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OPEN Childhood maltreatment

and emotion regulation in everyday
life: an experience sampling study
Andrei Ion 1, Mirela I. Bîlc 2,3, Simina Pițur 2, Claudia Felicia Pop 4,
Aurora Szentágotai‑Tătar 5* & Andrei C. Miu 2*

Childhood maltreatment is a major risk factor for psychopathology, and increasing evidence suggests
that emotion regulation is one of the underlying mechanisms. However, most of this evidence comes
from single assessments of habitual emotion regulation, which may not overlap with spontaneous
emotion regulation in daily life and which fail to account for within-individual variability in emotion
regulation across multiple contexts. In the present study, we investigated the relation between
history of childhood maltreatment, positive and negative affect, and multiple dimensions of
spontaneous emotion regulation (strategy use, emotion regulation goals, emotion regulation success
and effort) in everyday life, using experience sampling method (3 assessments/day, for 10 consecutive
days), in a sample of healthy volunteers (N = 118). Multilevel modeling results indicated that childhood
maltreatment was associated with lower positive affect and higher negative affect. Childhood
maltreatment was also related to lower use of reappraisal and savoring (but not suppression,
rumination and distraction), reduced emotion regulation success (but not effort), as well as lower
levels of and higher within-individual variability of hedonic (but not instrumental) emotion regulation
goals. These results provide ecological evidence for multiple differences in emotion regulation in
individuals with a history of childhood maltreatment.

Childhood maltreatment is associated with increased lifelong risk for virtually all common mental ­disorders1–3.
Recent efforts have focused on uncovering the psychological mechanisms underlying the influence of childhood
maltreatment on vulnerability to ­psychopathology4–6. This issue has major translational implications, especially
considering that individuals with a history of childhood maltreatment may show reduced response to current
mental health i­nterventions7. Identifying the mechanisms underlying the pervasive impact of childhood mal-
treatment will contribute to increasing the specificity of psychological interventions in this vulnerable category
of the population.

Childhood maltreatment and emotion regulation. Emotion regulation (i.e., the processes by which
one attempts to regulate the frequency and intensity of e­ motion8) is one of the candidate mechanisms that
has been extensively examined in relation to maltreatment and psychopathology. An important argument
supporting this hypothesis is that emotion regulation problems have been documented in multiple forms of
­psychopathology9, and may thus explain the transdiagnostic risk associated with childhood maltreatment. Fur-
thermore, the protracted development of emotion regulation, which spans childhood and adolescence, may
make it particularly vulnerable to the detrimental effects of maltreatment occurring during these developmental
­periods10.
Previous studies have generally supported this v­ iew11–13, but their focus on multiple dimensions of emo-
tion regulation and the heterogeneity of theoretical approaches have made it difficult, until recently, to draw a
firm conclusion. A large-scale meta-analysis has examined the relation between childhood maltreatment and
the habitual use of multiple emotion regulation strategies including cognitive reappraisal (i.e., reinterpreting

1
Assessment and Individual Differences – AID Lab, Department of Psychology and Cognitive Science, University
of Bucharest, Bucharest, Romania. 2Cognitive Neuroscience Laboratory, Department of Psychology, Babeș-Bolyai
University, 37 Republicii, 400015 Cluj‑Napoca, CJ, Romania. 3Institute of Medical Psychology, Medical Faculty,
Otto-Von-Guericke University of Magdeburg, Magdeburg, Germany. 4Nursing Discipline, Department Mother
and Child, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj‑Napoca, Romania. 5Department of Clinical
Psychology and Psychotherapy, Babeș-Bolyai University, Cluj‑Napoca, Romania. 6The authors have equally
contributed: Andrei Ion and Mirela I. Bîlc. *email: [email protected]; [email protected]

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an event so as to modulate its emotional impact), rumination (i.e., dwelling on an emotion, the situation that
triggered it or its consequences), expressive suppression (i.e., blocking the expression of emotion) and distrac-
tion (i.e., moving attention away from an emotional event, by thinking about something else or engaging in
another activity)13. Results have indicated that maltreatment is consistently associated with reduced habitual
reappraisal, and increased habitual rumination and expressive suppression. Furthermore, these differences in
emotion regulation have shown a consistent mediator role in the relation between childhood maltreatment and
symptoms of ­psychopathology13.

