The influence of childhood sexual abuse,physical abuse,family environment,and gender on the psychological adjustment of adolescents

OBJECTIVE: The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexual abuse and physical abuse perceive their family environments as more conflictual and less cohesive than nonabused adolescents. METHOD: Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment. RESULTS: Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences. CONCLUSIONS: Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed.     

Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women

OBJECTIVE: One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the relative contribution of psychosocial factors to infant placement. METHODS: Psychosocial profiles of MC women (n=144) were compared with NMC (n=66) cocaine-using women. Subjects were low income, urban, African-American women who delivered an infant at a county teaching hospital. The Brief Symptom Inventory (BSI), an assessment of coping strategies (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), Conflict Tactics Scale (CTS) and Childhood Trauma Questionnaire (CTQ) were administered. The associations of infant placement status to demographic factors, drug use and psychosocial measures were evaluated. RESULTS: The NMC group reported greater overall psychological distress, psychoticism, somatization, anxiety and hostility than the MC group. The NMC group had more childhood neglect and physical abuse and used more negative coping strategies than the MC group. Lack of prenatal care [OR=.83, CI (.75-.91), p<.0001], heavier prenatal cocaine use [OR=2.55, CI (1.13-4.34), p<.007], greater psychological distress [OR=2.21, CI (1.13-4.34), p<.02] and a childhood history of emotional neglect [OR=1.10, CI (1.02-1.19), p<.02] were associated with increased likelihood of loss of infant custody after control for other substance use and demographic variables. CONCLUSIONS: NMC women have more negative psychological and behavioral functioning post-partum than MC women. Less prenatal care and greater cocaine use, psychological distress and maternal childhood emotional neglect are associated with the post-partum placement of infants born to cocaine-using women. PRACTICE IMPLICATIONS: Results of this study indicate that poor, urban women who use cocaine prenatally display several measurable differences on psychosocial and behavioral risk factors based on child placement status. Among these risk factors heavier cocaine use, lack of prenatal care, more severe psychological symptoms and early childhood experiences of emotional neglect increase the likelihood of loss of infant custody. Routine, objective assessments of psychosocial and behavioral characteristics of women who use cocaine during pregnancy can aid Child Protective Service workers and clinicians by providing baseline data from which to tailor interventions and set improvement criteria for mother-child reunification.     

Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice

OBJECTIVE: There were two aims to this study: first to examine whether emotional abuse and neglect are significant predictors of psychological and somatic symptoms, and lifetime trauma exposure in women presenting to a primary care practice, and second to examine the strength of these relationships after controlling for the effects of other types of childhood abuse and trauma. METHOD: Two-hundred and five women completed the Childhood Trauma Questionnaire (Bernstein et al., 1994), Trauma History Questionnaire (Green, 1996), the Symptom Checklist-revised (Derogatis, 1997), and the Revised Civilian Mississippi Scale for posttraumatic stress disorder (Norris & Perilla, 1996) when presenting to their primary care physician for a visit. Hierarchical multiple regression analyses were conducted to examine unique contributions of emotional abuse and neglect variables on symptom measures while controlling for childhood sexual and physical abuse and lifetime trauma exposure. RESULTS: A history of emotional abuse and neglect was associated with increased anxiety, depression, posttraumatic stress and physical symptoms, as well as lifetime trauma exposure. Physical and sexual abuse and lifetime trauma were also significant predictors of physical and psychological symptoms. Hierarchical multiple regressions demonstrated that emotional abuse and neglect predicted symptomatology in these women even when controlling for other types of abuse and lifetime trauma exposure. CONCLUSIONS: Long-standing behavioral consequences may arise as a result of childhood emotional abuse and neglect, specifically, poorer emotional and physical functioning, and vulnerability to further trauma exposure.     

