Gender Differences in Child Abuse, Emotional Processing Difficulties, Alexithymia, Psychological Symptoms and Behavioural Problems among Chinese Adolescents

Neglecting the impact of childhood neglect: A scoping review of the relation between child neglect and emotion regulation in adulthood

BACKGROUND

Childhood neglect, a prevalent form of child abuse, has significant short-term and long-term consequences on mental health.

OBJECTIVE

This scoping review aimed to provide an overview of existing evidence on childhood neglect in relation to emotion regulation in adulthood.

PARTICIPANTS AND SETTING

Participants were not individually evaluated but we provided future directions for research based on the overview of studies.

METHODS

A systematic search strategy was conducted, resulting in the analysis of 25 selected articles. We performed an inventory of existing evidence to identify knowledge gaps.

RESULTS

The review identified the need for future research to differentiate neglect from other forms of child abuse. Longitudinal studies tracking individuals from childhood to adulthood are recommended to understand developmental trajectories and continuity. Diverse samples, with various ages, genders, and (socio-economic) backgrounds, should be included for enhanced generalizability. Geographical representation should be expanded to capture cultural variations in the association between neglect and adult emotion regulation. Furthermore, investigating other psychopathologies beyond depression in relation to neglect and emotion regulation is suggested.

CONCLUSIONS

Overall, this scoping review highlights the limited knowledge regarding the link between childhood neglect and adult emotion regulation and provides valuable recommendations for advancing research in this field.

The Association Between Child Abuse and Internet Addiction: A Three-Level Meta-Analysis

Child abuse is an important factor for Internet addiction. Despite numerous researches had observed there was a positive correlation between child abuse and Internet addiction, the strength of this association differed considerably in the previous studies. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderator of the association between child abuse and Internet addiction. Thirty-one studies reported the association between child abuse and Internet addiction (273 effect sizes and 55,585 participants) through a systematic literature search. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis approach, a three-level model was employed to conduct a three-level meta-analysis. The current meta-analysis found that child abuse was significantly positively correlated with Internet addiction. Besides, the study found that the type of child abuse and publication year had significant moderating effects on the association between child abuse and Internet addiction. This study suggested child abuse was a risk factor for Internet addiction. Moreover, child abuse is an essential factor should be considered when strengthening interventions for individuals' Internet addiction.

The relationship between childhood psychological abuse and depression in college students: a moderated mediation model

BACKGROUND

Childhood psychological abuse (CPA) are highly correlated with depression among college students, but the underlying mechanisms between variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia as a moderating factor, in order to further elucidate the potential risk factors between CPA and depression among college students.

METHODS

A self-report survey was conducted among 1196 college students from four universities in three provinces in China. The survey included measures of CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed.

RESULTS

CPA was positively correlated with depression among college students, as well as internet addiction with alexithymia. Internet addiction partially mediated the relationship between CPA and depression among college students, while alexithymia strengthened the relationships among the paths in the moderated mediation model.

CONCLUSION

This study provides further insights into the psychological mechanisms underlying the relationship between CPA and depression among college students. Internet addiction serves as a mediating factor in this relationship, while alexithymia may enhance the strength of the relationships among the three variables.

Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China

PURPOSE

The adverse health consequences of premarital sex and childhood sexual abuse (CSA) are both global public health problems. Based on a random sample of college students from a Chinese city, this study investigated the relationship between CSA severity and premarital sex among students, focusing on sex differences.

METHODS

A total of 2722 college students from 4 schools in Luzhou were recruited by multistage random sampling. Self-administered questionnaires were used to measure CSA experiences and premarital sex. Binary logistic regression analyses were conducted to analyse the relationship between CSA and premarital sex.

RESULTS

The prevalence of CSA was 9.39%, and that of mild, moderate and severe CSA was 4.04%, 2.90% and 2.46%, respectively. The premarital sex reporting rate was 22.42%. After adjusting for confounding variables, CSA was positively associated with premarital sex. Notably, a cumulative effect of CSA on premarital sex was observed among students. Further stratification analyses showed that males who experienced CSA had a higher premarital sex rate than females, and this sex difference was also observed among students with different CSA severities.