Moving from habitual to spontaneous emotion regulation. These ­results13 warrant further work in
this area, while also drawing attention to the limitations of the current literature. Until now, the large majority
of studies have relied on single retrospective assessments of the habitual use of emotion regulation (i.e., global,
trait-like assessments of the strategies that are typically used), which, on the one hand, are susceptible to recall
limitations and generalization biases, and, on the other, fail to account for within-individual variability. People
draw on different knowledge when reporting global (e.g., how you think you are in general) versus momentary
(e.g., how you think you are at present) characteristics of e­ motion14, and there is evidence that reports of the
habitual use of emotion regulation strategies have low ecological and discriminant validity in relation to the
spontaneous use of those strategies in daily ­life15–17. For example, self-reported habitual reappraisal predicts not
only reappraisal use in daily life, but also rumination and suppression ­use16. Furthermore, habitual measures
may also reflect other aspects of emotion regulation, such as its success: the self-reported frequency of using
reappraisal "in general", for instance, shows a positive, albeit modest association with the efficiency of using reap-
praisal to modulate emotion in laboratory ­tasks18,19. Overall, evidence suggests that habitual measures poorly
predict momentary measures of emotion regulation, and the former may capture differences in multiple stages
of emotion regulation (e.g., selection, implementation). Failing to account for within-individual variability is
another limit of previous studies considering that there is considerable emotion regulation variability over con-
texts and ­time20,21.
Experience sampling method (ESM) offers an alternative approach, which has been increasingly used in
studies on emotion and p ­ sychopathology22,23. In addition to capitalizing on ecological validity, this approach
involves multiple assessments of recent experience, with the obvious advantages of reducing recall biases and of
accounting for both within-, and between-individual v­ ariance24. However, to date, there is a dearth of evidence
on childhood maltreatment and emotion and emotion regulation using this approach. For example, several
studies have employed ESM to investigate the impact of childhood adversity on negative and positive affect, with
heterogeneous results. ­Some25–27, but not all ­studies28–30 found increased negative affect in individuals with a his-
tory of childhood maltreatment. Similarly, some studies reported lower l­ evels25 or higher v­ ariability30 of positive
affect in childhood maltreatment, while other studies failed to replicate this a­ ssociation27,29. In which emotion
regulation is concerning, there is very limited data from field studies. To our knowledge, there is only one diary
­study31 which assessed expressive suppression in relation to stressful events that happened throughout the day,
for seven consecutive days. Results indicated that history of emotional abuse was associated with increased use
of suppression, particularly in individuals with lower vagal flexibility and higher attentional c­ apacity31.

The present study. Childhood maltreatment, affect and emotion regulation strategies. The present study
used ESM to assess positive and negative affect, as well as the use of multiple emotion regulation strategies
(i.e., reappraisal, distraction, savoring, rumination, suppression) three times a day, for ten consecutive days,
in a sample of healthy volunteers in which history of childhood maltreatment was characterized. In line with
previous ESM studies on positive and negative a­ ffect25, we expected that childhood maltreatment would be as-
sociated with increased negative affect and decreased positive affect. In addition, we predicted, based on our
recent meta-analysis13 (but also mindful of the differences between habitual measures of emotion regulation,
and spontaneous emotion regulation in daily ­life16,17), that childhood maltreatment would be associated with
reduced use of reappraisal, and increased use of rumination and suppression. We also assessed savoring, an
emotion regulation strategy typically aimed at enhancing positive ­emotions32, and expected that the use of this
strategy was negatively associated with maltreatment. In which distraction was concerned, we did not have a
hypothesis, considering that this strategy has proven to be adaptive in some, but not all c­ ontexts33, and meta-
analytic results on habitual distraction failed to show a consistent association with childhood ­maltreatment13.
Notably, we examined the relation between history of childhood maltreatment and differences in the use of
emotion regulation strategies, characterized at both the within-individual (i.e., variation in the use of a strategy
from one situation to another) and the between-individual (i.e., variation in the use of a strategy across contexts,
from one person to another) level.

Childhood maltreatment and emotion regulation variability. Recent perspectives on emotion regulation have
emphasized that no single emotion regulation strategy is efficient in all situations, and that future efforts should
focus on emotion regulation flexibility or the capacity to adapt emotion regulation to situational d ­ emands34–36.
Several studies have shown that reduced flexibility in expressing and suppressing emotions (i.e., switching from
one behavior to the other, as demanded by the situation), for instance, is associated with poor mental ­health37–39.
Using similar laboratory measures, we have also found that people with a history of childhood maltreatment
show reduced expressive ­flexibility40. However, the topic of emotion regulation flexibility has been examined
relatively little in spontaneous emotion regulation and everyday life.
A recent ESM ­study41 proposed an approach to studying emotion regulation variability (i.e., a superordinate
concept relative to flexibility) by using standard deviations of the distribution of emotion regulation measures in
order to estimate between-strategy variability (i.e., variability in the level of employing multiple strategies at one

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occasion) and within-strategy variability (i.e., variability in the level of employing a single strategy across occa-
sions). The results of this s­ tudy41 suggested that variability in the emotion regulation strategies that are employed
in the same situation may be adaptive, considering its association with reduced negative affect.
In keeping with this study, we examined the relations between childhood maltreatment and emotion regula-
tion variability in the present analyses. Given the breadth of emotion regulation measures in the present study
and the novelty of the topic, we also investigated the links between emotion regulation variability and affect,
emotion regulation goals, and emotion regulation success and effort.

Childhood maltreatment and emotion regulation goals. Another aim of this study was to examine the relations
between childhood maltreatment and emotion regulation goals. According to the process model of emotion
­regulation8, the activation of an emotion regulation goal (i.e., why we choose to regulate emotion) is the start-
ing point of emotion regulation efforts. Emotion regulation goals have generally been categorized into hedonic
(e.g., regulating emotions so as to feel better) and instrumental (e.g., regulating emotions so as to facilitate per-
formance and maintain social connections)42. Evidence suggests that hedonic goals are associated with the use
of strategies such as reappraisal and distraction, but not suppression, and that instrumental goals are associated
with the use of r­ eappraisal43. However, to our knowledge, no study until now has investigated whether history
of childhood maltreatment is related to differences in emotion regulation goals. We propose two alternative
hypotheses, according to which maltreatment could be associated either with lower levels of hedonic emotion
regulation goals (i.e., a hypothesis consistent with anhedonia in maltreatment and ­psychopathology44,45) or with
higher levels of hedonic motives (i.e., an alternative hypothesis consistent with exaggerated self-focus46,47).

