Self-stigma mediates the relationships between childhood maltreatment and symptom levels of PTSD, depression, and anxiety

<b>Background:</b> Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear. <b>Objective:</b> Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety. <b>Methods:</b> Childhood trauma survivors (<i>N </i>= 685, <i>M</i>age = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment. <b>Results:</b> Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse – but not physical or emotional abuse – a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types. <b>Conclusion:</b> Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect. Childhood maltreatment is linked to depression, PTSD, and anxiety symptoms.Self-stigma, or internalizing negative stereotypes, plays a significant role in mediating this relationship.Different types of maltreatment are linked to varying levels of self-stigma and symptom severity. Childhood maltreatment is linked to depression, PTSD, and anxiety symptoms. Self-stigma, or internalizing negative stereotypes, plays a significant role in mediating this relationship. Different types of maltreatment are linked to varying levels of self-stigma and symptom severity.

<b>背景：</b>儿童虐待是多种精神病理障碍的风险因素，涵盖抑郁症、创伤后应激障碍（posttraumatic stress disorder, PTSD）与焦虑症。然而，联结儿童虐待与这类精神病理障碍的潜在机制仍尚不明确。
<b>研究目的：</b>本研究旨在探讨自我污名（self-stigma）——即个体对自身经历内化负面刻板印象的过程——是否在儿童虐待与抑郁症、创伤后应激障碍及焦虑症的症状严重程度之间发挥中介作用。
<b>研究方法：</b>本研究纳入685名儿童创伤幸存者（平均年龄M_age=36.8岁），对其儿童虐待经历、自我污名水平以及抑郁症、创伤后应激障碍、焦虑症的症状表现进行评估。以儿童虐待为自变量开展中介分析；随后分别针对儿童虐待与忽视的不同类型，以及儿童虐待的各亚型重复上述中介模型。
<b>研究结果：</b>自我污名在儿童虐待与抑郁症、创伤后应激障碍及焦虑症症状之间的关联中展现出显著的中介效应。仅在性虐待（而非躯体虐待或情感虐待）中，自我污名对各类症状均表现出显著的中介作用。针对儿童忽视而言，自我污名在情感忽视、躯体忽视与各类症状之间的关联中均起到了显著的中介效应。
<b>研究结论：</b>本项横断面研究表明，不同类型的儿童虐待经历或与特定的精神健康问题相关，其潜在通路可能与自我污名水平升高有关。自我污名或可成为儿童虐待与忽视幸存者的重要治疗靶点。儿童虐待与抑郁症、创伤后应激障碍及焦虑症症状存在关联。自我污名，即内化负面刻板印象，在该关联中发挥了显著的中介作用。不同类型的虐待经历与不同程度的自我污名及症状严重程度相关。儿童虐待与抑郁症、创伤后应激障碍及焦虑症症状存在关联。自我污名，即内化负面刻板印象，在该关联中发挥了显著的中介作用。不同类型的虐待经历与不同程度的自我污名及症状严重程度相关。