CONCLUSION

CSA and its severity were associated with premarital sex among college students. Furthermore, this association was stronger for males than females. Therefore, it is important to emphasize CSA prevention, especially for boys. These findings can promote understanding of the effects of CSA on premarital sex, and CSA prevention and intervention strategies should consider CSA severity and sex differences.

The Association Between Child Abuse and Aggressive Behavior: A Three-Level Meta-Analysis

Child abuse is considered to be an essential factor in the development of aggressive behavior. The intensity of the positive relations between child abuse and aggressive behavior differed considerably among researches despite the fact that abundant studies have observed this relation. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, a three-level meta-analysis was employed to obtain reliable estimates for the sizes of effects and investigate some potential moderators of the relation between child abuse and aggressive behavior. The present study obtained 51 studies (30,566 participants; 680 effect sizes) through performing the detailed literature search. It was found that child abuse was positively associated with aggressive behavior in the current study. In addition, the present meta-analysis observed significant moderating effects for type of child abuse, culture, measurement of child abuse, and publication year in the association between child abuse and aggressive behavior. This study suggests that child abuse is a predictor for the development of aggressive behavior in humans. Moreover, child abuse is an important aspect for consideration in efforts toward strengthening of interventions targeting individuals' aggressive behavior.

Adverse Childhood Experiences: Relationship with Empathy and Alexithymia

Several studies showed that adults who have experienced childhood adversity are more likely to develop alexithymia and low empathy. Therefore, this research aims to analyze the relationship between childhood adversity and alexithymia and empathy in adulthood and verify a predictive explanatory model of alexithymia. The sample comprised 92 adults who responded to the sociodemographic questionnaire, the Childhood History Questionnaire, the Interpersonal Reactivity Index, and the Alexithymia Scale of Toronto. Childhood adversity showed a positive relationship with alexithymia and a negative relationship with empathy. Predictive validity showed that marital status, adverse childhood experiences (ACEs), and empathic concern predicted higher alexithymia scores. These results show the impact of these childhood experiences on adult life, underlining the importance of developing intervention programs in this field.

The mediating role of perceived social support: alexithymia and parental burnout in parents of children with autism spectrum disorder

Background

Parental burnout is a concept that reflects the emotional exhaustion and emotional distance of parents from children due to their inability to cope with the pressure of parenting. It has been confirmed that parents of autistic children are at higher risk for parental burnout. Additional research has suggested a relationship between parental burnout and parents' personality traits. However, the relationship between alexithymia, an independent personality factor, with parental burnout is little to none.

Objective

To look into the connection between parental burnout and alexithymia among parents of autistic children.

Method

Three hundred and one parents were approached for recruitment and data were collected from 203 parents through a cross-sectional survey assessing parental burnout, alexithymia status, and perceived social support. Because the data is not normally distributed, Spearman's rank correlation coefficient rho(p) was used to assess the correlation between the variables; and then using AMOS to analyze the mediating effects of perceived social support and the moderating effect of gender.

Result

The result showed that (1) There is a negative association between alexithymia with parental burnout (β = 0.6, p < 0.01), while perceive social support was the negative predictor of alexithymia (β = -0.45, p < 0.01) and parental burnout (β = -0.26, p < 0.01); (2) perceive social support partially mediated the relationship between alexithymia and parental burnout of parents of autistic children, which can explain 16.3% of the total effect; (3) Gender plays a moderating role in the first half of the indirect effect of alexithymia on parental burnout, as evidenced by the significant difference in path coefficients between the male and female models (male: β = -0.10, p < 0.05; female: β = -0.60, p < 0.05).

Conclusion

Health professionals and policymakers should be aware of parental burnout among parents of autistic children in China and take early intervention steps. Furthermore, they should recognize the negative impact of alexithymia and the positive impact of social support when developing plans to alleviate parental burnout in children with autism, with a particular focus on mothers with alexithymia, who are more likely to experience low social support and burnout than fathers with alexithymia.

