Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology.
Child maltreatment is a robust risk factor for internalizing and externalizing psychopathology in children and adolescents. We examined the role of disruptions in emotion regulation processes as a developmental mechanism linking child maltreatment to the onset of multiple forms of psychopathology in adolescents. Specifically, we examined whether child maltreatment was associated with emotional reactivity and maladaptive cognitive and behavioral responses to distress, including rumination and impulsive behaviors, in two separate samples. We additionally investigated whether each of these components of emotion regulation were associated with internalizing and externalizing psychopathology and mediated the association between child maltreatment and psychopathology. Study 1 included a sample of 167 adolescents recruited based on exposure to physical, sexual, or emotional abuse. Study 2 included a sample of 439 adolescents in a community-based cohort study followed prospectively for 5 years. In both samples, child maltreatment was associated with higher levels of internalizing psychopathology, elevated emotional reactivity, and greater habitual engagement in rumination and impulsive responses to distress. In Study 2, emotional reactivity and maladaptive responses to distress mediated the association between child maltreatment and both internalizing and externalizing psychopathology. These findings provide converging evidence for the role of emotion regulation deficits as a transdiagnostic developmental pathway linking child maltreatment with multiple forms of psychopathology.
Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA.
Charlotte
C
Heleniak
Department of Psychology, University of Denver, Denver, CO, USA.
Jessica L
JL
Jenness
Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Washington School of Medicine, Seattle, WA, USA; Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA.
Ann Vander
AV
Stoep
Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Washington School of Medicine, Seattle, WA, USA.
Elizabeth
E
McCauley
Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA.
Katie A
KA
McLaughlin
Adolescence; Child maltreatment; Emotion regulation; Emotional reactivity; Externalizing; Internalizing; Responses to distress; Rumination
J Child Psychol Psychiatry. 1997 Mar;38(3):365-74
9232482
Psychophysiology. 2003 Sep;40(5):655-65
14696720
J Emot Behav Disord. 2005 Dec;13(4):213-223
21430789
J Abnorm Child Psychol. 2000 Feb;28(1):73-86
10772351
Soc Cogn Affect Neurosci. 2012 Jan;7(1):93-105
21775386
Arch Gen Psychiatry. 1990 Jun;47(6):511-8
2350203
J Consult Clin Psychol. 2000 Dec;68(6):976-92
11142550
J Child Psychol Psychiatry. 2006 Jan;47(1):69-78
16405643
J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):980-8
9204677
Dev Psychol. 2007 Mar;43(2):438-53
17352551
Br J Psychiatry. 2013 Apr;202(4):269-76
23470285
Arch Gen Psychiatry. 2010 Feb;67(2):113-23
20124111
J Pediatr. 1990 May;116(5):815-21
2329431
Arch Gen Psychiatry. 1982 Oct;39(10):1205-12
7125850
J Am Acad Child Adolesc Psychiatry. 1997 May;36(5):610-9
9136495
Dev Psychopathol. 2006 Summer;18(3):815-29
17152402
Psychol Bull. 2008 Nov;134(6):807-28
18954158
J Adolesc Health. 2009 Feb;44(2):153-160
19167664
J Abnorm Child Psychol. 2011 Apr;39(3):389-400
20953828
J Child Psychol Psychiatry. 2010 Jun;51(6):706-16
20050965
J Abnorm Child Psychol. 2008 Oct;36(7):999-1014
18437551
Clin Psychol Rev. 2010 Mar;30(2):217-37
20015584
J Am Acad Child Adolesc Psychiatry. 1997 Mar;36(3):340-8
9055514
Behav Res Ther. 2011 Sep;49(9):544-54
21718967
Dev Psychopathol. 2001 Fall;13(4):981-99
11771917
Psychol Inq. 1998;9(4):241-273
16865170
J Abnorm Psychol. 2000 Aug;109(3):504-11
11016119
Child Neuropsychol. 2015;21(2):225-33
24650292
J Abnorm Psychol. 2007 Feb;116(1):198-207
17324030
Arch Pediatr Adolesc Med. 2011 Jan;165(1):16-21
21199975
Dev Psychopathol. 2002 Summer;14(3):499-520
12349871