The joint impact of parental psychological neglect and peer isolation on adolescents’ depression

Adolescents receive psychological or emotional care from both parents and peers, which is crucial for mental health at this stage. Little research has been undertaken to evaluate the experience and consequences of caregiver psychological neglect during adolescence. Less is known about the unique and combined impacts of neglectful experiences with parents and peers. The purpose of this study was to evaluate the relationship between exposure to caregiver psychological neglect and isolation from peers with depression for a population of at-risk adolescents. A sample of 2776 adolescents who represent a cohort population of adolescents in contact with Child Protective Services in the U.S. was studied. Data come from the National Survey of Child and Adolescent Well-being (NSCAW) and are pooled across four waves representing seven years duration. Structural equation modeling with latent variables was used to estimate within-time associations. A two-stage-least squares path model was used to determine within-time reciprocal effects between depression and neglectful experiences. Adolescents who are emotionally neglected by their primary caregivers and are isolated from peers have substantially increased depression, a combined standardized effect of 0.78–0.91. Isolation from peers is more impactful for depression compared to psychological neglect by caregivers. The effects of deficits in these two primary sources of emotional support explain 40 percent of the variation in depression. The relationships between depression and peer isolation and depression and psychological neglect are reciprocal, but the primary direction of effect is from neglectful experiences to depression.     

Mediators of childhood trauma and suicidality in a cohort of socio-economically deprived Scottish men

Background: There is little research investigating the relationship between childhood abuse, including neglect, and suicidality in adult men, despite epidemiological data suggesting that they are most at risk for suicide.Objective: To investigate the relationship between childhood abuse and neglect and suicidality, and the possible mediating roles of affect dysregulation and social inhibition.Participants and setting: a cohort of eighty-six socio-economically deprived male Caucasian participants previously identified as suicidal, attending a non-clinical community group.Methods: Participants completed self-report measures on childhood trauma, emotion regulation, interpersonal difficulties and suicidal behavior.Results: Mediation analysis indicated that emotion dysregulation and interpersonal difficulties significantly mediated the relationship between childhood trauma and suicidality with a medium effect size (R² = .41, p < .001).Conclusions: Study results suggest that early childhood abuse and neglect results in dysfunctional emotion regulation, which leads to suicidality in the context of impoverished social environments. The provision of psychological interventions aimed at improving social and emotional functioning may help to safeguard men who are most at risk of suicide.     

Childhood emotional invalidation and adult psychological distress: the mediating role of emotional inhibition

OBJECTIVE: To evaluate a model in which chronic emotional inhibition mediates the relationship between a history of childhood emotional invalidation or abuse and adult psychological distress. METHOD: One hundred and twenty-seven participants completed a series of self-report questionnaires, and a subset of this group (n=88) completed an additional measure of current avoidant coping in response to a laboratory stressor. Structural equation modeling was used to evaluate and compare a full and partial mediational model. RESULTS: Findings strongly supported a model in which a history of childhood emotional invalidation (i.e., psychological abuse and parental punishment, minimization, and distress in response to negative emotion) was associated with chronic emotional inhibition in adulthood (i.e., ambivalence over emotional expression, thought suppression, and avoidant stress responses). In turn, emotional inhibition significantly predicted psychological distress, including depression and anxiety symptoms. CONCLUSION: This study found support for a model in which the relation between recollected negative emotion socialization in childhood and adult psychological distress was fully mediated by a style of inhibiting emotional experience and expression. Although it is likely that childhood emotional inhibition is functional (e.g., reduces parental distress and rejection), results suggest that chronic emotional inhibition may have long-term negative consequences for the inhibitor.     

A structural model of mechanisms predicting depressive symptoms in women following childhood psychological maltreatment

Two underlying mechanisms, emotion dysregulation and negative internalized beliefs, were examined as potential mediators of the association between childhood psychological maltreatment (PM) and depression in emerging adult women. PM was assessed as a multi-faceted construct including aspects of psychological abuse (e.g., corrupting) and psychological neglect (e.g., emotional unresponsiveness) that occurred by parents. Female undergraduates (n = 771) completed anonymous, retrospective, self-report surveys assessing childhood PM, current depressive symptoms, emotion dysregulation (lack of emotional clarity and regulation strategies), and negative internalized beliefs (mistrust, shame, and defectiveness). Psychological maltreatment was represented as four subtypes of psychological abuse or neglectful behavior: Emotional Non-Responsiveness, Spurning/Terrorizing, Corrupting, and Demanding/Rigid (i.e., controlling behavior). Both emotion dysregulation and negative internalized beliefs significantly mediated the link between childhood PM and depressive symptoms, accounting for approximately 68% of the variance in symptomatology. Findings suggest the importance of focusing intervention on development of emotion regulation capacity including emotional awareness and regulatory strategies, as well as a focus on core negative beliefs including shame, defectiveness, and mistrust of others. Implications for future research are discussed.     

