Impact of Child Maltreatment on Attachment and Social Rank Systems: Introducing an Integrated Theory

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.

Shame, guilt, and drinking motives as mediators between child maltreatment and problematic alcohol use in college students

Objective: Drinking for emotion regulation may be a concern for college students who have experienced childhood maltreatment, due to high levels of shame and guilt. The present cross-sectional survey study tested how trait shame-proneness, trait guilt-proneness, and trauma-related guilt are differently related to drinking motives and how these pathways mediate the links between maltreatment severity and alcohol outcomes. Participants: Undergraduate student drinkers (n = 464; M age = 19.50, SD = 2.20) from a midsized midwestern University. Methods: Participants completed an online survey inquiring about demographics, childhood maltreatment, shame, guilt, drinking motives, alcohol use, and alcohol-related consequences. Results: There were several significant serial indirect effects of maltreatment on alcohol consumption and related consequences, through trauma-related guilt, shame-proneness, guilt-proneness, drinking-to-cope, and drinking for mood enhancement. Conclusions: On college campuses, to address problematic drinking among childhood maltreatment survivors, interventions may target maladaptive feelings of shame and guilt stemming from trauma exposure.

Compassion Focused Group Psychotherapy for attachment and relational trauma: Engaging people with a diagnosis of personality disorder

OBJECTIVES

The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder.

DESIGN

This study utilised a quasi-experimental non-randomised within subject controlled design for the evaluation of the efficacy of the programme.

METHODS

Participants were recruited from tertiary care services. The programme consisted of a 12-week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40-week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self-report measures was administered at various points during the therapeutic process and following completion of the group interventions.

RESULTS

The results of the research showed that the provision of a long-term, slow-paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12-month follow-up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education.

CONCLUSIONS

This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group-based safeness as a necessary precursor to cultivating compassion and reworking early shame-based trauma memories.

Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis

OBJECTIVE

Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations.

METHODS

A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976).

RESULTS

Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition.

CONCLUSIONS

Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.

A conceptual analysis of maltreatment in sports: A sport social work perspective

Maltreatment in sports is an epidemic and occurs in many relational forms such as physical, sexual, and emotional abuse or neglect. Maltreatment in sports also exists in forms of non-relational abuse and focuses on mezzo and macro forms of maltreatment such as systematic abuse, organizational abuse, and physiological abuse or neglect (e.g., exploitation and athlete trafficking). It is imperative to study the effects of maltreatment in sports as athletes can be the victims (survivors) as well as perpetrators of abuse. Recent research in the field of social work points to the benefits of Trauma-Informed Sports and Short Focused Brief Therapy (SFBT) as possible interventions. It is imperative for transferability in the field of maltreatment in sports, that practitioners define each form of abuse in the context of maltreatment and trauma. This commentary aims to discuss the different forms of maltreatment in sports that could affect athletes and provide discussion and insights into the void of research surrounding certain forms of non-relational abuse and the role trauma-informed therapies serve in promoting athlete wellbeing from a social work lens.

Parent-Child Relationship Quality, Childhood Maltreatment, and Psychological Symptoms in Chinese Adolescent

This study aimed to examine the association between childhood maltreatment, parent-child relationship quality with psychological symptoms and to explore the moderating role of parent-child relationship quality in the association between childhood maltreatment and psychological symptoms among adolescents. It also probed to the role of gender differences in this effect. A representative sample of 14,500 middle school students in China were asked to complete a standard questionnaire on the details of childhood maltreatment, parent-child relationship quality, and psychological symptoms. All data were analyzed using SPSS 23.0. The PROCESS program was used to analyze whether parent-child relationship quality moderated the link between childhood maltreatment and psychological symptoms. The analyses revealed significant correlations between childhood maltreatment, parent-child relationship quality, and psychological symptoms (p < .001). Specifically, paternal relationship quality moderated the association between childhood maltreatment and psychological symptoms in the total sample (B = -0.01, p < .05) and the subgroup of girls (B = -0.01, p < .05), while maternal relationship quality moderated only the association between childhood maltreatment and psychological symptoms in the subgroup of boys (B = -0.01, p < .05). As the findings indicate, priority should be given to the quality of parent-child relationship and gender-specific methods employed to effectively reduce the psychological symptoms of adolescents with a history of childhood maltreatment.

