Degree Date

10-2025

Document Type

Dissertation - Public Access

Degree Name

Psy.D. Doctor of Clinical Psychology

Academic Discipline

Clinical Psychology

First Advisor

Emese Vitalis, PhD

Second Advisor

Brad Olson, PhD

Third Advisor

Leah Horvath, PhD

Abstract

This mixed-methods, cross-sectional study investigated the associations between childhood emotional neglect, perfectionism, attachment insecurity, and internalizing symptoms (depression and anxiety) among adults from varying socioeconomic (SES) backgrounds. Participants (N = 210) aged 18 years or older completed five validated self-report instruments for the quantitative analyses and answered two optional open-ended questions that yielded qualitative data. Data from the self-report measures were analyzed using independent samples t-tests, linear regressions, and moderation analyses conducted with the PROCESS macro. Three hypotheses were tested in this study. First, participants from high-SES backgrounds reported experiencing emotional neglect more frequently than other maltreatment subtypes (t = -2.33, p = .021, d = -.34), supporting the hypothesis that emotional neglect may be relevant in high-SES environments. Second, within the high-SES subgroup (n = 61), emotional neglect predicted higher perfectionism (β = .40, R² = .16, p = .001), greater depressive symptoms (β = .36, R² = .13, p = .004), and increased anxiety (β = .41, R² = .17, p < .001). Third, attachment anxiety, but not attachment avoidance, significantly moderated the relationship between emotional neglect and perfectionism (ΔR² = .018, p = .033), with stronger associations observed at higher levels of attachment anxiety. Results from this study challenge assumptions that financial privilege protects children from maltreatment and highlights the importance of looking at both relational factors, such as attachment, and personality factors, such as perfectionism, when attempting to better understand the lasting impact of childhood adversities. Clinical implications include routine screening and culturally sensitive care when working with individuals from high-SES households where emotional neglect may be masked by privilege.

Included in

Psychology Commons

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