Childhood emotional maltreatment, anxiety, attachment, and mindfulness: Associations with facial emotion recognition

Child Abuse & Neglect 80 (2018) 146–160

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Child Abuse & Neglect journal homepage: www.elsevier.com/locate/chiabuneg

Childhood emotional maltreatment, anxiety, attachment, and mindfulness: Associations with facial emotion recognition

T

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Lianne H. Englisha, , Melanie Wisenerb, Heidi N. Baileya a b

University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1, Canada McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada

A R T IC LE I N F O

ABS TRA CT

Keywords: Emotional maltreatment Facial emotion processing Anxiety Attachment Mindfulness Cognitive load

The current study investigated factors thought to contribute to facial emotion processing. Female university students (N = 126) completed self-report measures of childhood emotional maltreatment, anxiety symptoms, attachment anxiety and avoidance, and trait mindfulness before completing a facial emotion recognition task, where they viewed sequences of faces that incorporated progressively more emotional content until they were able to correctly identify the emotion. They completed the task under low and high cognitive load conditions to distinguish between relatively effortful versus automatic processing abilities. Regression analyses revealed that under low cognitive load, attachment avoidance and mindfulness predicted quicker identification of fear (i.e., with less perceptual information), whereas anxiety predicted slower identification of fear (i.e., with more perceptual information). In the high cognitive load condition, emotional maltreatment and mindfulness predicted quicker identification of fear, and anxiety and mindfulness predicted faster identification of emotions overall. Although current findings are correlational, most of these effects were specific to fearful faces, suggesting that experiences of childhood emotional maltreatment and associated socio-emotional sequelae are related to heightened processing of threat-related information.

1. Introduction Childhood emotional maltreatment is a psychologically damaging act that can adversely impact an individual’s development and ongoing emotional functioning. Experiences of emotional maltreatment “convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another’s needs” (American Professional Society on the Abuse of Children, 1995, p. 2). Early emotional maltreatment has been associated with a host of negative developmental outcomes, including anxiety, depression, low self-esteem (Briere & Runtz, 1988; Kim & Cicchetti, 2006; Wright, Crawford, & Del Castillo, 2009), poor health (Schafer, Morton, & Ferraro, 2014), and neurobiological sequelae associated with stress (see McCrory, De Brito, & Viding, 2010 for review). Given that emotional maltreatment is arguably the most pervasive and damaging form of maltreatment and constitutes a core element of diverse forms of abuse and neglect (Barnett, Miller-Perrin, & Perrin, 2005; Binggeli, Hart, & Brassard, 2001; Brassard & Donovan, 2006; Navarre, 1987), it is important to understand the processes that give rise to these deleterious outcomes. The experience of emotional maltreatment has been associated with differences in how children process emotional cues (Gervai, 2009; Joseph, 1999). Such effects, however, are far from deterministic, as other exacerbating or ameliorating factors can lead to wide variability in outcomes (Cicchetti & Rogosch, 2009; Cicchetti, 2016). According to an organizational perspective on development

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Corresponding author. E-mail addresses: [email protected] (L.H. English), [email protected] (M. Wisener), [email protected] (H.N. Bailey).

https://doi.org/10.1016/j.chiabu.2018.02.006 Received 6 July 2017; Received in revised form 2 January 2018; Accepted 7 February 2018 0145-2134/ © 2018 Published by Elsevier Ltd.

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(Cicchetti & Sroufe, 1978), children learn different socio-emotional abilities at each developmental stage; these serve as a foundation for the development of subsequent abilities, but may be reorganized as new stage-relevant skills are acquired. Thus, although children acquire the ability to perceive emotional cues in early childhood, this skill continues to be honed and to influence, and be influenced by, other relational and emotional abilities across development. The focus of the current study was on perception of facial emotion cues, a subtype of emotional cue considered particularly important since many emotional cues are social in nature and the perception and understanding of facial emotions is critical for navigating social relationships (Buck, 1999; Ekman, 1992; Fridlund, 1992; Hampson, van Anders, & Mullin, 2006). Furthermore, deficits in this ability have been associated with negative mental health outcomes (Edwards, Jackson, & Pattison, 2002; Matthews & MacLeod, 2005). Since an organizational perspective would predict multiple indirect as well as direct effects of childhood emotional maltreatment on subsequent facial emotion perception, we also investigated associations involving socio-emotional sequelae of childhood maltreatment with theoretical and empirical ties to the processing of facial emotions: these included anxiety, insecure attachment, and (deficits in) mindfulness. 2. Emotional maltreatment and facial emotional processing A sizable literature speaks to the influence of maltreatment on facial emotion processing; however, the majority of previous research has not systematically delineated the influence of emotional versus other forms of maltreatment. Furthermore, research has focused on examining children’s responses to facial emotions, leaving the correlates in adulthood unclear. Research has found that children who experienced maltreatment were more sensitive to anger than other emotions. Maltreated children have displayed attentional biases including preferential attention (Pollak & Tolley-Schell, 2003), attentional avoidance (Pine et al., 2005; Pollak & Tolley-Schell, 2003; Pollak, 2003), and difficulty disengaging from angry facial cues (Pollak). At face value, these findings may seem contradictory, but they could be conceived as a heightened response to anger taking different forms. A bias toward anger has also been found in tasks examining speed of recognition and amount of perceptual information required for recognition. Generally, abused children have been found to recognize anger more quickly than nonabused children, and with less perceptual information (Pollak & Sinha, 2002; Pollak, Messner, Kistler, & Cohn, 2009). As early as infancy, emotionally maltreated infants have been found to use fewer cognitive resources when looking at angry faces, leading Curtis and Cicchetti (2013) to speculate familiarity with facial displays of anger as the underlying mechanism. This possibility is supported by the finding that children’s speed of recognition has also been associated with degree of anger and/or hostility reported by the child’s parent, such that higher levels of anger and hostility yielded faster reaction times (Pollak et al., 2009). Such biases may constitute an adaptive response to frequent anger exposure, in that children who quickly and accurately identify angry expressions are more readily able to avoid abuse (Cicchetti, Toth, & Maughan, 2000; Pollak, 2003). More broadly, however, maltreated children have evidenced reduced accuracy identifying a range of emotions (Curtis & Cicchetti, 2003). This is generally due to abused children over-identifying anger when presented with ambiguous facial expressions, likely due to the greater frequency of anger found in their home environment (Pollak & Kistler, 2002). Maltreated children have shown specific difficulty recognizing positive emotional states, potentially reflecting a lack of understanding or familiarity with shared positive experiences (Koizumi & Takagishi, 2014). In contrast, nonabused children have been found to be more accurate recognizing positively and negatively valenced facial expressions (During & McMahon, 1991), whether pure or masked (Camras et al., 1988). Most previous research with children has tended to focus on anger and has not examined possible biases toward other negatively valenced emotions. As an exception, Masten et al. (2008) looked at responses to facial displays of fear, and found that abused children displayed faster reaction times when identifying fearful faces compared to happy and neutral faces. Children’s responses to the negatively valenced emotions of fear and anger have rarely been compared within the same study (but see Camras et al., 1988). Masten et al. (2008) speculated that researchers saw fear and anger as too similar in that they elicit equal levels of distress and negative affectivity (Johnsen, Thayer, & Hugdahl, 1995). However, it has been well established that fear and anger serve different functions and elicit different behavioural responses. For example, research has found that when primed to fear, young adults demonstrated increased aversion to risk, whereas no such change was observed among those primed to anger (Lindquist & Barrett, 2008). One study with adolescents juxtaposed perception of facial anger and fear. Contrary to research with younger children, Leist and Dadds (2009) found that maltreated adolescents were more accurate in recognizing fear and sadness, but not anger. Although findings must be replicated, increased perception of fear relative to anger may reflect an evolutionary bias that is particularly pronounced in individuals with adverse life experiences. Fear likely evolved as an important component of a human’s defense system, signaling danger and eliciting distress and escape (Öhman, 2008). Consequently, the rapid detection of fearful faces would be automatic for most and enhanced for some. It may be that a heightened response to angry faces among maltreated children shifts toward reactivity to fearful expressions in adulthood, when maltreating caregivers are a less frequent or imminent threat. From an evolutionary perspective, an adult tendency to be overly cautious or attuned to fearful cues may benefit survival more than attunement to angry cues, given that in adulthood, fearful faces signal the presence of impending danger to a greater extent than angry faces (Casey, Jones, & Hare, 2008). According to the principle of heterotypic continuity (Kagan, 1971), a heightened perception of threat due to childhood emotional maltreatment could manifest differently at different developmental stages. Such discrepancies may be a function of the recency of maltreatment experiences: when the environmental risk for maltreatment lowers, individuals may demonstrate reduced preferential awareness for anger (Leist & Dadds, 2009). In neurobiological research with adults, the amygdala typically has functioned centrally in the recognition of fearful faces (Adolphs, 2008). The amygdala network, one of a small number of neural networks thought to centrally support social interaction, 147