Childhood maltreatment and emotion regulation success and effort. The present study also investigated the rela-
tion between childhood maltreatment and emotion regulation success and effort. An extensive literature indi-
cates that maltreatment is associated with reduced self-reported efficiency in emotion regulation, as reflected
by perceived difficulty in controlling cognitive performance and social behavior in the presence of e­ motion13.
However, all previous studies have used global assessments of emotion regulation success, and single measures.
Therefore, it remains to be examined whether multiple momentary assessments of emotion regulation success,
as employed in the present ESM study, paint a similar picture, and whether differences reside at the between-
or within-individual level. Finally, evidence of increased prefrontal activity during reappraisal in childhood
­maltreatment48 were taken to suggest that people with a history of maltreatment may employ additional effort
in emotion regulation. In the present study, we investigated this hypothesis based on self-reports of effort in
emotion regulation.

Results
Descriptive and preliminary analyses. Table 1 shows the childhood maltreatment scores and their dis-
tribution into severity categories. Overall, 58.50% of participants had scores above the low-to-moderate thresh-
old for at least one type of maltreatment.
In the ESM, the average questionnaire completion rate was 88.90%. No incomplete entries (participants com-
pleting only part of the survey on any given occasion) were observed. The number of occasions when participants
failed to fill in the questionnaire ranged between 0 and 13, with an average of 3.33 occasions. The intra-class
correlations (ICCs), which indicate the proportion of variance at the between-individual level, ranged between
0.16 for savoring, and 0.52 for instrumental emotion regulation goals, with a mean of 0.32 across measures. This
suggests that there was variance in affect and emotion regulation, at both the between- and the within-individual
level (see Tables 2, 3, 5, 6).

Relations between emotion regulation and affect. We examined the relations between emotion reg-
ulation strategies, and between emotion regulation strategies, on the one hand, and affect, emotion regulation
goals, and emotion regulation success and effort, on the other hand. All results are described in Supplementary
Tables 1–4.

Relations among emotion regulation strategies. We first analyzed the associations between emotion regulation
strategies (see Supplementary Table 1). At the between-individual level, there were significant positive associa-
tions between all strategies, with the exception of savoring, which did not significantly correlate with any of

Severity categories (frequency and %)

CTQ subscale Mean score (± SEM) None (or minimal) Low to moderate Moderate to severe Severe to extreme
Emotional abuse 9.43 ± 4.75 67 (56.78) 29 (24.58) 8 (6.78) 14 (11.86)
Physical abuse 6.43 ± 2.71 99 (83.90) 10 (8.47) 3 (2.54) 6 (5.08)
Sexual abuse 5.64 ± 2.26 102 (86.44) 7 (5.93) 4 (3.39) 5 (4.24)
Emotional neglect 10.01 ± 4.56 67 (56.78) 26 (22.03) 16 (13.56) 9 (7.63)
Physical neglect 6.16 ± 2.19 100 (84.75) 9 (7.63) 6 (5.08) 3 (2.54)

Table 1.  Childhood maltreatment scores and severity categories. CTQ, Childhood Trauma Questionnaire;
SEM, standard error of the mean.

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Within-individual level Between-individual level

Dimension Parameter Unstandardized estimate SE p Unstandardized estimate SE p
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.01 0.01 0.680 0.25** 0.26 0.006
Negative affect (ICC = 0.37)
Residual variance 0.99*** 0.00 0.000 0.94*** 0.04 0.000
R2 0.00 0.00 0.837 0.00 0.00 0.907
Intercept – – – 3.08** 0.09 0.050
CTQ Total −0.01 0.02 0.814 −0.19*** 0.09 0.000
Positive affect (ICC = 0.27)
Residual variance 0.99*** 0.00 0.000 0.97*** 0.03 0.000
R2 0.00 0.00 0.987 0.03 0.05 0.326

Table 2.  Within-person and between-person relations between childhood maltreatment and negative
and positive affect. *p < .05. **p < .01. ***p < .001. CTQ, Childhood Trauma Questionnaire; ICC, intra-class
correlation; SE, standard error.

Within-individual level Between-individual level

Dimension Parameter unstandardized estimate SE p unstandardized estimate SE p
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.02 0.03 0.198 0.02 0.10 0.856
Suppression (ICC = 0.28)
Residual variance 0.99*** 0.00 0.000 0.99*** 0.01 0.000
R2 0.00 0.00 0.520 0.00 0.00 0.927
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.02 0.02 0.344 0.02 0.10 0.800
Distraction (ICC = 0.28)
Residual variance 0.99 0.00 0.000 0.99*** 0.01 0.000
R2 0.00 0.00 0.636 0.00 0.01 0.899
Intercept – – – 3.08*** 0.22 0.000
CTQ Total − 0.02 0.02 0.266 –0.28** 0.09 0.005
Savoring (ICC = 0.16)
Residual variance 0.99*** 0.00 0.000 0.92*** 0.05 0.000
R2 0.00 0.00 0.578 0.07 0.05 0.159
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.05 0.02 0.790 −0.16** 0.09 0.005
Reappraisal (ICC = 0.32)
Residual variance 0.99*** 0.00 0.000 0.97*** 0.03 0.000
R2 0.00 0.00 0.894 0.03 0.03 0.395
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.01 0.02 0.663 −0.06 0.10 0.529
Rumination (ICC = 0.31)
Residual variance 0.99*** 0.00 0.000 0.99*** 0.01 0.000
R2 0.00 0.00 0.898 0.01 0.01 0.753

