Results from an ongoing longitudinal study provide strong evidence that childhood maltreatment predisposes victims to relationship difficulties in adulthood. The findings, published in the journal Child Abuse & Neglect, further suggest that this link between maltreatment and poor quality relationships can be explained by victims’ increased levels of depression and insecure attachment.

Childhood experiences of physical abuse, sexual abuse, emotional abuse, or neglect have been associated with future relationship issues in adulthood. For example, child abuse victims go on to experience more breakups and less caring and supportive relationships in later life.

However, it appears that not all victims of abuse come to experience such problems, leading researchers Mona K. Shahab and her team to question the underlying mechanism connecting past abuse to interpersonal issues in adulthood. Past research has hinted that attachment styles and mental health issues such as depression, anxiety, and alcohol dependence might mediate this relationship, but few studies have explored the interplay between all of these factors.

Shahab and her colleagues analyzed data from the Netherlands Study of Depression and Anxiety (NESDA), an ongoing longitudinal study of Dutch adults that explores the trajectories of depression and anxiety disorders. The study includes over 2,000 participants, of whom 22% are healthy and 78% have a history of depression or anxiety.

The current researchers focused their analysis on participants who provided data on the quality of their intimate relationships and their attachment styles at the 9-year follow-up assessment. The presence of childhood maltreatment was assessed at the 4-year follow-up, and depression and anxiety were assessed at baseline and at the 1-year, 2-year, 4-year, and 6-year follow-ups.

In line with previous findings, the researchers found that respondents with a history of childhood maltreatment had more severe depression and anxiety, as measured by their average depression and anxiety scores over the five waves. They also had higher levels of both anxious attachment and avoidant attachment, as well as poorer quality interpersonal relationships.

Next, the researchers tested various pathways that might be connecting childhood maltreatment to relationship quality, controlling for participants’ age, gender, and level of education. They found that the relationship between maltreatment and poor quality intimate relationships was fully mediated by insecure attachment and depression severity so that these two variables completely explained the association.

The strongest pathway went from childhood maltreatment to heightened depressive symptoms, to anxious attachment, and finally to lower quality relationships. As the study authors illustrate, this suggests that some victims of maltreatment went on to develop low mood and became subsequently less self-assured and more reliant on relationship partners. This clinginess, which is characteristic of anxious attachment, may have created more friction in relationships, resulting in poorer quality partnerships.

A weaker but still significant pathway went from childhood maltreatment to depression and avoidant attachment, and finally to poor quality relationships. This suggests that some participants with past abuse experienced heightened depression combined with a distrust in partners and a rejection of intimacy that is characteristic of avoidant attachment. These participants were likely less willing to confide in and rely on their partners, leading to relationship difficulties.

Shahab and her team note that their data came from a prospective study with a large population of individuals with anxiety and depression histories, adding to the study’s clinical relevance. “In clinical practice, routine assessment of a history of childhood maltreatment is warranted in individuals with symptoms of depression and anxiety and/or individuals with insecure attachment styles and/or troublesome intimate relationships,” the researchers say.

They mention that their findings could also inspire early detection of at-risk youth. “Informing parents, teachers, general practitioners, and the general public about the possible destructive impact of childhood maltreatment on mental wellbeing and intimate relations, may lead to better recognition and earlier detection.”

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