Mediating Effect of Resilience on the Association between Emotional Neglect and Depressive Symptoms

Objective Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms. Methods A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression. Results Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps<0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms. Conclusion Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment.

[1]  A. Karl,et al.  The association between childhood maltreatment and emotion regulation: two different mechanisms contributing to depression? , 2015, Journal of affective disorders.

[2]  M. Bakermans-Kranenburg,et al.  The neglect of child neglect: a meta-analytic review of the prevalence of neglect , 2012, Social Psychiatry and Psychiatric Epidemiology.

[3]  M. O. Wright,et al.  Childhood emotional maltreatment and later psychological distress among college students: the mediating role of maladaptive schemas. , 2009, Child abuse & neglect.

[4]  D. Finkelhor,et al.  On the incidence and prevalence of child maltreatment: a research agenda , 2016, Child and Adolescent Psychiatry and Mental Health.

[5]  A. Wingo,et al.  The effect of resilience on posttraumatic stress disorder in trauma-exposed inner-city primary care patients. , 2011, Journal of the National Medical Association.

[6]  D. Charney,et al.  Understanding resilience , 2013, Front. Behav. Neurosci..

[7]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[8]  T. Suslow,et al.  Childhood maltreatment is associated with an automatic negative emotion processing bias in the amygdala , 2013, Human brain mapping.

[9]  M. Bakermans-Kranenburg,et al.  Cultural-geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence. , 2013, International journal of psychology : Journal international de psychologie.

[10]  M. Stein,et al.  The Childhood Trauma Questionnaire in a Community Sample: Psychometric Properties and Normative Data , 2001, Journal of traumatic stress.

[11]  L. Roberts,et al.  Medical student illness and impairment: a vignette-based survey study involving 955 students at 9 medical schools. , 2005, Comprehensive psychiatry.

[12]  C. Brewin,et al.  Recovered memories of trauma: phenomenology and cognitive mechanisms. , 1998, Clinical psychology review.

[13]  W. Watson,et al.  Behavioural consequences of child abuse. , 2013, Canadian family physician Medecin de famille canadien.

[14]  J. Newby,et al.  Negative intrusive memories in depression: the role of maladaptive appraisals and safety behaviours. , 2010, Journal of affective disorders.

[15]  Thomas J. Eluvathingal,et al.  Abnormal Brain Connectivity in Children After Early Severe Socioemotional Deprivation: A Diffusion Tensor Imaging Study , 2006, Pediatrics.

[16]  K. Rosenblum,et al.  The roles of resilience and childhood trauma history: main and moderating effects on postpartum maternal mental health and functioning. , 2015, Journal of affective disorders.

[17]  D. Bernstein,et al.  Childhood Trauma Questionnaire: A retrospective self-report , 1998 .

[18]  E. M. Euser,et al.  A Global Perspective on Child Sexual Abuse: Meta-Analysis of Prevalence Around the World , 2011, Child maltreatment.

[19]  C. Cheung,et al.  Resilience as a Positive Youth Development Construct: A Conceptual Review , 2012, TheScientificWorldJournal.

[20]  U. John,et al.  The impact of childhood trauma on depression: does resilience matter? Population-based results from the Study of Health in Pomerania. , 2014, Journal of psychosomatic research.

[21]  C. Vázquez,et al.  Memory biases in remitted depression: the role of negative cognitions at explicit and automatic processing levels. , 2014, Journal of behavior therapy and experimental psychiatry.

[22]  Walter Heindel,et al.  Limbic Scars: Long-Term Consequences of Childhood Maltreatment Revealed by Functional and Structural Magnetic Resonance Imaging , 2012, Biological Psychiatry.

[23]  Theo Vos,et al.  The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis , 2012, PLoS medicine.

[24]  David R. Williams,et al.  Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys , 2010, British Journal of Psychiatry.

[25]  Jeffrey Leiter,et al.  Child Maltreatment and School Performance Declines: An Event-History Analysis , 1997 .

[26]  Brief report: Neurocognitive functioning in adolescents following childhood maltreatment and evidence for underlying planning & organizational deficits , 2015, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[27]  M. Stein,et al.  Prevalence and demographic correlates of childhood maltreatment in an adult community sample. , 2004, Child abuse & neglect.

[28]  R. Yehuda,et al.  Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. , 2003, Child abuse & neglect.

[29]  C. Lyketsos,et al.  Perceptions of academic vulnerability associated with personal illness: a study of 1,027 students at nine medical schools. Collaborative Research Group on Medical Student Health. , 2001, Comprehensive psychiatry.

[30]  A. Wingo,et al.  Moderating effects of resilience on depression in individuals with a history of childhood abuse or trauma exposure. , 2010, Journal of affective disorders.

[31]  M. Newcomb,et al.  Development and validation of a brief screening version of the Childhood Trauma Questionnaire. , 2003, Child abuse & neglect.

[32]  J. Davidson,et al.  Development of a new resilience scale: The Connor‐Davidson Resilience Scale (CD‐RISC) , 2003, Depression and anxiety.

