Emotion dysregulation Mediates the Relationship Between Emotional Abuse and Metabolic Syndrome in Adults at a Non-acute, Mental Health Treatment Facility Restricted; Files Only

Abstract

Background: Childhood trauma is linked to a higher risk of developing metabolic syndrome (MetS), but the underlying psychological and behavioral mechanisms are unclear. Psychological symptoms like emotion dysregulation and avoidance may worsen functional impairment after trauma. Research highlights the connection between stress exposure and physiological symptoms, with the hypothalamic-pituitary-adrenal (HPA) axis as a potential biological link. This study examines how emotion dysregulation and avoidant coping behavior mediate the relationship between trauma and MetS. 

Methods: Validated self-report measures assessed childhood trauma exposure, emotion dysregulation, avoidant coping, and metabolic health indicators gathered on adult patients admitted to residential and partial hospitalization programs in a non-acute mental health facility at baseline. A mediation analysis was conducted on emotion dysregulation and avoidant coping. Regression-based mediation models tested whether emotion dysregulation and avoidant coping independently mediated the relationship between childhood trauma and MetS, adjusting for key covariates. 

Results: This analysis included 246 participants, 55.7% were female, 65.4% were non-Hispanic white, and the average age was 29.2 years. Major Depressive Disorder was diagnosed in 65.1% of participants, and 62.3% reported experiencing childhood trauma, primarily emotional abuse (62.8%) and emotional neglect (57%). The prevalence of Metabolic Syndrome (MetS) was 23.4%. Emotion dysregulation mediated the link between childhood emotional abuse and MetS (b=0.006, SE=0.004, 95% CI (0.00, 0.01)), indicating that greater emotional abuse exposure leads to higher metabolic risk. Avoidant coping was not a significant mediator (b=0.0014, SE=0.0028, 95% CI (-0.004, 0.007)). The overall model was significant (F=4.33, p<0.001), explaining 12.8% of the variance in MetS outcomes. 

Conclusion: This study identifies emotion dysregulation as a crucial link between childhood emotional abuse and metabolic health. It emphasizes the connection between mental and physical health through stress pathways like the HPA axis. Interventions such as Dialectical Behavior Therapy (DBT) or mindfulness may reduce metabolic health risks in those exposed to trauma. Future research should replicate these findings through controlled approaches and investigate specific aspects of emotion dysregulation and childhood emotional abuse's impact on metabolic health. Overall, the study highlights the importance of emotional regulation in the childhood emotional abuse-MetS pathway. 

Table of Contents

Introduction...................................................................................................................................7 

Methods.......................................................................................................................................12 

Results.........................................................................................................................................18 

Discussion....................................................................................................................................24 

Conclusion....................................................................................................................................28 

References....................................................................................................................................30 

Appendix A...................................................................................................................................37 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Mental Health Health Sciences, Public Health Health Sciences, Epidemiology
Mot-clé	Childhood Trauma Metabolic Syndrome Coping Emotion Regulation
Committee Chair / Thesis Advisor	Terryl J. Hartman, Emory University
Committee Members	Raneeka DeMoss, Skyland Trail Alex O. Rothbaum, Skyland Trail

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