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EMOTIONAL ABUSE AND DEPRESSION 1 Childhood Emotional Abuse: The Relationship with Adult Depression Riley Howard Department of Psychology University of Northern Iowa

EMOTIONAL ABUSE AND DEPRESSION 2 Childhood Emotional Abuse: The Relationship with Adult Depression Every fifteen minutes someone takes their life in the United States. Of those who commit suicide, 60% have depression, which is often undiagnosed or untreated (American Foundation of Suicide Prevention, 2011). Depression can cause a lot of problems and have a lot of consequences. Depression can cause increased chances of drug/alcohol abuse by advancing the need to find something to numb the pain. It can also ruin relationships because your partner may not understand that you cannot help the way you feel. It can also cause problems at work that may lead to you getting fired. It can even make it more difficult to overcome physical illnesses and may even increase the risk of cardiovascular disease and obesity. (Pennix et al., 2013). Today, depression is a common and serious mental illness that negatively affects how you feel, the way you think and how you act. One in six Americans will suffer from major depression sometime in their life (Rosenbaum, 1996). Fortunately, it is treatable through medication and therapy. However, it often goes untreated and many patients with depression do not reach remission. The recurrence rate stays high at 53% over 2 or more years (Steinert et al., 2014). Depression has a range of different forms and severities from as significant as severe depressive disorder to not so severe as “situational” depression and it varies from person to person (Brandon et al. 2007). One cause of depression is emotional abuse. Emotional abuse is a form of abuse that is emotional in nature rather than physical. It is often used to control someone by using their emotions to embarrass, shame, frighten, criticize, blame, or manipulate them (Brandon et al., 2007). Emotional abuse, unlike other types, is hard to name because there is no physical evidence. However, that does not make it any less serious or damaging than physical abuse. A meta-analysis by Stoltenborgh et al. of 46 studies, with a joint total of 7,082,279

EMOTIONAL ABUSE AND DEPRESSION 3 participants, found the worldwide prevalence of childhood emotional abuse to be 26.7%, with a substantial difference between studies based on the judgment of professionals compared to self- report studies (0.3% vs. 36.3%) (Stoltenborgh et al., 2012). The research linking emotional abuse to depression is unarguable. Study after study shows that there is a strong correlation between the two. Parental abuse is seen as one of the main causes of abuse and several studies show that specifically emotional abuse is related to elevated risks of depression later. Emotional abuse specifically can crush someone’s self-esteem and make it seem like they are alone in the world. (Mishra el al., 2022). It can make you feel helpless and depressed which is why it can lead to some individual taking their own life. Main Effects of Abuse on Depression Childhood maltreatment, also known as abuse, is a problem that affects over six million children in the United States each year. Childhood maltreatment (CM) has also been identified as a critical etiological factor underlying an increased risk for depression onset (Chapman et. al., 2004). Emotional abuse is a type of childhood maltreatment that is often less focused on, yet it can be just as damaging to a child's health. Emotional abuse specifically can crush someone’s self-esteem and lower levels of perceived social support making it seem like you are alone in the world ( Mishra et al. , 2022). Much like depression, it can make you feel helpless which is why some think that there is no other way to end the abuse besides suicide. Some signs of emotional abuse include things like the child being socially withdrawn or not wanting to do the things they used to love. Unfamiliar problems with their peers could also be a common sign. Many empirical studies support the idea that childhood abuse causes depression. For example, Mental health surveys in multiple countries emphasized that childhood abuse was “one of the strongest predictors of adult psychopathology” (Kessler et al, 2010) When someone is unable to escape

