What mediates the link between childhood maltreatment and depression? The role of emotion dysregulation, attachment, and attributional style

Background: Childhood maltreatment (CM) has been shown to be related to a severe and/or chronic course of depression. This study investigated which psychological processes mediate this relationship. Method: A large sample of acute or recovered depressed individuals (N = 340) participated in an online survey assessing characteristics of depression, trauma exposure, and potential mediators (emotion regulation difficulties, attributional style, and attachment). Results: The experience of CM was related to more severe depression and more depressive episodes. In multiple mediation models, emotion dysregulation, a depressogenic attributional style, and avoidance in close relationships conjointly mediated the relationship between CM and depression severity as well as number of depressive episodes. However, a significant direct path between CM and depression characteristics remained. Exploratory analyses suggested that posttraumatic stress disorder symptom severity was an important additional mediator in our sample. Conclusions: Our findings provide preliminary evidence for psychological mediators between CM and depression that may be promising targets for interventions tailored for the treatment of depression in this subgroup