The Effects of Severe Childhood Physical and Sexual Abuse on Adult Socioeconomic Prosperity

Our study utilizes Adverse Childhood Experience (ACE) scores to estimate the relationship between forced sexual intercourse and physical abuse on socioeconomic outcomes in adulthood. ACEs have been shown to have long-term negative impacts on health, mental health, and cognition. We expand upon the literature that analyzes the effects of ACEs on human capital investment and adult socioeconomic outcomes by focusing on the ACE scores pertaining to repeated physical and forced sexual abuse in childhood. Specifically, we estimate probit models using data from the Behavioral Risk Factor Surveillance System to measure the marginal effects of childhood sexual abuse (CSA) and physical abuse on the probability of high school completion, unemployment, and the likelihood of living in poverty in adulthood. We find adults who suffered physical abuse in childhood are more likely to live in poverty. Adult survivors of CSA are less likely to finish high school and more likely to live in poverty. The likelihood of high school noncompletion increases when the individual suffered both forms of abuse. We also find that only those who suffered both forms of abuse in childhood had a greater likelihood of being unemployed and high school noncompletion. We find the negative socioeconomic impact in adulthood is larger for women than for men, implying gender heterogeneity in outcomes of CSA and physical abuse. Researchers should control for the correlation between sexual abuse and physical abuse in childhood, particularly in women, when estimating their effects on socioeconomic outcomes.

Emotional Loneliness, Suicidal Ideation, and Alexithymia in Adolescents Who Commit Child-to-Parent Violence

The objective of this research was to explore the relationship between involvement in child-to-parent violence (CPV) and the development of emotional loneliness, suicidal ideation, and alexithymia based on sex; 1,928 adolescents of both sexes participated (50.5% males and 49.5% females), aged between 12 and 18 years (M = 14. 67, SD = 1.77), enrolled in four educational centers in Spain. A multivariate analysis of variance (3 × 2 MANOVA) was applied using sex and CPV levels as independent variables. Univariate analyses were carried out to explore the significant relationships detected. Results showed that the adolescents with higher CPV scored higher in emotional loneliness, suicidal ideation, and alexithymia. Girls showed a greater prevalence of CPV at the medium and high levels. An interaction of sex and CPV with alexithymia was detected. Girls with high and moderate values of CPV presented a higher level of alexithymia. These results provide novel information in the field of CPV. Previous research has placed the main focus of analysis on the adolescents' behavior problems and not so much on their perceptions of personal adjustment and their emotional experiences. The information presented in this study contributes to achieve a more precise definition of the profile of adolescent who assault their parents for better prevention of CPV.

Associations between childhood psychological trauma, posttraumatic stress symptoms, and mental health in female college students: Mediation of coping styles

PURPOSE

To investigate the associations between childhood psychological trauma, posttraumatic stress symptoms (PTSS), and mental health in adulthood and to identify the mediation of active and passive coping on these associations in Korean female undergraduates.

CONCLUSIONS

Childhood psychological trauma had a direct association with current mental health in adulthood (β = 0.15, p < 0.001), which was mediated by PTSS (β = 0.34, p < 0.001). Each coping style partially mediated the relationship between (a) childhood psychological trauma and mental health and (b) PTSS and mental health.

PRACTICE IMPLICATIONS

It is necessary to develop nursing interventions to enhance coping strategies in female undergraduates to ensure better mental health and well-being.

The interaction of early life factors and depression-associated loci affecting the age at onset of the depression

Multiple previous studies explored the associations between early life factors and the age at onset of the depression. However, they only focused on the influence of environmental or genetic factors, without considering the interactions between them. Based on previous genome-wide association study (GWAS) data, we first calculated polygenic risk score (PRS) for depression. Regression analyses were conducted to assess the interacting effects of depression PRS and 5 early life factors, including felt hated by family member (N = 40,112), physically abused by family (N = 40,464), felt loved (N = 35633), and sexually molested (N = 41,595) in childhood and maternal smoking during pregnancy (N = 38,309), on the age at onset of the depression. Genome-wide environment interaction studies (GWEIS) were then performed to identify the genes interacting with early life factors for the age at onset of the depression. In regression analyses, we observed significant interacting effects of felt loved as a child and depression PRS on the age at onset of depression in total sample (β = 0.708, P = 5.03 × 10^-3) and males (β = 1.421, P = 7.64 × 10^-4). GWEIS identified a novel candidate loci interacting with felt loved as a child at GSAP (rs2068031, P = 4.24 × 10^-8) and detected several genes with suggestive significance association, such as CMYA5 (rs7343, P = 2.03 × 10^-6) and KIRREL3 (rs535603, P = 4.84 × 10^-6) in males. Our results indicate emotional care in childhood may affect the age at onset of depression, especially in males, and GSAP plays an important role in their interaction.

