Meta-analysis of associations between childhood emotional abuse and adulthood emotion regulation

This meta-analytic study examined the associations between childhood emotional abuse (CEA) history in adults and eleven emotion regulation abilities (i.e., distress tolerance, emotional awareness, acceptance, clarity, impulse control) and strategies (i.e., behavioural avoidance, distraction, experiential avoidance, expressive suppression, reappraisal, rumination, savouring). Inclusion criteria were the use of validated and reliable multi-item measures, cross-sectional Pearson's correlation coefficient(s), and retrievable in English. We considered the sample as the unit of analysis and used the random-effects model. The final analysis included 124 independent samples, and 308 independent effect sizes on 1654 to 20,556 participants across all emotion regulation constructs (savouring was excluded due to no valid data). Very small to medium mean effect sizes with substantial heterogeneity was observed. A synthesis suggested that CEA history is associated with a broader tendency for avoidant strategy use in a small-to-large range (k = 39, r = 0.32, 95% prediction interval = [0.11, 0.51]) and for aversive emotional representation in a small-to-medium range (k = 69, r = 0.24, 95% prediction interval = [0.08, 0.40]). The mean effects were generally higher for suppressive tendencies and slightly lower for emotional non-acceptance, where sample-level neglect-deprivation and sexual abuse increased, respectively. Notable moderators included symptom presence and percent female. Results were robust to sensitivity analysis and publication bias. The findings suggested focused research on the aversive-avoidant emotion regulation tendencies of CEA history, which may not diminish with age. Specialised treatment plans may particularly target cognitive over-engagement coupled with aversive emotional representations in affected people.