Childhood maltreatment and depressive symptoms among Chinese college students: A moderated mediation model of adult attachment styles and physical activity

BACKGROUND

Previous research has investigated the independent effects of childhood maltreatment, adult attachment, and physical activity, on depressive symptoms. However, explanatory mechanisms linking childhood maltreatment to current depressive symptoms are poorly understood. This study investigated the mediating role of adult attachment between childhood maltreatment and depressive symptoms among college students and explored the moderating effect of physical activity in the mediating pathway.

METHODS

The data for the present study were gathered in three waves with 6-month lags. A total of 3662 Chinese college students completed anonymous questionnaires concerning demographic variables, childhood maltreatment, and depressive symptoms in Wave 1, adult attachment and physical activity in Wave 2, and depressive symptoms in Wave 3.

RESULTS

Childhood maltreatment and adult attachment were significantly associated with depressive symptoms, identifying a mediating role of adult attachment in the relationship between childhood maltreatment and depressive symptoms, and a moderating role of physical activity between attachment anxiety and depressive symptoms in the mediating pathway.

LIMITATIONS

This study utilized self-reported questionnaires for data collection purposes, which could constitute key study limitations.

CONCLUSIONS

These findings highlight the need to consider early stress factors (childhood maltreatment), social psychological factors (adult attachment), and potential protective factors (physical activity) simultaneously when evaluating the occurrence and development of depressive symptoms.

Love in a time of anti-Blackness: social rank, attachment, and race in psychotherapy

This paper draws on critical race theory and research on attachment, social rank and dehumanization to theorize the implications of addressing anti-Blackness in psychotherapy with both Black and non-Black clients in the context of White Supremacy. Drawing on and critiquing a recent review of attachment theory and race, the author draws on historical and empirical research outlining the contours of a racial capitalist world. Recontextualizing attachment theory through this critical race theory lens, it will be argued psychotherapy must address anti-Blackness with both Black and non-Black clients, redefining therapeutic action not only as the provision of repair of interpersonal ruptures, but also as the capacity to mentalize about socio-historical ruptures, allowing space to clarify and pursue one's values despite an anti-Black, capitalist and White Supremacist world. This paper will provide case examples illustrating these principles with Black and non-Black clients and conclude with their clinical and political implications.

The Compassionate Kitbag: A creative and integrative approach to compassion-focused therapy

PURPOSE

This paper outlines the concept of the 'Compassionate Kitbag', a novel multi-sensory-based means of helping draw together the various elements of compassionate mind training and processes within compassion-focused therapy (CFT), to help clients cultivate and facilitate their capacities for compassion. Building on the work of Lucre and Corten (2013, Psychology and Psychotherapy: Theory, Research and Practice, 86, 387), this is the first published work exploring this concept and the theoretical underpinnings, with a specific focus on how this can be used to support people with attachment and relational trauma.

METHODS

A narrative review of the literature on multi-sensory stimulation in facilitating people's capacities for compassion was conducted, coupled with a review of the literature of the use of non-human and transitional objects as explained by attachment theory and the broader scientific research underpinning the CFT model.

RESULTS

Clinical examples of how to use the Compassionate Kitbag to help stimulate compassionate therapeutic processes demonstrate the benefits of and how to begin utilizing this approach in compassion-focused work with clients with complex needs.

CONCLUSIONS

The Compassionate Kitbag's potential therapeutic value lies in offering multifarious creative and tangible means of accessing compassion to a wide range of individuals whom are typically fearful of, blocked, and/or resistant to compassion. Further research into the wider application of the concept of the Compassionate Kitbag is needed.

PRACTITIONER POINTS

Many patients with ruptured and/or traumatized early attachment relationships can find more traditional talking therapies difficult to access. Compassion-focused therapy (CFT) can offer an evolutionary-based understanding of interpersonal difficulties which can be helpful for such patients. Creatively harnessing and utilizing multi-sensory and non-linguistic social signals in CFT is key to exercising the care-giving and care-receiving social mentalities that facilitate compassionate flow. There is considerable evidence to support the use of a multi-sensory component to the therapeutic work to help patients cultivate and facilitate their capacities for compassion. The Compassionate Kitbag can be a way of supporting patients to create concrete representations of compassion in the context of the compassionate mind training component of the therapeutic work. Some of these objects can become transitional objects which can aid the therapeutic work.