Table 3.  Within-individual and between-individual relations between childhood maltreatment and emotion
regulation strategies. *p < .05. **p < .01. ***p < .001. CTQ, Childhood Trauma Questionnaire; ICC, intra-class
correlation; SE, standard error.

the other strategies. That is, individuals tended to use similar levels of reappraisal, distraction, rumination and
suppression, but the use of savoring was independent of the other emotion regulation strategies. At the within-
individual level, there were again significant positive associations between suppression, distraction, reappraisal
and rumination. Savoring correlated negatively with the use of these strategies at the within-individual level.
These results suggest that in situations in which reappraisal, distraction, rumination and suppression were used
at higher levels, savoring was used at lower levels.

Relations between emotion regulation strategies and affect. The use of suppression, distraction, and rumination
was positively associated with negative affect at the between-individual level (see Supplementary Table 2). In a
complementary fashion, reappraisal and savoring were positively associated with positive affect at the between-
individual level. That is, individuals who used higher levels of suppression, distraction and rumination reported
higher levels of negative affect, whereas those who use reappraisal and savoring reported higher levels of positive
affect. At the within-individual level, suppression and rumination, as well as distraction and reappraisal, were
positively associated with negative affect, whereas savoring was negatively associated with negative affect. In
other words, in situations in which suppression and rumination, distraction and reappraisal were increasingly
used, and in which savoring was used at lower levels, there was more negative affect. At the within-individual
level, savoring and suppression were positively associated, and distraction and rumination were negatively asso-

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ciated with positive affect. Therefore, higher levels of positive affect were reported in situations in which savoring
and suppression were used at higher levels, and distraction and rumination at lower levels.

Relation between emotion regulation strategies and emotion regulation goals. There were also significant asso-
ciations between the use of emotion regulation strategies and emotion regulation goals (see Supplementary
Table 3). At the between-individual level, suppression, distraction, and rumination were positively associated
with instrumental goals. Reappraisal was positively associated with hedonic goals. That is, individuals who
reported using suppression, distraction and rumination at higher levels also reported that their emotion regula-
tion efforts were increasingly motivated by performance-related and social goals, for instance. Those who used
higher levels of reappraisal reported that their emotion regulation efforts were motivated by feeling better. At
the within-individual level, the use of suppression, distraction, reappraisal, and rumination was positively asso-
ciated with instrumental goals. Distraction, savoring, reappraisal, and rumination were positively associated
with hedonic goals. This suggests that situations in which emotion regulation efforts were motivated by either
instrumental or hedonic goals did not differ in terms of the emotion regulation strategies that were used, with
the sole exception of suppression, which seemed to be specifically associated with performance or social goals.

Relation between emotion regulation strategies and emotion regulation success and effort. At the between-indi-
vidual level, the use of suppression and distraction was positively associated, and the use of rumination was
negatively associated with the perceived success of emotion regulation (see Supplementary Table 4). The use of
distraction and rumination was positively associated with emotion regulation effort, also at the between-indi-
vidual level. Overall, those who used suppression and distraction reported better success in regulating emotions,
in contrast to those who use rumination. People who used higher levels or distraction and rumination reported
that emotion regulation was more taxing. At the within-individual level, suppression, distraction, savoring and
reappraisal were positively associated, and rumination was negatively associated with emotion regulation suc-
cess. Suppression, distraction, reappraisal, and rumination were positively associated, and savoring was nega-
tively associated with emotion regulation effort, also at the within-individual level. These results suggested that
in situations that involved the use of any of the strategies except rumination, emotion regulation was perceived
as more efficient. Those which involved the use of any of the strategies except savoring were perceived as more
effortful.

Childhood maltreatment, affect and emotion regulation. Childhood maltreatment and affect. At
the between-individual level, childhood maltreatment was significantly related to both positive affect and nega-
tive affect (Table 2). As expected, participants with higher levels of childhood maltreatment reported lower
positive affect and higher negative affect (Fig. 1). At the within-individual level, the relations between childhood
maltreatment and both positive and negative affect were not significant.

Childhood maltreatment and emotion regulation strategies. At the between-individual level, significant nega-
tive associations were observed between childhood maltreatment and both savoring and reappraisal (Table 3).
In other words, people with higher levels of maltreatment reported using less savoring and reappraisal (Fig. 2).
No significant associations at the between-individual level were observed between childhood maltreatment and
suppression, distraction and rumination. At the within-individual level, no significant relationships were found.

Childhood maltreatment and emotion regulation variability. We also analyzed the associations between child-
hood maltreatment and indices of emotion regulation variability (i.e., between- and within-strategy variability).
Maltreatment was not significantly associated with between-strategy variability (r = 0.01, p = 0.242). However,
maltreatment was positively associated with variability within-distraction, but not the other four emotion regu-
lation strategies, after accounting for the mean level of strategy endorsement (Table 4). That is, level of maltreat-

Figure 1.  The association between childhood maltreatment and positive affect (A) and negative affect (B).
CTQ, Childhood Trauma Questionnaire.

Figure 2.  The association between childhood maltreatment savoring (A) and reappraisal (B). CTQ, Childhood
Trauma Questionnaire.