“Neglected moms” - The implications of emotional neglect in childhood for the transition to motherhood

BackgroundThe transition to motherhood involves many challenges that require adjustment; included among them are adapting to body changes, forging a maternal identity, and attaching to the baby. Although these tasks may not be easy for any women, those who experienced emotional neglect during childhood may find them especially difficult.ObjectiveThe aim of the current study was to examine a model illuminating the mechanism underlying the association between childhood emotional neglect and women’s adjustment during pregnancy and the postpartum period.Participants and settingThree hundred and ninety four Israeli women participated in the study, during their pregnancy (Time 1) and two months postpartum (Time 2).MethodsParticipants filled out a battery of questionnaires assessing their history of childhood emotional neglect, body experience, maternal self-efficacy, attachment to the fetus/baby, and depression.ResultsResults from structural equation modeling (SEM) indicated that childhood emotional neglect was associated with depression at both Time 1 and Time 2. These associations were mediated by the body experience during pregnancy (Time 1) and motherhood (Time 2) as well as by anticipated maternal self-efficacy (Time 1) and maternal self-efficacy (Time 2). The model explained 56% of the variance of postpartum depression (Time 2).ConclusionsThese findings point to the long-term implications of childhood emotional neglect for women’s adjustment to the transition to motherhood. The underlying mechanism suggested by the research model is discussed.     

Influence of negative childhood experiences on psychological functioning, social support, and parenting for mothers recovering from addiction.

OBJECTIVE: This study was conducted with mothers recovering from drug and alcohol addiction and had three aims: first, to understand the range of negative childhood events these mothers experienced; second, to understand their current level of distress and their parenting experiences; and third, to examine the relationships between negative childhood events and parenting experiences. METHOD: Forty-six mothers participated in a cross-sectional exploratory study and completed a range of self-report measures, including the Child Abuse & Trauma Scale, Social Support Inventory, CES-D, Parenting Stress Index, and the Parenting Scale. RESULTS: When compared to norming samples these mothers reported significantly higher levels of aversive childhood experiences, psychological distress, parenting stress and use of problematic parenting behaviors along with lower levels of social support. Higher levels of neglect and growing up in a negative home environment were significantly correlated with lower levels of social support from the family, higher levels of distress and parenting stress, and greater use of problematic parenting behaviors. CONCLUSION: For this sample there is a greater incidence of aversive childhood experiences and greater problems with maternal functioning. Mothers recovering from addiction have an additional need for clinical attention towards issues of recovery from childhood abuse and responding to parenting difficulties with their own children.     

The co-occurrence of adverse childhood experiences among children investigated for child maltreatment: A latent class analysis

Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N = 5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2–5 (preschool age), 6–10 (school age), and 11–18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed.     

The impact of individual forms of childhood maltreatment on health behavior

OBJECTIVE: This study examines the unique contribution of five types of maltreatment (sexual abuse, physical abuse, emotional abuse, physical neglect, emotional neglect) to adult health behaviors as well as the additive impact of exposure to different types of childhood maltreatment. METHOD: Two hundred and twenty-one women recruited from a VA primary care clinic completed questionnaires assessing exposure to childhood trauma and adult health behaviors. Regression models were used to test the relationship between childhood maltreatment and adult health behaviors. RESULTS: Sexual and physical abuse appear to predict a number of adverse outcomes; when other types of maltreatment are controlled, however, sexual abuse and physical abuse do not predict as many poor outcomes. In addition, sexual, physical, and emotional abuse and emotional neglect in childhood were all related to different adult health behaviors. The more types of childhood maltreatment participants were exposed to the more likely they were to have problems with substance use and risky sexual behaviors in adulthood. IMPLICATIONS: The results indicate that it is important to assess a broad maltreatment history rather than trying to relate specific types of abuse to particular adverse health behaviors or health outcomes.     

