The mediating role of personality functioning impairment between childhood maltreatment and adult mental health problems

Background: Childhood maltreatment is a critical societal and public health concern significantly associated with adult mental health outcomes. Recent research suggests that impaired personality functioning may mediate this association.Objective: The aim of the present study was to examine personality functioning impairment (PFI) as a potential mediator between different types of childhood maltreatment and self-reported adult mental health problems in a large community-based sample. In addition, this study sought to identify the domains and subdomains of PFI that have the strongest mediating effects between different types of childhood maltreatment and adult mental health problems.Method: 1,148 adults, with a mean age of 43.49 years (SDage = 5.80; 85.89% female) were included in the analysis. Childhood maltreatment was measured with the Childhood Trauma Questionnaire (CTQ-SF), PFI with the Levels of Personality Functioning Questionnaire – Adult (LoPF-Q Adult), and mental health problems with the Brief Symptom Inventory (BSI-18). Mediation analyses were conducted through structural equation modelling.Results: A total of 352 (30.69%) reported at least one type of childhood maltreatment, with emotional abuse being most common (14.48%). Emotional abuse and neglect showed the strongest association with PFI (r = 0.41 and r = 0.45, p < .001) and adult mental health problems (r = 0.32 and r = 0.30, p < .001). Overall, PFI significantly mediated the effects of all types of childhood maltreatment, but when self- and interpersonal functioning were considered separately, only self-functioning remained a significant mediator.Conclusions: Taken together, the present findings suggest that PFI, particularly self-functioning, may present an important pathway linking childhood maltreatment to adult mental health outcomes. In addition, findings revealed emotional maltreatment to be particularly important in the context of PFI and adult mental health. Integrating trauma-informed practices within community-based child programmes may foster resilience and counteract unfavourable mental health outcomes.