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involves interconnectivity between the amygdala and orbitofrontal regions of the brain (Kennedy & Adolphs, 2012). Some research has found increased activation to fearful over angry faces (Anderson, Christoff, Panitz, De Rosa, & Gabrieli, 2003; Whalen et al., 2001), suggesting that adults may perceive fearful faces as indicating greater threat. More broadly, however, research findings point to a generalized role for the amygdala, processing stimuli that are salient for any reason (e.g., threat, reward, unpredictability; Adolphs, 2008; Whalen, 2007). Childhood maltreatment has been associated with heightened amygdala activation in childhood and adulthood, which can manifest as hypervigilance to threat (McCrory et al., 2013, Hein & Monk, 2017; McCrory et al., 2010). Indeed, van Harmelen and colleagues found that adults emotionally maltreated as children evidenced increased amygdala responsivity to all facial emotions regardless of emotion type. Although presumably adaptive within the original maltreating context, alerting children to potential harm, outside of threatening social contexts such increased vigilance may interfere with a more flexible interactive style if it cannot be modulated (Pollak & Tolley-Schell, 2003; Pollak, 2008). Hypervigilance to threat has been associated with anxiety disorders (Armstrong & Olatunji, 2012) and posttraumatic stress disorder (Dalgleish, Moradi, Taghavi, Neshat-Doost, & Yule, 2001) and carries a substantial allostatic load, depleting one’s physical and psychological resources (Cicchetti & Rogosch, 2012). 2.1. Anxiety Anxiety, an outcome associated with childhood maltreatment (Teicher, Samson, Polcari, & McGreenery, 2006), has been implicated in facial emotion perception, purportedly via its connection to heightened amygdala activation (Adolphs, 2008; Bishop, Duncan, & Lawrence, 2004). Investigation using event related potentials found that socially anxious individuals were more hypervigilant to all facial expressions, and also attended to facial expressions longer and processed them more elaborately (Felmingham, Stewart, Kemp, & Carr, 2016). However, other research has found that they were less accurate at identifying specific emotions, in some cases overestimating threat in the form of anger (Bronfman, Brezis, Lazarov, Usher, & Bar-Haim, 2017; Maoz et al., 2016; Peschard & Philippot, 2017) and in other cases having difficulty accurately identifying fear, and requiring more time to do so (Tseng et al., 2017). An added complexity is that cognitive load appears to modulate associations between anxiety and amygdala activation to fearful faces. Specifically, when they could devote their attention fully to a task, anxious individuals showed a heightened amygdala response to fearful facial expressions compared to low-anxious individuals, whereas when challenged with additional cognitive demands, no such anxiety-related differences were found. The authors deduced that relatively more automatic processing of fearful faces may involve similar amygdala activation, regardless of anxiety level, whereas among those with anxiety, amygdala response may increase during more elaborative stages of processing that recruit other cognitive and attentional resources (Bishop, Jenkins, & Lawrence, 2006; Hsu & Pessoa, 2007; Lim, Padmala, & Pessoa, 2008). 2.2. Attachment Childhood maltreatment has been found to influence socio-emotional development broadly, affecting the development of multiple skills and strategies contributing to social and emotional functioning. As successive stage-relevant tasks provide opportunities for reorganization, these skills and strategies are presumed to influence one another in a manner that is best conceptualized as iterative and transactional (Cicchetti & Valentino, 2006; Cicchetti, 2016). Thus, the influence of emotional maltreatment on the development of facial emotion processing may be indirect, facilitated by other developmental sequelae. Of the vast array of such variables that may be involved, we focused on attachment style for a number of reasons, including its universality (Bowlby, 1969/Bowlby, 1982), reliance upon many specific attentional, cognitive, and emotional processes (Cassidy & Shaver, 2002), and relevance to socioemotional development across the lifespan. One’s attachment style is a broad approach to developing and maintaining close emotional relationships with important others (Bowlby, 1980; Mikulincer & Shaver, 2007, Mikulincer & Shaver, 2012) that has been recognized to underpin social and emotional development in childhood (Belsky & Fearon, 2002; Bretherton, 1985; Thompson, 2000) and contribute meaningfully to intimate relationships in adulthood (Mikulincer & Shaver, 2003). Attachment relationships first develop in infancy, and are closely tied to early neurological development (Newman, Sivaratnam, & Komiti, 2015). Secure attachment generally results when parents respond to attachment-related needs in a sensitive way that promotes an effective resolution (Thompson, 2000), whereas insecure attachment tends to develop when caregivers are inconsistent, insensitive, and/or unresponsive to children’s emotional needs (Bowlby, 1988). Unsurprisingly, early maltreatment has been infrequently associated with secure attachment with caregivers (Baer & Martinez, 2006; Barnett, Ganiban, & Cicchetti, 1999); rather, it has been disproportionately related to disorganized attachment (Cyr, Euser, Bakermans-Kranenburg, & Van Ijzendoorn, 2010). Among young adults, retrospective reports of childhood maltreatment (Styron & Janoff-Bulman, 1997), and also specifically emotional maltreatment (Riggs & Kaminski, 2010), have been associated with insecure attachment style in romantic relationships. It is likely that the predominantly insecure attachment strategies that children develop within maltreating families, and subsequently maintain and refine, shape (and are shaped by) the social and emotional processing abilities that support these strategies. Attachment anxiety and avoidance, forms of insecure attachment in adulthood, have been associated with compromised emotional processing (Edelstein & Shaver, 2004; Fraley, Davis, & Shaver, 1998; Newman & McKinney, 2002; Shaver & Hazan, 1994), and like maltreatment, are related to a host of emotional vulnerabilities such as anxiety and depression (e.g., Cole-Detke & Kobak, 1996; Eng, Heimberg, Hart, Schneier, & Liebowitz, 2001; Williams & Riskind, 2004). Attachment anxiety has been conceptualized as excessive worry with regard to relationships. Individuals with high levels of attachment anxiety employ hyperactivating strategies, or attempts to increase proximity and interpersonal connectedness, in threatening situations (Mikulincer & Shaver, 2003). This vigilance has also been observed in their processing of facial emotion cues: using a movie morph paradigm, Fraley, Niedenthal, Marks, Brumbaugh, and Vicary, (2006) observed that highly attachment-anxious participants perceived angry, happy, and sad faces with less 148

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perceptual information. Attachment avoidance refers to the degree to which individuals prefer to avoid emotional intimacy in close relationships. High levels of attachment avoidance have been associated with distrust, avoidance of proximity, and emotional distancing (Mikulincer & Shaver, 2003). For avoidant individuals, exposure to emotional stimuli may elicit discomfort, which they have learned to modulate by reducing attention to negative or threatening information (Bowlby, 1987). Researchers have found that avoidant adults demonstrate poor memory for attachment-related emotional information (Mikulincer & Orbach, 1995), likely due to a preference to attend away from threat (Edelstein et al., 2005). Avoidant individuals appear to require less perceptual information to quickly identify emotion-laden pictures, including facial expressions (Dan & Raz, 2012; Maier et al., 2005; Niedenthal, Brauer, Robin, & Innes-Ker, 2002). It is thought that the ability to quickly detect highly salient facial cues (e.g., fear) could facilitate their disengagement from emotionally charged or threatening situations (Niedenthal et al., 2002). This possibility is supported by the finding that avoidant individuals performed well when they were required to inhibit emotional stimuli on emotional Stroop tasks, but only when they could devote their full attention to the task (i.e., under low cognitive load; Edelstein & Gillath, 2008). Thus, when they are capable of using their cognitive resources, they become aware of emotional threats quickly in order to attend away from them. Other research also has found that when placed in threat-evoking scenarios, those with an avoidant attachment style have detected threat more quickly than securely attached individuals despite their preference to attend away from threat (Ein-Dor, Mikulincer, & Shaver, 2011).

2.3. Mindfulness Preliminary evidence suggests that childhood maltreatment is also associated with deficits in mindfulness (Elices et al., 2015; Kuhlman et al., 2017). Kabat-Zinn (1994) has defined mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” Mindfulness can be conceptualized as a context-dependent mental state (e.g., Lau et al., 2006) or a dispositional, trait-like ability (e.g., Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006), and heightened state mindfulness can lead to increased trait mindfulness (Kiken, Garland, Bluth, Palsson, & Gaylord, 2015). Successful interventions have demonstrated that mindfulness can be learned later in life, with corresponding neural changes (see Cahn & Polich, 2006 for review). Research has found that trait mindfulness alters brain structure, facilitates neural plasticity, and alters interconnections between neurons. Lazar et al. (2005) found associations between trait mindfulness and increased the thickness of areas of the brain devoted to emotion and emotion regulation (Cozolino, 2002; Schore, 2003; Siegel, 2007; Solomon & Siegel, 2003); these overlap with areas compromised in maltreated children (Bremner et al., 1995, Bremner, Randall, Vermetten, & Staib, 1997; Teicher et al., 2004). Mindful individuals have been found to focus on positive emotional information and demonstrate corresponding neuronal activity (e.g., Davidson et al., 2003). This can serve various protective functions, particularly with regard to adaptation following stressful events (Folkman & Lazarus, 1985; Levenson, 1988). Thus, whether learned (e.g., through intervention or a meditative practice) or dispositional in nature, mindfulness may protect individuals from the negative outcomes associated with maltreatment, such as mood disturbance and stress (Brown & Ryan, 2003). To the authors’ knowledge, no studies have examined associations between mindfulness and facial emotion processing. Mindfulness may contribute to differences in facial emotion processing via a mechanism distinct from the processing of threatening cues. The practice of non-reactivity, inherent to mindfulness, essentially functions to reduce hypervigilance as it precludes a heightened response to threat. Mindful individuals respond to the environment without wanting to change or escape it, irrespective of the unpleasantness or unwantedness of their experience; such non-judgment and non-reactivity is thought to allow a less encumbered awareness of their experience (Baer, 2009). Conversely, it is possible that mindfulness may facilitate other neural networks that centrally support social interaction: the mentalizing network, involved in automatically inferring mental states, and the empathy network, which perceives and responds to emotional distress in others (see Kennedy & Adolphs, 2012). Their increased awareness of cues they perceive in the present moment may facilitate their identifying emotional facial expressions more quickly.

2.4. Strategic versus automatic processing Of additional interest is the degree to which processing of emotional cues results from effortful deployment of strategies, or rather is an automatic reaction. When a response is relatively novel or unpracticed, individuals require the use of their lateral prefrontal cortex and top-down control to improve performance (Diamond, 2013). Once individuals habitually engage in a task, however, their response becomes automatic: prefrontal function and top-down control are no longer needed (Herrigel, 1999). Network modelling has shown that disruptions to the lateral prefrontal cortex early in training (thus impeding the influence of top-down control) impairs task performance, whereas these same disruptions later in training improve performance (Miller, Brody, Romo, & Wang, 2003). In other words, automatic processes function most effectively when top-down control is not utilized, whereas less practiced behaviors require this top-down attentional control. Researchers have varied participants’ cognitive load to try to differentiate between automatic responses and those requiring attentional control. When given another task that simultaneously taxes their cognitive resources, individuals cannot devote the same cognitive effort to a task such as processing facial cues; therefore, they are more reliant on automatic processes to complete the latter task. Differences in facial emotion perception under high and low cognitive load would indicate to some degree whether early perception of emotional expressions is learned or automatic. 149

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2.5. Summary and hypotheses In the current study we investigated whether history of emotional maltreatment, anxiety symptoms, attachment style, and trait mindfulness were associated with the ability to perceive emotional facial expressions in a sample of female undergraduate university students. Based on previous research, we proposed that students with higher levels of self-reported childhood emotional maltreatment would identify fear with less perceptual information than females reporting minimal maltreatment. We contrasted this with the alternative that they might recognize anger with less perceptual cues. We anticipated that anxiety might be associated with decreased efficiency in identifying emotions, including fear and anger, particularly under low cognitive load, as has been found in other preliminary research. We further predicted that those reporting greater attachment anxiety and avoidance would perceive fearful expressions more rapidly, with associations involving avoidance specific to low cognitive load. In addition, we predicted that young adults reporting a high degree of mindfulness would be more attuned to perceptual changes in all emotions (not specific to fear). Although other predictions regarding whether associations would be observed under high versus low cognitive load were tentative due to lack of prior research, we generally assumed that experiences dating back to childhood (e.g., childhood emotional maltreatment) would more likely affect automatic processing of threat-related facial emotions, whereas differences in facial processing that were apparent only under low cognitive load (when full cognitive resources could be devoted to perceiving facial emotions) likely would reflect more recently learned strategies to cope with early experiences. Since emotional maltreatment typically occurs together with other forms of maltreatment, we compared associations involving different types of maltreatment and the socio-emotional sequelae thought to influence facial emotion perception. We also compared emotional maltreatment to a broader index of maltreatment incorporating physical and sexual abuse, and physical neglect, with respect to their association with facial emotion perception. We reasoned that it was not conceptually possible, or empirically realistic, to delineate emotional from physical forms of maltreatment, but that findings involving other indices of maltreatment would provide a context within which to interpret findings involving emotional maltreatment. 3. Method 3.1. Participants Female undergraduate students (N = 126) aged 18–26 (M = 18.98 years) who scored in the upper 40th and lower 20th percentiles on an online emotional maltreatment screening questionnaire1were randomly selected to participate in the current study. Participants were selected from the higher and lower ends of the distribution to increase the number of students in the sample with high levels of emotional maltreatment, thereby yielding higher variability. All participants were female due to well established gender differences in emotional processing (Kwon, Yoon, Joormann, & Kwon, 2013; Zlomke & Hahn, 2010). Participants were involved in a larger screening process in exchange for one course credit in their introductory psychology course, and were e-mailed an invitation to participate. Eligibility was based on responses to 12 items, six of which evaluated emotional abuse and six of which evaluated emotional neglect. In total, 126 undergraduates participated. 3.2. Procedure This study received ethics approval from the University of Guelph Research Ethics Board. Participants completed the study individually, in a private office, together with one of three experimenters. After informed consent, participants completed the emotional processing task. They subsequently completed a series of online questionnaires, with the exception of the Childhood Trauma Questionnaire, which was administered using pen and paper. 3.3. Measures 3.3.1. Self-report measures Participants’ history of maltreatment was assessed using the short form of The Childhood Trauma Questionnaire (CTQ; Bernstein et al., 2003). The CTQ consists of 25 questions, with 5 questions representing each of the following subscales of maltreatment: emotional abuse (α = .87), physical abuse (α = .76), sexual abuse (α = .89), emotional neglect (α = .92), and physical neglect (α = .70). The emotional abuse and emotional neglect subscales were highly correlated and a composite score including the mean of both emotional abuse and neglect scales (α = .93) was calculated. Participants rated statements on a Likert scale. Previous studies (e.g., Bernstein et al., 2003) indicate strong psychometric properties for the CTQ, including construct reliability and validity. Anxiety was measured using the anxiety subscale of the Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995), which has demonstrated strong psychometric properties (e.g., Antony, Bieling, Cox, Enns, & Swinson, 1998). This 14-item scale measures the degree to which participants have experienced anxiety over the past week (α = .91), using a 4-point Likert scale ranging from 0 (“Did not apply to me at all”) to 3 (“Applied to me very much, or most of the time”). Attachment anxiety and avoidance were measured using the Experiences in Close Relationships Scale (ECR; Brennan, Clark, & Shaver, 1998). This measure consisted of 36 items, 18 measuring attachment anxiety (α = .93), and 18 measuring attachment 1

Contact the first author for the screening questionnaire.

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avoidance (α = .95). Participants responded to items on a 7-point scale. The ECR has demonstrated strong psychometric properties, including construct validity and reliability (e.g., Brennan et al.; Fraley, Waller, & Brennan, 2000). Mindfulness was evaluated from a trait (versus state) perspective using the Five Facet Mindfulness Questionnaire, which has demonstrated strong internal consistency and validity (FFMQ; Baer et al., 2006). Participants rated statements on a 5-point Likert scale along four dimensions: observing (α = .76), describing (α = .91), acting with awareness (α = .90), non-judging (α = .93), and non-reactivity (α = .71). The five dimensions were aggregated to create a total scale (α = .89).

3.3.2. Emotional faces task Images were obtained from the Cohn-Kanade Facial Expression Database (Kanade, Cohn, & Tian, 2000), which were down sampled from video sequences by Pollak et al. (2009).2 One male and one female actor were used for each emotion, with different actors for each sequence. This study focused on four main emotions (i.e., anger, happiness, sadness, fear). Each sequence started with a neutral expression and ended with the target emotion. In order to ensure uniform duration across emotion sequences, each sequence was down-sampled to ten images representing 5, 11, 16, 20, 36, 59, 69, 75, 83, 89, and 90% of the elapsed sequence. The final stimuli were identical to those used by Pollak et al. (2009). A total of 80 target images were presented to each participant (4 emotions x 2 sequences x 10 perceptual degrees). The picture sequences were presented to participants in a counterbalanced order (using a Latin Square design), in two conditions (low cognitive load, high cognitive load). Four sequences were presented in each condition, representing all four emotions. The specific sequences presented within the conditions were alternated across participants. Participants viewed each image (16 cm × 16 cm) within a ten-picture sequence for three seconds. After each picture presentation, participants identified the displayed emotion based on five forced choice responses that were used in the study by Pollak et al. (2009); i.e., nothing yet, happy, sad, angry, afraid. Participants were told they would view ten pictures within each sequence. They were instructed to state “nothing yet” until they saw an emotion. Participants did not receive any feedback following their responses, and they were required to respond to all pictures presented, regardless of when they identified an emotional expression. In the low cognitive load condition, participants simply viewed four sequences of emotional expressions and identified the expression expressed in each picture. In the high cognitive load condition, participants were also required to repeat seven digits after each of the four sequences. The point at which participants reliably (i.e., until the end of the sequence) identified the correct emotion was used for analyses. This procedure resulted in eight threshold scores, one for each of the four emotions under both low and high cognitive load. Additionally, to index participants’ general ability to perceive facial emotions, threshold composites were computed across the four emotions, separately for low (α = .83) and high cognitive load (α = .79).

4. Results 4.1. Descriptive statistics Mean values, standard deviations, and inter-correlations of self-report measures are summarized in Table 1. As expected, different types of childhood maltreatment were substantially correlated with one another, and with the overall maltreatment score. Emotional abuse and neglect were the most strongly correlated (r = .73), supporting their aggregation to create an emotional maltreatment variable. Both emotional maltreatment, and total maltreatment, were positively related to anxiety symptoms, positively related to attachment anxiety and avoidance, and negatively related to mindfulness. Table 2 provides means and standard deviations of perceptual thresholds for the four emotions (happy, angry, sad, afraid), and the overall (average) perceptual threshold, separately for the low and high cognitive load conditions. Zero-order correlations between key self-report variables and facial emotion processing thresholds are presented in Table 3. Participant data (n = 6) were excluded from analyses if participants failed to correctly identify the targeted emotion within the tenpicture sequence. Consistent with hypotheses, we focused on perception of facial anger and fear, and compared these to overall (average) perception across all emotions. Lower scores indicated that less visual information was required to accurately identify the emotion. (a) In the high cognitive load condition, emotional maltreatment, and total maltreatment, both were related to earlier perception of fearful faces.3 (b) Anxiety was differentially associated with facial emotion perception depending on condition. Under low cognitive load, participants who reported more anxiety were relatively delayed in perceiving fear, whereas under high cognitive load, anxiety was associated with earlier perception of facial emotions in general, with a similar trend toward earlier identification of fearful faces. (c) Attachment anxiety and avoidance were not strongly correlated with perception thresholds; however, results are inconclusive, since some modest correlations preclude the conclusion that there are no effects in the population. (d) In the low cognitive load condition, there was a trend for mindfulness to be associated with earlier perception of all facial emotions, with similar trends also found for anger and fear. The confidence intervals for these effects were highly overlapping and consistent with a generally modestly improved accuracy that was not specific to a particular emotion.

2 3

Contact the first author for the specific sequences. Associations involving childhood physical abuse were highly similar to those involving emotional maltreatment and total maltreatment.

151

152

36.33 (12.41)

17.81 (7.72)

9.09 (4.38)

8.77 (3.92)

6.26 (2.45)

6.42 (2.55)

5.90 (2.70) 8.25 (8.40)

3.69 (1.23)

2.99 (1.23) 3.15 (.45)

1. Total Maltreatment

2. Emotional Maltreatment

3. Emotional Abuse

4. Emotional Neglect

5. Physical Abuse

6. Physical Neglect

7. Sexual Abuse 8. Anxiety

9. Attachment Anxiety

10. Attachment Avoidance 11. Mindfulness

.93** [.89, .96] –

2. .90** [.86, .93] .94** [.91, .97] –

3.

.73** [.60, .83] –

.83** [.76, .89] .92** [.89, .95

4. .73** .84] .62** .74] .63** .77] .52** .65] –

5.

[.37,

[.46,

[.47,

[.58,

.72** .80] .52** .68] .51** .66] .47** .63] .38** .63] –

6.

Note. * p ≪ .05; ** p ≪ .01; Standard deviations are in parentheses, 95% confidence intervals in brackets. a Associations between physical abuse and facial emotion processing paralleled emotional maltreatment.

M (SD)

Measure

Table 1 Descriptive Statistics and Inter-correlations of Study Variables.a

[.15,

[.33,

[.39,

[.41,

[.62,

.28** [.06, .54] .51** [.27, .71] –

.59** [.40, .729] .33** [.12, .56] .37** [.16, .18] .23* [.02, .44]

7.

.05 [-.10, .25] –

.21* [.04, .39]

.30** [.12, .51] .36** [.16, .55] .35** [.14, .55] .33** [.16, .50] .09 [-.13, .36]

8.

–

.25** [.078, .41] .12 [-.07, .28] .48** [.34, .60]

.336** [.17, .49] .15 [-.02, .31]

.37** [.20, .52]

.35** [.16, .50]

.32** [.15, .49]

9.

.13 [-.02, .30] .27** [.11, .45] .37** [.20 .53] –

.21* [.02, .36]

.28** [.11, .45] .34** [.14, .51] .24** [.06, .43] .40** [.21, .54] .01 [-.13, .19]

10.

−.52** [-.65, -.37] –

−.55** [-.65, -.44]

−.07 [-.27, .14] −.43** [-.59, -.26]

−.24** [-.45, -.01]

−.060 [-.24, .10]

−.44** [-.57, -.28]

−.30** [-.50, -.06]

−.39** [-.56, -.20]

−.32** [-.49, -.13]

11.

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Table 2 Mean (SD) Threshold Percentage of Visual Information Required to Identify Various Facial Emotions Under Low and High Cognitive Load Conditions.a Cognitive Load Emotion

Low

Happy Angry Sad Afraid Overall

54.12 45.31 17.99 28.64 36.92

High (13.25) (21.24) (13.89) (19.29) (9.21)

49.29 42.07 18.94 35.59 36.61

(15.08) (18.99) (13.31) (18.45) (7.90)

t-value

p-value

2.86 1.13 −.53 −3.23 .35

.005 .262 .600 .002 .730

Note. * p ≪ .05; ** p ≪ .001. a The threshold for sad may have been lower than other emotions because sadness has the most distinguishing features relative to the other emotions (e.g., the eyes and muscles conveyed less engagement and intensity than fear and anger, and even happiness. Table 3 Correlations Between Self-Report and Performance Variables. Cognitive Load

Emotion

Emotional Maltreatment

Total Maltreatment

Anxiety

Attachment Anxiety

Attachment Avoidance

Mindfulness

Low Cognitive Load

Fear Anger Overall Fear Anger

−.08 [-.24, .08] −.05 [-.22, .13] −.05 [-.19, .09] −.22* [-3.5, -0.7] −.02 [-.21, .17]

−.09 [-.23, .06] −.05 [-.22, .13] −.06 [-.19, .070] −.23* [-.34, -.08] .010 [-.17, .19]

.06 [-.13, .24] −.03 [-.21, .15] .06 [-.02, .24] −.12 [-.31, .07] −.04 [-.25, .16]

−.10 [-.27, .07] .04 [-.14, .23] .04 [-.14, .21] .08 [-.10, .24] −.13 [-.29, .04]

−.15 [-.33, .03] .04 [-.13, .21] −.17 [-.34, .02] −.10 [-.30, .09] .04 [-.11, .22]

Overall

−.13 [-.26, .03]

−.11 [-.24, .05]

.22* [-.02, .43] −.01 [-.26, .08] .13 [-.07, .31] −.16 [-.31, .01] −.15 [-.37, -.06] −.25** [-.42, -.08]

−.14 [-.30, .045]

−.01 [-.19, .16]

−.05 [-.22, .11]

High Cognitive Load

Note. * p ≪ .05; ** p ≪ .01; 95% confidence intervals in brackets.

4.2. Emotional maltreatment, anxiety, attachment, mindfulness, and emotional processing We conducted regression analyses to determine whether emotional maltreatment, anxiety, attachment anxiety and avoidance, and mindfulness influenced the perceptual threshold required to correctly identify fear, and overall average threshold, under low and high cognitive load conditions. Variables were entered in a single step testing main effects. Due to the unavoidable multicollinearity between predictor variables, interactions were not tested because of the difficulty replicating such interaction effects (Stanley & Spence, 2014). Statistically significant predictive effects were found for three of the four regression models (see Tables 4 and 5). Under low cognitive load, the model predicting threshold identification for fear achieved statistical significance, F(5, 115) = 3.52, p = .005, and accounted for 13.3% of the variance in fear identification threshold. Unique effects were found for anxiety, t(120) = 2.522, p = .0313, attachment avoidance, t(120) = −2.152, p = .034, and mindfulness, t(120) = −2.316, p = .044. Participants with high levels of attachment avoidance and high levels of mindfulness were able to identify fear more quickly (i.e., with less perceptual information) whereas those high in anxiety identified fear more slowly (i.e., with more perceptual information). Under high cognitive load for the fear sequence, the model predicting threshold identification for fear was also statistically significant, F(5, 115) = 3.52, p = .005, accounting for 13.3% of the variance in fear identification threshold. Unique predictive effects were observed for emotional maltreatment, t(120) = −2.382, p = .019 and mindfulness t(120) = −2.651, p = .009. Participants with high levels of these variables identified fear with less perceptual information when cognitively taxed. Under low cognitive load, the model predicting overall perception thresholds did not achieve statistical significance, F(5, Table 4 Summary of Regression Analyses for Emotional Maltreatment, Attachment, Mindfulness, and Negative Emotions Predicting Perceptual Threshold for Fear, under Low and High Cognitive Load. Measure

Emotional Maltreatment Anxiety Attachment Anxiety Attachment Avoidance Mindfulness

Low

High

B

SE B

β

t

p

B

SE B

β

t

p

−.477 .623 −1.212 −3.719 −12.249

.252 .247 1.807 1.728 5.288

−.185 .261 −.074 −.223 −.271

−1.894 2.522 −.671 −2.152 −2.316

.061 .013* .504 .034* .022*

−.548 −.331 −2.810 1.410 −12.832

.230 .226 1.654 1.582 4.840

−.233 −.151 −.187 .092 −.310

−2.382 −1.462 −1.699 .892 −2.651

.019* .146 .092 .375 .009**

Note. * p ≪ .05; ** p ≪ .01. 153

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Table 5 Summary of Regression Analyses for Emotional Maltreatment, Attachment, Mindfulness, and Negative Emotions Predicting Perceptual Threshold for Emotions, under Low and High Cognitive Load. Measure

Emotional Maltreatment Anxiety Attachment Anxiety Attachment Avoidance Mindfulness

Low

High

B

SE B

β

t

p

B

SE B

β

t

p

−.199 .141 −.440 −.220 −4.837

.120 .118 .864 .826 2.529

−.168 .128 −.058 −.029 −.233

−1.654 1.193 −.509 −.266 −1.913

.101 .235 .611 .791 .058

−.084 −.255 −.862 .012 −4.899

.098 .096 .705 .674 2.063

−.085 −.277 −.136 .002 −.281

−.855 −2.649 −1.223 .017 −2.375

.394 .009** .224 .986 .019*

Note. * p ≪ .05; ** p ≪ .01.

115) = 1.565, p = .176, accounting for only 6.4% of the variance. However, under high cognitive load, the model accounted for 11.4% of the variance in overall facial perception threshold, F(5, 115) = 2.950, p = .015. Unique effects were found for anxiety, t (120) = -2.649, p = .009 and mindfulness, t(120) = -2.376, p = .019. Participants with high levels of mindfulness and high levels of anxiety were able to identify fear more quickly (i.e., with less perceptual information). 5. Discussion The primary goal of the current study was to examine whether emotional facial processing was associated with a history of childhood emotional maltreatment, with particular attention to developmental sequelae of emotional maltreatment believed to influence facial emotion perception. A number of associations were observed, especially pertaining to the processing of fearful facial expressions. Considering that fearful faces are thought to serve an adaptive function in signalling danger and eliciting distress and escape behavior (Öhman, 2008), the specificity of most findings to fearful expressions is consistent with the assumption that experiences of emotional maltreatment, and associated socio-emotional sequelae, are related to heightened processing of threat-related information. In contrast, other associations involved more rapid perception of emotions in general, possibly suggesting a different underlying mechanism. Effects differed across the high versus low cognitive load conditions, with implications for the relative degree of automaticity involved in the facial expression processing. 5.1. Childhood emotional maltreatment A history of emotional maltreatment was related to the recognition of fear, but this effect was found only when participants were under high cognitive load. Although this finding certainly requires replication, it suggests that when cognitive resources are diverted elsewhere, thus necessitating a more automatic response, female young adults who have experienced childhood emotional maltreatment more readily identify fearful faces with less perceptual information. This finding is consistent with the argument that early experiences of emotional maltreatment foster a heightened vigilance toward potentially threatening cues that becomes relatively automatic, presumably due to its habitual nature. Furthermore, associations involving the general index of maltreatment, comprised of multiple maltreatment types, paralleled associations involving emotional maltreatment. Although some outcomes are relatively specific to a particular type of maltreatment (e.g., Bailey, DeOliveira, Wolfe, Evans, & Hartwick, 2012a), different types tend to cooccur, and all have an emotional component; thus, it is difficult to disentangle emotional maltreatment and its sequelae from the experience of maltreatment more broadly (Binggeli et al., 2001; Brassard & Donovan, 2006). The comparable strength of associations involving emotional versus overall maltreatment points to the former’s central relevance to the developmental outcomes considered here. Although the current findings do not conclusively address the issue of whether vigilance toward threat may shift from a focus on angry toward fearful faces across development, the specificity of most findings to fearful expressions provides further evidence to support this premise. Previous research has found that maltreated children (Pine et al., 2005; Pollak & Tolley-Schell, 2003) and young adults (Gibb, Schofield, & Coles, 2009) required less perceptual information to identify angry faces; however, Gibb et al. (2009) did not examine facial expressions of fear to allow for comparison. It is possible that the focus of past research on childhood physical rather than emotional maltreatment may have elicited stronger associations involving attentional biases for anger. Alternatively, in accordance with the principle of heterotypic continuity (Rutter & Sroufe, 2000), this inconsistency also may result from differences in the meaning and salience of emotional expressions at different developmental stages. Children may be particularly attuned to quickly identify anger, whereas adults may be particularly attuned to quickly identify fear. Leist and Dadd’s (2009) finding of a preferential awareness for fear, but not anger, in young adults with a history of maltreatment is consistent with this premise. It is not known, however, how (or when, or even whether) an earlier childhood bias toward perception of angry faces, as observed in past research, changes to focus more on fearful expressions. Future research employing participants of graduated ages would shed light on this issue. The relatively automatic nature of the heightened fear perception among those with a reported history of emotional maltreatment suggests that in the course of their everyday lives, they may perceive threat differently when they are engaged in other activities that tax their cognitive resources. This may be the case fairly often, as it is unlikely that individuals would devote their cognitive resources 154

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primarily to facial emotion processing when their attention is drawn to many competing demands outside of the laboratory environment. In the current study participants’ cognitive resources were diverted toward a cognitively challenging task; however, reliance on automatic processing also may be precipitated by mental preoccupation with a practical or interpersonal issue. These possibilities await future study. 5.2. Anxiety There was a clear contrast between associations involving anxiety and facial emotion perception at high and low cognitive load. When cognitive resources were not taxed, anxious participants required more perceptual information to identify fear. This finding accords with those of Tseng et al. (2017) that social anxiety related to slower and less accurate identification of fearful expressions. It also fits with neurological findings that anxiety amplifies amygdala responses to fearful faces under low cognitive load (Bishop et al., 2006; Hsu & Pessoa, 2007; Lim et al., 2008), ostensibly by increasing the perceived affective significance of fear-related cues at a post-attentive processing stage (Lim et al., 2008). If anxiety were associated with such an increased amygdala response in the current study, it may have had a dysregulating effect on task performance. Conversely, at high cognitive load, anxiety facilitated earlier identification of all emotion types, including a trend-level association with fear. Neuroimaging research has found that anxiety does not amplify amygdala responses under conditions of high cognitive load, apparently because processing resources are not available to support subsequent threat appraisal processes (Adolphs, 2008; Lim et al., 2008). It is possible that those with anxiety are actually more efficient at recognizing facial emotions at the early, fairly automatic stage. That their processing abilities would be more automatized is consistent with the observed neural indices of hypervigilance to all facial expressions (Felmingham et al., 2016). 5.3. Attachment anxiety and avoidance Compared to other key variables, effects involving attachment measures were more modest in strength. At high cognitive load, there was a trend toward faster identification of fearful emotions among individuals high in attachment anxiety, but in regression analyses this effect was superseded by associations involving anxiety. In contrast, a moderate and non-significant association involving attachment avoidance accounted for unique variance in subsequent regression analysis, suggesting that its effect could be better identified once variance attributable to larger effects was accounted for. Individuals with high self-reported levels of attachment avoidance identified fear with less perceptual information, but only under low cognitive load. It is thought that the ability to quickly detect highly salient facial cues (i.e., fear) could enable highly avoidant individuals to disengage from emotionally charged or threatening situations (Niedenthal et al., 2002). Despite the presumed long-term use of such a strategy, however, the finding that attachment avoidance conferred an advantage under low but not high cognitive load suggests that the processes involved were not automatized. Rather, those with greater attachment avoidance may have developed more effective top-down processing abilities relevant to detecting fearful faces. The substantially reduced association under high cognitive load, when cognitive resources were taxed, may reflect a break-down in top-down attentional strategies normally used in service of avoidance. Similar conclusions were reached by Edelstein and Gillath (2008), who found that attachment-avoidant attentional biases in an emotional Stroop task were compromised under high cognitive load, thereby suggesting that inhibiting attention was effortful rather than automatic. Since emotional Stroop is processed for threat to some degree before one attends away from it (Bailey, Paret, Battista, & Xue, 2012b), avoidant individuals would have to first recognize and subsequently attend away from threatening cues; either or both of these processes may have been disrupted under high cognitive load (Edelstein & Gillath, 2008). Taken together, these findings also suggest that avoidant strategies require sufficient executive functioning abilities. 5.4. Mindfulness To the authors’ knowledge, the present study was the first to reveal the influence of mindfulness on the perception of emotional faces. Rather than being specific to fear, under low cognitive load trait mindfulness was modestly associated with an enhanced general ability to perceive emotions, regardless of the particular type of emotion. This increased facilitation was found when low cognitive load permitted full use of available top-down attentional control, consistent with findings that trait mindfulness is associated with both improved attentional processing and executive functioning, and that mindfulness interventions improve executive function abilities (Teper, Segal, & Inzlicht, 2013). Associations involving mindfulness may be quite sample-specific, however: self-reported mindfulness among university students likely differs considerably from mindfulness cultivated by experienced meditation practitioners, with the latter involving greater automatization of associated processes due to habitual practice. 6. Limitations and future directions The results of the present study provide empirical support for the influence of childhood emotional maltreatment on processing emotional faces, and suggest that developmental trajectories also are influenced by associated experiential and characterological sequelae such as anxiety, attachment style, and trait mindfulness. The replication of these findings in more heterogeneous samples (e.g., community, clinical) would provide additional contextualized information about the interplay of these constructs. Inclusion of males in future research is necessary to examine the extent to which effects observed in females would generalize to males. Since the current study was correlational, no conclusions can be made regarding direction of causality or indeed whether the 155

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strength of any association was due to an unidentified third variable. The conceptual and practical overlap between emotional maltreatment and other forms of abuse and neglect was only partially addressed in the current study; however, we viewed a focus on emotional maltreatment as complementary to the bulk of research in this area with its focus on physical abuse, and critical considering the extent and impact of emotional maltreatment (Binggeli et al., 2001; Brassard & Donovan, 2006). In using self-report measures to assess history of emotional maltreatment, anxiety symptoms, attachment style, and trait mindfulness, we relied on participants’ perceptions and recollections of these complex constructs. This introduces an element of bias, since despite the scales’ reasonable reliability and validity, people vary in their ability and willingness to report accurately on their social behavior and inner experiences (McLean, Bailey, & Lumley, 2014; Shedler, Mayman, & Manis, 1993). Retrospective recall of childhood maltreatment also is subject to memory reconstruction; however, reviews have indicated that adults can provide a fairly valid estimate of their maltreatment experiences, especially when assessment measures are clear and specific (Brewin, Andrews, & Gotlib, 1993; Cicchetti & Manly, 2001; Dube, Williamson, Thompson, Felitti, & Anda, 2004; Rutter & Maughan, 1997). Assessment alternatives to retrospective reports also suffer from validity concerns: studies that exclude participants based on a lack of a verified record typically underestimate the actual experience of maltreatment, particularly in cases of emotional maltreatment that are notoriously underreported (Garbarino & Garbarino, 1980). Within the current findings, a pattern emerged in which variables tended to relate more strongly to facial emotion perception in regression analyses than in zero-order correlations. This pattern is consistent with the interpretation that threshold for perceiving fear is determined by multiple factors: any one factor would not be expected to explain much of the variance, but after accounting for variance associated with one relevant factor, a second factor would account for proportionately more of the remaining variance. The effect of any one variable in a regression analysis is largely dependent on the constellation of predictor variables. Although more realistic in its complexity, regression models that include multiple variables are more difficult to replicate. Not unique to this study, this phenomenon presents researchers with the challenge of identifying and studying collectively only the most relevant variables, in order better understand and delineate their respective contributions. The results of the present study revealed multiple influences on emotional facial processing, some pertaining to difficult early life experiences and others reflecting approaches to coping with life experiences. The assessment of facial emotion processing under high and low cognitive load allowed us to differentiate whether associations with perception threshold were relatively automatic or strategic (i.e., requiring more cognitive resources). Future research can build on the current behavioral findings, which centred around fear and threat perception, by investigating the neurobiology of facial emotion perception and its relation to emotional maltreatment, attachment, and trait mindfulness. Investigation of amygdala functioning may further inform our understanding of the mechanisms involved, as research has found that speed of identification is not necessarily related to degree of amygdala reactivity (Taylor, Eisenberger, Saxbe, Lehman, & Lieberman, 2006; van Harmelen et al., 2013). These discrepancies reveal a need to further explore the amygdala’s role in processing emotional faces, as well as its impact on behavior. To our knowledge this study was the first to investigate the influence of mindfulness on facial emotional processing, and revealed a general, rather than fear-specific, improvement in perceiving emotions, thus suggesting that the reduced threshold associated with mindfulness involved a different mechanism. It has been proposed that mindfulness may ameliorate negative outcomes following maltreatment and trauma (e.g., Batten & Hayes, 2005; Batten, Orsillo, & Walser, 2005; Follette & Vijay, 2009). With respect to the specific outcome of facial emotion processing, however, mindfulness may have a distinct and separate role, independent of emotional maltreatment. We look forward to future research replicating this outcome and exploring additional emotion-related processes. 7. Clinical implications These findings have implications for clarifying developmental theories and evaluating clinical interventions that may mitigate some of the negative effects of childhood emotional maltreatment. Emotional maltreatment and a more comprehensive measure of maltreatment related similarly to associated socio-emotional sequelae (anxiety, attachment, mindfulness), and to facial emotion processing, highlighting the deleterious effects of non-physical abuse and neglect, and their relevance to clinical decision-making. Indeed, research with a high-risk clinical sample found that emotional neglect and other forms of maltreatment were associated with impairment on more basic facial emotion recognition tasks (Russo et al., 2015) than employed in the current study. The ability to perceive emotions is critical for navigating social relationships (Buck, 1999; Ekman, 1992; Fridlund, 1992; Hampson et al., 2006) and associated with positive mental health outcomes (Edwards et al., 2002; Matthews & MacLeod, 2005). Associations with facial emotion perception suggest potential underlying vulnerabilities, and their occurrence at high versus low cognitive load may indicate whether they are relatively automatic, or reliant on cognitive resources, and therefore possibly more open to change. Among young females who experienced childhood abuse, it may be difficult to change automatic responses, such as the facilitated recognition of fearful faces thought to reflect increased vigilance to threat; however, anxiety-related difficulty interpreting fearful faces, and tendencies to watch for and avoid fearful cues, both required greater cognitive processing, and thus new patterns might be learned. The association between mindfulness and emotion recognition also depended on cognitive resources, suggesting that interventions aimed at increasing mindfulness may enhance young adults’ attentional processing and ability to perceive emotions. By teaching purposeful attunement toward emotions in a non-judgmental, accepting manner, mindfulness training would be expected to improve the ability to cope with anxiety-inducing emotional cues. This would theoretically decrease anxiety and improve the ability to cope with incoming emotion-laden facial cues. Preliminary studies have explored the utility of mindfulness for treating maltreatment and trauma-related concerns such as experiential avoidance, psychological distress, inflexibility, distress tolerance and emotion regulation (e.g., Batten & Hayes, 2005; Batten et al., 2005; Follette & Vijay, 2009). These broader processes involve the more discrete function of emotion recognition and are central to well-being and mental health. 156

