Childhood abuse can negatively impact behavioral and mental health among Black women in emerging adulthood.
These effects may occur by increasing emotion dysregulation and reducing adaptive coping abilities (Heleniak et al., 2016; Vilhena-Churchill & Goldstein, 2014).
However, secure adult attachment relationships may protect against some harmful consequences by influencing post-abuse developmental pathways (Alink et al., 2009).
Gause, N. K., Sales, J. M., Brown, J. L., Pelham, W. E. III, Liu, Y., & West, S. G. (2022). The protective role of secure attachment in the relationship between experiences of childhood abuse, emotion dysregulation and coping, and behavioral and mental health problems among emerging adult Black women: A moderated mediation analysis. Journal of Psychopathology and Clinical Science, 131(7), 716–726. https://doi.org/10.1037/abn0000772
Key Points
- Childhood abuse is associated with increased behavioral and mental health issues in emerging adulthood among Black women.
- Emotion dysregulation and maladaptive coping mediate the relationship between childhood abuse and later mental/behavioral health issues.
- High levels of adult attachment security can mitigate the harmful effects of childhood abuse on emotion dysregulation and coping.
- At high attachment security, childhood abuse was not indirectly associated with mental/behavioral health via coping; indirect effects via emotion dysregulation were still present but reduced.
Rationale
Previous research shows childhood abuse puts individuals at risk for adverse behavioral and mental health outcomes later in life (Anda et al., 2006; Edwards et al., 2003).
However, fewer studies have examined mechanisms underlying this relationship or factors that might prevent/attenuate negative effects in at-risk groups.
This study aimed to address gaps by testing:
- Emotion dysregulation and coping as mediators between childhood abuse and later problems.
- Attachment security as a moderator influencing the mediated pathways, among Black emerging adult women.
Method
440 Black women aged 18-24, who reported drinking alcohol and having recent unprotected sex, were sampled from a larger HIV prevention trial.
One hundred fifty-nine women reported some form of abuse before age 18 (emotional, physical, sexual), while 281 reported no lifetime abuse. Measures assessed abuse history, adult attachment security, emotion dysregulation, coping strategies, mental health symptoms, substance use problems, and sexual risk behaviors.
Sample
Black cisgender women aged 18-24 (M=20.3 years) from a southeast U.S. city, all of whom reported recent alcohol use and unprotected sex.
Statistical Analysis
Multiple regression tested interaction effects between abuse and attachment security. Structural equation modeling examined
- Direct effects of abuse on outcomes
- Indirect (mediated) effects through emotion dysregulation/coping at high and low attachment security levels.
Results
Childhood abuse directly predicted mental health problems, substance issues, and sexual risk-taking. Abuse also indirectly influenced these outcomes by reducing coping abilities and increasing emotional dysfunction.
However, high attachment security weakened the harmful effects that passed through coping and (to a lesser degree) emotional dysregulation.
Strengths
- Large sample of understudied high-risk group
- Assessed a range of relevant outcomes
- Established temporal order more clearly
- Analyzed conditional indirect effects at high/low moderator levels
Limitations
- Self-report measures
- Limited abuse assessment
- Cross-sectional mediators
- Sample specific to those reporting recent HIV risks
Implications
Interventions for emerging adult women with abuse histories could teach emotion regulation and coping skills.
Bolstering attachment security may also mitigate post-abuse maladjustment across behavioral and mental health domains.
References
Primary reference
Gause, N.K., Sales, J.M., Brown, J.L., Pelham III, W.E., Liu, Y., & West, S.G. (2022). The protective role of secure attachment in the relationship between experiences of childhood abuse, emotion dysregulation and coping, and behavioral and mental health problems among emerging adult Black women: A moderated mediation analysis. Journal of Psychopathology and Clinical Science, 131(7), 716-726. https://doi.org/10.1037/abn0000772
Other references
Alink, L. R., Cicchetti, D., Kim, J., & Rogosch, F. A. (2009). Mediating and moderating processes in the relation between maltreatment and psychopathology: Mother-child relationship quality and emotion regulation. Journal of Abnormal Child Psychology, 37(6), 831–843. https://doi.org/10.1007/s10802-009-9314-4
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174-186. https://doi.org/10.1007/s00406-005-0624-4
Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. The American Journal of Psychiatry, 160(8), 1453-1460. https://doi.org/10.1176/appi.ajp.160.8.1453
Heleniak, C., Jenness, J. L., Stoep, A. V., McCauley, E., & McLaughlin, K. A. (2016). Childhood maltreatment exposure and disruptions in emotion regulation: A transdiagnostic pathway to adolescent internalizing and externalizing psychopathology. Cognitive Therapy and Research, 40(3), 394–415. https://doi.org/10.1007/s10608-015-9735-z
Vilhena-Churchill, N., & Goldstein, A. L. (2014). Child maltreatment and marijuana problems in young adults: Examining the role of motives and emotion dysregulation. Child Abuse & Neglect, 38(5), 962–972. https://doi.org/10.1016/j.chiabu.2013.10.009
Keep Learning
- How might racism and discrimination worsen the effects of childhood abuse in the study population?
- Would similar patterns emerge in emerging adult men or other racial groups?
- What are additional protective factors that could be studied as moderators?
- What are clinical strategies to enhance attachment security among those with insecure styles?
