Disentangling Distress Tolerance, Emotion Regulation, and Quality of Life in Childhood Trauma and Adult Anxiety

Childhood trauma has been linked to deficits in functioning and the onset and maintenance of anxiety disorders in adulthood. However, few studies have examined whether transdiagnostic mechanisms relevant to anxiety, namely distress tolerance (DT) and emotion regulation (ER), may differentially explain the relationship between certain types of childhood trauma (i.e., emotional abuse and emotional neglect) and anxiety-related dysfunction. This study examined the relationships among childhood trauma, DT, difficulties in ER, and quality of life (QoL) in a sample of adults (N = 73; 68% female) meeting DSM-IV criteria for generalized or social anxiety disorder. Mediator analyses revealed that DT, but not difficulties in ER, mediated the relationship between childhood emotional neglect and QoL in adulthood; however, when examining emotional abuse instead of neglect, no significant indirect effects were found. Implications for differential pathways for emotional abuse and neglect among adults with anxiety disorders are discussed.