The DOI matches its Crossref record; 46 of the 47 references it cites were found in a registry or an index.
Unseen wounds: The contribution of psychological maltreatment to child and adolescent mental health and risk outcomes.
Abstract
For this study, we evaluated the independent and additive predictive effects of psychological maltreat-ment on an array of behavioral problems, symptoms, and disorders in a large national sample of clinic-referred children and adolescents drawn from the National Child Traumatic Stress Network Core Data Set (CDS; see Layne, Briggs-King, & Courtois, 2014). We analyzed a subsample of 5,616 youth with lifetime histories of 1 or more of 3 forms of maltreatment: psychological maltreatment (emotional abuse or emotional neglect), physical abuse, and sexual abuse. Measures included the University of California, Los Angeles Posttraumatic Stress Disorder–Reaction Index (Steinberg et al., 2004), Child Behavior Checklist (Achenbach & Rescorla, 2004), and 27 diagnostic and CDS-specific clinical severity indicators. Psychologically maltreated youth exhibited equivalent or greater baseline levels of behavioral problems, symptoms, and disorders compared with physically or sexually abused youth on most indicators. The co-occurrence of psychological maltreatment with physical or sexual abuse was linked to the exacerbation of most outcomes. We found that the clinical profiles of psychologically maltreated youth overlapped with, yet were distinct from, those of physically and/or sexually abused youth. Despite its high prevalence in the CDS, psychological maltreatment was rarely the focus of intervention for youth in this large national sample. We discuss implications for child mental health policy; educational outreach
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“Emotional abuse and neglect often occur in combination with physical and sexual abuse but have been found to have adverse biopsychosocial effects that are distinct from those of physical or sexual abuse [159, 165].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [159]
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“Compared with the PA group, the PM ϩ PA group had significantly higher CBCL-Int. scores (Achenbach & Rescorla, 2004), estimated difference ϭ 2.66, SE ϭ 0.62; p Ͻ .0001, and PTSD-RI scores (Steinberg et al., 2004), estimated difference ϭ 2.45, SE ϭ 0.81; p ϭ 0.0025.”
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“However, the present exploratory network analyses, consistent with prior studies, underscore emotional maltreatment as a central and impactful form linked to depression development (Spinazzola et al., 2014).”
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“Furthermore, legal definitions of child PM vary from jurisdiction to jurisdiction and state to state (Spinazzola et al., 2014).”
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“Also, in various studies, it has been found that the e ff ects of abuse on children di ff er in terms of gender (Asscher et al., 2015; Hagborg et al., 2017; Spinazzola et al., 2014).”
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“…of any singular type of CM and/or IPV type was captured or modeled given our threshold, despite understanding that severity and frequency of CM and IPV, even of a singular type, are associated with PTSD and depressive symptom severity (e.g., Spinazzola et al., 2014; Stein & Kennedy, 2001).”
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“Spinazzola et al. (2014) found that CPA is a significant and unique predictor of detrimental mental health outcomes among treatment-seeking youth, including depression, generalized anxiety, PTSD, and attachment problems.”
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“Emotional abuse and emotional neglect, although both classified as emotional maltreatment, represent distinct developmental negative experiences with divergent psychological consequences [33, 34].”
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“This may reflect the idea that different types of abuse and neglect may exert differential effects on mental health (Spinazzola et al., 2014).”
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“Theories of intergenerational transmission of abuse support these findings (Spinazzola et al, 2014; Grünbaum et al., 2018). articles 605”
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“Moreover, emotional maltreatment may have consequences that are at least as severe as, and in some cases more harmful than, those associated with other forms of abuse and neglect (6).”
Sharma, B., Joshi, P., Javeth, A., Chakraborty, B., Devi, D. M. R., Roy, A., Basu, A., & Khandelwal, N. (2026) · Children and Youth Services Review · doi:10.1016/j.childyouth.2026.109306
Metadata
- Authors
- Spinazzola, J., Hodgdon, H., Liang, L.-J., Ford, J. D., Layne, C. M., Pynoos, R., Briggs, E. C., Stolbach, B., & Kisiel, C.
- Affiliations
- Justice Resource Institute (US)
- University of California, Los Angeles (US)
- University of Chicago (US)
- Northwestern University (US)
- ORCID
- Venue
- Psychological Trauma: Theory, Research, Practice, and Policy
- Published
- 2014
- Volume
- 6
- Issue
- Suppl 1
- Pages
- S18-S28
- ISSN
- 1942-9681 (ISSN-L)
- 1942-969X
- OpenAlex
- W2123420814
- Cited by
- 297
- References
- 47
- Citations by year
- 2026: 28 · 2025: 34 · 2024: 23 · 2023: 23 · 2022: 39 · 2021: 32 · 2020: 22 · 2019: 23 · 2018: 18 · 2017: 18 · 2016: 25 · 2015: 9 · 2014: 2
- FWCI
- 21.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Trauma Theory Research Practice and Policy (publishedVersion)
- Funders
- U. S. Department of Health and Human Services (3U79SM054284-10S and 1U79SM059314-03)
- Substance Abuse and Mental Health Services Administration
- Center for Mental Health Services
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- psychological maltreatment, emotional abuse, emotional neglect, child abuse, adolescent mental health, behavioral problems, post-traumatic stress disorder, physical abuse, sexual abuse, clinic-referred children, National Child Traumatic Stress Network, child mental health policy
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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