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 11 emotion regulation (ER) 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 102 papers, 107 samples, and 274 independent effect sizes on 1,263 to 18,754 participants across all ER 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 (r = 0.32, 95% prediction interval = [0.07, 0.52]) and for aversive emotional representation in a small-to-medium range (r = 0.24, 95% prediction interval = [0.04, 0.42]). Most moderation analyses were non-significant, but some effect sizes were contingent on ER subconstructs, symptom presence, neglect history, percent female, and percent lower education. Results were robust to sensitivity analysis and publication bias. These cross-sectional associations warrant focused research on the aversive-avoidant ER tendencies of CEA history, which may not diminish with age. Focus on the response-focused stage of ER helps unravel ER non-acceptance and intolerance to create new, targeted therapies for people with a history of higher CEA.