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

BACKGROUND AND AIM: Childhood trauma is a major transdiagnostic risk factor for mood disorders, whereas resilience may mitigate its long-term impact, yet their domain-specific interplay remains poorly defined. This study examined the multidimensional associations between childhood trauma and resilience in major depressive disorder, bipolar disorder, and healthy controls. We tested whether specific trauma subtypes differentially predict distinct resilience domains across diagnostic groups. METHODS: In this cross-sectional study, the final analytic sample comprised 300 participants: 100 healthy controls, 116 individuals with unipolar depression, and 84 individuals with bipolar disorder. Childhood trauma was assessed using the Childhood Trauma Questionnaire, and resilience was measured with the Connor-Davidson Resilience Scale, enabling domain-specific analyses of resilience profiles. RESULTS: Patients with mood disorders showed significantly lower resilience and higher childhood trauma exposure than healthy controls, with no differences between unipolar and bipolar disorder. All resilience domains except Spiritual Influences were reduced in patients. PCA-derived dimensions of resilience and childhood trauma robustly distinguished patients from controls but failed to separate unipolar from bipolar disorder, indicating shared latent vulnerability patterns. Correlation analyses showed inverse associations between childhood trauma and resilience in healthy controls and unipolar depression, but not in bipolar disorder. Across the full sample and within patients only, emotional neglect emerged as the strongest and most consistent independent association with reduced resilience, particularly affecting perceived control, personal competence, positive acceptance of change, and spiritual influences. CONCLUSION: A careful assessment of developmental history, including subtle forms of childhood trauma such as emotional neglect, is essential for understanding resilience differences in mood disorders. Identifying these vulnerabilities may help reveal compromised resilience domains and guide more personalized, resilience-oriented interventions.