Attachment and social support mediate the association between childhood maltreatment and depressive symptoms

Struck, Nele; Krug, Axel; Feldmann, Matthias; Yűksel, Dilara; Stein, Frederike; Schmitt, Simon; Meller, Tina; Brosch, Katharina; Dannlowski, Udo; Meinert, Susanne; Opel, Nils; Lemke, Hannah; Waltemate, Lena; Nenadić, Igor; Kircher, Tilo; Brakemeier, Eva‐Lotta

doi:10.1016/j.jad.2020.04.041

Cited by 66 publications

(45 citation statements)

References 40 publications

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“…This finding also supports McCullough's theoretical model (9), proposing that depressed patients who were exposed to histories of CM show pervasive interpersonal fear-avoidance resulting in dysfunctional interpersonal behavior. Possibly, those interpersonal problems lead to higher depression severity via lower perceived social support and weaker social ties (69,70). However, contrary to our hypothesis, CM and depression severity were not associated with general deficits in affective ToM.…”

Section: Childhood Maltreatment As An Origin Of Alteration In Social Cognition and Interpersonal Problemscontrasting

confidence: 94%

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Struck

Gärtner²,

Kircher

et al. 2021

Front. Psychiatry

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Objective: Little is known about the specific psychological features that differentiate persistent depressive disorder (PDD) and episodic depression (ED). Thus, the present study aimed to investigate differences in social cognition and interpersonal problems between these two forms of depression and healthy controls. In addition, we aimed to examine childhood maltreatment (CM) as a possible origin of these alterations.Methods: In a cross-sectional study, adult patients with a current PDD (n = 34) or in a current episode of ED (n = 38), and healthy controls (n = 39) completed questionnaires about depression severity, empathy, interpersonal problems, and CM, as well as tests of affective theory of mind and facial emotion recognition.Results: Patients with PDD reported higher empathic distress than patients with ED and healthy controls. Both depressive groups recognized angry faces with higher accuracy and reported more interpersonal problems, with no differences between PDD and ED. Empathic distress and interpersonal problems mediated the link between CM and depression in the combined sample.Limitations: Patient groups were not drug-naïve and antidepressant intake might have influenced social-cognitive functions. Self-report measures of empathy and interpersonal problems are vulnerable to bias. The cross-sectional design does not allow causal conclusions.Conclusion: Depressed patients may not show deficits in decoding the affective states of others and in feeling with others. However, depressed individuals—in particular patients with PDD—may feel easily overwhelmed by emotionally tense situations, resulting in empathic distress and avoidant/submissive interpersonal behavior. Exposure to CM might be an origin of alterations in social cognition and interpersonal problems.

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Section: Childhood Maltreatment As An Origin Of Alteration In Social Cognition and Interpersonal Problemscontrasting

confidence: 94%

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Struck

Gärtner²,

Kircher

et al. 2021

Front. Psychiatry

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“…Meanwhile, survivors of EN have deficits in the development of intimate relationships ( 39 ), resulting in a weak supportive network insufficient for them to use. Finally, there may exist a mediator between EN and social support, such as attachment ( 40 ). According to Kapeleris and Paivio ( 38 ), EN is correlated with emotional competence such as lack of sense of contentment, worth, and importance, which contributes to insecure attachment styles leading to low trust in others and poor utilization of social support.…”

Section: Discussionmentioning

confidence: 99%

Childhood Emotional Neglect Is Associated With Low Social Support in Chinese Patients With Major Depressive Disorder

Qin

Wang

et al. 2021

Front. Psychiatry

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Background: Previous studies have shown that childhood maltreatment (CM) is closely associated with social support in the general population. However, little is known about the associations of different types of CM with social support in Chinese patients with major depressive disorder (MDD), which was the goal of the current study.Methods: One hundred and sixty-six patients with moderate-to-severe MDD were enrolled. Participants were assessed by the Childhood Trauma Questionnaire-28 item Short Form, Social Support Rating Scale (SSRS), the 24-item Hamilton rating scale for depression, and the 14-item Hamilton Anxiety Rating Scale. Correlation analysis and Hierarchical multiple linear regression analysis were adopted to investigate associations of types of CM with social support.Results: (1) Physical neglect (PN) and emotional neglect (EN) were the most commonly reported types of CM in patients with MDD. (2) EN was the only type of CM significant in the regression models of the SSRS total score, the score of subjective support, and the score of utilization of support.Limitations: The data of CM was collected retrospectively and recall bias may be introduced. Assessment of CM and social support were self-reported and could be influenced by the depression status.Conclusion: In Chinese patients with MDD, PN and EN are the most prevalent types of CM. EN is the only type of CM associated with low social support in regression models, calling for special attention in the assessment and intervention of EN.

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“…Many empirical studies showed that experiencing childhood maltreatment is related to an increased risk of various types of psychopathology, such as physical and mental health, internalizing/externalizing problems, as well as psychiatric symptoms (Duprey et al, 2020;Jaffee, 2017;Tubman et al, 2021). For example, a strong positive association between childhood maltreatment and symptoms of depression has been evidenced in both cross-sectional (Novelo et al, 2018;Struck et al, 2020) and longitudinal research (Hovens et al, 2016;Widom et al, 2007). In a recent meta-analysis of 190 studies, Humphreys et al (2020) have demonstrated that higher childhood maltreatment scores were significantly related to a diagnosis of depression, and to higher depression symptom scores (Humphreys et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults’ depressive symptoms

et al. 2021

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The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory.Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.

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Attachment and social support mediate the association between childhood maltreatment and depressive symptoms

Cited by 66 publications

References 40 publications

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Childhood Emotional Neglect Is Associated With Low Social Support in Chinese Patients With Major Depressive Disorder

Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults’ depressive symptoms

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