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Funding This work was supported by a doctoral fellowship awarded to the first author from the Social Sciences and Humanities Research Council of Canada [grant number 767-2009-1471]; and a New Investigator Fellowship from the Social Sciences and Humanities Research Council of Canada awarded to the third author [grant number 430005]. References Adolphs, R. (2008). Fear, faces, and the human amygdala. Current Opinion in Neurobiology, 18(2), 166–172. American Professional Society on the Abuse of Children (1995). Guidelines for psychosocial evaluation of suspected psychological maltreatment in children and adolescents. Chicago: APSAC. Anderson, A. K., Christoff, K., Panitz, D., De Rosa, E., & Gabrieli, J. D. (2003). Neural correlates of the automatic processing of threat facial signals. The Journal of Neuroscience, 23(13), 5627–5633. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176. Armstrong, T., & Olatunji, B. O. (2012). Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis. Clinical Psychology Review, 32(8), 704–723. Baer, R. A. (2009). Self-focused attention and mechanisms of change in mindfulness-based treatment. Cognitive Behaviour Therapy, 38(S1), 15–20. http://dx.doi.org/10. 1080/16506070902980703. Baer, J. C., & Martinez, C. D. (2006). Child maltreatment and insecure attachment: A meta‐analysis. Journal of Reproductive and Infant Psychology, 24(3), 187–197. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. http://dx.doi.org/10.1177/1073191105283504. Bailey, H. N., DeOliveira, C. A., Wolfe, V. V., Evans, E. M., & Hartwick, C. (2012a). The impact of childhood maltreatment history on parenting: A comparison of maltreatment types and assessment methods. Child Abuse and Neglect, 36, 236–246. http://dx.doi.org/10.1016/j.chiabu.2011.11.005. Bailey, H. N., Paret, L., Battista, C., & Xue, Y. (2012b). Attachment anxiety and attentional control predict immediate and delayed emotional stroop interference. Emotion, 12(2), 376. Batten, S. V., & Hayes, S. C. (2005). Acceptance and commitment therapy in the treatment of comorbid substance abuse and post-traumatic stress disorder: A case study. Clinical Case Studies, 4(3), 246–262. http://dx.doi.org/10.1177/1534650103259689. Batten, S. V., Orsillo, S. M., & Walser, R. D. (2005). In S. M. Orsillo, & L. Roemer (Eds.). Acceptance and mindfulness-based approaches to the treatment of posttraumatic stress disorderNew York, NY, US: Springer Science+Business Media. http://dx.doi.org/10.1007/0-387-25989-9_10. Barnett, D., Ganiban, J., & Cicchetti, D. (1999). Maltreatment, negative expressivity, and the development of type D attachments from 12 to 24 months of age. Monographs of the Society for Research in Child Development, 64(3), 97–118. http://dx.doi.org/10.1111/1540-5834.00035. Barnett, O., Miller-Perrin, C. L., & Perrin, R. D. (2005). Family violence across the lifespan: an introduction. Sage Publications, Inc. Belsky, J., & Fearon, R. P. (2002). Infant–mother attachment security, contextual risk, and early development: A moderational analysis. Development and Psychopathology, 14(02), 293–310. http://dx.doi.org/10.1017/S0954579402002067. Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., ... Zule, W. (2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse & Neglect, 27(2), 169–190. http://dx.doi.org/10.1016/S0145-2134(02)00541-0. Binggeli, N. J., Hart, S. N., & Brassard, M. R. (2001). Psychological Maltreatment of Children. Sage. Bishop, S. J., Duncan, J., & Lawrence, A. D. (2004). State anxiety modulation of the amygdala response to unattended threat-related stimuli. Journal of Neuroscience, 24(46), 10364–10368. Bishop, S. J., Jenkins, R., & Lawrence, A. D. (2006). Neural processing of fearful faces: effects of anxiety are gated by perceptual capacity limitations. Cerebral cortex, 17(7), 1595–1603. Bowlby, J. (1969). Attachment and loss. Attachment, Volume 1. New York: Basic Books. Bowlby, J. (1980). Attachment and loss. New York, NY, US: Basic Books. http://search.proquest.com/docview/619966017?accountid=11233. Bowlby, J. (1982). Attachment and loss: Retrospect and prospect. American Journal of Orthopsychiatry, 52(4), 664. Bowlby, J. (1987). In D. P. Schwartz, J. L. Sacksteder, & Y. Akabane (Eds.). Defensive processes in the light of attachment theoryMadison, CT, US: International Universities Press, Inchttp://search.proquest.com/docview/617358434?accountid=11233. Bowlby, J. (1988). A secure base: parent-child attachment and healthy human development. New York, NY, US: Basic Books. Brassard, M. R., & Donovan, K. L. (2006). In M. M. Feerick, J. F. Knutson, P. K. Trickett, & S. M. Flanzer (Eds.). Defining psychological maltreatmentBaltimore, MD, US: Paul H Brookes Publishing, Baltimore, MD http://search.proquest.com/docview/621799641? accountid=11233. Bremner, J. D., Randall, P., Scott, T. W., Capelli, S., Delaney, R., McCarthy, G., ... Charney, D. S. (1995). Deficits in short-term memory in adult survivors of childhood abuse. Psychiatry Research, 59(1-2), 97–107. http://dx.doi.org/10.1016/0165-1781(95)02800-5. Bremner, J. D., Randall, P., Vermetten, E., & Staib, L. (1997). Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse: A preliminary report. Biological Psychiatry, 41(1), 23–32. http://dx.doi.org/10.1016/S0006-3223(96)00162-X. Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). In J. A. Simpson, & W. S. Rholes (Eds.). Self-report measurement of adult attachment: An integrative overviewNew York, NY, US: Guilford Presshttp://search.proquest.com/docview/619175756?accountid=11233. Bretherton, I. (1985). Attachment theory: Retrospect and prospect. Monographs of the Society for Research in Child Development, 3–35. http://dx.doi.org/10.2307/ 3333824. Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: A reappraisal of retrospective reports. Psychological Bulletin, 113(1), 82–98. http://dx.doi.org/10.1037/0033-2909.113.1.82. Briere, J., & Runtz, M. (1988). Multivariate correlates of childhood psychological and physical maltreatment among university women. Child Abuse & Neglect, 12(3), 331–341. http://dx.doi.org/10.1016/0145-2134(88)90046-4. Bronfman, Z. Z., Brezis, N., Lazarov, A., Usher, M., & Bar-Haim, Y. (2017). Extraction of mean emotional tone from face arrays in social anxiety disorder. Depression and Anxiety, 1–8. http://dx.doi.org/10.1002/da.22713. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822. http://dx.doi.org/10.1037/0022-3514.84.4.822. Buck, R. (1999). The biological affects: A typology. Psychological Review, 106(2), 301–336. http://dx.doi.org/10.1037/0033-295X.106.2.301. Cahn, B. R., & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 132(2), 180. http://dx.doi.org/10.1037/00332909.132.2.180. Camras, L. A., Ribordy, S., Hill, J., Martino, S., Spaccarelli, S., & Stefani, R. (1988). Recognition and posing of emotional expressions by abused children and their mothers. Developmental Psychology, 24(6), 776. http://dx.doi.org/10.1037/0012-1649.24.6.776. Casey, B. J., Jones, R. M., & Hare, T. A. (2008). The adolescent brain. Annals of the New York Academy of Sciences, 1124(1), 111–126. Cassidy, J., & Shaver, P. R. (Eds.). (2002). Handbook of Attachment: Theory, Research, and Clinical Applications. Rough Guides. Cicchetti, D. (2016). Developmental psychopathology, maladaptation and psychopathology, Volume 3. John Wiley & Sons. Cicchetti, D., & Manly, J. T. (2001). Editorial: Operationalizing child maltreatment: developmental processes and outcomes. Development and Psychopathology, 13, 755–758. http://dx.doi.org/10.1017/S0954579401003017. Cicchetti, D., & Rogosch, F. A. (2009). Adaptive coping under conditions of extreme stress: Multilevel influences on the determinants of resilience in maltreated

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Child Abuse & Neglect 80 (2018) 146–160

L.H. English et al.

