A Systematic Review of Emotional Abuse and its Consequences on the Mental Health of Adolescents

A Systematic Review of Emotional Abuse and its Consequences on the Mental Health of Adolescents

Samuel J. Obot PhD¹, Abigail A. Azorondu PhD² and Newworld O. Hamed³

¹Department of Counselling Psychology and Educational Foundation, Tai Solarin University of Education, Ijagun, Nigeria,

^2,3Department of Social Work, Babcock University, Ogun State, Nigeria

DOI: https://dx.doi.org/10.47772/IJRISS.2024.8100185

Received: 07 October 2024; Accepted: 15 October 2024; Published: 14 November 2024

ABSTRACT

Emotional abuse is a significant form of maltreatment that profoundly affects adolescent mental health. This systematic review investigates the impact of emotional abuse on adolescents, addressing the research question: How does emotional abuse influence their mental health outcomes? A comprehensive search of electronic databases, including PubMed, PsycINFO, and Cochrane Library, was conducted for studies published between 2000 and 2023. Peer-reviewed studies examining adolescents aged 10-19, emotional abuse, and its mental health effects were included. After screening titles and abstracts, a full-text review was completed. Data extraction followed a standardized approach, with the Cochrane Risk of Bias Tool used for assessment. A total of 32 studies met the criteria, revealing consistent associations between emotional abuse and negative mental health outcomes such as depression, anxiety, and suicidal ideation. The severity and frequency of emotional abuse were directly linked to the level of psychological distress. Meta-analysis demonstrated a strong overall effect size, confirming the significant impact of emotional abuse on mental health. This review emphasizes the urgent need for early detection and intervention by healthcare providers, educators, and policymakers to mitigate the damaging effects of emotional abuse on adolescents. Future research should focus on longitudinal studies to better understand long-term consequences and assess the efficacy of intervention strategies.

Keywords: Emotional abuse, Adolescents, Mental health, Systematic review, and Meta-analysis.

INTRODUCTION

Adolescence is a pivotal stage of human development, marked by a complex interplay of physical, psychological, and emotional changes (Steinberg, 2021). It is a time of self-discovery, identity formation, and the pursuit of independence. Despite its growth potential, adolescence can be marred by experiences of emotional abuse, which have far-reaching and enduring consequences for mental health and well-being. Emotional abuse encompasses a wide range of behaviors and strategies designed to harm an individual emotionally, undermine self-esteem, and exert control (Beker & Louie, 2022). These tactics include verbal abuse, psychological manipulation, neglect, isolation, gaslighting, cyberbullying, and coercion and control. Unlike physical or sexual abuse, emotional abuse operates subtly, making it challenging to identify and quantify, thus often remaining concealed and perpetuating its devastating effects on adolescents’ mental health.

The importance of this systematic review lies in addressing the significant gap in the existing literature regarding the specific impacts of emotional abuse on adolescent mental health. While the effects of physical and sexual abuse are more extensively documented, emotional abuse tends to be underestimated and underreported (Holt, Pellow, & Morrow, 2020). This review aims to synthesize existing studies to provide a comprehensive understanding of the prevalence, forms, and psychological consequences of emotional abuse among adolescents. By doing so, it seeks to highlight the critical need for increased awareness, early detection, and intervention strategies to mitigate the adverse effects of emotional abuse.

The primary objective of this systematic review is to investigate the consequences of emotional abuse on the mental health of adolescents. The review seeks to answer the following research questions:

1. What is the prevalence of emotional abuse among adolescents?
2. What factors contribute to the underreporting of emotional abuse in this population?
3. How prevalent is emotional abuse among adolescents, and what factors contribute to its underreporting?
4. What are the psychological and emotional consequences of emotional abuse on adolescents?
5. How does the co-occurrence of emotional abuse with other forms of abuse affect adolescent mental health?
6. What are the unique challenges faced by vulnerable populations, such as LGBTQ+ adolescents and those from racial and ethnic minority backgrounds, in the context of emotional abuse?
7. What role does technology play in the perpetuation of emotional abuse among adolescents?
8. What coping and resilience strategies can mitigate the impact of emotional abuse, and what are effective prevention strategies?

This review aims to provide a detailed synthesis of the current knowledge on emotional abuse in adolescence, offering insights into the development of targeted interventions and support mechanisms to promote the mental health and well-being of young individuals.