Trauma and Social Pathways to Psychosis, and Where the Two Paths Meet

The pathways from trauma-via dissociation-to psychosis have been thoroughly tested and evidenced, but what has received less attention has been the social pathways-via dissociation-to psychosis. Often social factors are more commonly linked to other influences, e.g., to appraisals and the creation of negative schema in cognitive models, or to unsupportive caregiving experiences where there is high "expressed emotion." However, evidence is now emerging that negative social rank experiences, such as being excluded or shamed, may themselves have dissociative properties, which poses intriguing questions as to how trauma pathways and social pathways might interact. This article reviews the state of knowledge in trauma and social pathways to psychosis and then considers the potential mechanisms and the relationships between them, specifically (i) dissociation, (ii) attachment, and (iii) social rank. Recommendations are suggested for future modeling and testing of three-way interactions (dissociation × attachment × social rank) in the pathway from trauma to psychosis.

Conceptual Analysis: A Social Neuroscience Approach to Interpersonal Interaction in the Context of Disruption and Disorganization of Attachment (NAMDA)

Humans are strongly dependent upon social resources for allostasis and emotion regulation. This applies especially to early childhood because humans-as an altricial species-have a prolonged period of dependency on support and input from caregivers who typically act as sources of co-regulation. Accordingly, attachment theory proposes that the history and quality of early interactions with primary caregivers shape children's internal working models of attachment. In turn, these attachment models guide behavior, initially with the set goal of maintaining proximity to caregivers but eventually paving the way to more generalized mental representations of self and others. Mounting evidence in non-clinical populations suggests that these mental representations coincide with differential patterns of neural structure, function, and connectivity in a range of brain regions previously associated with emotional and cognitive capacities. What is currently lacking, however, is an evidence-based account of how early adverse attachment-related experiences and/or the emergence of attachment disorganization impact the developing brain. While work on early childhood adversities offers important insights, we propose that how these events become biologically embedded crucially hinges on the context of the child-caregiver attachment relationships in which the events take place. Our selective review distinguishes between direct social neuroscience research on disorganized attachment and indirect maltreatment-related research, converging on aberrant functioning in neurobiological systems subserving aversion, approach, emotion regulation, and mental state processing in the wake of severe attachment disruption. To account for heterogeneity of findings, we propose two distinct neurobiological phenotypes characterized by hyper- and hypo-arousal primarily deriving from the caregiver serving either as a threatening or as an insufficient source of co-regulation, respectively.

Mediating effect of neuroticism and negative coping style in relation to childhood psychological maltreatment and smartphone addiction among college students in China

BACKGROUND

Smartphones are convenient for college students. However, overuse of smartphone or smartphone addiction, can lead to problems related to healthy development. The cause of smartphone addiction can be traced to adverse childhood experiences such as childhood psychological maltreatment. Therefore, exploring the cause and mechanism underlying smartphone addiction in college students with a history of childhood psychological maltreatment is crucial.

OBJECTIVE

The purpose of this study was to explore the mediating effect of neuroticism and coping style in relationship between childhood psychological maltreatment and smartphone addiction among college students.

METHODS

The participants included 1169 (43.8 % female and 56.2 % male) college students ranging in age from 17 to 23 years (M = 19.89, SD = 1.25). All participants completed a self-report questionnaire measuring childhood psychological maltreatment, neuroticism, coping style, and smartphone addiction symptoms. A multiple mediation model was used to test the hypotheses.

RESULTS

Findings from mediation analysis showed that both in parallelly and sequentially, neuroticism and negative coping style mediated the relationship between childhood psychological maltreatment and smartphone addiction.

CONCLUSIONS

The present study can provide an understanding of how childhood psychological maltreatment influences college students' smartphone addiction. This study also provides implications on how to reduce the effects of childhood psychological maltreatment on smartphone addiction in college students.

Pathways from childhood sexual abuse to trait anxiety

BACKGROUND

Children exposed to sexual abuse are at risk for developing several psychological and behavioral difficulties during adulthood. Here, direct and indirect effects of family conflict, insecurity within the family system (manifested as disengagement and/or preoccupation), and negative feelings provoked by childhood sexual abuse (CSA) on trait anxiety scores were analyzed with structural equation modeling. Both Finkelhor and Browne's traumagenic dynamics model and Davies and Cummings Emotional Security Theory were applied.

