Pathways to trait-aggression - the role of childhood emotional maltreatment, hostile attribution bias and emotion regulation: a systematic review and empirical study.
Background: The long-term detrimental impact of childhood emotional maltreatment is being increasingly recognised in the empirical literature. Adulthood trait-aggression is one proposed outcome of childhood emotional maltreatment. However, the pathways by which emotional maltreatment leads to trait-aggression are not well understood. Method: A systematic review was conducted to appraise the current empirical evidence base regarding the relationship between childhood emotional maltreatment and adulthood trait-aggression. Eighteen studies were reviewed and their quality analysed based on a number of pre-defined criteria. An empirical study was conducted using a cross-sectional, survey based design to evaluate hostile attribution bias and emotion regulation difficulties as mediators between childhood emotional maltreatment and adulthood trait-aggression. Participants were men (N = 42) recruited from NHS Forensic Mental Health Services. Results: Results from the systematic review provided support for a positive and significant association between childhood emotional abuse and adulthood traitaggression. There was evidence to indicate that childhood emotional neglect was also positively associated with adulthood trait-aggression, however, only a small number of studies have examined this relationship. The empirical study found significant indirect effects of childhood emotional abuse on self-reported aggression through emotion regulation difficulties. Emotion regulation difficulties did not have a significant effect on the relationship between childhood emotional neglect and aggression. Hostile attribution bias was not found to significantly mediate the relationship between either emotional abuse and aggression or emotional neglect and aggression. Conclusion: Those who experience emotional maltreatment during childhood may be at increased likelihood of engaging in aggressive behaviour in adulthood. Emotion regulation difficulties may play a key role in the relationship between childhood emotional abuse and aggression and this should be taken into consideration when assessing and treating adults who have difficulties with aggression. The routes by which emotional neglect and emotional abuse lead to aggression may differ. Further research is required to better understand the processes which lead from emotional maltreatment to aggression, particularly with regards to emotional neglect.