Childhood Maltreatment and Threat Bias: The Moderating Roleof Anxiety, Dysthymia, Depression, and Overall PsychologicalDistress

Introduction: Child labour, prevalent in low- and middle-income countries, harms millions of children globally, often leading to maltreatment. Childhood maltreatment commonly results in attentional bias towards threats; however, bias away from threats has also been observed. Given that psychiatric disorders are also linked with attentional biases, this study aimed to examine how anxiety, depression, dysthymia, and overall psychological distress interact with childhood maltreatment to moderate the association of childhood maltreatment and attentional bias in adolescents with a history of child labour. Materials and Methods: Eighty-six rescued child workers (76 males), aged 12-18 years, participated in this study. Participants were assessed for a history of maltreatment, potential psychiatric diagnoses, emotional and behavioural issues, and completed two computerised tasks: the Spatial Cueing Task (SCT) and the Emotion Visual Search Task (EVST), which evaluated attentional biases towards emotionally-valenced stimuli. Results: Physical abuse was the most commonly reported form of maltreatment, followed by emotional abuse, with 16.28% of participants reporting at least one form of abuse. Anxiety, dysthymia, and overall mental health significantly moderated the association between childhood maltreatment and attentional bias. Participants with high anxiety or dysthymia and low maltreatment severity, and those with low anxiety but high maltreatment severity, displayed attentional focus on negative emotions. Conversely, individuals with severe maltreatment and high mental health issues tended to avoid negative emotions. Discussion: The findings indicate that anxiety, dysthymia, and overall psychological distress influence how childhood maltreatment relates to attentional bias. High anxiety or dysthymia with low maltreatment severity leads to a focus on negative stimuli, while severe maltreatment coupled with high distress results in avoidance of negative emotions. This suggests that mental health conditions shape attentional processing, potentially as a coping mechanism to manage distress. Conclusion: The findings underscore the necessity of routine mental health assessments for rescued child workers living in care homes or with families. Interventions targeting attentional biases could help reduce the risk of progression to mental health disorders in these vulnerable individuals.