Toward an empirically based Developmental Trauma Disorder diagnosis and semi-structured interview for children: The DTD field trial replication

OBJECTIVE

Developmental trauma disorder (DTD) is a childhood psychiatric syndrome designed to include sequelae of trauma exposure not fully captured by PTSD. This study aimed to determine whether the assessment of DTD with an independent sample of children in mental health treatment will replicate results from an initial validation study.

METHODS

The DTD semi-structured interview (DTD-SI) was administered to a convenience sample in six sites in the United States (N = 271 children in mental health care, 8-18 years old, 47% female, 41% Black or Latinx) with measures of trauma history, DSM-IV PTSD, probable DSM-IV psychiatric diagnoses, emotion regulation/dysregulation, internalizing/externalizing problems, and quality of life. Confirmatory factor (CFA) and item response theory (IRT) analyses tested DTD's structure and DTD-SI's information value. Bivariate and multivariate analyses tested DTD's criterion and convergent validity.

RESULTS

A three-factor solution (i.e., emotion/somatic, attentional/behavioral, and self/relational dysregulation) best fit the data (CFI = 0.91; TLI = 0.89; BIC = 357.17; RMSEA = 0.06; SRMR = 0.05). DTD-SI items were informative across race/ethnicity, gender, and age with three exceptions. Emotion dysregulation was the most informative item at low levels of DTD severity. Non-suicidal self-injury was rare but discriminative in identifying children with high levels of DTD severity. Results supported the criterion and convergent validity of the DTD construct.

CONCLUSION

This replication provides empirical support for DTD as a construct and potential psychiatric syndrome, and the DTD-SI's validity as a clinical research tool.

Understanding Emotion Regulation and Humor Styles in Individuals with Callous-Unemotional Traits and Alexithymic Traits

Alexithymia is a personality trait which is characterized by impairments in identifying and describing emotions. Both psychopathic and alexithymic personality traits have been associated with impairments in emotion processing. This study aims to clarify the conceptual overlap between psychopathic traits (focusing on callous-unemotional traits) and alexithymic traits, with emotion regulation strategies and humor styles using a community sample. A battery of self-report measures was distributed through an online platform to 538 male and female participants between the ages of 18 to 65. Hierarchal linear regression analyses demonstrated that emotion regulation strategies were the strongest predictors and accounted for the largest variance of callous-unemotional traits and alexithymic traits. More specifically, expressive suppression arose as a positive predictor while cognitive reappraisal arose as a negative predictor for both personality traits. Aggressive humor (maladaptive) arose as a positive predictor while self-defeating humor (maladaptive) and affiliative humor (adaptive) arose as negative predictors for callous-unemotional traits. In contrast, self-defeating humor arose as a positive predictor for alexithymic traits while affiliative humor and self-enhancing humor arose as negative predictors. Findings indicate that there are similarities and differences between these personality traits. The implications regarding tailoring interventions that target specific deficits associated with each personality trait are discussed.

Sex-Related Difference in the Association Between Child Neglect and the Accuracy of Body Weight Perception Among Chinese Primary Schoolchildren

Introduction: Body weight perception (BWP) directly determines weight management behaviors. Although child neglect is a well-established risk factor for managing body weight, little is known about its association with the accuracy of BWP. This study aimed to assess the cross-sectional and longitudinal associations between child neglect and BWP accuracy in primary schoolchildren, and explore how these differ based on the sex of the child. Methods: The sample included 1,063 primary schoolchildren (557 boys and 506 girls, aged 8-10 years) from a two-wave observational study between 2018 and 2019 in Wuhan, China. Child neglect and BWP were investigated using self-administered questionnaires. The accuracy of BWP was defined by comparing the BWP and actual body weight, and it was categorized into three groups-consistent, underestimated, and overestimated. Multinomial logistic regression analysis was conducted with fitting child neglect as the independent variable and the accuracy of BWP as the dependent variable. Results: The prevalence of weight misperception was ~44% at baseline (underestimation 40%; overestimation 4%) in Chinese primary schoolchildren. In the cross-sectional analysis, children with a higher level of neglect were more likely to misperceive their body weight. Moreover, there was an apparent sex-related difference that boys who experienced a higher level of neglect significantly reported more underestimation, while girls reported more overestimation. There was no significant longitudinal association between child neglect and the change in BWP accuracy. Conclusions: This study revealed that a higher level of neglect was significantly associated with underestimated BWP in boys and overestimated BWP in girls. The mechanisms of sex-related difference and whether child neglect is involved in the change in BWP, merit further investigations.

