Childhood trauma survivors show increased emotional intensity and variability

A two-week study examining the daily emotional experiences of childhood trauma survivors in the Netherlands revealed that these individuals experienced significantly lower levels of positive emotions and higher levels of negative emotions throughout the study period compared to those who did not suffer childhood trauma. Additionally, they exhibited greater variations in the intensity of their emotions. The study was published in Psychological Medicine.

Childhood trauma includes highly distressing experiences during a person’s early years that can have profound and enduring effects. This encompasses physical, emotional, or sexual abuse, neglect, or exposure to violence or extreme stress. Such traumas can disrupt the normal development of a child’s brain and contribute to long-term issues in psychological, emotional, and even physical health. These effects may manifest in various ways, including difficulties in forming relationships, mental health disorders, and increased vulnerability to stress in adulthood.

Studies consistently show that childhood trauma is linked to an increased prevalence of various diseases, earlier onset age, and greater severity and persistence of these illnesses. For instance, a recent study found that individuals with a history of childhood trauma are two to three times more likely to develop depression and anxiety disorders. Moreover, these disorders are twice as likely to become chronic in survivors of childhood trauma.

Lead author Erika Kuzminskaite of the Department of Psychiatry at Amsterdam University Medical Center, along with her colleagues, aimed to investigate the everyday emotional experiences of childhood trauma survivors, specifically whether these individuals exhibit greater variability or instability in their emotions daily.

“Childhood traumatic experiences may increase vulnerability to psychopathology through affective dysregulation (greater fluctuations of emotional symptoms) in everyday life. However, dynamic affect fluctuations in individuals with childhood trauma have been understudied, limiting the understanding of long-lasting childhood trauma effects and ultimate development of personalized treatment plans,” explained Kuzminskaite, who recently published her dissertation, “Childhood trauma: Unfolding the lifelong impact on mental health.”

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The researchers conducted a two-week ecological momentary assessment study, a method where participants report on the study topic several times a day over a certain period, typically via a mobile app.

The study involved 384 Dutch-fluent adults participating in an ongoing longitudinal study, the Netherlands Study of Depression and Anxiety. Among these participants, some had ongoing or remitted depression or anxiety disorders, while others were healthy individuals serving as controls. Their average age was 49 years, and 67% were female.

Before the study, participants completed assessments of childhood trauma (the Childhood Trauma Interview) and severity of their depressive and anxiety symptoms (the Inventory of Depressive Symptomatology and The Beck Anxiety Inventory). The researchers also used data on their psychiatric diagnosis. Based on this, they divided them into three groups – current disorder, remitted disorder, and healthy controls (no depressive/anxiety disorder in their lifetime).

During the study period, participants reported on their emotional state at the moment through the mobile app (reporting how they felt at the moment). They did this by filling-out assessments on their mobile phones 5 times per day (i.e., every three hours, from waking till going to sleep) for a period of two weeks and to also wear an actigraphy device (a device registering movements) on their wrists. If participants did not have a mobile device suitable for taking these assessments, study authors provided them with one.

The results showed that about half of the participants reported experiencing at least one type of childhood trauma, with emotional neglect and abuse being the most common types. Compared to individuals without childhood trauma, survivors were significantly older, less educated, and more likely to have been diagnosed with depression or anxiety disorders. They were also more frequently on antidepressant medication and tended to have more severe depressive and anxiety symptoms.

On average, childhood trauma survivors reported much lower levels of positive emotions during everyday activities and higher levels of negative emotions. They also had a much greater variability in these emotions. Survivors of childhood trauma who reported lower or higher levels of negative emotions at one point were more likely to report similar levels at other points as well. This pattern was less evident in individuals without childhood trauma.

Further analysis showed that variability of emotions was a function of their intensity. Individuals reporting stronger emotional experiences also tended to report greater variability of emotions. As it was childhood trauma survivors who tended to report stronger experiences of negative emotions, this translated to greater variability of these emotional experiences as well.

“Using a 2-week ecological momentary assessment, we showed that adults with childhood trauma history exhibit greater fluctuation of emotional symptoms in everyday life,” Kuzminskaite told PsyPost. “However, this was entirely explained by individuals with childhood trauma consistently scoring higher on negative affect and lower on positive affect on a day-to-day basis.”

The study highlights the connections between experiences of childhood trauma and later emotional functioning. However, it has limitations that need consideration. Notably, the assessment of childhood trauma experiences was based on participants’ self-reported memories, which relate to events that occurred nearly half a century ago. Therefore, the extent to which the associations are due to actual differences in childhood experiences versus recall bias — the different ways individuals remember and report their childhood experiences decades later — remains unclear.

Looking forward, Kuzminskaite outlined two important questions for future research: “In what context (e.g., daily stressors, social interactions) emotional symptoms in everyday life get particularly triggered or dampened in individuals with childhood trauma history? How different psychotherapeutic and pharmacological treatments may impact on affect dynamics?”

The paper, “Day-to-day affect fluctuations in adults with childhood trauma history: a two-week ecological momentary assessment study”, was authored by Erika Kuzminskaite, Christiaan H. Vinkers, Arnout C. Smit, Wouter van Ballegooijen, Bernet M. Elzinga, Harriëtte Riese, Yuri Milaneschi, and Brenda W.J.H. Penninx.