children. New Directions for Child and Adolescent Development, 2009(124) 47-59.ty. Cicchetti, D., & Rogosch, F. A. (2012). Neuroendocrine regulation and emotional adaptation in the context of child maltreatment. Monographs of the Society for Research in Child Development, 77(2), 87–95. Cicchetti, D., & Sroufe, L. A. (1978). An organizational view of affect: Illustration from the study of Down’s syndrome infants. The development of affect. US: Springer309–350. Cicchetti, D., Toth, S. L., & Maughan, A. (2000). An ecological–transactional model of child maltreatment. In A. J. Sameroff, M. Lewis, & S. M. Miller (Eds.). Handbook of developmental psychopathology (pp. 689–722). (2nd ed.). Dordrecht, Netherlands: Kluwer Academic Publishers. http://dx.doi.org/10.1007/978-1-4615-41639_37. Cicchetti, D., & Valentino, K. (2006). An ecological-transactional perspective on child maltreatment: failure of the average expectable environment and its influence on child development. Risk, disorder, and adaptation. Wiley. Cole-Detke, H., & Kobak, R. (1996). Attachment processes in eating disorder and depression. Journal of Consulting and Clinical Psychology, 64(2), 282–290. http://dx. doi.org/10.1037/0022-006X.64.2.282. Cozolino, L. J. (2002). The neuroscience of psychotherapy: Building and rebuilding the human brain. New York, NY: W Norton & Co. Curtis, W. J., & Cicchetti, D. (2003). Moving research on resilience into the 21st century: Theoretical and methodological considerations in examining the biological contributors to resilience. Development and Psychopathology, 15, ((Reprinted in Dziecko Autystyczne (2003); Reprinted in Audiofonologia (2004)) (2003)). Curtis, W. J., & Cicchetti, D. (2013). Affective facial expression processing in 15-month-old infants who have experienced maltreatment an event-related potential study. Child Maltreatment, 18(3), 140–154. http://dx.doi.org/10.1177/1077559513487944. Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & Van Ijzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development and Psychopathology, 22(1), 87–108. Dalgleish, T., Moradi, A. R., Taghavi, M. R., Neshat-Doost, H. T., & Yule, W. (2001). An experimental investigation of hypervigilance for threat in children and adolescents with post-traumatic stress disorder. Psychological Medicine, 31(3), 541–547. Dan, O., & Raz, S. (2012). Adult attachment and emotional processing biases: an event-related potentials (ERPs) study. Biological Psychology, 91(2), 212–220. http:// dx.doi.org/10.1016/j.biopsycho.2012.06.003. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564–570. http://dx.doi.org/10.1097/01.PSY.0000077505.67574.E3. Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135. http://dx.doi.org/10.1146/annurev-psych-113011-143750. Dube, S. R., Williamson, D. F., Thompson, T., Felitti, V. J., & Anda, R. F. (2004). Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse & Neglect, 28(7), 729–737. During, S. M., & McMahon, R. J. (1991). Recognition of emotional facial expressions by abusive mothers and their children. Journal of Clinical Child and Adolescent Psychology, 20(2), 132–139. http://dx.doi.org/10.1207/s15374424jccp2002_4. Edelstein, R. S., Ghetti, S., Quas, J. A., Goodman, G. S., Alexander, K. W., Redlich, A. D., ... Cordón, I. M. (2005). Individual differences in emotional memory: Adult attachment and long-term memory for child sexual abuse. Personality and Social Psychology Bulletin, 31(11), 1537–1548. http://dx.doi.org/10.1177/ 0146167205277095. Edelstein, R. S., & Gillath, O. (2008). Avoiding interference: Adult attachment and emotional processing biases. Personality and Social Psychology Bulletin, 34(2), 171–181. http://dx.doi.org/10.1177/0146167207310024. Edelstein, R. S., & Shaver, P. R. (2004). Avoidant attachment: Exploration of an oxymoron. In D. J. Mashek, & A. P. Aron (Eds.). Handbook of closeness and intimacy (pp. 397–412). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers. Edwards, J., Jackson, H. J., & Pattison, P. E. (2002). Emotion recognition via facial expression and affective prosody in schizophrenia: A methodological review. Clinical Psychology Review, 22(6), 789–832. http://dx.doi.org/10.1016/S0272-7358(02)00130-7. Ein-Dor, T., Mikulincer, M., & Shaver, P. R. (2011). Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people's coping strategies. Journal of Personality and Social Psychology, 101(1), 78. http://dx.doi.org/10.1037/a0022503. Ekman, P. (1992). Facial expressions of emotion: New findings, new questions. Psychological Science, 3(1), 34. Elices, M., Pascual, J. C., Carmona, C., Martín-Blanco, A., Feliu-Soler, A., Ruiz, E., ... Soler, J. (2015). Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder. BMC Psychiatry, 15(1), 180. Eng, W., Heimberg, R. G., Hart, T. A., Schneier, F. R., & Liebowitz, M. R. (2001). Attachment in individuals with social anxiety disorder: The relationship among adult attachment styles, social anxiety, and depression. Emotion, 1(4), 365. http://dx.doi.org/10.1037/1528-3542.1.4.365. Felmingham, K. L., Stewart, L. F., Kemp, A. H., & Carr, A. R. (2016). The impact of high trait social anxiety on neural processing of facial emotion expressions in females. Biological Psychology, 117, 179–186. Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48, 150–170. http://dx.doi.org/10.1037//0022-3514.48.1.150. Follette, V. M., & Vijay, A. (2009). In F. Didonna (Ed.). Mindfulness for trauma and posttraumatic stress disorderNew York, NY, US: Springer Science+Business Media. http://dx.doi.org/10.1007/978-0-387-09593-6_17. Fraley, R. C., Davis, K. E., & Shaver, P. R. (1998). Dismissing-avoidance and the defensive organization of emotion, cognition, and behavior. In J. A. Simpson, & W. S. Rholes (Eds.). Attachment theory and close relationships (pp. 249–279). New York, NY, US: Guilford Press. Fraley, R. C., Niedenthal, P. M., Marks, M., Brumbaugh, C., & Vicary, A. (2006). Adult attachment and the perception of emotional expressions: Probing the hyperactivating strategies underlying anxious attachment. Journal of Personality, 74(4), 1163–1190. http://dx.doi.org/10.1111/j.1467-6494.2006.00406.x. Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78(2), 350–365. http://dx.doi.org/10.1037/0022-3514.78.2.350. Fridlund, A. J. (1992). In M. S. Clark (Ed.). The behavioral ecology and sociality of human facesThousand Oaks, CA, US: Sage Publications, Inchttp://search.proquest. com/docview/618213617?accountid=11233. Garbarino, J., & Garbarino, A. C. (1980). Emotional maltreatment of children. National Committree for Prevention of Child Abuse. Gibb, B. E., Schofield, C. A., & Coles, M. E. (2009). Reported history of childhood abuse and young adults' information-processing biases for facial displays of emotion. Child Maltreatment, 14(2), 148–156. http://dx.doi.org/10.1177/1077559508326358. Gervai, J. (2009). Environmental and genetic influences on early attachment. Child and Adolescent Psychiatry and Mental Health, 3(1), 1. http://dx.doi.org/10.1186/ 1753-2000-3-25. Hampson, E., van Anders, S. M., & Mullin, L. I. (2006). A female advantage in the recognition of emotional facial expressions: Test of an evolutionary hypothesis. Evolution and Human Behavior, 27(6), 401–416. http://dx.doi.org/10.1016/j.evolhumbehav.2006.05.002. Hein, T. C., & Monk, C. S. (2017). Research review: neural response to threat in children, adolescents, and adults after child maltreatment—A quantitative meta‐analysis. Journal of Child Psychology and Psychiatry, 58(3), 222–230. Herrigel, E. (1999). Zen in the art of archery. New York: Vintage. Hsu, S. M., & Pessoa, L. (2007). Dissociable effects of bottom-up and top-down factors on the processing of unattended fearful faces. Neuropsychologia, 45(13), 3075–3086. Johnsen, B. H., Thayer, J. F., & Hugdahl, K. (1995). Affective judgment of the Ekman faces: A dimensional approach. Journal of Psychophysiology, 9, 193–202. Joseph, R. (1999). Environmental influences on neural plasticity, the limbic system, emotional development and attachment: A review. Child Psychiatry and Human Development, 29(3), 189–208. http://dx.doi.org/10.1023/A:1022660923605. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperionhttp://dx.doi.org/10.1016/0005-7967(95)90133-7. Kagan, J. (1971). Change and continuity in infancy. Kanade, T., Cohn, J. F., & Tian, Y. (2000). Comprehensive database for facial expression analysis. The 4th IEEE International Conference on Automatic Face and Gesture Recognition (FG'00)http://www.ri.cmu.edu/pub_files/pub2/kanade_takeo_2000_1/kanade_takeo_2000_1.pdf.

158

Child Abuse & Neglect 80 (2018) 146–160

L.H. English et al.

