Personality functioning in adolescents: exploring the links with childhood maltreatment types and internalizing and externalizing difficulties

Background The reconceptualization of the personality disorder model brought by the DSM‐5 and ICD‐11 introduced the level of personality functioning as the main criterion of PD, which encompasses a set of intrapsychic functions necessary for self‐other understanding in interpersonal contexts. Research interest has been growing in examining the relationship between childhood traumatic experiences and personality functioning, predominantly with adult populations; however, there is a notable scarcity of studies exploring these associations in adolescents. Aims The aim of the present study was to analyze the association between different types of childhood maltreatment and personality functioning and to test internalizing and externalizing difficulties as potential mediators in this link. Methods A total of 1048 adolescents, aged 11–17, 65.7% of whom were females (855 from public schools, 193 clinically referred), completed a set of questionnaires measuring childhood maltreatment, level of personality functioning, and internalizing and externalizing difficulties. Mediation analysis was used to explore the potential mediating effects. Results Significant mediating effects of internalizing and externalizing problems were found in the relationship between different types of childhood maltreatment and personality functioning: emotional abuse ( β 1 = .269, CI 1 0.226–0.312; β 2 = .033, CI 2 0.011–0.055), physical abuse ( β 1 = .165, CI 1 0.123–0.206; β 2 = .031, CI 2 0.010–0.052), sexual abuse ( β 1 = .100, CI 1 0.060–0.140; β 2 = .018, CI 2 0.006–0.030); emotional neglect ( β 1 = .324, CI 1 0.280–0.368; β 2 = .028, CI 2 0.007–0.049), and physical neglect ( β 1 = .119, CI 1 0.079–0.159; β 2 = .020, CI 2 0.007–0.032). Conclusions These findings have the potential to enrich the understanding of personality functioning impairments in adolescents in the context of childhood maltreatment and highlight the importance of focusing attention on the impact of emotional maltreatment.