Childhood emotional maltreatment and internalizing problems in a non-clinical sample of adolescents: a moderated-mediation model of insecure anxious attachment style and gender
Open accessAbstract
Childhood emotional maltreatment (abuse and neglect) may contribute to the development of internalizing problems in adolescence. However, the mechanisms explaining this association should be examined further. This study explored the mediating role of insecure anxious attachment style in the relationship between emotional maltreatment and internalizing symptoms in a non-clinical sample of adolescents. Analyses were also conducted to determine whether gender moderated the direct and indirect pathways between emotional maltreatment and internalizing problems. We recruited 449 adolescents aged between 14 and 18 years old [(Mage)=16.46, standard deviation (SD)=1.38]. 60.8% of adolescents were female (Mage=16.51, SD=1.43), whereas 39.2% identified as male (Mage=16.39, SD=1.28). Participants completed a survey including socio-demographic information and three selfreport questionnaires: the Childhood Trauma Questionnaire-Short Form, the Attachment Style Questionnaire, and the Youth Self- Report for ages 11-18. Results showed that emotional abuse and neglect were related to internalizing problems both directly and indirectly through anxious attachment style. Girls who experienced higher levels of emotional abuse and who had an anxious attachment style reported more internalizing problems than boys, whereas higher levels of emotional neglect were associated with increasing levels of internalizing problems only for boys. This study expanded our knowledge of the role of anxious attachment in the onset of internalizing problems among adolescents with experiences of childhood emotional maltreatment.
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Persons with a history of emotional abuse and neglect often develop an anxious (preoccupied) attachment style.
“Clinically, persons with a history of emotional abuse and neglect often develop an anxious (preoccupied) attachment style [42–45], characterized by heightened sensitivity to rejection, difficulties with affect regulation, and persistent fears about the availability of close others [21].”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [45]
The Introduction says emotional abuse and neglect tend to be related to insecure attachment, with a stronger association for anxious attachment. The Discussion reports a positive association in adolescents and suggests maltreatment may contribute to the style’s development. The claim’s wording, “often develop,” implies a frequency and developmental outcome that these passages do not establish. (LLM, conf=0.82)
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- Authors
- Falgares, G., Costanzo, G., Manna, G., & Lamis, D. A.
- Affiliations
- University of Palermo (IT)
- Emory University (US)
- Corresponding author
- Costanzo, Giulia
- Venue
- Research in Psychotherapy: Psychopathology, Process and Outcome
- Publisher
- PAGEPress Publications
- Published
- 2024-06-24
- Volume
- 27
- Issue
- 2
- ISSN
- 2239-8031 (ISSN-L)
- 2499-7552
- PMC
- PMC11420744
- OpenAlex
- W4399978134
- Cited by
- 7
- References
- 65
- Citations by year
- 2026: 3 · 2025: 4
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Research in Psychotherapy Psychopathology Process and Outcome (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Università degli Studi di Palermo
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- childhood emotional abuse, emotional abuse, emotional neglect, internalizing problems, gender differences, moderated mediation, adolescents, non-clinical sample, attachment styles
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