Difficulties with emotion regulation as a transdiagnostic mechanism linking child maltreatment with the emergence of psychopathology

Abstract

Childhood maltreatment is associated with increased risk for most forms of psychopathology. We examine emotion dysregulation as a transdiagnostic mechanism linking maltreatment with general psychopathology. A sample of 262 children and adolescents participated; 162 (61.8%) experienced abuse or exposure to domestic violence. We assessed four emotion regulation processes (cognitive reappraisal, attention bias to threat, expressive suppression, and rumination) and emotional reactivity. Psychopathology symptoms were assessed concurrently and at a 2-year longitudinal follow-up. A general psychopathology factor (p factor), representing co-occurrence of psychopathology symptoms across multiple internalizing and externalizing domains, was estimated using confirmatory factor analysis. Maltreatment was associated with heightened emotional reactivity and greater use of expressive suppression and rumination. The association of maltreatment with attention bias varied across development, with maltreated children exhibiting a bias toward threat and adolescents a bias away from threat. Greater emotional reactivity and engagement in rumination mediated the longitudinal association between maltreatment and increased general psychopathology over time. Emotion dysregulation following childhood maltreatment occurs at multiple stages of the emotion generation process, in some cases varies across development, and serves as a transdiagnostic mechanism linking child maltreatment with general psychopathology.

Keywords: adversity; attention bias; p factor; rumination; threat.

Figure 1

Factor structure of the bifactor model used to generate p factor scores from transdiagnostic symptom counts.

Figure 2

Attention bias toward threat increases significantly with increasing maltreatment severity for younger (1.5 SD below the mean = 8.7 and 1 SD below the mean = 10.0 year old) participants and decreases significantly with increasing maltreatment for the oldest (1.5 SD above the mean = 16.5 year old) participants. Figure produced using the interActive data visualization tool (McCabe, Kim, & King, 2018).

Figure 3

Models used to test the indirect effects of maltreatment and maltreatment severity on psychopathology (p factor) at follow-up, via emotional reactivity and rumination, controlling for baseline psychopathology. Income-to-needs ratio and racial minority status were also included as covariates in both models. Independent variables (maltreatment exposure and severity), mediators (emotional reactivity and rumination), and covariates (p factor at baseline, race/ethnicity, and income-to-needs) were collected concurrently, but independent variables were retrospective. Dependent variable (p factor at follow-up) was collected 2 years later. Standardized coefficients are shown. Solid lines indicate significant paths. Dotted lines indicate nonsignificant paths.