The current study extends our knowledge about the effects of childhood emotional maltreatment in several ways. First, using a prospective design, the impact of emotional maltreatment was analyzed in a representative sample of maltreated children with a recent entry into out-of-home care. Second, the focus of this study was not only on the relationships between emotional maltreatment and mental health symptoms, but also on the relationships between emotional maltreatment and interpersonal functioning, employing both youth self-report and caregiver reports of functioning. The use of subtypes to describe emotional maltreatment and its associations with functioning also broadens the knowledge-base of the field, as most previous research has examined emotional maltreatment as a homogeneous construct.
The descriptive analyses that were conducted suggest that males and females were equally likely to experience emotional maltreatment of any type (including verbal abuse, inappropriate responsibility, and violence exposure), except that males were more likely to be abandoned. There was some overlap among the emotional abuse subtypes, most notably between verbal abuse and abandonment and between inappropriate responsibility and violence exposure. There was no evidence of an association between age and emotional maltreatment or emotional maltreatment subtypes, but our failure to find an effect may be attributable to the fact that our sample had a limited age range (9- to 11-year-old children). Future studies should examine the rate of emotional maltreatment across the age spectrum, as differences in prevalence by age would have implications for prevention efforts.
In informing prevention efforts, it is important to identify those risk factors associated with the perpetration of emotional maltreatment. In the current study, the associations between maternal characteristics (as coded from child welfare records) and perpetration of emotional maltreatment were examined. Maternal characteristics were targeted because the majority of the emotional maltreatment perpetrators in the current study were mothers and most children were removed from their mothers. In general, maternal characteristics, which included criminal history, alcohol and substance use problems, mental illness, and maltreatment history, were not related to emotional maltreatment perpetration. Future studies should examine the associations between maternal characteristics and emotional maltreatment with a sample that is restricted to those children who have been emotionally maltreated by their mothers. Preliminarily, however, these analyses suggest that one cannot identify which children are at risk for emotional maltreatment based on their mothers' risk factors. This differs from other studies, which find that maternal characteristics predict perpetration of emotional maltreatment (Chamberland et al., 2005
; Mullen et al., 1996
). Finally, the overlap between emotional maltreatment and other types of maltreatment was examined. As other studies have found (Chamberland et al., 2005
; Crittenden et al., 1994
; McGee et al., 1997
; Rodgers et al., 2004
; Wolfe & McGee, 1994
), there was a great deal of overlap between emotional maltreatment types and other types of maltreatment, although there was less overlap between abandonment and violence exposure and other types of maltreatment.
After examining the descriptive characteristics, bivariate and multivariate analyses were conducted to examine the impact of emotional maltreatment and subtypes of emotional maltreatment on social and related functioning. Regression results, after controlling for other types of maltreatment, suggest that it is important to evaluate the effects of emotional maltreatment subtypes. An exclusive focus on the effects of an overall measure of emotional maltreatment would have masked some key subtype differences. For example, it was found that verbal aggression was related to lower perceived social acceptance and self-esteem, but overall emotional maltreatment was not. This theoretically makes sense as verbal aggression, which often belittles children, may make children feel bad about themselves and may make them feel that others do not like them. Abandonment was related to greater anxiety and less life satisfaction, whereas overall emotional maltreatment was not. Similarly, inappropriate responsibility was related to fewer social problems as reported by current caregivers, but overall emotional maltreatment was not. Children who have been forced to care for other children and to maintain household functioning may display parentified behaviors that are viewed by other caregivers as helpful or mature. Finally, exposure to violence was associated with fewer self-reported posttraumatic stress symptoms. Although this may seem counterintuitive, it is important to remember that in this sample, all children had experienced maltreatment. Those children who were coded as having been emotionally maltreated solely because they had been exposed to violence displayed the fewest problems. Thus, witnessing violence may be less traumatic than being the subject of violence, whether verbal, physical, or sexual. These findings are similar to those observed in other studies that compare children who have been exposed to domestic violence with children who have been abused or neglected (Allen, 2008
; Chamberland et al., 2005
; Lewis et al., 2006
; Linder & Collins, 2005