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EMOTIONAL ABUSE AND DEPRESSION 4 from anger, shame, fear, guilt or if someone is preventing them from feeling human emotions it may cause them to try to shut down all their emotions. There are many types of emotional abuse but here are some of the most common. Different Types of Emotional Abuse Unintentional Emotional Abuse In an article published by Single Parent Advocate, Cedrick Tardy (2012) he writes, “abuse and neglect are one in the same”. He also defines unintentional neglect as “an instance when a parent decides to put a priority of lower value over the ultimate wellbeing of their child”. The parents also may even believe, he says, that they are “acting in the child’s best interest”. Parents who treat their children like they do not matter or show no affection toward them can cause them to develop a self-alienated way. The rates of people affected by emotional abuse are about 18% of the adult population in the United States (Stoltenborgh et al., 2012). Another way unintentional emotional abuse occurs is when parents talk badly about themselves and that in turn affects how their children see themselves because children look up to their parents and believe everything they say. Parental Alienation Parental Alienation is another form of emotional child abuse that occurs when a child gets close to one parent only to reject the other because of parental alienating behaviors. Parental alienating behaviors are “the process of psychological manipulation of a child by a parent to show fear, disrespect, or hostility toward the other parent” (Harman et al., 2021). Examples of this include badmouthing the other parent to the child, causing the child to reject the other parent, interfering with the child’s visitation times with the other parent, or undermining the child’s relationship with the other parent. The effects of parental alienation are well documented - low

EMOTIONAL ABUSE AND DEPRESSION 5 self-esteem and self-hatred, lack of trust between child and parent, depression, and substance abuse or other forms of addiction. Judge Michael Haas put it best when he said, “ No matter what you think of the other party, these children are one-half of each of you. Remember that, because every time you tell your child what an ‘idiot’ his father is, or what a ‘fool’ his mother is, you are telling the child half of him is bad” (Verhaar et al., 2022). Parental Gaslighting Parental gaslighting is a subtle and covert form of emotional child abuse. It is often used unknowingly by the parents. Parents who gaslight their children tend to manipulate and undermine the child’s sense of reality and mental stability but then frame it as a way of caring or emotional support. Which leaves the child to question their reaction to the situation (Harman et al., 2018). This happens most often with physical and mental health concerns. An example of this is when a child is brought up that they think they need therapy for their mental health, but the parent just says that they do not need therapy and that they are just being dramatic or sensitive. This can have a negative effect on the child’s mental health and can lead to depression. Current Study The association between childhood abuse and mental health outcomes is well established. However, researchers tend to focus on physical and sexual abuse and leave out mental abuse. This study would not only offer more information about the effects of abuse on mental health to therapists and those working in the health field, but it will also give out valuable information to those who have experienced abuse and are struggling with depression to let them know that they are not alone. For this study, the participants will take a self-survey about their current mental health along with a childhood trauma questionnaire to assess their levels of childhood emotional abuse. I hypothesize that the study results will confirm the idea that those who experienced

EMOTIONAL ABUSE AND DEPRESSION 6 emotional abuse in their childhood now have higher levels of depression than those who did not. Method Participants The sample will be 500 randomly selected college students from colleges in the United States. They will be recruited through social media sources like Instagram, Facebook, and twitter. They must be between the ages of 19-25 to take part. Those who decide to take part will be entered in a drawing to win a cash prize. Procedure A post will be made on Instagram, Facebook, and Twitter explaining the study and mentioning that participants need to be 19-25 years old to take part. It will also have link that they will need to click in order to participate. As soon as they click the link the participants will sign a consent form before they begin. They will then be taken to a self-survey about their current mental health for them to complete along with a Childhood Trauma questionnaire to assess their levels of childhood emotional abuse. Everything will be anonymous. Once every participant has taken the survey and questionnaire both sets of results will be calculated and compared to obtain an outcome. All the participants will be made aware that participation is voluntary and that they can stop taking the survey or questionnaire at any time without consequences. Since this topic tends to bring up a lot of emotions, there will be a list of resources they can contact at the end so that if they have been affected by any sort of childhood trauma or struggle with mental health so that they can get the help they may need. Expected Results Changes in mental health over time will be assessed in relation to emotional abuse. Separate scores will be calculated for both the survey and the questionnaire and compared to

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EMOTIONAL ABUSE AND DEPRESSION 7 obtain an outcome and conclude whether emotional abuse can cause depression later in life. I expect the study to show a positive correlation between those who have experienced emotional abuse and depression in adulthood. I expect those who have not experienced emotional abuse would have no correlation between abuse and their mental health and those with depression but have never experienced other types of trauma in their life. I expect my results to be an example of an interaction between emotional abuse and depression. Limitations of Past Research While researching this topic I realized that past studies tend to have many limitations. One of the main ones was that the definition of abuse is broad within society which may lead to an inconsistency within the results. Another limitation is the method used in most of the studies. Mostly all the studies that have been done before are cross-sectional. While this method is useful when combined with other methods, it tends to jump to conclusions when it comes to causation of childhood trauma. Most studies also often use a self-report method or research. While this does get some results, the results are often inaccurate due to people not being truthful. References American Foundation for Suicide Prevention. (2011). AFSP: Understanding and preventing suicide through research, education, and advocacy .

EMOTIONAL ABUSE AND DEPRESSION 8 http://www.afsp.org , Brandon E. Gibb, Iwona Chelminski, and Mark Zimmerman, M.D. Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and anxiety disorders in adult psychiatric outpatients. (2007). Depression and Anxiety., 24(4), 256–263 https://www.binghamton.edu/psychology/labs/mood/pdfs/2007_gibb_child_abuse _dep_anx.pdf , Chapman, D.P., Whitfield, C.L., Felitti, V.J., Dube, S.R., Edwards, V.J., Anda, R.F., (2004) Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect. Disord. 82, 217-225. https://www.sciencedirect.com/science/article/pii/S016503270400028X?via %3Dihub , Harman J.J., Matthewson M.L., Baker A.J.L. (2021) Losses experienced by Children alienated from a parent. Current Opin. Psychol ;43:7–12. https://www.sciencedirect.com/science/article/pii/S2352250X2100066X , Harman, J. J., Kruk, E., & Hines, D. A. (2018). Parental alienating behaviors: An unacknowledged form of family violence. Psychological Bulletin, 144 (12), 1275– 1299. https://doi.org/10.1037/bul0000175 , Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., et al. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British Journal of Psychiatry , 197(5), 378–385. https://pubmed.ncbi.nlm.nih.gov/21037215/ , Mishra, A. A., Marceau, K., Christ, S. L., Schwab Reese, L. M., Taylor, Z. E., & Knopik, V. S. (2022). Multi-type childhood maltreatment exposure and substance use development from adolescence to early adulthood: A GxE study. Child Abuse & Neglect, 126, 1–13. https://www.sciencedirect.com/science/article/pii/S0145213422000278? dgcid=rss_sd_all&utm_source=researcher_app&utm_medium=referral&utm_cam paign=RESR_MRKT_Researcher_inbound ,

EMOTIONAL ABUSE AND DEPRESSION 9 Penninx, B.W., Milaneschi, Y., Lamers, F. et al. (2013) Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. BMC Med 11, 129. https://doi.org/10.1186/1741-7015-11-129 , Steinert, C., Hofmann, M., Kruse, J., Leichsenring, F., (2014) Relapse rates after psychotherapy for depression- stable long-term effects? A meta-analysis, Journal of Affective Disorders Volume 168 , https://doi.org/10.1016/j.jad.2014.06.043 ., Stoltenborgh. (2012). The universality of childhood emotional abuse: A meta-analysis of worldwide prevalence. Journal of Aggression, Maltreatment & Trauma , 21 (8), 870–890. https://doi.org/10.1080/10926771.2012.708014 , Tardy C: (2012). The effects of unintentional child abuse (Neglect). Single parent advocate: Coping (Self-Care)—Parents, Parenting. http://singleparentadvocate.org/get-advice/item/the-effects-of-unintentional-child- abuse . Verhaar S, Matthewson ML, Bentley C. (2022) The Impact of Parental Alienating Behaviors on the Mental Health of Adults Alienated in Childhood. Children ; 9(4):475. https://doi.org/10.3390/children9040475 , Yang, Y., Ma, X., Kelifa, M. O., Li, X., Chen, Z., & Wang, P. (2022). The relationship between childhood abuse and depression among adolescents: The mediating role of school connectedness and psychological resilience. Child Abuse & Neglect, 131, 1–9. https://pubmed.ncbi.nlm.nih.gov/35803026/ ,

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