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Within-suppression SD Within-distraction SD Within-savoring SD Within-reappraisal SD Within-rumination SD

Step β R2 ∆ R2 β R2 ∆ R2 β R2 ∆ R2 β R2 ∆ R2 β R2 ∆ R2
Intercept 0.51*** 0.303 – 1.03*** 0.011 – 0.65*** 0.181 – 0.85*** 0.043 – 0.49*** 0.311 –
1
Mean ER Endorsement 0.27** 0.05 0.25*** 0.09* 0.26***
Intercept 0.42*** 0.308 0.005 0.82*** 0.053 0.042* 0.82*** 0.192 0.011 0.78*** 0.046 0.003 0.61*** 0.321 0.010
2 Mean ER Endorsement 0.27* 0.04 0.24*** 0.09* 0.26***
CTQ 0.01 0.06* –0.01 0.01 –0.01

Table 4.  The relation between childhood maltreatment and within-strategy variability (after controlling for
mean strategy endorsement). SD, standard error.

Within-individual level Between-individual level

Dimension Parameter Unstandardized estimate SE p Unstandardized estimate SE p
Intercept – – – 3.08*** 0.22 0.000
Instrumental motives CTQ Total 0.03 0.02 0.108 − 0.11 0.09 0.268
(ICC = 0.52) Residual variance 0.99*** 0.00 0.000 0.98*** 0.02 0.000
R2 0.00 0.00 0.422 0.01 0.02 0.580
Intercept – – – 3.08*** 0.22 0.000
Hedonic motives CTQ Total 0.05** 0.09 0.007 − 0.25** 0.09 0.006
(ICC = 0.39) Residual variance 0.99*** 0.00 0.000 0.93 0.04 0.000
R2 0.01 0.01 0.613 0.00 0.01 0.808

Table 5.  Within-individual and between-individual relations between childhood maltreatment and emotion
regulation goals. * p < .05. ** p < .01. *** p < .001. CTQ, Childhood Trauma Questionnaire; ICC, intra-class
correlation; SE, standard error.

ment was related to more fluctuation in using distraction from one situation to another, irrespective of whether
this strategy was used more or less often across situations.

Childhood maltreatment and emotion regulation goals. Childhood maltreatment was negatively associated
with hedonic emotion regulation goals at the between-individual level (Table 5 and Fig. 3A). In contrast, mal-
treatment was positively associated with hedonic emotion regulation goals at the within-individual level. These
results suggest that, when regulating emotion, people with higher levels of maltreatment are less driven by goals
that focus on improving their affective state. In addition, their hedonic motivation in emotion regulation showed
higher variability from one occasion to another. No significant associations were found between childhood mal-
treatment and instrumental goals, neither at the between-individual, nor at the within-individual level.

Childhood maltreatment and emotion regulation success and effort. As expected, childhood maltreatment was
negatively associated with emotion regulation success at both the between-individual, and the within-individual
level (Table 6 and Fig. 3B). Therefore, people with higher levels of maltreatment reported less success in emotion
regulation, and this pattern of reduced emotion regulation efficiency was more constant from one situation to
another in them. No significant associations between maltreatment and emotion regulation effort were found,
at neither level of analysis.

Discussion
The present study offers a comprehensive description of emotion regulation in relation to history of childhood
maltreatment, including differences in the use of multiple emotion regulation strategies, in emotion regulation
goals, in emotion regulation success and effort. Notably, some of these differences have not been examined until
now in relation to childhood maltreatment, and highlight novel aspects of emotional vulnerability in individuals
with a history of maltreatment. These results also extend the limited ESM literature on childhood maltreatment,

Figure 3.  The association between childhood maltreatment and hedonic emotion regulation goals (A) and
emotion regulation success (B). Abbreviation: CTQ, Childhood Trauma Questionnaire.

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Within-individual level Between-individual level

Dimension Parameter Unstandardized estimate SE p Unstandardized estimate SE p
Intercept – – – 3.82*** 0.22 0.000
CTQ Total − 0.04* 0.02 0.038 − 0.17** 0.94 0.050
Success (ICC = 0.29)
Residual variance 0.97*** 0.00 0.000 0.97*** 0.03 0.000
R2 0.01 0.00 0.299 0.03 0.03 0.365
Intercept – – – 3.08*** 0.22 0.000
CTQ Total 0.01 0.02 0.311 0.05 0.09 0.626
Difficulty (ICC = 0.31)
Residual variance 0.99*** 0.00 0.000 0.99*** 0.01 0.000
R2 0.00 0.00 0.613 0.00 0.01 0.808

Table 6.  Within-individual and between-individual relations between childhood maltreatment and emotion
regulation success and difficulty. *p < .05. **p < .01. ***p < .001. CTQ, Childhood Trauma Questionnaire; ICC,
intra-class correlation; SE, standard error.