Psychol Med. 2012 Apr;42(4):717-26
21906421
J Abnorm Psychol. 2003 Aug;112(3):323-38
12943012
Dev Psychopathol. 2009 Winter;21(1):47-68
19144222
Psychol Bull. 1987 Mar;101(2):213-32
3562706
Arch Pediatr Adolesc Med. 2002 Aug;156(8):824-30
12144375
J Affect Disord. 2006 Nov;96(1-2):39-47
16837053
Proc Natl Acad Sci U S A. 2002 Jun 25;99(13):9072-6
12072570
Am J Public Health. 2001 May;91(5):753-60
11344883
Dev Psychopathol. 2001 Fall;13(4):783-804
11771908
Psychophysiology. 2007 Nov;44(6):905-12
17666029
J Abnorm Psychol. 1998 Feb;107(1):128-40
9505045
Child Care Health Dev. 2010 Mar;36(2):275-84
20438475
J Clin Child Adolesc Psychol. 2004 Sep;33(3):557-65
15271613
J Child Psychol Psychiatry. 1994 Nov;35(8):1419-35
7868637
Emotion. 2008 Jun;8(3):364-78
18540752
J Adolesc. 2010 Feb;33(1):43-54
19556002
J Am Acad Child Adolesc Psychiatry. 1999 Dec;38(12):1490-6
10596248
Psychol Methods. 2007 Mar;12(1):23-44
17402810
Psychosom Med. 2014 Sep;76(7):538-46
25170753
Dev Psychopathol. 2001 Fall;13(4):891-912
11771913
J Consult Clin Psychol. 1994 Oct;62(5):1017-1025
7806710
J Pers Soc Psychol. 2000 Jan;78(1):136-57
10653511
Biol Psychiatry. 1999 May 15;45(10):1259-70
10349032
Psychol Bull. 2001 Jan;127(1):87-127
11271757
Am J Psychiatry. 2003 Jun;160(6):1078-85
12777265
New Dir Child Dev. 1992 Spring;(55):57-73
1608515
Appl Neuropsychol Child. 2013;2(2):125-32
23442015
J Abnorm Psychol. 2010 May;119(2):376-88
20455610
Cogn Behav Ther. 2009;38 Suppl 1:8-14
19697180
J Abnorm Psychol. 2014 Feb;123(1):13-23
24661155
J Am Acad Child Adolesc Psychiatry. 2004 Apr;43(4):393-402
15187799
Child Abuse Negl. 2003 Feb;27(2):169-90
12615092
Psychiatr Clin North Am. 2009 Sep;32(3):483-524
19716988
J Psychosom Res. 2006 Aug;61(2):229-36
16880026
Multivariate Behav Res. 2001 Apr 1;36(2):249-77
26822111
Behav Res Ther. 2007 Dec;45(12):3018-29
17923108
Proc Natl Acad Sci U S A. 2013 Sep 24;110(39):15638-43
24019460
J Pers Soc Psychol. 1991 Jul;61(1):115-21
1890582
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
15939837
J Consult Clin Psychol. 2009 Oct;77(5):894-904
19803569
Biol Psychiatry. 2009 Oct 1;66(7):681-5
19596121
J Adolesc. 2010 Feb;33(1):241-6
19481247
Science. 2005 May 27;308(5726):1323-6
15919997
Curr Biol. 2011 Dec 6;21(23):R947-8
22153160
Science. 1990 Dec 21;250(4988):1678-83
2270481
Biol Psychiatry. 2001 Jun 15;49(12):1023-39
11430844
Psychol Bull. 1991 Jul;110(1):86-108
1891520
J Res Adolesc. 2018 Mar;28(1):229-244
28646545
Psychol Med. 2000 May;30(3):529-44
10883709
Arch Gen Psychiatry. 1999 Jul;56(7):609-13
10401506
Psychol Addict Behav. 2011 Sep;25(3):446-54
21553946
Clin Psychol Rev. 2009 Nov;29(7):607-16
19682781
J Adolesc Health. 2010 Jun;46(6):545-52
20472211
Am J Psychiatry. 1994 Aug;151(8):1132-6
8037246
Child Dev. 2002 Sep-Oct;73(5):1525-42
12361317
Psychol Med. 1997 Jul;27(4):951-9
9234472
Child Dev. 1996 Oct;67(5):2227-47
9022240
Ann N Y Acad Sci. 2004 Jun;1021:51-8
15251873
J Abnorm Psychol. 2013 May;122(2):339-52
23713497
Psychoneuroendocrinology. 2009 Jan;34(1):62-75
18835102
Arch Gen Psychiatry. 2003 Aug;60(8):837-44
12912767
Arch Gen Psychiatry. 2012 Nov;69(11):1151-60
23117636
J Stud Alcohol Drugs. 2012 May;73(3):444-53
22456249
Child Neuropsychol. 2000 Sep;6(3):235-8
11419452
Child Dev. 2004 Mar-Apr;75(2):317-33
15056186
J Abnorm Child Psychol. 2002 Oct;30(5):515-27
12403154
Child Dev. 2003 Nov-Dec;74(6):1869-80
14669901
J Youth Adolesc. 2010 Dec;39(12):1485-97
19830533
J Clin Child Adolesc Psychol. 2002 Dec;31(4):480-90
12402567
Psychol Methods. 2006 Jun;11(2):142-63
16784335
Behav Ther. 2008 Jun;39(2):107-16
18502244
J Child Psychol Psychiatry. 2004 Feb;45(2):260-73
14982240
Child Abuse Negl. 2004 Apr;28(4):393-410
15120922
Clin Psychol Rev. 2002 Mar;22(2):223-46
11806020
Appl Neuropsychol Child. 2014;3(3):197-204
24559500
Child Dev. 2002 Jul-Aug;73(4):1151-65
12146740
J Clin Child Adolesc Psychol. 2008 Jan;37(1):156-83
18444057
J Clin Child Adolesc Psychol. 2002 Dec;31(4):465-79
12402566