Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States

TLDR

Child maltreatment is a major public health issue, yet the long‑term effects of emotional maltreatment on mental health remain poorly understood. The study aimed to assess how emotional abuse, emotional neglect, and their combination relate to other child maltreatment, family dysfunction, and lifetime Axis I and Axis II disorders. Data came from the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions, including 34,653 participants. In this nationally representative sample, emotional neglect (6.2%) was the most common form, and all categories of emotional maltreatment were strongly linked to other maltreatment types, family dysfunction, and higher odds of almost every examined mental disorder (adjusted ORs 1.2–7.4), with abusive acts showing stronger effects than neglect.

Abstract

Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders.