Previous studies have consistently found a robust relationship between childhood maltreatment and psychological distress. Despite the increasing number of studies in recent years that have identified social support or self-compassion as potential mechanisms in this relationship, no study examines the mediating role of both social support and self-compassion in adults.
Aim:
This study aimed to investigate social support and self-compassion as potential mediators in the relationship between childhood maltreatment and psychological distress using a serial mediation model.
Method:
Using online surveys, a total of 310 participants (Mage = 28.83, SD = 6.07) were included in this study. The data was collected using the Childhood Trauma Questionnaire, Self-Compassion Scale-Short Form, Multidimensional Scale of Perceived Social Support, and Depression Anxiety Stress Scales – Short Form. The proposed serial mediation model was conducted using PROCESS macro for SPSS.
Results:
After controlling age and gender, the results showed that: (a) there was a direct effect of childhood maltreatment on psychological distress (B = 0.192, p < .001); (b) self-compassion mediated the relationship between childhood maltreatment and psychological distress (effect = 0.107, SE = 0.03, 95% CI [0.051, 0.170]) whereas social support did not mediate this relationship (effect = 0.026, SE = 0.01, 95% CI [−0.009, 0.065]); and (c) social support and self-compassion mediated the relationship between childhood maltreatment and psychological distress in a sequential way (effect = 0.053, SE = 0.01, 95% CI [0.031, 0.083]).
Conclusions:
This study demonstrated that increasing social support resources and particularly addressing self-compassion in therapy may help individuals exposed to childhood maltreatment.
BadrH. E.NaserJ.Al-ZaabiA.Al-SaeediA.Al-MunefiK.Al-HouliS.Al-RashidiD. (2018). Childhood maltreatment: A predictor of mental health problems among adolescents and young adults. Child Abuse & Neglect, 80, 161–171. https://doi.org/10.1016/j.chiabu.2018.03.011
3.
BakerD. A.CaswellH. L.EcclesF. J. (2019). Self-compassion and depression, anxiety, and resilience in adults with epilepsy. Epilepsy & Behavior, 90, 154–161. https://doi.org/10.1016/j.yebeh.2018.11.025
4.
BarreraM.Jr. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14(4), 413–445. https://doi.org/10.1007/BF00922627
5.
BenkaJ.NagyovaI.RosenbergerJ.CalfovaA.MacejovaZ.LazurovaI.van DijkJ. P.GroothoffJ. W. (2014). Social support as a moderator of functional disability’s effect on depressive feelings in early rheumatoid arthritis: A four-year prospective study. Rehabilitation Psychology, 59(1), 19–26. https://doi.org/10.1037/a0035115
BernsteinD. P.SteinJ. A.NewcombM. D.WalkerE.PoggeD.AhluvaliaT.StokesJ.HandelsmanL.MedranoM.DesmondD.ZuleW. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0
8.
BreinesJ. G.ThomaM. V.GianferanteD.HanlinL.ChenX.RohlederN. (2014). Self-compassion as a predictor of interleukin-6 response to acute psychosocial stress. Brain, Behavior, and Immunity, 37, 109–114https://doi.org/10.1016/j.bbi.2013.11.006
9.
ChuP. S.SaucierD. A.HafnerE. (2010). Meta-analysis of the relationships between social support and well-being in children and adolescents. Journal of Social and Clinical Psychology, 29(6), 624–645. https://doi.org/10.1521/jscp.2010.29.6.624
10.
CicchettiD.TothS. L. (2016). Child maltreatment and developmental psychopathology: A multilevel perspective. In CicchettiD. (Ed.), Developmental psychopatholog: Maladaptation and psychopathology (Vol. 3, pp. 457–512). Wiley.
11.
CloitreM.CohenL. R.KoenenK. C. (2006). Treating survivors of childhood abuse: Psychotherapy for the interrupted life. Guilford Press.
12.
CurranP. J.BollenK. A.PaxtonP.KirbyJ.ChenF. (2002). The noncentral chi-square distribution in misspecified structural equation models: Finite sample results from a Monte Carlo simulation. Multivariate Behavioral Research, 37(1), 1–36. https://doi.org/10.1207/S15327906MBR3701_01
13.
DaneseA.WidomC. S. (2020). Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nature Human Behaviour, 4(8), 811–818. https://doi.org/10.1038/s41562-020-0880-3
14.
DongS.DongQ.ChenH.YangS. (2023). Childhood emotional neglect and adolescent depression: The role of self-compassion and friendship quality. Current Psychology, 42(28), 24451–24463. https://doi.org/10.1007/s12144-022-03539-4
15.
DovranA.WinjeD.ØverlandS.ArefjordK.HansenA.WaageL. (2016). Childhood maltreatment and adult mental health. Nordic Journal of Psychiatry, 70(2), 140–145. https://doi.org/10.1176/appi.ajp.20220174
16.
EkerDArkarH. (1995). Çok boyutlu algılanan sosyal destek ölçeği’nin faktör yapısı, geçerlik ve güvenirliği. Türk Psikoloji Dergisi, 34, 45–55.
17.
EkerD.ArkarH.YaldızH. (2001). Çok boyutlu algılanan sosyal destek ölçegi’nin gözden geçirilmiş formunun faktör yapısı, geçerlik ve güvenirliği. Türk Psikiyatri Dergisi, 12, 17–25.
18.
FangX.FryD. A.BrownD. S.MercyJ. A.DunneM. P.ButchartA. R.CorsoP.S.MaynzyukK.DzhygyrY.ChenY.SwalesD. M. (2015). The burden of child maltreatment in the East Asia and Pacific region. Child Abuse & Neglect, 42, 146–162. https://doi.org/10.1016/j.chiabu.2015.02.012
19.
FeiringC.TaskaL.ChenK. (2002). Trying to understand why horrible things happen: Attribution, shame, and symptom development following sexual abuse. Child Maltreatment, 7, 26–41. https://doi.org/10.1177/1077559502007001003
GardnerM. J.ThomasH. J.ErskineH. E. (2019). The association between five forms of child maltreatment and depressive and anxiety disorders: A systematic review and meta-analysis. Child Abuse & Neglect, 96, Article 104082. https://doi.org/10.1016/j.chiabu.2019.104082
22.
GlassmanL. H.WeierichM. R.HooleyJ. M.DelibertoT. L.NockM. K. (2007). Child maltreatment, non-suicidal self-injury, and the mediating role of self criticism. Behaviour Research and Therapy, 45(10), 2483–2490. https://doi.org/10.1016/j.brat.2007.04.002
23.
GilbertP.IronsC. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In GilbertP. (Ed.), Compassion: Conceptualizations, research and use in psychotherapy (pp. 263–325). Routledge.
24.
GilbertP.ProcterS. (2010). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379. https://doi.org/10.1002/cpp.507
25.
GilbertR.WidomC. S.BrowneK.FergussonD.WebbE.JansonS. (2009). Burden and consequences of child maltreatment in high-income countries. The Lancet, 373(9657), 68–81. https://doi.org/10.1016/S0140-6736(08)61706-7
26.
GreenbergJ.DattaT.ShaperoB. G.SevincG.MischoulonD.LazarS. W. (2018). Compassionate hearts protect against wandering minds: Self-compassion moderates the effect of mind-wandering on depression. Spirituality in Clinical Practice, 5(3), 155–169. https://doi.org/10.1037%2Fscp0000168
27.
HayesA. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. The Guilford Press.
28.
HeckerT.BoettcherV. S.LandoltM. A.HermenauK. (2019). Child neglect and its relation to emotional and behavioral problems: A cross-sectional study of primary school-aged children in Tanzania. Development and Psychopathology, 31(1), 325–339. https://doi.org/10.1017/S0954579417001882
29.
HoranJ. M.WidomC. S. (2015). From childhood maltreatment to allostatic load in adulthood: The role of social support. Child Maltreatment, 20(4), 229–239. https://doi.org/10.1177/1077559515597063
KearneyD. J.MalteC. A.McManusC.MartinezM. E.FellemanB.SimpsonT. L. (2013). Loving-kindness meditation for posttraumatic stress disorder: A pilot study. Journal of Traumatic Stress, 26(4), 426–434. https://doi.org/10.1002/jts.21832
32.
KiselyS.AbajobirA. A.MillsR.StrathearnL.ClavarinoA.NajmanJ. M. (2018). Child maltreatment and mental health problems in adulthood: Birth cohort study. The British Journal of Psychiatry, 213(6), 698–703. https://doi.org/10.1192/bjp.2018.207
33.
KiselyS.LeskeS.OgilvieJ.ThompsonC.SiskindD.AllardT. (2024). A longitudinal birth cohort study of child maltreatment and mental disorders using linked statewide child protection and administrative health data for 83,050 Queensland residents from 1983 to 2014. Epidemiology and Psychiatric Sciences, 33, Article e69. https://doi.org/10.1017/s204579602400074x
34.
KızıltepeR.Ebeoğlu-DumanM.Sağel-ÇetinerE.HeckerT. (2023). The unique contribution of childhood maltreatment types to risk-taking behavior and self-esteem. Current Psychology, 42(10), 8478–8488. https://doi.org/10.1007/s12144-023-04300-1
35.
KlineR. B. (2015). Principles and practice of structural equation modeling (4th ed.). Guilford Press.
36.
KlumparendtA.NelsonJ.BarenbrüggeJ.EhringT. (2019). Associations between childhood maltreatment and adult depression: A mediation analysis. BMC Psychiatry, 19, Article 36. https://doi.org/10.1186/s12888-019-2016-8
37.
KolkoD. J.BrownE. J.BerlinerL. (2002). Children’s perceptions of their abusive experience: Measurement and preliminary findings. Child Maltreatment, 7, 41–53. https://doi.org/10.1177/1077559502007001004
38.
KyriazosT. A. (2018). Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology, 9(08), 2207–2230. https://doi.org/10.4236/psych.2018.98126
39.
LagdonS.RossJ.RobinsonM.ContractorA. A.CharakR.ArmourC. (2021). Assessing the mediating role of social support in childhood maltreatment and psychopathology among college students in Northern Ireland. Journal of Interpersonal Violence, 36(3–4), 2112–2136. https://doi.org/10.1177/0886260518755489
LiE. T.LuytenP.MidgleyN. (2020). Psychological mediators of the association between childhood emotional abuse and depression: A systematic review. Frontiers in Psychiatry, 11, Article 559213. https://doi.org/10.3389/fpsyt.2020.559213
42.
LiM.D’ArcyC.MengX. (2016). Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies: Systematic review, meta-analysis, and proportional attributable fractions. Psychological Medicine, 46(4), 717–730. https://doi.org/10.1017/S0033291715002743
43.
LiM.O’DonnellK. J.CaronJ.MeaneyM. J.KoborM.D’ArcyC.SuY.LiuA.MengX. (2024). To what extent do social support and coping strategies mediate the relation between childhood maltreatment and major depressive disorder: A longitudinal community-based cohort. Development and Psychopathology, 36(1), 50–61. https://doi.org/10.1017/S0954579422000918
44.
LiuJ.DengJ.ZhangH.TangX. (2023). The relationship between child maltreatment and social anxiety: A meta-analysis. Journal of Affective Disorders, 329, 157–167. https://doi.org/10.1016/j.jad.2023.02.081
45.
LovibondP.LovibondS. (1995a). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-u
46.
LovibondS. H.LovibondP. F. (1995b). Manual for the depression, anxiety and stress scales (2nd ed.). Psychology Foundation.
47.
MaheuxA.PriceM. (2016). The indirect effect of social support on post-trauma psychopathology via self-compassion. Personality and Individual Differences, 88, 102–107. https://doi.org/10.1016/j.paid.2015.08.051
48.
MarshI. C.ChanS. W.MacBethA. (2018). Self-compassion and psychological distress in adolescents—A meta-analysis. Mindfulness, 9, 1011–1027. https://doi.org/10.1007/s12671-017-0850-7
49.
MasathF. B.NkubaM.HeckerT. (2023). Prevalence of and factors contributing to violent discipline in families and its association with violent discipline by teachers and peer violence. Child Abuse Review, 32(4), Article e2799. https://doi.org/10.1002/car.2799
50.
NeffK. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860309032
51.
NeffK. D.McGeheeP. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9(3), 225–240. https://doi.org/10.1080/15298860902979307
52.
NegriffS.CederbaumJ. A.LeeD. S. (2019). Does social support mediate the association between maltreatment experiences and depressive symptoms in adolescence. Child Maltreatment, 24(2), 203–212. https://doi.org/10.1177/1077559518814680
PunamäkiR. L.KomproeI.QoutaS.El-MasriM.de JongJ. T. (2005). The deterioration and mobilization effects of trauma on social support: Childhood maltreatment and adulthood military violence in a Palestinian community sample. Child Abuse & Neglect, 29(4), 351–373.https://doi.org/10.1016/j.chiabu.2004.10.011
55.
RaesF.PommierE.NeffK. D.Van GuchtD. (2011). Construction and factorial validation of a short form of the self-compassion scale. Clinical Psychology & Psychotherapy, 18(3), 250–255. https://doi.org/10.1002/cpp.702
56.
ReffiA. N.BoykinD. M.OrcuttH. K. (2019). Examining pathways of childhood maltreatment and emotional dysregulation using self-compassion. Journal of Aggression, Maltreatment & Trauma, 28(10), 1269–1285. https://doi.org/10.1080/10926771.2018.1485810
57.
RoseD. T.AbramsonL. Y. (1992). Developmental predictors of depressive cognitive style: Research and theory. In CicchettiD.TothS. L. (Eds.), Developmental perspectives on depression (pp. 323–349). University of Rochester Press.
58.
ŞarV.NecefI.MutluerT.FatihP.Türk-KurtçaT. (2021). A revised and expanded version of the Turkish Childhood Trauma Questionnaire (CTQ-33): Overprotection overcontrol as additional factor. Journal of Trauma & Dissociation, 22(1), 35–51. https://doi.org/10.1080/15299732.2020.1760171
59.
ŞarV.ÖztürkE.İkikardeşE. (2012). Çocukluk Çağı Ruhsal Travma Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenirliği. Türkiye Klinikleri, 32(4), 1054–1063. https://doi.org/10.5336/medsci.2011-26947
60.
SarıçamH. (2018). The psychometric properties of Turkish version of depression anxiety stress scale-21 (DASS-21) in community and clinical samples. Journal of Cognitive-Behavioral Psychotherapy and Research, 7(1), 19–30. https://doi.org/10.5455/jcbpr.274847
61.
SperryD. M.WidomC. S. (2013). Child abuse and neglect, social support, and psychopathology in adulthood: A prospective investigation. Child Abuse & Neglect, 37(6), 415–425. https://doi.org/10.1016/j.chiabu.2013.02.006
62.
SofuoğluZ.OralR.AydınF.CankardeşS.KandemirciB.KoçF.HalıcıoğluO.AkşitS. (2014). Türkiye’nin üç ilinde olumsuz çocukluk çağı deneyimleri epidemiyolojik çalışması. Türk Pediatri Arşivi, 49(1), 47–56.
63.
StallmanH. M.OhanJ. L.ChieraB. (2018). The role of social support, being present and self-kindness in university student well-being. British Journal of Guidance & Counselling, 46(4), 365–374. https://doi.org/10.1080/03069885.2017.1343458
64.
StoltenborghM.Bakermans-KranenburgM. J.AlinkL. R.van IJzendoornM. H. (2015). The prevalence of child maltreatment across the globe: Review of a series of meta-analyses. Child Abuse Review, 24(1), 37–50. https://doi.org/10.1002/car.2353
65.
SuY.MengX.YangG.D’ArcyC. (2022). The relationship between childhood maltreatment and mental health problems: Coping strategies and social support act as mediators. BMC Psychiatry, 22, Article 359. https://doi.org/10.1186/s12888-022-04001-2
66.
TaillieuT. L.BrownridgeD. A.SareenJ.AfifiT. O. (2016). Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States. Child Abuse & Neglect, 59, 1–12. https://doi.org/10.1016/j.chiabu.2016.07.005
67.
TaoJ.HeK.XuJ. (2021). The mediating effect of self-compassion on the relationship between childhood maltreatment and depression. Journal of Affective Disorders, 291, 288–293. https://doi.org/10.1016/j.jad.2021.05.019
68.
TarberD. N.CohnT. J.CasazzaS.HastingsS. L.SteeleJ. (2016). The role of self- compassion in psychological well-being for male survivors of childhood maltreatment. Mindfulness, 7, 1193-1202. https://doi.org/10.1007/s12671-016-0562-4
69.
TeicherM. H.AndersenS. L.PolcariA.AndersonC. M.NavaltaC. P.KimD. M. (2003). The neurobiological consequences of early stress and childhood maltreatment. Neuroscience & Biobehavioral Reviews, 27(1–2), 33–44. https://doi.org/10.1016/S0149-7634(03)00007-1
70.
TerrL. C. (1991). Childhood traumas: An outline and overview. The American Journal of Psychiatry, 148(1), 10–20. https://doi.org/10.1176/ajp.148.1.10
71.
TestaM.MillerB. A.DownsW. R.PanekD. (1992). The moderating impact of social support following childhood sexual abuse. Violence and Victims, 7(2), 173–186
72.
TranN. K.AlinkL. R.Van BerkelS. R.Van IjzendoornM. H. (2017). Child maltreatment in Vietnam: Prevalence and cross-cultural comparison. Journal of Aggression, Maltreatment & Trauma, 26(3), 211–230. https://doi.org/10.1080/10926771.2016.1250851
73.
VranceanuA. M.HobfollS. E.JohnsonR. J. (2007). Child multi-type maltreatment and associated depression and PTSD symptoms: The role of social support and stress. Child Abuse & Neglect, 31(1), 71–84. https://doi.org/10.1016/j.chiabu.2006.04.010
WilsonJ. M.WeissA.ShookN. J. (2020). Mindfulness, self-compassion, and savoring: Factors that explain the relation between perceived social support and well-being. Personality and Individual Differences, 152, Article 109568. https://doi.org/10.1016/j.paid.2019.109568
76.
WrightM. O.FolgerS. F. (2017). Creating a safe haven following child maltreatment: The benefits and limits of social support. In TetiD. M. (Ed.), Parenting and family processes in child maltreatment and intervention (pp. 23–34). Springer.
77.
XiangY.ZhouY.LiX. (2024). The role of perceived social support from family, friends and significant others in the association between childhood maltreatment on sleep quality in adolescents: Evidence from a weekly diary study. Child Abuse & Neglect, 151, Article 106715. https://doi.org/10.1016/j.chiabu.2024.106715
78.
YangX.ZhuJ.HuP. (2023). Perceived social support and procrastination in college students: A sequential mediation model of self-compassion and negative emotions. Current Psychology, 42(7), 5521–5529. https://doi.org/10.1007/s12144-021-01920-3
79.
YıldırımM.SarıT. (2018). Öz-şefkat ölçeği kısa formu’nun türkçe uyarlaması: Geçerlik ve güvenirlik çalışması. Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi, 18(4), 2502–2517.
80.
ZhaoJ.PengX.ChaoX.XiangY. (2019). Childhood maltreatment influences mental symptoms: The mediating roles of emotional intelligence and social support. Frontiers in Psychiatry, 10, Article 415. https://doi.org/10.3389/fpsyt.2019.00415
81.
ZessinU.DickhäuserO.GarbadeS. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.12051
82.
ZimetG. D.DahlemN. W.ZimetS. G.FarleyG. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
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