations between maladaptive CERSs and adolescent suicidal ideation.

CONCLUSIONS

The findings assist in understanding the mechanisms of maladaptive CERSs and perceived social support in the relationship between childhood maltreatment and suicidal ideation and can provide new perspectives for researchers designing interventions for suicidal ideation.

Reactive and control processes in the development of internalizing and externalizing problems across early childhood to adolescence

Reactive and control processes - e.g., negative emotionality and immediacy preference - may predict distinct psychopathology trajectories. However, externalizing and internalizing problems change in behavioral manifestation across development and across contexts, thus necessitating the use of different measures and informants across ages. This is the first study that created developmental scales for both internalizing and externalizing problems by putting scores from different informants and measures onto the same scale to examine temperament facets as risk factors. Multidimensional linking allowed us to examine trajectories of internalizing and externalizing problems from ages 2 to 15 years (N = 1,364) using near-annual ratings by mothers, fathers, teachers, other caregivers, and self report. We examined reactive and control processes in early childhood as predictors of the trajectories and as predictors of general versus specific psychopathology in adolescence. Negative emotionality at age 4 predicted general psychopathology and unique externalizing problems at age 15. Wait times on an immediacy preference task at age 4 were negatively associated with age 15 general psychopathology, and positively associated with unique internalizing problems. Findings demonstrate the value of developmental scaling for examining development of psychopathology across a lengthy developmental span and the importance of considering reactive and control processes in development of psychopathology.

Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

Childhood maltreatment and Internet addiction among Chinese adolescents: A moderated mediation model

Although childhood maltreatment has been suggested to play an important role in developing Internet addiction among adolescents, little is known about the mediating and moderating mechanisms underlying this association. The present study investigated (a) the mediating role of maladaptive cognitive emotion regulation strategy (MCERS) in the association between childhood maltreatment and Internet addiction, and (b) the moderating role of peer support in the relationship between childhood maltreatment and Internet addiction. A sample of 4163 Chinese adolescents (50.3 % females, Mage = 14.25, SD = 1.53) were recruited. The moderated mediation model showed that MCERS mediated the relationship between childhood maltreatment and Internet addiction. Furthermore, the mediating process was moderated by peer support. Interestingly, peer support can protect adolescents from being affected by higher levels of MCERS while it displays limited protective effect when adolescents suffered from higher levels of childhood maltreatment. These findings indicate that reducing the MCERS and enhancing peer support can contribute to the alleviation of negative influences of childhood maltreatment on Internet addiction.

Experience-dependent neurodevelopment of self-regulation in adolescence

Adolescence is a period of rapid biobehavioral change, characterized in part by increased neural maturation and sensitivity to one's environment. In this review, we aim to demonstrate that self-regulation skills are tuned by adolescents' social, cultural, and socioeconomic contexts. We discuss adjacent literatures that demonstrate the importance of experience-dependent learning for adolescent development: environmental contextual influences and training paradigms that aim to improve regulation skills. We first highlight changes in prominent limbic and cortical regions-like the amygdala and medial prefrontal cortex-as well as structural and functional connectivity between these areas that are associated with adolescents' regulation skills. Next, we consider how puberty, the hallmark developmental milestone in adolescence, helps instantiate these biobehavioral adaptations. We then survey the existing literature demonstrating the ways in which cultural, socioeconomic, and interpersonal contexts drive behavioral and neural adaptation for self-regulation. Finally, we highlight promising results from regulation training paradigms that suggest training may be especially efficacious for adolescent samples. In our conclusion, we highlight some exciting frontiers in human self-regulation research as well as recommendations for improving the methodological implementation of developmental neuroimaging studies and training paradigms.

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.

Reliability and validity estimation of Urdu version of Children Emotion Management Scales (CEMS) in Pakistan

Introduction

The present study aimed to translate and validate Children's Emotion Management Scales into Urdu, the national language of Pakistan.

Method

The current study comprised three different phases, i.e., phase I: Cross-language validation over a sample of (N = 169) school children, estimated at a 1-week interval.