METHODS

This research aimed to conduct a detailed analysis of emotional abuse and its consequences on adolescent mental health. The methodology involved the collection, analysis, and interpretation of existing research published between 2000 and 2023. This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, which promote transparency and completeness in the reporting of systematic reviews (Moher, Liberati, Tetzlaff, and Altman, 2015). PRISMA outlines essential elements to be included in a systematic review, ensuring that the process is reproducible and that the findings are credible. By following these guidelines, this review seeks to provide a comprehensive and transparent synthesis of the literature on the effects of emotional abuse on the mental health of adolescents.

Inclusion Criteria

To determine the inclusion of studies in this systematic literature review (SLR), several specific criteria were established. Peer-reviewed empirical studies were deemed essential, incorporating both quantitative research methods, such as cross-sectional, longitudinal, case-control, and cohort studies and qualitative research approaches. The focus was on adolescents aged 10 to 19 years, reflecting a critical developmental stage where emotional abuse can significantly impact mental health (Naylor, Cowie, & O’Moore, 2021).

Included studies are needed to investigate the experience of emotional abuse, defined comprehensively to encompass behaviours and strategies intended to cause emotional harm. These behaviours included verbal abuse, psychological manipulation, neglect, isolation, gaslighting, cyberbullying, and coercive control. Furthermore, the inclusion criteria mandated that studies feature some form of control or comparison group, which could consist of non-abused adolescents or those experiencing different types of abuse. The primary outcomes of interest were mental health-related indicators such as depression, anxiety, suicidal ideation, self-esteem, and psychological distress. Both observational and experimental study designs that provided data on the relationship between emotional abuse and mental health outcomes were deemed suitable for inclusion in the review.

Exclusion Criteria

Studies were excluded based on several criteria to ensure the quality and relevance of the review. Non-peer-reviewed articles, including dissertations, theses, and conference abstracts, were excluded to maintain a high standard of evidence. Additionally, studies not published in English were excluded due to practical constraints related to translation and potential biases in interpretation. Research focusing on adults or children outside the specified age range of 10-19 years was excluded unless age-specific data for adolescents were provided. Articles lacking empirical data, such as reviews, commentaries, and theoretical papers, were also excluded to ensure that only primary research findings were included. Furthermore, studies where emotional abuse was not clearly defined or was conflated with other forms of abuse without separate analysis were excluded to maintain the specificity and clarity of the review’s focus on emotional abuse (Fletcher & Rassool, 2018).

Information Sources

A comprehensive search strategy was employed to identify relevant studies on emotional abuse and its impact on adolescent mental health. Multiple electronic databases were systematically searched, including PubMed, PsycINFO, Cochrane Library, Embase, and Web of Science. These databases were selected for their extensive coverage of medical, psychological, and health-related literature (Higgins & Green, 2011). In addition to database searches, supplementary sources were consulted to enhance the thoroughness of the review. Reference lists of identified studies were hand-searched to discover additional articles not captured in the electronic database searches. Furthermore, key journals in the fields of adolescent psychology and mental health were manually reviewed to identify relevant studies that may have been overlooked through other search methods. This multi-faceted approach aimed to provide a comprehensive and representative sample of the literature concerning the effects of emotional abuse on adolescent mental health.

Search Strategy

A detailed search strategy was developed using a combination of keywords and MeSH (Medical Subject Headings) terms related to emotional abuse and adolescent mental health. The primary search terms included: “emotional abuse” OR “psychological abuse” OR “verbal abuse”, “adolescents” OR “teenagers” OR “youth”, and “mental health” OR “depression” OR “anxiety” OR “suicidal ideation” OR “self-esteem” OR “psychological distress.” An example of the search string used in PubMed is as follows: (“emotional abuse” OR “psychological abuse” OR “verbal abuse”) AND (“adolescents” OR “teenagers” OR “youth”) AND (“mental health” OR “depression” OR “anxiety” OR “suicidal ideation” OR “self-esteem” OR “psychological distress”). The search was limited to studies published in English from January 2000 to December 2023 to ensure the relevance and recency of the data. This structured approach aligns with established guidelines for systematic reviews, emphasizing the importance of a rigorous search strategy to ensure comprehensive coverage of the literature (Moher et al., 2009).

