3 57 Looking into troubled waters: Childhood emotional maltreatment modulates neural responses to prolonged gazing into one’s own, but not others’, eyes INTRODUCTION Childhood emotional maltreatment (CEM) is common with global prevalence rates between 18.436.3% (Stoltenborgh et al., 2015). It encompasses both emotional abuse (i.e., verbal assaults and demeaning behaviors directed towards children by adults that are harmful for a child’s selfworth) and emotional neglect (i.e., caregivers’ irresponsibility or failure in satisfying children’s basic psychological needs for love, belonging, nurturance, and support) (Bernstein et al., 1994; Bernstein et al., 2003). It is considered one of the most devastating forms of maltreatment due to its chronic exposure pattern from an early age onwards and the involvement of a primary caregiver. CEM gives rise to long-term negative consequences into adulthood (Egeland, 2009; Gilbert et al., 2009; Reyome, 2010; Spertus et al., 2003; van Harmelen et al., 2010). One of these potential outcomes is the development of negative cognitions about the self and others as a result of the perceived betrayal of trust during childhood by a primary caregiver (Baugh et al., 2019). On the one hand CEM may result in the generalization of distrust to others leading to maladaptive other-schemas (e.g., everyone has bad intentions), while on the other hand it may also fuel maladaptive schemas about the self leading to the believe that they are unloved, worthless, or unwanted (Baugh et al., 2019; Gobin & Freyd, 2014). Although studies including a direct comparison between responses to the self and others are sparse, people with a history of CEM seems to be particularly vulnerable to develop negative self-views when compared to other types of maltreatment (i.e., physical or sexual abuse) (Alloy et al., 2006; Gibb, 2002; Gibb et al., 2004; Rose & Abramson, 1992; van Harmelen et al., 2010). In turn, negative self-views put people with a history of CEM at a greater risk for developing internalizing disorders, such as anxiety disorders and depression, and can contribute to interpersonal difficulties and problems in the formation and maintenance of (intimate) relationships (Reyome, 2010; Riggs, 2010; Wright et al., 2009). One of the most prevalent nonverbal, social phenomena known to automatically elicit both self- and other-referential processes is eye contact (Conty et al., 2016). Eye contact with others generally elicits positive feelings (Hietanen, 2018; Wever et al., 2022). However, people who were abused as a child often perceive eye contact as a signal of threat (Krill, 2011; Wilkinson, 2010). Hence, avoiding eye contact may be an automatic response in individuals with CEM as a means to cope with negative affect caused by face-to-face interactions (Tottenham et al., 2011). In addition to social eye contact, gazing into one’s own eyes (e.g., in the mirror) elicits strong emotional responses related to the self in people with low self-esteem, including feelings of shame and disgust (Erdem, 2019; Ypsilanti et al., 2020). However, how a history of CEM may affect the processing of gazing into one’s own eyes has yet to be determined.
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