From Maltreatment to Psychiatric Disorders in Childhood and Adolescence: The Relevance of Emotional Maltreatment

Abstract

Different forms of maltreatment are thought to incur a cumulative and non-specific toll on mental health. However, few large-scale studies draw on psychiatric diagnoses manifesting in early childhood and adolescence to identify sequelae of differential maltreatment exposures, and emotional maltreatment, in particular. Fine-grained multi-source dimensional maltreatment assessments and validated age-appropriate clinical interviews were conducted in a sample of N = 778 3 to 16-year-olds. We aimed to (a) substantiate known patterns of clinical outcomes following maltreatment and (b) analyse relative effects of emotional maltreatment, abuse (physical and sexual), and neglect (physical, supervisory, and moral-legal/educational) using structural equation modeling. Besides confirming known relationships between maltreatment exposures and psychiatric disorders, emotional maltreatment exerted particularly strong effects on internalizing disorders in older youth and externalizing disorders in younger children, accounting for variance over and above abuse and neglect exposures. Our data highlight the toxicity of pathogenic relational experiences from early childhood onwards, urging researchers and practitioners alike to prioritize future work on emotional maltreatment.

Associations between childhood adversity, psychiatric symptoms, and self‐esteem outcomes in adolescents and young adults: An experience sampling study

“…When looking at separate adversity types it was observed that the negative association between childhood adversity and global self‐esteem was only statistically significant for emotional neglect and abuse. This is also consistent with the existing literature, which finds similar results (Babad et al, 2020; Reid‐Russell et al, 2021; Schlensog‐Schuster et al, 2022). One possible explanation might lie in attachment theory (Bowlby, 1969).…”

“…In addition, several studies have demonstrated a negative effect of childhood adversity via self‐esteem on several different psychiatric symptoms (Berber Çelik & Odacı, 2020; Ju & Lee, 2018). Particularly childhood emotional abuse and neglect seem to be the most poignant contributing factors (Reid‐Russell et al, 2021; Schlensog‐Schuster et al, 2022). Second, the relationship between self‐esteem and psychiatric symptoms may be bidirectional.…”

Long-term cortisol secretion in attention deficit hyperactivity disorder: roles of sex, comorbidity, and symptom presentation

“…In the ADHD group, children of mothers with a lower education level and higher depressive symptoms showed lower HCC. This corresponds to the findings of studies by White et al [21,53] on children/adolescents with externalizing disorders: low HCC was found in children with externalizing disorders who experienced (emotional) maltreatment. Maternal depressive symptoms may reflect family adversity and indicate less adequate parenting, thus potentially chronic ACE, which in turn leads to low HCC in the child [10].…”

“…Considering maltreatment could be particularly elucidating (see e.g. [21,53,57]). Finally, in future studies, it may be illuminating to analyze further hormones (e.g.…”

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

“…As suggested by Hett et al 2022, 128 one possible explanation for this is that sexual and physical abuse typically also involve emotional abuse, either predating it or being part of it. In turn, there is a substantial body of evidence demonstrating that emotional abuse may be more strongly associated with high levels of affective instability, 129,130 emotional dysregulation, 131,132 internalising and externalising disorders, 133 factors that may mediate the relationship between CM and social features of AD. Taken together, our findings indicate that emotional abuse represents an important potential therapeutic target for AD.…”