and argue for an increased focus on spontaneous emotion regulation. Some, but not all results from previous
studies on habitual emotion regulation have been replicated in the present study, which is in line with the view
that global and momentary measures of emotion regulation do not always overlap.
The wide range of measures allowed us to describe the relations between multiple dimensions of emotion
regulation, and their association with affect. One finding was that the use of savoring was independent from or
negatively correlated with the use of reappraisal, distraction, rumination and suppression. This is in line with
previous studies, which have suggested that, in relation to positive emotions, savoring is used to enhance them,
whereas the other four strategies are typically used to dampen t­ hem32. Another difference may relate to the level
of engagement with emotion: savoring may involve attending and directly responding to emotion, whereas
rumination, suppression, and distraction may entail avoiding ­emotion49. The present results also showed that
using suppression, rumination and distraction at higher levels was associated with more negative affect, and
using savoring at higher levels was associated with more positive affect (for similar results, ­see49). Hedonic and
instrumental emotion regulation goals were associated with the use of similar strategies, with the exception of
suppression which was related, in the present study and in previous w ­ ork43, to instrumental goals. The pattern
of self-reported emotion regulation success and effort suggested that rumination was perceived as less efficient
(and indeed, that is not surprising given that, as one reviewer noted, forms of rumination such as brooding
could be conceptualized as emotion regulation failures), and savoring was perceived as less effortful. Due to
the relatively long intervals (i.e., up to 3 h) between assessments, we could not examine the temporal dynamics
of emotion and emotion regulation. This remains a challenge for future studies, with shorter intervals between
assessments, that would allow for the effect of emotion regulation at one occasion to carry over emotion at the
next occasion (or vice versa).
Childhood maltreatment was associated with increased negative affect and decreased positive affect in this
study. This pattern has also been reported in previous ESM studies on mood disorders and p ­ sychosis22,50, for
instance, which underscores the potential involvement of negative and positive affect in the link between child-
hood maltreatment and transdiagnostic risk of psychopathology. However, not all previous studies on childhood
maltreatment have replicated this p ­ attern28–30. It is difficult to speculate on the possible reasons for these incon-
sistencies given the multiple methodological differences between studies, but it is noteworthy that the ­studies25
that found significantly increased negative affect and significantly decreased positive affect took a dimensional
approach to childhood maltreatment. Dichotomous measures (e.g., checklists) and the practice of dichotomizing
originally continuous maltreatment scores based on a threshold (e.g., severity) are known to reduce power and
have been previously c­ riticized51,52.
This study supported part of our hypotheses on emotion regulation strategies. Specifically, we expected and
found that childhood maltreatment was associated with reduced use of reappraisal and savoring. Reappraisal
is an emotion regulation strategy that is typically efficient in reducing negative e­ motions53,54, whereas savoring
is known to efficiently increase positive e­ motions55. Therefore, lower use of these strategies in daily life may
partially account for the pattern of increased negative affect and decreased positive affect that we and others
have observed in association with childhood maltreatment. However, the present results failed to support the
more frequent use of rumination and expressive suppression at higher levels of maltreatment. Our previous
meta-analysis on habitual emotion r­ egulation13 suggested that increased use of rumination and suppression are
consistently associated with childhood maltreatment, and these effects are typically larger than the association
with reduced reappraisal. Why, then, were we able to find only the latter effect? One explanation may be related
to the characteristics of the present sample, which only included putatively healthy young adults who navigated
a typical school environment throughout the sampling interval. This may have involved relatively lower levels of
negative affect, which are known to promote an increased use of r­ eappraisal56. Another explanation may relate
to the differences between habitual and momentary measures of emotion ­regulation16,17. Future ESM studies
could ideally examine the association between childhood maltreatment and use of emotion regulation strategies
in representative samples of the population and in more heterogeneous contexts.
We also found that childhood maltreatment was associated with larger variability in using distraction over
different contexts. A previous ­study41 found a negative association between within-strategy variability and nega-
tive affect, which suggested that using different levels of the same strategy across different occasions may be