Childhood abuse and neglect in body dysmorphic disorder

OBJECTIVE: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder. METHODS: Seventy-five subjects (69.3% female, mean age=35.4+/-12.0) with DSM-IV BDD completed the Childhood Trauma Questionnaire and were interviewed with other reliable and valid measures. RESULTS: Of these subjects, 78.7% reported a history of childhood maltreatment: emotional neglect (68.0%), emotional abuse (56.0%), physical abuse (34.7%), physical neglect (33.3%), and sexual abuse (28.0%). Forty percent of subjects reported severe maltreatment. Among females (n=52), severity of reported abuse and neglect were .32-.57 standard deviation units higher than norms for a health maintenance organization (HMO) sample of women. Severity of sexual abuse was the only type of maltreatment significantly associated with current BDD severity (r=.23, p=.047). However, severity of sexual abuse did not predict current BDD severity in a simultaneous multiple regression analysis with age and current treatment status. There were other significant associations with childhood maltreatment: history of attempted suicide was related to emotional (p=.004), physical (p=.014), and sexual abuse (p=.038). Childhood emotional abuse was associated with a lifetime substance use disorder (r=.26, p=.02), and physical abuse was negatively associated with a lifetime mood disorder (r=-.37, p=.001). CONCLUSIONS: A high proportion of individuals with BDD reported childhood abuse and neglect. Certain types of abuse and neglect appear modestly associated with BDD symptom severity and with gender, suicidality, and certain disorders.     

Prevalence and demographic correlates of childhood maltreatment in an adult community sample

PURPOSE: This study had two aims: (1) to determine the prevalence of five categories of retrospectively reported childhood maltreatment in an adult community sample and (2) to examine relationships between three theoretically and practically chosen demographic variables and childhood maltreatment. METHOD: Participants were a representative sample of 967 adult men and women in the metropolitan Memphis, Tennessee area. They completed a telephone survey that included a reliable, valid questionnaire assessing five types of childhood maltreatment (i.e., emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and demographic questions. Simultaneous logistic regression analyses were used to identify demographic correlates of specific trauma types. RESULTS: Prevalence of childhood maltreatment ranged from approximately 30% for women to over 40% for men. Approximately 13% of participants reported multiple forms of maltreatment. The most common forms of trauma for both men and women were physical abuse, physical neglect, and emotional abuse, all of which were highly likely to co-occur. Race, sex, and current educational level were each associated with an increased likelihood of childhood maltreatment; differential relationships with particular maltreatment types were also observed. IMPLICATIONS: These findings highlight the importance of research on the prevalence of and risks for multiple types of childhood maltreatment, particularly in the somewhat neglected area of emotional abuse and neglect. These findings can be used to highlight the need for preventive interventions aimed at the negative sequelae of childhood maltreatment and to tailor preventive interventions to the needs and expectations of those at high risk.     

Psychological functioning and family discord among African-American adolescent females with and without a history of childhood sexual abuse

OBJECTIVES: The aim was to examine the rate of childhood sexual abuse along with the factors (age of abuse onset, type of perpetrator, and duration of the abuse), as well as the relationship of these factors to psychological functioning among females with a history of childhood abuse. Second, to determine whether levels of psychological functioning and family discord differ among females with and without a history of childhood sexual abuse. METHOD: A cross-sectional design was used. Two hundred and forty-nine adolescent females were recruited from a community-based health program. Two trained female interviewers administered an anonymous survey that assessed childhood sexual abuse, psychological functioning, and family environment. RESULTS: Fifty-seven (22.9%) of those surveyed reported childhood sexual abuse, of which 44.3% were intrafamilial and 55.7% were interfamilial. Age at onset ranged from 3 years to 17 years; 62.5% reported that the sexual abuse occurred 1 to 4 times; 27.9% reported a duration ranging from 1 year to 13 years; and 9.6% reported a duration of 1 month to 7 months. Multiple regression analysis revealed that a greater duration predicted higher levels of depression and lower levels of self-esteem among females with a history of sexual abuse. Females with a history of childhood sexual abuse scored significantly lower on measures of self-esteem and mastery, and significantly higher on measures of physical and emotional abuse. CONCLUSIONS: Results indicate that adolescent females with a history of childhood sexual abuse suffer an array of negative sequelae that include psychological and family distress.     