Results

The results indicate a significant correlation (r = 0.846-0.891) at p < 0.01. In phase II, the internal consistency reliability (r = 0.808-0.904) and split-half reliability (r = 0.737-0.898) of the scale were assessed (N = 683) at p < 0.01. Furthermore, significant results for test-retest reliability analysis (N = 168) were obtained (r = 0.736-0.917 at p < 0.01), following the confirmatory factor analysis (CFA) (N = 1,083). Exploratory factor analysis (EFA) was conducted on the same sample chosen for CFA. EFA resulted in the retention of original inhibition (INH), dysregulated expression (DYS), and emotional coping (EMO) factors. CFA findings suggest a good model fit. In phase III, convergent validity and divergent validity were checked (N = 385, 255, and 213). Convergent validity of INH and DYS subscales and divergent validity of EMO subscales were established, with SBI (r = 0.217-0.609; 0.210-0.445; -0.026 to -0.553), SHS (r = 0.417-0.441; 0.480-0.546; -0.338 to -0.582), and suppression subscale of ERQ (r = 0.430-0.480; 0.468-0.522; -0.245 to -0.369) at p < 0.01. For divergent validity of INH and DYS subscales and convergent validity of EMO subscales, their scores were correlated with the SPS (r = -0.204 to -0.350; -0.318 to -0.459; 0.191-0.531), RSE Scale (r = -0.226 to -0.351; -0.279 to -0.352; 0.255-0.507), DTS (-0.290 to -0.617; -0.369 to -0.456; 0.246-0.680), and reappraisal subscale of ERQ (r = -0.456 to -0.541; -0.329 to -0.544; 0.446-0.601) at p < 0.01.

Discussion

It is concluded that the scale is reliable and valid with sound psychometric properties.

A network analysis of psychopathology in young Black children: Implications for predicting outcomes in adolescence

OBJECTIVE

Network analysis may identify specific symptoms involved in the maintenance and development of psychopathology. This approach, however, has not been applied to the study of young Black children, a population facing unique challenges and developmental risks. It is also unclear whether network analysis identifies early symptoms in Black children that are linked to their longer-term difficulties and strengths in adolescence.

METHODS

We conducted a network analysis of emotional and behavioral difficulties in 1238 Black (non-Hispanic) children from the age-3 assessment in the Future of Families and Child Wellbeing Study (47 % female). We also explored whether early childhood symptoms predict subsequent caregiver-reported internalizing and externalizing problems, and youth-reported social competencies and extracurricular and community involvement, at the age-15 assessment.

RESULTS

We identified specific symptoms of externalizing and emotional reactivity as central in the network. Symptoms of emotional reactivity were also involved in comorbidity, bridging different communities of symptoms. Using elastic net models, we identified specific central and bridge symptoms, but also peripheral network symptoms, that contributed uniquely to the prediction of internalizing and externalizing problems in adolescence. Early childhood symptoms were less predictive of positive outcomes in adolescence.

CONCLUSIONS

This study identified central and bridge symptoms in young Black children, an underrepresented population in network analysis research. Some of these central and bridge symptoms, but also peripheral network symptoms, may be useful targets in early interventions to prevent long-term difficulties. Conversely, network approaches to understanding early psychopathology may have less utility for predicting Black children's subsequent strengths in adolescence.

Emotion regulation as a mediator in the relationship between childhood maltreatment and symptoms of social anxiety among college students

OBJECTIVE

The current study explored emotion regulation strategies (ie, suppression, cognitive reappraisal, experiential avoidance) as mediators in the relationship between childhood maltreatment and social anxiety.

PARTICIPANTS

One hundred and ninety-three undergraduate students (Mage = 19.5 years; 83.9% female) were recruited from a public university in the northeastern United States.

METHODS

Participants completed measures assessing childhood maltreatment, emotion regulation strategies, and social anxiety.

RESULTS

Structural equation modeling was used to examine the mediation paths. Childhood maltreatment was negatively associated with cognitive reappraisal and experiential avoidance, and positively associated with suppression. Higher suppression was associated with higher social anxiety, and higher experiential avoidance was associated with lower social anxiety. The association between childhood maltreatment and symptoms of social anxiety was mediated by suppression and experiential avoidance, but not cognitive reappraisal. All other paths were nonsignificant.

CONCLUSIONS

Findings suggest that treatments for childhood maltreatment should aim to bolster experiential avoidance and minimize suppression to address social anxiety symptoms.

Intergenerational cascade processes from parental childhood adversity to child emotional and behavioral problems

BACKGROUND

Parental adverse childhood experiences (ACEs) may transmit to the next generation and influence children's emotional and behavioral problems. Relatively little evidence exists on the underlying pathways of this intergenerational transmission at the family- and individual-level.

OBJECTIVE

This study examined the intergenerational cascade processes of parental ACEs on children's emotional and behavioral problems via family cohesion, children's ACEs, and children's self-control.

PARTICIPANTS AND SETTING

283 children (52 % male, Mage = 10.47 years) and their parents (61.1 % mothers, Mage = 38.62 years) were recruited for a 2-month longitudinal study with surveys administered at three time points.

METHOD

Mediation models examined the intergenerational effects of parental ACEs (T1/T3) and family cohesion (T1) as reported by parents, and children's ACEs (T1) and children's self-control (T2) as reported by children, on children's internalizing and externalizing problems (T3) as reported by parents.

RESULTS

Family cohesion, children's ACEs, and children's self-control sequentially mediated the link between parental ACEs and children's externalizing problems (indirect effect = 0.004, 95 % CI [0.001, 0.014]). Parental ACEs were directly linked with children's internalizing problems (β = 0.191, SE = 0.075, p = .011).

CONCLUSIONS

Findings demonstrated intergenerational cascades of distal and proximal risk processes from parental ACEs to children's behavioral problems. These findings have implications for future interventions on children's externalizing problems that aim at improving family cohesion and children's self-control for families exposed to childhood adversity.

A Developmentally Informed Systematic Review and Meta-Analysis of the Strength of General Psychopathology in Childhood and Adolescence

Considerable support exists for higher-order dimensional conceptualizations of psychopathology in adults. A growing body of work has focused on understanding the structure of general and specific psychopathology in children and adolescents. No prior meta-analysis has examined whether the strength of the general psychopathology factor (p factor)-measured by explained common variance (ECV)-changes from childhood to adolescence. The primary objective of this multilevel meta-analysis was to determine whether general psychopathology strength changes across development (i.e. across ages) in childhood and adolescence. Several databases were searched in November 2021; 65 studies, with 110 effect sizes (ECV), nested within shared data sources, were identified. Included empirical studies used a factor analytic modeling approach that estimated latent factors for child/adolescent internalizing, externalizing, and optionally thought-disordered psychopathology, and a general factor. Studies spanned ages 2-17 years. Across ages, general psychopathology explained over half (~ 56%) of the reliable variance in symptoms of psychopathology. Age-moderation analyses revealed that general factor strength remained stable across ages, suggesting that general psychopathology strength does not significantly change across childhood to adolescence. Even if the structure of psychopathology changes with development, the prominence of general psychopathology across development has important implications for future research and intervention.

The cognitive tasks and event-related potentials associated childhood adversity: A systematic review

In this systematic review, 18 articles met inclusion criteria to be qualitatively analyzed for converging evidence of brain activity, measured using event-related potential (ERP), related to retrospectively reported childhood adversity/trauma. Using the PRISMA guidelines for systematic reviews, 917 articles were assessed for inclusion and were filtered using study parameters. The most common ERP components listed in the literature were P100, N170, N200, P200, P300, ERN, and LPP. We discuss levels of evidence for changed brain activity, each ERP component, and the tasks used to evoke them. The Childhood Trauma Questionnaire was found to be the most commonly cited measure. We note the need to assess the duration and intensity of childhood adversity/trauma measurements in the strengths and limitations of the reported childhood adversity/trauma measurements. No concrete converging evidence was found to support a relationship between ERP-measured brain activity and retrospectively reported childhood adversity/trauma. Thus, a discussion of limitations and future directions for this field of research is presented.