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adaptive. However, this study collapsed within-strategy variability across multiple strategies, and controlled
for depressive symptoms. In light of this ­study41, the present result is difficult to interpret, but it opens the way
for further studies on maltreatment and emotion regulation variability and flexibility. We argue that, in light of
burgeoning evidence on the association between emotion regulation flexibility and risk of ­psychopathology37,39,
this topic should be increasingly investigated in research on maltreatment.
Another novel finding is that childhood maltreatment was associated, at the between-individual level, with
reduced hedonic goals in emotion regulation (i.e., modulating emotion so as to feel better), and, at the within-
individual level, with increased variability in hedonic emotion regulation goals. Goals are fundamental in high-
lighting which emotions should be modulated and in which direction (i.e., increase or decrease)57. For instance,
when talking to a friend who has lost someone and expresses sadness, once we realize that we are also starting
to experience sadness, we may choose to downregulate this emotion for hedonic reasons (e.g., feeling less bad),
or upregulate it for instrumental reasons (e.g., show empathy). In the same example, if something had made us
happy before we met this sad friend, we may choose to downregulate happiness or not, depending on whether
we are motivated by instrumental or hedonic goals. Recent evidence suggests that emotion goals are altered in
psychopathology, with depressed patients reporting that they generally want to feel less happy and more sad,
and also being twice as likely to use reappraisal to increase their emotional reactions to sad pictures compared
to non-depressed c­ ontrols58. This may also be the case of individuals with a childhood maltreatment history, as
suggested by the blunted motivation to regulate emotions in order to feel better. The higher variability of this
motivation over time may also be related to higher positive affect variability, which has been previously reported
in childhood m ­ altreatment30.
The present results also show that childhood maltreatment is associated with reduced perceived emotion
regulation success in daily life. This in in line with previous evidence from studies using dispositional (habitual)
measures, which have indicated a consistent association between childhood maltreatment and increased self-
reported emotion regulation difficulties (as well as decreased emotion regulation abilities)13. Emotion regulation
effort was not related to childhood maltreatment in this study. A previous s­ tudy6 suggested that individuals with
a history of maltreatment may expend increased effort when using reappraisal, but this was based on neural
activity rather than subjective reports and it involved a laboratory task in which participants were instructed to
use reappraisal (i.e., reappraisal ability) rather than spontaneously using reappraisal, as in this study.
The main limitation of this study is related to the focus on a student sample, which puts into question the gen-
eralizability of these results. The reason for choosing this sample was to maximize compliance with the intensive
10-day ESM design. Another reason was that this sample was followed up on the occasion of an exam, with the
aim of investigating the relations between spontaneous emotion regulation in daily life and during acute stress
(these data will be reported in another manuscript). Generalizability is also limited by the asymmetric sex dis-
tribution, with most of the present sample being women. Another limit, in our opinion, is related to not having
collected data about the contexts. Previous s­ tudies59,60 have assessed daily events and found greater emotional
reactivity in childhood maltreatment, with both higher negative affect and positive affect following negative and
positive events, respectively. Our focus (and indeed, one of the sources of novelty in this study) was on emotion
regulation, and we chose to include more items on the characteristics of this domain. ESM questionnaires need
to be kept as short as possible in order to limit the interruption of current a­ ctivities24. It is noteworthy that, for
theoretical reasons discussed ­elsewhere13,61, we chose to focus on cumulative childhood maltreatment, rather than
examine the putatively specific effects of different forms of maltreatment. Briefly, in light of evidence of signifi-
cant co-occurrence of multiple forms of maltreatment, disentangling their effects seems empirically unrealistic.
In conclusion, these results indicate that childhood maltreatment is associated with emotion regulation dif-
ferences in daily life, at multiple levels including strategy selection, goals, and overall efficiency. They support
the view that emotion regulation is one of the important domains that could shed light on the mechanisms
between childhood maltreatment and risk of psychopathology. We argue that focusing on process measures of
emotion regulation is crucial for identifying targets for the next generation of mental health interventions in
childhood maltreatment.

Methods
Participants. The present sample included N = 118 participants (82.76% women; age M = 19.65, range
18–33 years). They were all students enrolled in the same course. We did not run an a priori sample size estima-
tion. However, it is noteworthy that there is little consensus on the methods of estimating sample size a priori in
multilevel ­models62–64, and current recommendations rely on common practice in previous studies. For instance,
Gabriel and ­colleagues62 reviewed sample size in over 100 ESM studies published in top-tier journals. They found
that the mean level 2 (between-individual) sample size was 83, and the mean level 1 (within-individual) sample
size was 835, and recommended that studies should aim for at least these sample sizes. The present sample is
comparable to those in other ESM studies, and exceed the suggested sample size necessary for Level 1 and Level
2 ­inferences62. Before the beginning of the study, participants were informed about the procedure and signed an
informed consent. All measures were collected, stored and analyzed anonymously, in line with the Declaration
of Helsinki recommendations. The study was approved by the Ethical Committee of Babeș-Bolyai University,
as part of the co-first author (M.I.B.) Ph.D. thesis, under the supervision of the senior author (A.C.M.). Course
credit was provided for participation in this study.

Measures. Childhood maltreatment. Childhood maltreatment was assessed using the short form of the
Childhood Trauma Questionnaire (CTQ)65,66. This scale includes 25 items (rated on 5-point Likert scale ranging
from 1 = never true to 5 = very often true) assessing multiple forms of abuse and neglect while the respondent
was growing up: (1) emotional abuse (i.e., “verbal assaults on a child’s sense of worth or well-being or any humili-

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ating or demeaning behavior directed toward a child by an adult or older person”); (2) sexual abuse (i.e., “sexual
contact or conduct between a child younger than 18 years of age and an adult or older person”); (3) physical
abuse (i.e., “bodily assaults on a child by an adult or older person that posed a risk of or resulted in injury”);
(4) emotional neglect (i.e., “the failure of caretakers to meet children’s basic emotional and psychological needs,
including love, belonging, nurturance, and support”); and (5) physical neglect (i.e., “the failure of caretakers to
provide for a child’s basic physical needs, including food, shelter, clothing, safety, and health care”)65, p. 175. A total
childhood maltreatment score was calculated by summing the five subscale scores, showing good reliability in
the present sample (Cronbach’s alpha = 0.89).

Experience sampling questionnaire. The ESM questionnaire was adapted from established emotion (e.g.,
Positive and Negative Affect S­ chedule67) and emotion regulation (e.g., Emotion Regulation Q ­ uestionnaire68;
69
Response Style ­Questionnaire ) scales, and included items related to: (1) positive (i.e., happiness/joy, surprise,
pride) and negative (i.e., anger, sadness, fear/anxiety, shame, guilt, boredom, disgust) affect (how did you feel
since the last beep?), rated on 5-point Likert scale (ranging from 0 = not at all, to 5 = very much); (2) emotion
regulation strategies (what did you do to try to change your emotions?), including: (i) distraction (I tried to redirect
my attention to something else), (ii) savoring (I tried to savor my emotions as much as possible), (iii) cognitive reap-
praisal (I tried to see the situation in a different way), (iv) rumination/reflection (I tried, but I couldn’t stop thinking
about what happened), and (v) expressive suppression (I tried not to show my emotions to others), all rated on a
5-point Likert scale (ranging from 0 = not at all, to 5 = very much); (3) emotion regulation goals (why did you try
to change your emotions?): hedonic (1 item: to feel better) and instrumental (3 items: to maintain appearances; to
make others feel better; to focus on what I needed to do), all rated on a 5-point Likert scale (ranging from 0 = total
disagreement, to 5 = total agreement); (4) emotion regulation success (how well did you succeed to change your
emotions?), rated on a 5-point Likert scale from 0 = not at all, to 5 = very well); and (5) emotion regulation effort
(how hard was it to change your emotions?), rated on a 5-point Likert scale from 0 = not at all, to 5 = very much).
In the case of items with multiple answers (i.e., affect, emotion regulation strategies, emotion regulation goals),
all answers were rated.