As the findings of the current study suggest, some emotional maltreatment subtypes (e.g., verbal aggression, abandonment) are positively associated with psychosocial problems, while others (e.g., inappropriate responsibility, violence exposure) are negatively associated with such problems, relative to other types of maltreatment. The examination of a global category of emotional maltreatment, therefore, may hide critical findings. It is also important to examine a range of outcomes from multiple reporters (Morimoto & Sharma, 2004
; McGee et al., 1997
), as some important, yet subtle differences were found in the current study. Finally, given the overlap between emotional maltreatment and other types of maltreatment, it is critical to control for the impact of other types of maltreatment in order to isolate the unique effects of emotional maltreatment (Berzenski & Yates, in press
; Sachs-Ericsson et al., 2006
; Vissing et al., 1991
; Zurbriggen, Gobin, & Freyd, in press
Studies should also examine outcomes by gender, as previous research has found inconsistent results with regard to gender differences concerning the impact of emotional maltreatment (Kim & Cicchetti, 2006
; McGee et al., 1997
; Morimoto & Sharma, 2004
; Vissing et al., 1991
; Wolfe & McGee, 1994
). In the current study, females who had been emotionally maltreated were faring better on some indices of mental health and social functioning than maltreated females who experienced other types of maltreatment. On the other hand, males who were emotionally maltreated endorsed more posttraumatic stress and anxiety symptoms and reported lower levels of life satisfaction, less attachment to friends, lower self-esteem, and less attachment to their biological parents than did maltreated males who experienced other types of maltreatment. In an effort to understand why males might be more negatively impacted by emotional maltreatment than females, a closer examination of the data revealed that the males in our sample experienced a greater severity of emotional maltreatment than did females, t
(132) = 2.58, p
= .011. A recent study found that the association between emotional abuse and adolescent competence was mediated by social withdrawal, but only for males (Shaffer, Yates, & Egeland, 2009
). Future studies should examine gender by emotional maltreatment interactions while controlling for severity of emotional maltreatment. In addition, an examination of the relationship between the gender of the perpetrator (mother, father) and the gender of the victim may illuminate any differential impact of emotional abuse.
One of the limitations of the current study is that each of the subtypes of emotional maltreatment was not coded for severity. These data would have been helpful in understanding the topography of emotional maltreatment and for analyzing the data to better understand the impact of different subtypes. It is recommended that a standardized method for coding emotional maltreatment subtypes and associated severity be developed because emotional maltreatment, as currently defined in the literature, is a very heterogeneous construct and is often operationalized differently in each study. This would enhance researchers' ability to compare findings across studies and to examine the impact of subtypes within a developmental framework.
Another limitation of the current study was that multiple analyses were conducted and the level of significance was not adjusted, thereby increasing the possibility that our findings may be attributable to chance. The significance levels were not adjusted because of the exploratory nature of this study and because the associations between emotional maltreatment and psychosocial functioning have not been previously studied with a sample of preadolescent youth placed in out-of-home care. For this reason, trends were also noted in the tables and accompanying text. Another limitation was the use of caregivers as informants, as the length of time that they knew the child was variable. In addition, the generalizability of these findings are limited by the fact that the sample only included youth within a limited age range and those who were living in out-of-home care as a result of court order.
Finally, the current study did not include a control group of non-maltreated children who were matched on other, important sociodemographic variables. It would have been helpful to compare three groups of children: those who experienced emotional maltreatment, those who were maltreated but did not experience emotional maltreatment, and a non-maltreated group. This may have better clarified the unique impact of emotional maltreatment on psychosocial outcomes for youth. A strength of the current design, however, was its ability to control for other types of maltreatment, as only eight children (3% of the sample) experienced solely emotional maltreatment.
The results of the current study suggest that emotional maltreatment may impair psychosocial functioning and related outcomes. Adult reports of the impact of childhood emotional maltreatment suggest that problems experienced by youth who are emotionally maltreated will not resolve on their own (see Carbone, this issue
; Dodge Reyome, in press
; Riggs, this issue
; Riggs & Kaminski, this issue
). Longitudinal studies are needed to examine not only the impact of emotional maltreatment over time, but salient risk and protective factors developmentally. Analyses of mediation and moderation (e.g., Morimoto & Sharma, 2004
; Sachs-Ericsson et al., 2006
; Wright, 2007
), as well as analyses evaluating the impact of preventive interventions, should help to identify key mechanisms in the development of healthy social functioning for children whose lives have been impacted by grossly inappropriate parenting.