Emotion dysregulation accounts for psychopathology associated with emotional abuse but not neglect: A systematic review of mediation studies

Background
Up to one in three children worldwide experience emotional abuse or emotional neglect, a great number of which develop mental health issues in adolescence and adulthood. Although the precise mechanisms by which these psychological consequences arise are still poorly understood, past research has identified difficulties with emotion regulation as an important, transdiagnostic factor that links experiences of childhood emotional abuse and neglect in childhood with later psychopathology. Past research has not sufficiently considered differences between childhood emotional abuse and emotional neglect in this respect, investigating it as one construct instead. Consequently, in this systematic review, we investigate how childhood emotional abuse and neglect are differentially associated with psychopathology through emotion dysregulation in mediation studies.

Methods
A tailored search strategy to identify relevant mediation studies was developed. The search was performed across five databases in May 2025, including citation searches. 33 articles met the inclusion criteria.

Results
Of the identified studies, 32 investigated emotional abuse and 16 emotional neglect. All but one study (97%) found significant indirect effects of emotion dysregulation from emotional abuse towards psychopathology, regardless of clinical status. For emotional neglect, only half of the studies found significant indirect effects of emotion dysregulation towards psychopathology.

Conclusion
Our findings assert the significance of emotion dysregulation in explaining the relationship between emotional abuse and psychopathology. There is less certainty for emotional neglect, a difference which should be explored by future research. Long-term longitudinal studies are needed to support these relationships as a developmental sequelae.