Study Establishes Connections Between Emotional Maltreatment, Psychiatric Disorders

In younger children, emotional maltreatment led primarily to behavioral problems, whereas in older children it was more likely to lead to depression and anxiety disorders.

New study results published in Child Maltreatment have found links between emotional maltreatment, also known as psychological violence, and psychiatric disorders in childhood and adolescence.

Emotional maltreatment can be challenging to recognize and record, both in research and in practice. Navigating that challenge resulted in an elaborate study conducted by researchers at the Faculty of Medicine in the University of Leipzig, with the goal of understanding the psychological effects that abuse, neglect, and emotional maltreatment have on children and adolescents.

Examples of emotional abuse include when parents subject their children to extreme humiliation, threaten to put them in foster care, or blame children for their own psychological distress or suicidal thoughts. Physical violence also plays a crucial role in the development of psychiatric disorders.

“Our study findings clearly show that emotional maltreatment is not only a very common form of maltreatment, but also one with psychiatric consequences that are similar to or even more severe than other forms of maltreatment,” said study leader and last author Lars White, PhD, in a press release.

In their study of 778 children, researchers found that 80% of the children and adolescents who reported having been mistreated had also experienced emotional maltreatment. This makes emotional maltreatment the most common form of child abuse.

Additionally, the investigators were able to show that of all forms of maltreatment, psychological violence had the strongest effects on the psyche of the children and adolescents, even in comparison with forms of maltreatment that generally receive more attention, such as physical abuse. In younger children between 3 and 8 years of age, emotional maltreatment led primarily to behavioral problems, whereas in older children it was more likely to lead to depression and anxiety disorders.

To conduct the study, family data were collected with extensive interviews and the researchers analyzed files from youth welfare offices for evidence of maltreatment experiences. The sample consisted of 306 children and adolescents with an experience of maltreatment and 472 participants without these experiences. Among other sources, participants were recruited via the residents’ registration offices, daycare centers, child and youth psychiatry centers, and youth welfare offices in Leipzig and Munich.

“We are particularly grateful for the support of the youth welfare offices because this enabled us to recruit families for the study who have had extremely difficult experiences and who are otherwise difficult to reach for research projects,” said lead author Jan Keil, DrPhil, in the press release.

The findings illustrate that the risk of developing psychiatric disorders after maltreatment is already heightened in early and middle childhood, which underlines the need for early intervention. The authors said emotional maltreatment should be understood as a dimension of abuse unto itself and should be a key focus in both research and treatment efforts.

“We need to educate parents so that they take the child’s perspective more often,” White said in the press release. “As recently as 30 years ago, the commonly held view was that children should be left to cry and that what they experience in childhood they forget anyway. But increasingly, there is a complete shift in attitudes and an appreciation that we need to reach out to the youngest children when they are showing difficult emotions, such as being angry or sad.”


From emotional maltreatment to psychiatric disorders in childhood and adolescence. News release. EurekAlert; January 12, 2023. Accessed January 17, 2023.

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