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Cognit Ther Res. 2016 Jun;40(3):394-415. Epub 2015 Dec 12.

Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology.

Author information

1
Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA.
2
Department of Psychology, University of Denver, Denver, CO, USA.
3
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.
4
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.

Abstract

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.

KEYWORDS:

Adolescence; Child maltreatment; Emotion regulation; Emotional reactivity; Externalizing; Internalizing; Responses to distress; Rumination

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