Kennedy, D. P., & Adolphs, R. (2012). The social brain in psychiatric and neurological disorders. Trends in Cognitive Sciences, 16(11), 559–572. Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2015). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences, 81, 41–46. Kim, J., & Cicchetti, D. (2006). Longitudinal trajectories of self‐system processes and depressive symptoms among maltreated and nonmaltreated children. Child Development, 77(3), 624–639. http://dx.doi.org/10.1111/j.1467-8624.2006.00894. Koizumi, M., & Takagishi, H. (2014). The relationship between child maltreatment and emotion recognition. PLoS One, 9(1), e86093. Kuhlman, K. R., Boyle, C. C., Irwin, M. R., Ganz, P. A., Crespi, C. M., Asher, A., ... Bower, J. E. (2017). Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer. Child Abuse & Neglect, 72, 360–369. Kwon, H., Yoon, K. L., Joormann, J., & Kwon, J. (2013). Cultural and gender differences in emotion regulation: relation to depression. Cognition & Emotion, 27(5), 769–782. http://dx.doi.org/10.1080/02699931.2013.792244. Lau, M. A., Bishop, S. R., Segal, Z. V., Buis, T., Anderson, N. D., Carlson, L., ... Devins, G. (2006). The Toronto mindfulness scale: Development and validation. Journal of Clinical Psychology, 62(12), 1445–1467. Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., et al. (2005). Meditation experience is associated with increased cortical thickness. NeuroReport: For Rapid Communication of Neuroscience Research, 16(17), 1893–1897. http://dx.doi.org/10.1097/01.wnr.0000186598.66243.19. Leist, T., & Dadds, M. R. (2009). Adolescents ability to read different emotional faces relates to their history of maltreatment and type of psychopathology. Clinical Child Psychology and Psychiatry, 14(2), 237–250. http://dx.doi.org/10.1177/1359104508100887. Levenson, R. W. (1988). Emotion and the autonomic nervous system: A prospectus for research on autonomic specificity. In H. L. Wagner (Ed.). Social psychophysiology and emotion: Theory and clinical applications (pp. 17–42). Oxford, England: Wiley. Lim, S. L., Padmala, S., & Pessoa, L. (2008). Affective learning modulates spatial competition during low-load attentional conditions. Neuropsychologia, 46(5), 1267–1278. Lindquist, K., & Barrett, L. F. (2008). Constructing emotion: the experience of fear as a conceptual act. Psychological Science, 19, 898–903. http://dx.doi.org/10.1111/j. 1467-9280.2008.02174.x. Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343. Maier, M. A., Bernier, A., Pekrun, R., Zimmermann, P., Strasser, K., & Grossmann, K. E. (2005). Attachment state of mind and perceptual processing of emotional stimuli. Attachment & Human Development, 7(1), 67–81. http://dx.doi.org/10.1080/14616730500039606. Masten, C. L., Guyer, A. E., Hodgdon, H. B., McClure, E. B., Charney, D. S., Ernst, M., ... Monk, C. S. (2008). Recognition of facial emotions among maltreated children with high rates of post-traumatic stress disorder. Child Abuse & Neglect, 32(1), 139–153. http://dx.doi.org/10.1016/j.chiabu.2007.09.006. Matthews, A., & MacLeod, C. (2005). Cognitive vulnerability to emotional disorders. Annual Review of Clinical Psychology, 1, 167–195. http://dx.doi.org/10.1146/ annurev.clinpsy.1.102803.143916. McCrory, E. J., De Brito, S. A., Kelly, P. A., Bird, G., Sebastian, C. L., Mechelli, A., ... Viding, E. (2013). Amygdala activation in maltreated children during pre-attentive emotional processing. The British Journal of Psychiatry, 202(4), 269–276. McCrory, E., De Brito, S. A., & Viding, E. (2010). Research review: the neurobiology and genetics of maltreatment and adversity. Journal of Child Psychology and Psychiatry, 51(10), 1079–1095. McLean, H. R., Bailey, H. N., & Lumley, M. N. (2014). The secure base script: Associated with early maladaptive schemas related to attachment. Psychology and Psychotherapy: Theory, Research and Practice, 87(4), 425–446. http://dx.doi.org/10.1111/papt.12025. Mikulincer, M., & Orbach, I. (1995). Attachment styles and repressive defensiveness: the accessibility and architecture of affective memories. Journal of Personality and Social Psychology, 68(5), 917–925. http://dx.doi.org/10.1037//0022-3514.68.5.917. Mikulincer, M., & Shaver, P. R. (2003). The attachment behavioral system in adulthood: activation, psychodynamics, and interpersonal processes. In M. P. Zanna (Vol. Ed.), Advances in experimental social psychology: Volume 35, (pp. 53–152). San Diego, CA, US: Elsevier Academic Press. Mikulincer, M., & Shaver, P. R. (2007). Attachment, group-related processes, and psychotherapy. International Journal of Group Psychotherapy, 57(2), 233–245. http:// dx.doi.org/10.1521/ijgp.2007.57.2.233. Mikulincer, M., & Shaver, P. R. (2012). An attachment perspective on psychopathology. World Psychiatry, 11(1), 11–15. http://dx.doi.org/10.1016/j.wpsyc.2012.01. 003. Miller, P., Brody, C. D., Romo, R., & Wang, X. J. (2003). A recurrent network model of somatosensory parametric working memory in the prefrontal cortex. Cerebral Cortex, 13(11), 1208–1218. http://dx.doi.org/10.1093/cercor/bhg101. Maoz, K., Eldar, S., Stoddard, J., Pine, D. S., Leibenluft, E., & Bar-Haim, Y. (2016). Angry-happy interpretations of ambiguous faces in social anxiety disorder. Psychiatry Research, 241, 122–127. Navarre, E. L. (1987). Psychological maltreatment: The core component of child abuse. In M. R. Brassard, R. Germain, & S. N. Hart (Eds.). Psychological Maltreatment of Children and Youth (pp. 45–56). New York: Pergamon Press. Newman, L. S., & McKinney, L. C. (2002). Repressive coping and threat avoidance: An idiographic stroop study. Personality and Social Psychology Bulletin, 28(3), 409–422. http://dx.doi.org/10.1177/0146167202286011. Newman, L., Sivaratnam, C., & Komiti, A. (2015). Attachment and early brain development–neuroprotective interventions in infant–caregiver therapy. Translational Developmental Psychiatry, 3(1), 28647. Niedenthal, P. M., Brauer, M., Robin, L., & Innes-Ker, Å. H. (2002). Adult attachment and the perception of facial expression of emotion. Journal of Personality and Social Psychology, 82(3), 419–433. http://dx.doi.org/10.1037/0022-3514.82.3.419. Öhman, A. (2008). In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.). Fear and anxiety: Overlaps and dissociationsNew York, NY, US: Guilford Presshttp://search. proquest.com/docview/622015355?accountid=11233. Peschard, V., & Philippot, P. (2017). Overestimation of threat from neutral faces and voices in social anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 57, 206–211. Pine, D. S., Mogg, K., Bradley, B. P., Montgomery, L., Monk, C. S., McClure, E., et al. (2005). Attention bias to threat in maltreated children: Implications for vulnerability to stress-related psychopathology. American Journal of Psychiatry, 162, 291–296. http://dx.doi.org/10.1176/appi.ajp.162.2.291. Pollak, S. D. (2003). Experience-dependent affective learning and risk for psychopathology in children. Annals of the New York Academy of Sciences, 1008, 102–111. http://dx.doi.org/10.1196/annals.1301.011. Pollak, S. D. (2008). Mechanisms linking early experience and the emergence of emotions: Illustrations from the study of maltreated children. Current Directions in Psychological Science, 17(6), 370–375. Pollak, S. D., & Kistler, D. J. (2002). Early experience is associated with the development of categorical representations for facial expressions of emotion. Proceedings of the National Academy of Sciences, 99(13), 9072–9076. Pollak, S. D., Messner, M., Kistler, D. J., & Cohn, J. F. (2009). Development of perceptual expertise in emotion recognition. Cognition, 110(2), 242–247. http://dx.doi. org/10.1016/j.cognition.2008.10.010. Pollak, S. D., & Sinha, P. (2002). Effects of early experience on children's recognition of facial displays of emotion. Developmental Psychology, 38(5), 784. http://dx.doi. org/10.1037//0012-1649.38.5.784. Pollak, S. D., & Tolley-Schell, S. A. (2003). Selective attention to facial emotion in physically abused children. Journal of Abnormal Psychology, 112(3), 323–338. http:// dx.doi.org/10.1037/0021-843X.112.3.323. Riggs, S. A., & Kaminski, P. (2010). Childhood emotional abuse, adult attachment, and depression as predictors of relational adjustment and psychological aggression. Journal of Aggression, Maltreatment & Trauma, 19(1), 75–104. Russo, M., Mahon, K., Shanahan, M., Solon, C., Ramjas, E., Turpin, J., ... Burdick, K. E. (2015). The association between childhood trauma and facial emotion recognition in adults with bipolar disorder. Psychiatry Research, 229(3), 771–776. Rutter, M., & Maughan, B. (1997). Psychosocial adversities in childhood and adult psychopathology. Journal of Personality Disorders, 11(1), 4–18. http://dx.doi.org/10.

159

Child Abuse & Neglect 80 (2018) 146–160

L.H. English et al.

1521/pedi.1997.11.1.4. Rutter, M., & Sroufe, L. A. (2000). Developmental psychopathology: Concepts and challenges. Development and Psychopathology, 12(03), 265–296. Schafer, M. H., Morton, P. M., & Ferraro, K. F. (2014). Child maltreatment and adult health in a national sample: Heterogeneous relational contexts, divergent effects? Child Abuse & Neglect, 38(3), 395–406. http://dx.doi.org/10.1016/j.chiabu.2013.08.003. Schore, J. R. (2003). The development of attachment and affect regulation in infancy and childhood with possible clues to psychological gender. In J. B. Sanville, & E. B. Ruderman (Eds.). Committee on psychoanalysis reflections 2000 series; this paper is based on a panel presentation entitled "attachment theory and the regulation of affect: developmental changes for women across the lifespan" presented at the aforementioned committee series (pp. 77–89). Madison, CT, US: International Universities Press, Inc. Shaver, P. R., & Hazan, C. (1994). In A. L. Weber, & J. H. Harvey (Eds.). AttachmentNeedham Heights, MA, US: Allyn & Baconhttp://search.proquest.com/docview/ 618571460?accountid=11233. Shedler, J., Mayman, M., & Manis, M. (1993). The illusion of mental health. American Psychologist, 48(11), 1117. http://dx.doi.org/10.1037/0003-066X.48.11.1117. Siegel, D. J. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. New York: W.W. Norton & Company. Solomon, M., & Siegel, D. J. (2003). Healing trauma. New York: WW Norton. Stanley, D. J., & Spence, J. R. (2014). Expectations for replications: Are yours realistic? Perspectives on Psychological Science, 9(3), 305–318. Styron, T., & Janoff-Bulman, R. (1997). Childhood attachment and abuse: Long-term effects on adult attachment, depression, and conflict resolution. Child Abuse & Neglect, 21(10), 1015–1023. Taylor, S. E., Eisenberger, N. I., Saxbe, D., Lehman, B. J., & Lieberman, M. D. (2006). Neural responses to emotional stimuli are associated with childhood family stress. Biological Psychiatry, 60(3), 296–301. http://dx.doi.org/10.1016/j.biopsych.2005.09.027. Teicher, M. H., Dumont, N. L., Ito, Y., Vaituzis, C., Giedd, J. N., & Andersen, S. L. (2004). Childhood neglect is associated with reduced corpus callosum area. Biological Psychiatry, 56(2), 80–85. http://dx.doi.org/10.1016/j.biopsych.2004.03.016. Teicher, M. H., Samson, J. A., Polcari, A., & McGreenery, C. E. (2006). Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. American Journal of Psychiatry, 163(6), 993–1000. Teper, R., Segal, Z. V., & Inzlicht, M. (2013). Inside the mindful mind how mindfulness enhances emotion regulation through improvements in executive control. Current Directions in Psychological Science, 22(6), 449–454. http://dx.doi.org/10.1177/0963721413495869. Thompson, R. A. (2000). The legacy of early attachments. Child Development, 71(1), 145–152. http://dx.doi.org/10.1111/1467-8624.00128. Tseng, H. H., Huang, Y. L., Chen, J. T., Liang, K. Y., Lin, C. C., & Chen, S. H. (2017). Facial and prosodic emotion recognition in social anxiety disorder. Cognitive Neuropsychiatry, 1–15. van Harmelen, A. L., van Tol, M. J., Demenescu, L. R., van der Wee, N. J., Veltman, D. J., Aleman, A., ... Elzinga, B. M. (2013). Enhanced amygdala reactivity to emotional faces in adults reporting childhood emotional maltreatment. Social Cognitive and Affective Neuroscience, 8(4), 362–369. http://dx.doi.org/10.1093/scan/ nss007. Whalen, P. J. (2007). The uncertainty of it all. Trends in Cognitive Sciences, 11(12), 499–500. Whalen, P. J., Shin, L. M., McInerney, S. C., Fischer, H., Wright, C. I., & Rauch, S. L. (2001). A functional MRI study of human amygdala responses to facial expressions of fear versus anger. Emotion, 1(1), 70. http://dx.doi.org/10.1037/1528-3542.1.1.70. Williams, N. L., & Riskind, J. H. (2004). Adult romantic attachment and cognitive vulnerabilities to anxiety and depression: Examining the interpersonal basis of vulnerability models. Journal of Cognitive Psychotherapy, 18(1), 7–24. http://dx.doi.org/10.1891/jcop.18.1.7.28047. Wright, M. O. D., Crawford, E., & Del Castillo, D. (2009). Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse & Neglect, 33(1), 59–68. http://dx.doi.org/10.1016/j.chiabu.2008.12.007. Zlomke, K. R., & Hahn, K. S. (2010). Cognitive emotion regulation strategies: Gender differences and associations to worry. Personality and Individual Differences, 48(4), 408–413. http://dx.doi.org/10.1016/j.paid.2009.11.007.

160