2026 ECNP Congress

PS02-2128

Domain-specific associations between childhood trauma and resilience in mood disorders: the central role of emotional neglect

Antonio Maria D'Onofrio — R. Calia, F. Pesaresi, L. Moccia, A. Simonetti, M. Pettorruso, G. Martinotti, G. Sani, G. Camardese · Università Cattolica del Sacro Cuore, Department of Neuroscience- Section of Psychiatry, Rome, Italy

2026 ECNP Congress

Background

Childhood trauma is a robust transdiagnostic risk factor for mood disorders, while resilience represents a key protective dimension influencing clinical outcomes. Despite growing interest in their interplay, the domain-specific associations between distinct trauma subtypes and resilience dimensions in mood disorders remain poorly characterized.

Aims

This study investigated how specific childhood trauma domains relate to distinct resilience dimensions in patients with major depressive disorder (MDD) and bipolar disorder (BD), compared with healthy controls (HC).

Methods

A cross-sectional sample of 300 participants was recruited from an academic mood disorders outpatient clinic: 116 with MDD, 84 with BD, and 100 HC. Psychiatric diagnoses were established according to DSM-5 criteria and confirmed using the Mini International Neuropsychiatric Interview. Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ), measuring emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. Resilience was measured with the Connor–Davidson Resilience Scale (CD-RISC), capturing personal competence, trust in one’s instincts, positive acceptance of change, perceived control, and spiritual influences. Group differences were examined using Kruskal–Wallis tests with Dunn–Bonferroni post-hoc comparisons. Principal component analyses (PCA) were conducted separately on resilience, trauma, and combined measures to identify latent dimensional structure. Spearman correlations were computed within each diagnostic group. Multivariable linear regression models, with Bonferroni correction across five parallel models, were fitted to examine the independent contribution of each CTQ domain to each CD-RISC subscale, controlling for age, gender, and diagnosis. All analyses were conducted in R version 4.5.1.

Results

Both MDD and BD patients showed significantly lower resilience across all CD-RISC domains except spiritual influences, and higher childhood trauma exposure across all CTQ domains compared with HC (all p < 0.001), with no significant differences between the two clinical groups. PCA-derived dimensions robustly discriminated mood disorder patients from HC but did not differentiate MDD from BD. Spearman analyses revealed consistent inverse associations between childhood trauma and resilience in HC (total CTQ vs. total CD-RISC: ρ = –0.24, p < 0.05) and MDD (ρ = –0.21, p < 0.05), whereas no significant correlations were observed in BD. Across multivariable regression models, emotional neglect was the only trauma dimension consistently and independently associated with lower resilience after Bonferroni correction, predicting reduced perceived control (β = –0.36, p < 0.0001), personal competence (β = –0.25, p < 0.001), positive acceptance of change (β = –0.23, p < 0.001), and spiritual influences (β = –0.29, p < 0.001) in the full sample, with comparable findings in the patient-only subsample.

Conclusions

Mood disorders are characterized by convergent reductions in resilience and elevated childhood trauma burden, independent of diagnostic polarity. Emotional neglect emerges as the most robust and selective predictor of impaired resilience, particularly in domains reflecting agency, adaptive flexibility, and meaning-based coping. These findings highlight the clinical relevance of assessing subtle forms of early adversity in mood disorders and support the development of resilience-oriented, personalized therapeutic approaches.

References

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