How Does Psychological Distress Due to the COVID-19 Pandemic Impact on Internet Addiction and Instagram Addiction in Emerging Adults?

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

How Mindfulness and Acceptance Could Help Psychiatrists Predict Alexithymia Among Students

ABSTRACT

Mindfulness and acceptance have demonstrated associations with alexithymia facets. As a very limited body of research has explored the predictive strength among alexithymia-related constructs, this study aimed to investigate the prediction of alexithymia based on acceptance and mindfulness among students. The study group consisted of 586 university students, 237 (40.9%) females and 349 (59.1%) males. As for data collection, the five-factor mindfulness questionnaire, Acceptance and Commitment Questionnaire, and the Toronto Alexithymia Scale-2 were applied. A stepwise multiple linear regression was calculated to predict alexithymia based on components of commitment and action, mindfulness facets, and demographic variables (F[5,578] = 77.26, p ≤ 0.001), with an R2 of 0.41. The predictive variables including description (B = -0.59, t = -8.02, p < 0.001), commitment and action (B = -0.13, t = -4.38, p < 0.001), observation (B = -0.15, t = -2.94, p < 0.01), and no judgment (B = -0.16, t = -2.56, p < 0.05) exhibited significant prediction effects on the adjusted index of alexithymia. The findings contribute to the potential mechanism between mindfulness and alexithymia in intervention that seeks to improve mindfulness and acceptance skills and could prove more effective in treating patients with alexithymia.

Alexithymia and emotion dysregulation in adult patients with epilepsy

OBJECTIVE

The concept of alexithymia refers to difficulty perceiving, identifying, and describing emotions. We aimed at evaluating the prevalence of alexithymia in a sample of adult people with epilepsy (PWE) with and without psychogenic nonepileptic seizures (PNES) and healthy control subjects (HC) and identifying major factors able to affect it.

MATERIALS AND METHODS

We enrolled consecutively 91 PWE (12 of which with PNES in addition to seizures) and 146 HC age- and gender-matched. Both groups' subjects completed the following questionnaires: TAS-20, Beck Depression Inventory-II (BDI-II), Difficulties in Emotion Regulation Scale (DERS) and the Italian translation of Stigma Scale of Epilepsy (SSE), able to evaluate stigma related to epilepsy both in epileptic and nonepileptic subjects. Moreover, PWE completed the well-known Jacoby's Stigma Scale (JSS), dedicated to the evaluation of stigma only by patients with epilepsy and QOLIE-31 (Q31) for evaluating the quality of life. We analyzed correlations between alexithymia and several epilepsy-related (seizure frequency, antiseizure medications-ASMs) and psychosocial factors. Finally, a stepwise multiple regression analysis was performed to identify major factor affecting alexithymia in both groups.

RESULTS

Alexithymia was prevalent in PWE compared to controls (17.6% of alexithymic subjects in PWE vs 11% in HC), without discriminating epileptic subjects with and without PNES. This predominance disappeared when depressive symptoms (DS) were controlled for. The difficulties of identifying feelings and emotions resulted to be clearly higher in PWE, even when DS are controlled for, and significantly correlated with stigma perception. Alexithymia in PWE was also strongly associated with lower quality of life and education and greater number of ASMs and difficulties in emotion regulation (ER), that turned out to be the main factor affecting alexithymia in both groups (PWE and HC).

CONCLUSIONS

Alexithymia is prevalent in PWE, mostly influenced by DS and significantly associated with worse quality of life and higher emotion dysregulation and stigma perception. The latter finding could be explained by difficulty identifying emotions (DIE) that selectively characterizes PWE.