Screening Process

The study selection process was conducted in two stages to ensure a thorough and unbiased identification of relevant studies. Initially, two independent reviewers screened the titles and abstracts of all identified studies to assess their eligibility based on predefined inclusion and exclusion criteria. This initial stage aimed to quickly filter out irrelevant studies.

In total, 560 studies were identified through database searches. Following the application of the PRISMA guidelines, the initial screening resulted in 140 studies deemed potentially eligible for full-text review. Subsequently, the full texts of these potentially eligible studies were retrieved and independently reviewed by the same two reviewers to confirm their eligibility. During this stage, the reviewers examined the studies in greater detail to ensure they met all the criteria for inclusion. Any disagreements between the reviewers were resolved through discussion to reach a consensus. In cases where consensus could not be achieved, a third reviewer was consulted to make the final decision, thereby ensuring the integrity and thoroughness of the selection process (Liberati, Altman, Tetzlaff, & Mulrow, 2009). Ultimately, 25 studies were included in the final review.

Selection Criteria

To ensure the inclusion of studies that specifically addressed the research questions, stringent selection criteria were applied. These criteria encompassed the type of study, the population examined, the interventions evaluated, the outcomes measured, and the publication status of the studies. Any discrepancies in study selection were resolved through consensus among the reviewers (Moher et al., 2015).

The data collection process involved the use of a standardized extraction form developed specifically for this review. This form was initially tested on a sample of studies and adjusted as necessary (Higgins & Green, 2011). For each included study, data were extracted on several key aspects: study characteristics (such as author(s), year of publication, country, and study design), participant characteristics (including sample size, age, gender distribution, and demographic details), the definition and measurement of emotional abuse (detailing specific behaviors and tactics, measurement tools, and criteria used), mental health outcomes (including the types of outcomes measured, measurement tools, and reported results), and additional variables like potential confounders, mediators, and moderators assessed in the studies.

Risk of Bias Assessment

The risk of bias in individual studies was rigorously assessed using specific tools tailored to the study design. For randomized controlled trials (RCTs), the Cochrane Risk of Bias Tool was employed (Higgins et al., 2011), while the Newcastle-Ottawa Scale (NOS) was used for observational studies (Wells et al., 2014). Qualitative studies were evaluated using the Critical Appraisal Skills Programme (CASP) checklist (CASP, 2018). Each of these tools examines various domains of bias, including selection bias, performance bias, detection bias, attrition bias, reporting bias, and other potential sources of bias.

The assessment process involved two independent reviewers evaluating the risk of bias for each included study. Any discrepancies between the reviewers were discussed and resolved through consensus, and in cases where disagreements persisted, a third reviewer was consulted to reach a final decision. The outcomes of these risk-of-bias assessments played a crucial role in shaping the interpretation of the review findings and determining the overall strength of the evidence (Borenstein et al., 2009).

Data Synthesis

To synthesize the data, both qualitative and quantitative methods were employed to provide a comprehensive understanding of the impact of emotional abuse on adolescent mental health. For qualitative synthesis, a narrative approach was used to summarize findings from studies that either provided qualitative data or did not report sufficient quantitative data for meta-analysis (Sandelowski & Barroso, 2007). This involved identifying common themes, patterns, and discrepancies across the studies.

For quantitative synthesis, when sufficient data were available, a meta-analysis was conducted to combine the results of individual studies (Borenstein et al., 2009). This involved calculating pooled effect sizes and confidence intervals using either fixed-effect or random-effects models, depending on the level of heterogeneity among the studies (Higgins & Thompson, 2002). Standardized mean differences (SMDs) or odds ratios (ORs) were calculated for continuous and dichotomous outcomes, respectively. To assess heterogeneity among studies, the I² statistic and Chi-squared test were used, with I² values of 25%, 50%, and 75% considered indicative of low, moderate, and high heterogeneity, respectively (Higgins et al., 2003).

Sensitivity analyses were performed to evaluate the robustness of the findings by excluding studies with a high risk of bias or those that significantly contributed to heterogeneity (Borenstein et al., 2009). Funnel plots and Egger’s test were utilized to assess the potential for publication bias (Egger et al., 1997). Additionally, subgroup analyses were conducted to explore potential sources of heterogeneity and to identify specific groups of adolescents who might be particularly affected by emotional abuse. These subgroups were based on factors such as gender, age, type of emotional abuse, and co-occurrence with other forms of abuse (Higgins et al., 2011). Sensitivity analyses also tested the stability of the findings by excluding studies with a high risk of bias or by employing alternative statistical methods (Higgins & Green, 2011).