METHODS

A total of 168 female college student survivors of CSA participated in this study. Information regarding each participant's abuse was obtained from a self-reported questionnaires. Emotional security was assessed with the Security in the Family System scale. To assess negative feelings regarding abuse and trait anxiety, Children's Impact of Traumatic Events Scale-Revised and State-Trait Anxiety Inventory were applied, respectively.

RESULTS

Level of family conflict was found to directly relate to emotional insecurity and trait anxiety. In addition, preoccupation strategies were found to be directly related to trait anxiety. Conversely, disengagement strategies were indirectly related to anxiety through the negative feelings provoked by abuse. Experience with other types of abuse and/or neglect was also related to emotional insecurity and feelings provoked by CSA. Meanwhile, continuity of abuse only correlated with feelings provoked by abuse.

CONCLUSIONS

Strong relationships between family conflict, emotional insecurity, negative feelings provoked by CSA and trait anxiety were observed. These results suggest that treatment of CSA survivors should focus on improving security within the survivors' family system and reducing negative feelings provoked by abuse.

Attachment Orientations and Adult Alcohol Use Among Those With Childhood Adversities

Abstract. Adverse psychological consequences have been associated with both alcohol abstinence and alcohol disorders. The current study considers those who have experienced childhood adversities and examines whether secure attachment orientation represents a protective factor against an increased likelihood of either abstinence/rare alcohol consumption or alcohol disorder diagnosis. Data were used from the National Comorbidity Survey-Revised (NCS-R) ( N = 5,692), a random sample representative of the American population. Adult personal alcohol use was considered in terms of abstinence/rare alcohol use, regular alcohol use, and alcohol disorder diagnosis. Analyses focused on those who had experienced childhood adversities ( N = 2,182) and assessed attachment orientation as a predictor of alcohol use. Within those who had experienced childhood adversities, in comparison with securely attached individuals, both anxiously attached individuals and avoidant attached individuals had a significantly increased likelihood of being in the alcohol disorder diagnosis group as opposed to the regular alcohol consumption group. Avoidant individuals also had a significantly increased likelihood of being in the abstinence/rare alcohol use group. Results are discussed in terms of subgroups (vulnerable individuals and families) that may benefit from supportive interventions, and what format these interventions might take.

Getting less than their fair share: Maltreated youth are hyper-cooperative yet vulnerable to exploitation in a public goods game

Human cooperative behavior has long been thought to decline under adversity. However, studies have primarily examined perceived patterns of cooperation, with little eye to actual cooperative behavior embedded within social interaction. Game-theoretical paradigms can help close this gap by unpacking subtle differences in how cooperation unfolds during initial encounters. This study is the first to use a child-appropriate, virtual, public goods game to study actual cooperative behavior in 329 participants aged 9-16 years with histories of maltreatment (n = 99) and no maltreatment (n = 230) while controlling for psychiatric symptoms. Unlike work on perceived patterns of cooperation, we found that maltreated participants actually contribute more resources to a public good during peer interaction than their nonmaltreated counterparts. This effect was robust when controlling for psychiatric symptoms and peer problems as well as demographic variables. We conclude that maltreatment may engender a hyper-cooperative strategy to minimize the odds of hostility and preserve positive interaction during initial encounters. This, however, comes at the cost of potential exploitation by others.

Early relationships and paranoia: Qualitative investigation of childhood experiences associated with the development of persecutory delusions

Research suggests a link between Persecutory Delusions (PDs) and early interpersonal difficulties. However, little research has explored the first-hand experience of navigating such adversities in those who later developed PDs. The current study reports on a qualitative investigation of the early interpersonal experiences and challenges faced by a sample of individuals who have recovered from PDs, using a semi-structured interview. A sample of seven individuals who have previously experienced PDs were recruited from two National Health Services (NHS) and an Early Intervention Psychosis service in England. Using an Interpretative Phenomenological Analytic (IPA) approach, the analysis identified three main themes (early experiences, impact of early experiences, coping with adversity). Early experiences captured early inconsistent and problematic relationships in childhood, and experiences of victimization. Exploring the impact of these early events revealed important roles for the participants' inconsistent sense of self, their negative perception of others, and their disturbed social functioning and substance use. Coping with adversity revealed distinct forms of avoidant and proactive coping. The findings are consistent with models of PDs that emphasise the impact of early interpersonal experiences, and offer support for attachment and cognitive factors.