Procedure. The study took place during the course of the semester, in November 2018, at Babeș-Bolyai
University. The Personal Analytic Companion (PACO) mobile app was used to schedule and administer ques-
tionnaires. Before the study, participants attended a training session in which questionnaire items (e.g., con-
struct definitions, response options) and the procedure were carefully explained. Once the study started, the app
prompted participants 3 times per day, for 10 consecutive days, including workdays and weekends. Notifications
were sent at random times between 10 AM and 8 PM, with a minimum of 60 min between notifications. At
each sampling moment, participants were directed to a short questionnaire assessing multiple characteristics of
emotions (i.e., emotional experience, the use of emotion regulation strategies, emotion regulation goals, overall
emotion regulation efficiency and effort) that occurred in the time interval since the last notification. After each
notification, participants had 20 min to respond, otherwise the response was registered as missing data.

Statistical analysis. In order to describe childhood maltreatment, we categorized CTQ scores based on the
severity cutoffs reported in the scale ­manual66. Notably, the low-to-moderate cutoff has the highest sensitivity,
while keeping the specificity level to an acceptable level (> 80%). This cutoff allows one to identify participants
with any level of maltreatment, which is in line with the goals of the present study. However, continuous CTQ
scores were used in the main analysis.
To exploit the hierarchical structure of the data (three daily measurement occasions nested into persons),
we employed a multilevel modeling technique. This analysis is effective in disentangling between- and within-
individual effects, and in handling missing ­data70. Grand-mean centering was employed. Following the approach
outlined by K ­ leiman71, first, we first ran unconditional models (“intercept-only” models) in order to ensure that
there is sufficient between-participant supporting the deployment of multi-level modeling as our main data
analysis approach. The corresponding ICCs derived via the unconditional models are reported in Tables 2–3
and 5–6. Next, we ran a two-level random intercept model, where childhood maltreatment predicted the various
outcomes pertaining to affect or to emotion regulation: positive affect, negative affect, emotion regulation strate-
gies, emotion regulation goals, and emotion regulation success and effort. An additional outcome was emotion
regulation variability, as reflected by two indices calculated based on the standard deviations of the emotion
regulation strategy items: the between-strategy variability (i.e., variation in the level of using multiple strategies
at each measurement occasion) and the within-strategy variability (i.e., variation in the level of using the same
strategy over different contexts and time). All the formulas are presented in Blanke et al.41, and have been used
without modification. The only exception is that instead of calculating a global within-strategy variability across
all strategies, we calculated this index for each separate strategy. As r­ ecommended41, we controlled for the mean
endorsement level of the corresponding strategy in all analyses focused on within-strategy variability. All the
paths between the independent (childhood maltreatment) and the dependent variables (positive/negative affect,
emotion regulation strategies, emotion regulation variability, emotion regulation goals, and emotion regulation
success and effort) were estimated at both levels of analysis (within- and between-individual). We report stand-
ardized parameter estimates in order to indicate how much of the actual level of change in the outcome (e.g.,
emotion regulation) variables corresponds to the change in childhood trauma (measured in standard deviations).
All the estimators were derived by employing maximum likelihood estimator. Analyses were conducted using
Mplus version 7­ 72.

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Data availability
The data analyzed in current study are not publicly available due the fact that they are part of a larger dataset that
is subject to other ongoing analyses (with a different focus), but are available from the corresponding authors
on reasonable request.

Received: 12 October 2022; Accepted: 27 April 2023

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Acknowledgements
This work was funded through grants PN-III-P4-ID-PCE-2020-2609 (Andrei Miu), PN-III-P1-1.1-TE-2019-1243
(Andrei Ion) and PN-III-P4-ID-PCE-2020-2894 (Aurora Szentágotai-Tătar) from the Romanian Ministry of
Education and Research, CNCS – UEFISCDI. CNCS—UEFISCDI had no role in the study design, collection,
analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Author contributions
(CREDIT roles): A.I.: Conceptualization; Data curation; Formal analysis; Funding acquisition. M.I.B.: Concep-
tualization; Data curation; Formal analysis; Project administration. S.P.: Data curation; Formal analysis. C.-F.P.:
Conceptualization. A.S.-T.: Conceptualization; Funding acquisition; Supervision; Writing—review & editing.
A.C.M.: Conceptualization; Data curation; Formal analysis; Funding acquisition; Supervision; Writing—original
draft; Writing—review & editing.

Competing interests
The authors declare no competing interests.

Additional information
Supplementary Information The online version contains supplementary material available at https://​doi.​org/​
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