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A Prospective Examination of the Relations Between Emotional Abuse and Anxiety: Moderation by Distress Tolerance

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Abstract

Anxiety, the most common and impairing psychological problem experienced by youth, is associated with numerous individual and environmental factors. Two such factors include childhood emotional abuse (CEA) and low distress tolerance (DT). The current study aimed to understand how CEA and low DT impacted anxiety symptoms measured annually across 5 years among a community sample of youth. We hypothesized DT would moderate the relationship between CEA and anxiety, such that youth with higher levels of CEA and lower levels of DT would have elevated anxiety over time. Community youth (N = 244) were annually assessed across 5 years using the Revised Child Anxiety and Depression Scale, Childhood Trauma Questionnaire, and Behavioral Indicator of Resiliency to Distress. Higher CEA at baseline was associated with higher anxiety at baseline, higher anxiety at each annual assessment, and with greater overall decreases in anxiety over time. Lower DT was associated with higher anxiety at baseline, but did not predict changes in anxiety over time. Baseline DT significantly moderated the relationship between baseline CEA and anxiety, such that youth with both higher CEA and lower DT had the highest anxiety at each annual assessment. Youth with lower DT and higher CEA scores had the highest level of anxiety symptoms across time.

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  1. Using multiple linear regression (CEA and DT were z score transformed and multiplied to create interaction terms), we found higher baseline CEA scores were significantly associated with higher anxiety at Waves 2, 3, 4, and 5 (all ps < 0.01). We found lower DT was significantly associated with higher anxiety at Waves 2, 4, and 6 (all ps < 0.05). We found the interaction between DT and CEA was significantly associated with anxiety at Waves 2, 3, 4, and 5 (all ps < 0.05). Probing with simple slopes (±1 standard deviation for DT), we found for youth with lower DT, CEA predicted higher anxiety at all time points, except Wave 6 (all ps < 0.01), whereas for youth with higher DT, CEA predicted lower anxiety at Waves 2–4 (all ps < 0.05) and was not associated with anxiety at Waves 5 and 6.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (NCPTSD 324), Menlo Park, CA, 94025, USA

    Anne N. Banducci

  2. Department of Psychology, University of Maryland, 1147 Biology Psychology Building, College Park, MD, 20742, USA

    Anne N. Banducci, C. W. Lejuez, Lea R. Dougherty & Laura MacPherson

  3. Center for Addictions, Personality, and Emotion Research, University of Maryland, 2103 Cole Student Activities Building, College Park, MD, 20742, USA

    Anne N. Banducci, C. W. Lejuez & Laura MacPherson

  4. College of Liberal Arts & Sciences, The University of Kansas, Strong Hall, Room 200, 1450 Jayhawk Blvd., Lawrence, KS, 66049, USA

    C. W. Lejuez

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  1. Anne N. Banducci
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Correspondence to Anne N. Banducci.

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This research was supported by NIDA grants: F31 DA035033 (PI: Anne N. Banducci) and R01 DA018647 (PI: C.W. Lejuez). The authors have no conflicts of interest. All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent and assent was obtained from all participants.

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Banducci, A.N., Lejuez, C.W., Dougherty, L.R. et al. A Prospective Examination of the Relations Between Emotional Abuse and Anxiety: Moderation by Distress Tolerance. Prev Sci 18, 20–30 (2017). https://doi.org/10.1007/s11121-016-0691-y

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