[33]  C. Widom,et al.  The Role of Youth Problem Behaviors in the Path From Child Abuse and Neglect to Prostitution: A Prospective Examination. , 2010, Journal of research on adolescence : the official journal of the Society for Research on Adolescence.

[34]  M. Leuzinger‐Bohleber,et al.  Childhood Trauma and Its Relation to Chronic Depression in Adulthood , 2015, Depression research and treatment.

[35]  A. G. de Andrade,et al.  The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study , 2008, BMC medical education.

[36]  Murray B Stein,et al.  Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. , 2006, Behaviour research and therapy.

[37]  Seung-Hwan Lee,et al.  The Korean version of the Connor-Davidson Resilience Scale: an extended validation. , 2012, Stress and health : journal of the International Society for the Investigation of Stress.

[38]  James F. Jones,et al.  Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction. , 2009, Archives of general psychiatry.

[39]  A. Hariri,et al.  Blunted Ventral Striatum Development in Adolescence Reflects Emotional Neglect and Predicts Depressive Symptoms , 2015, Biological Psychiatry.

[40]  M. Boyle,et al.  Child Maltreatment and Educational Attainment in Young Adulthood , 2015, Journal of interpersonal violence.

[41]  Seon-Cheol Park,et al.  Reliability and Validity of the Korean Version of the Childhood Trauma Questionnaire-Short Form for Psychiatric Outpatients , 2011, Psychiatry investigation.

[42]  A. Pickles,et al.  Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample. , 2007, Child abuse & neglect.

[43]  Richard J. Davidson,et al.  Developmental pathways to amygdala-prefrontal function and internalizing symptoms in adolescence , 2012, Nature Neuroscience.

[44]  Brandon E. Gibb,et al.  Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and anxiety disorders in adult psychiatric outpatients , 2007, Depression and anxiety.

[45]  Norman Johnson,et al.  Mental disorder and violence: is there a relationship beyond substance use? , 2012, Social Psychiatry and Psychiatric Epidemiology.

[46]  D. Bernstein,et al.  Childhood Trauma Questionnaire: A retrospective self-report manual , 1998 .

[47]  T. Hare,et al.  Elevated amygdala response to faces following early deprivation. , 2011, Developmental science.

[48]  Mi-Young Lee,et al.  Reliability and Validity of the Korean Version of the Connor-Davidson Resilience Scale , 2010, Psychiatry investigation.

[49]  A. Masten,et al.  Resilience and development: Contributions from the study of children who overcome adversity , 1990, Development and Psychopathology.

[50]  D. Charney,et al.  Trauma exposure, posttraumatic stress disorder and depression in an African-American primary care population. , 2006, Journal of the National Medical Association.

[51]  D. Glaser Emotional abuse and neglect (psychological maltreatment): a conceptual framework. , 2002, Child abuse & neglect.

[52]  A. Roy,et al.  Resilience mitigates the suicide risk associated with childhood trauma. , 2011, Journal of affective disorders.

[53]  Dick J Veltman,et al.  Enhanced amygdala reactivity to emotional faces in adults reporting childhood emotional maltreatment. , 2013, Social cognitive and affective neuroscience.

[54]  James F. Jones,et al.  Early adverse experience and risk for chronic fatigue syndrome: results from a population-based study. , 2006, Archives of general psychiatry.

[55]  B. Jeong,et al.  Aberrant function of frontoamygdala circuits in adolescents with previous verbal abuse experiences , 2015, Neuropsychologia.

[56]  C. Brewin,et al.  Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. , 2000, Journal of consulting and clinical psychology.

[57]  L. Wissow,et al.  The influence of childhood maltreatment on adolescents' academic performance. , 2007, Economics of education review.

[58]  Bumseok Jeong,et al.  Preliminary Evidence for White Matter Tract Abnormalities in Young Adults Exposed to Parental Verbal Abuse , 2009, Biological Psychiatry.

[59]  A. Danese,et al.  Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. , 2011, The American journal of psychiatry.

[60]  A. Bifulco,et al.  Adult attachment style. II: Its relationship to psychosocial depressive-vulnerability , 2002, Social Psychiatry and Psychiatric Epidemiology.

[61]  M. Bakermans-Kranenburg,et al.  The Universality of Childhood Emotional Abuse: A Meta-Analysis of Worldwide Prevalence , 2012 .

[62]  E. Brähler,et al.  Frequency of child maltreatment in a representative sample of the German population , 2013, BMC Public Health.

[63]  M. Stein,et al.  Relationship of childhood maltreatment to the onset and course of major depression in adulthood , 1999, Depression and anxiety.

[64]  J. Currie,et al.  Long-Term Consequences of Child Abuse and Neglect on Adult Economic Well-Being , 2010, Child maltreatment.

[65]  Monique Ernst,et al.  A preliminary study of medial temporal lobe function in youths with a history of caregiver deprivation and emotional neglect , 2010, Cognitive, affective & behavioral neuroscience.