The mediation effect of personality functioning between different types of child maltreatment and the development of depression/anxiety symptoms-A German representative study

Background: Child maltreatment (CM) is associated with an increased risk to develop symptoms of depression/ anxiety across an individual's lifespan. Recent studies indicated that impairments in personality functioning might mediate this association. The purpose of this study is to add evidence of this mediating effect by regarding different types of CM (emotional, physical and sexual abuse as well as emotional and physical neglect) in the general population. Methods: A representative sample of the German population (N = 2,354) completed a set of standardized measures (OPD-SQS: Operationalized Psychodynamic Diagnosis - Structure Questionnaire Short, PHQ-4: Patient Health Questionnaire, CTQ: Childhood Trauma Questionnaire). Mediation analyses were carried out to examine the association between CM types, symptoms of depression/anxiety, and personality functioning. Results: Up to two-thirds of the associations between CM types and symptoms of depression/anxiety are mediated by personality functioning [indirect effect: emotional abuse (13 = 0.219, 95%-CI: 0.187-0.251, p < .001), physical abuse (13 = 0.151, 95%-CI: 0.123-0.178, p < .001), sexual abuse (13 = 0.163, 95%-CI: 0.138-0.188, p < .001), emotional neglect (13 = 0.131, 95%-CI: 0.104-0.159, p < .001) and physical neglect (13 = 0.102, 95%-CI: 0.078-0.127, p < .001)]. Limitations: Symptoms of depression/anxiety were measured with screening instruments and results are based on cross-sectional data. Conclusions: The present investigation expands the evidence on the mediating effect of personality functioning in the association between CM and depression/anxiety symptoms based on data of the general population. Our results show the relevance of types, as the mediating effects are slightly stronger in CM abuse types than in CM neglect types. Knowledge about impaired personality might be an angle for clinical interventions and inspire future research.

Automated summary

The study showed that the association between different types of child maltreatment and symptoms of depression/anxiety is largely mediated by personality functioning in the general population. The mediating effects were slightly stronger in abuse types than in neglect types, highlighting the importance of understanding impaired personality for clinical interventions and future research.