Family of origin environments in two clinical samples of survivors of intra-familial, extra-familial, and both types of sexual abuse

OBJECTIVE: It has been suggested that survivors of ongoing childhood sexual abuse (CSA) tend to have been reared in ineffective family environments that render them particularly vulnerable to maltreatment and which foster psychological difficulties beyond those accounted for solely by their abuse. If this conjecture is valid, one would expect that the family of origin environments of CSA survivors would be disturbed whether their abuser was intra-familial or extra-familial. To assess this hypothesis, two studies compared the childhood family of origin environments and supportive parenting characteristics of a clinical sample of women sexually abused by family members only (the intra-familial group), by non-family members only (the extra-familial group), and by both family and non-family members (the "both" group). METHOD: Study 1 compared the three groups (total N = 213) using the Family Environment Scale (FES). Study 2 compared groups (total N = 86) on the positive parenting scales of the Exposure to Abusive and Supportive Environments Parenting Inventory (EASE-PI). RESULTS: In Study 1, multivariate analyses indicated significant differences on the independence, cohesion, and conflict subscales of the FES. Pairwise comparisons revealed that the extra-familial group reported significantly higher levels of family independence and lower levels of conflict than the other two groups. In addition, the extra-familial group reported higher levels of cohesion than the intra-familial group. However, the effect sizes of these comparisons were extremely small. In Study 2, multivariate analyses revealed no group differences on the EASE-PI scales. CONCLUSIONS: Low effect sizes on the three significant FES scales, non-significance on the remaining seven FES scales, and non-significance on the EASE-PI scales suggest that there is considerable similarity in the family of origin environments of adult female CSA survivors seeking therapy regardless of whether their perpetrators were family members, non-family members, or both family and non-family members.     

Family systems as predictors of career attitude maturity for Korean high school students

This study examined the relationships between family systems and high school students’ career development. Family adaptability and family cohesion were considered as indicators of family function, and career attitude maturity was conceptualized as a representative factor explaining adolescents’ career development. A total of 634 high school students participated in this study. Overall, the results showed that family adaptability and family cohesion were both significant predictors of tenth graders’ career attitude maturity. The effects of parents’ educational backgrounds on career attitude maturity were negligible. However, the relationships were inconsistent across gender. For female students, family cohesion was a more influential predictor of career attitude maturity than family adaptability, while the opposite pattern was observed for the male students.     

Childhood trauma and eating psychopathology: A mediating role for dissociation and emotion dysregulation?

The present study examined the relationship between different forms of childhood trauma and eating psychopathology using a multiple mediation model that included emotion dysregulation and dissociation as hypothesised mediators. 142 female undergraduate psychology students studying at two British Universities participated in this cross-sectional study. Participants completed measures of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, dissociation and emotion dysregulation. Multiple mediation analysis was conducted to investigate the study's proposed model. Results revealed that the multiple mediation model significantly predicted eating psychopathology. Additionally, both emotion dysregulation and dissociation were found to be significant mediators between childhood trauma and eating psychopathology. A specific indirect effect was observed between childhood emotional abuse and eating psychopathology through emotion dysregulation. Findings support previous research linking childhood trauma to eating psychopathology. They indicate that multiple forms of childhood trauma should be assessed for individuals with eating disorders. The possible maintaining role of emotion regulation processes should also be considered in the treatment of eating disorders.     

Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas

ObjectiveTheoretically, exposure to experiences of emotional abuse (EA) and emotional neglect (EN) in childhood may threaten the security of attachment relationships and result in maladaptive models of self and self-in-relation to others. The purpose of this study was to explore the extent to which EA and EN treatment by parents contributed uniquely to young adult maladaptive long-term outcome with respect to symptoms of anxiety, depression, and dissociation. The extent to which the relationships between EA and EN and later symptoms were mediated by specific internalized maladaptive interpersonal schemas was also explored.MethodsQuestionnaires completed by 301 college men and women (52% female) assessed perceptions of experiences of childhood abuse and neglect, exposure to parental alcoholism, current symptoms of psychological distress, and endorsement of maladaptive interpersonal schemas.ResultsHierarchical regression analyses revealed that perceptions of childhood EA and EN each continued to exert an influence on later symptoms after controlling for gender, income, parental alcoholism, and other child abuse experiences. Both EA and EN were associated with later symptoms of anxiety and depression and were mediated by schemas of vulnerability to harm, shame, and self-sacrifice. Only EN was related to later symptoms of dissociation; this relationship was mediated by the schemas of shame and vulnerability to harm.ConclusionThe findings are discussed from an attachment perspective, focusing on how early interactions with parents contribute to the development of internal working models of self and self-in-relation to others that influence later cognitive schemas and psychological adjustment.Practice implicationsAlthough emotional abuse and emotional neglect are the least studied of all forms of child maltreatment, they may be the most prevalent. The current findings suggest that how college students have evaluated and internalized these experiences may be even more important than the events themselves in determining the extent to which these experiences exert a long-term impact. For this reason, early intervention might be particularly important in helping to modify internal working models of the self as worthless, others as abusive, or the world as threatening and dangerous as a result of past abuse experiences. This study underscores the need for counselors to actively elicit and explore experiences of emotional abuse and neglect in clients, in addition to inquiring about other abuse experiences and types of family dysfunction.The results of this study also support existing data suggesting that internalized representational models of self and others are a key mechanism underlying the relationship between emotional maltreatment and later psychopathology. Young's schema questionnaire proved to be quite sensitive in detecting specific maladaptive schemas that mediated later difficulties with depression, anxiety, and dissociation. Targeting these negative schemas in therapy may help to ameliorate such symptoms. The therapeutic relationship provides a particularly effective context for developing more positive models of self and others, as well as providing a context to explore core relationship themes across different relationship contexts (e.g., intimate partner, parent, friend, and work relationships). In particular, if the assessment of the client reveals that dissociative symptoms are present, counselors can acknowledge the adaptive function that this strategy once served, while also addressing potential limitations to over-reliance on this coping strategy.     

Emotion dysregulation as a mediator between childhood emotional abuse and current depression in a low-income African-American sample

Abuse and neglect in childhood are well-established risk factors for later psychopathology. Past research has suggested that childhood emotional abuse may be particularly harmful to psychological development. The current cross-sectional study employed multiple regression techniques to assess the effects of childhood trauma on adulthood depression and emotion dysregulation in a large sample of mostly low-income African Americans recruited in an urban hospital. Bootstrap analyses were used to test emotion dysregulation as a potential mediator between emotional abuse in childhood and current depression. Childhood emotional abuse significantly predicted depressive symptoms even when accounting for all other childhood trauma types, and we found support for a complementary mediation of this relationship by emotion dysregulation. Our findings highlight the importance of emotion dysregulation and childhood emotional abuse in relation to adult depression. Moving forward, clinicians should consider the particular importance of emotional abuse in the development of depression, and future research should seek to identify mechanisms through which emotional abuse increases risk for depression and emotion dysregulation.     

Organic vs. functional neurological disorders: The role of childhood psychological trauma

Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, we set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. We have hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders. Sample consisted of a consecutive series of people with functional neurological disorders and with organic neurological disorders (n = 82) recruited from a hospital in Scotland. Participants completed measures of life events, traumatic stress, emotional regulation, anxiety and depression. The two groups were found to significantly differ in relation to all measures, with the MUS group being more likely to report childhood and adulthood life events, more severe emotional dysregulation, traumatic stress and symptoms of anxiety and stress. Logistic regression analysis revealed that exposure to childhood traumatic life events, specifically childhood sexual abuse, and childhood physical neglect, were the only factors which were significantly associated with membership of the medically unexplained neurological symptoms group. Although further research is required to confirm our findings, our results suggest that identifying and addressing the impact of childhood trauma, may alleviate distress and aid recovery from functional neurological disorders.