Abstract

Previous studies have shown the negative impacts of child abuse on mental health in later life. Compared to physical and sexual abuse, psychological maltreatment has received less attention. Emerging literature has explored the associations between psychological maltreatment on adult mental health. However, no systematic review or meta-analysis focuses on the associations between childhood psychological maltreatment and adult mental health while controlling for other adverse childhood experiences. In addition, there is a lack of measures in China that focus on assessing childhood psychological maltreatment in all its relevant dimensions. Further, limited studies have explored the associations between different types and profiles of childhood psychological maltreatment and its associations with adult mental health. Therefore, this thesis aims to fill these gaps by reviewing previous literature on childhood psychological maltreatment and adult mental health, translating and validating a measure that focuses on childhood psychological maltreatment for use in China, assessing the associations between different types of childhood psychological maltreatment and adult mental health, and exploring different profile patterns in Chinese and the UK populations of childhood psychological maltreatment and its associations on mental well-being. Chapter 1 provides a brief background to the existing literature on childhood psychological maltreatment and its associations with adult mental health outcomes. It also presents an overview of frequently used measures assessing childhood psychological maltreatment in China and the UK. In addition, this chapter demonstrates the key gaps in the previous literature. Chapter 2 uses a systematic review approach to review the previous literature on childhood psychological maltreatment and various adult mental health outcomes (i.e., depression and anxiety, eating disorders, personality disorders, suicidal ideation and attempts, substance abuse, and other psychological symptoms). It also reviews the comparison of the mental health outcomes between clinical populations and the general population on the prevalence of childhood psychological abuse and neglect. Meta-analyses are conducted on several themes (i.e., depression and anxiety, suicidal ideation, and clinical population) to explore the effects sizes of childhood psychological abuse on these mental health outcomes. Chapter 3 introduces, translates, and validates the Psychological Maltreatment Review (PMR) for the Chinese population. Factorial validity, internal consistency, convergent and divergent validity, and gender measurement invariance are assessed. Chapter 4, which builds on Chapters 2 and 3, uses the higher-order model to examine the associations between childhood psychological abuse, neglect, and non-support and various mental health outcomes (i.e., depression, anxiety, anger, hostility, and physical aggression). This chapter explores whether different types of childhood psychological maltreatment are more harmful than others, whether the harms associated with different types of psychological maltreatment are generalised or specific to particular domains of psychopathology, and whether there are gender invariances in these associations. Building on Chapter 4, which compares sub-dimensions of childhood psychological maltreatment, Chapter 5 explores the effects of different profiles of psychological maltreatment in the Chinese and the UK population. Various mental health outcomes, such as depression, anxiety, and aggression, and broader well-being, such as self-esteem, are assessed. Lastly, Chapter 6 provides a general summary of the results from Chapters 2 – 5 and an overall discussion. In conclusion, this thesis contributes to understanding the associations between childhood psychological maltreatment and adult mental health. The empirical findings of this thesis emphasise the need to have policies that prevent psychological maltreatment and interventions that can address its psychological harms.