RESULTS

The process of study selection adhered to a rigorous methodology, as depicted in the PRISMA flow diagram below. The initial search across multiple databases yielded a substantial number of records. Following the removal of duplicates, the titles and abstracts were screened for relevance, leading to the exclusion of studies that did not meet the inclusion criteria. Full-text articles were then assessed in detail, resulting in the final selection of studies that met the established criteria. The included studies varied in their methodological approaches, encompassing both quantitative and qualitative research, with a common focus on the prevalence and impact of emotional abuse among adolescents.

PRISMA flow diagram

Risk of Bias in Studies

The assessment of the risk of bias revealed a spectrum of quality across the included studies. Many studies demonstrated robust methodologies with clear definitions and measures of emotional abuse and well-defined control groups. However, some studies exhibited potential biases, including selection bias due to non-randomized sampling methods and information bias stemming from self-reported data. The majority of studies utilized validated assessment tools, which helped mitigate some of these biases. Overall, while the risk of bias varied, the majority of studies were deemed reliable for contributing to the synthesis of results.

Results of Individual Studies

Individual studies provided detailed insights into the prevalence and types of emotional abuse experienced by adolescents. For instance, Smith et al. (2021) and Turner et al. (2022) reported prevalence rates ranging from 20% to 40%, highlighting the widespread nature of emotional abuse. Verbal abuse was reported by approximately 35% of adolescents (Beker & Louie, 2022), while psychological manipulation and neglect were noted in 25% and higher, respectively (Johnson & Thompson, 2021; Robinson & White, 2023). The subtle nature of emotional abuse and the cultural factors contributing to underreporting were frequently discussed (Garcia & Johnson, 2023; Johnson & Martinez, 2022). The impact of these abusive experiences on mental health was significant, with adolescents exhibiting higher rates of depression, anxiety, and other psychological distress (Hartman & Green, 2021; Turner et al., 2022).

Synthesis of Results

The synthesis of results from the included studies provides a comprehensive picture of emotional abuse among adolescents. The overall findings underscore the pervasive nature of emotional abuse, affecting a substantial proportion of adolescents across diverse settings. The combined results indicate that emotional abuse significantly impacts mental health, contributing to conditions such as depression, anxiety, suicidal ideation, and lowered self-esteem. Subgroup analyses revealed that certain populations, such as LGBTQ+ adolescents and those from racial and ethnic minority backgrounds, experience higher rates of emotional abuse, often compounded by societal prejudices and discrimination (Lopez et al., 2022; Garcia & Johnson, 2023). Furthermore, the co-occurrence of emotional abuse with other forms of abuse, such as physical and sexual abuse, exacerbates the negative mental health outcomes (Wilson & Davis, 2021).

Prevalence of Emotional Abuse in Adolescence

The prevalence of emotional abuse among adolescents is alarmingly high, with rates reported between 20% and 40% in various studies. This form of abuse includes verbal abuse and psychological manipulation, affecting about 30% of adolescents (Smith et al., 2021). Despite its prevalence, emotional abuse is often underreported, with up to 60% of adolescents not disclosing their experiences (Johnson & Martinez, 2022). The covert nature of emotional abuse and cultural stigmas surrounding discussions of abuse contribute to this underreporting, complicating efforts to address the issue effectively (Garcia & Johnson, 2023).

Types of Emotional Abuse

Emotional abuse manifests in various forms, each uniquely affecting adolescents’ mental health. Verbal abuse, reported by 35% of adolescents, involves harmful comments and name-calling that erode self-esteem and emotional stability (Beker & Louie, 2022). Psychological manipulation, affecting 25% of adolescents, employs subtle tactics to undermine self-worth and induce instability (Johnson & Thompson, 2021). Neglect, characterized by a lack of emotional support, leads to feelings of abandonment and worthlessness (Robinson & White, 2023). Isolation, impacting 20% of adolescents, involves deliberate separation from supportive relationships, intensifying emotional distress (Johnson & Thompson, 2021). Gaslighting, which distorts reality and undermines perception, leaves lasting effects of doubt and confusion (Beker & Louie, 2022).

Cyberbullying, affecting 15% of adolescents, extends emotional abuse into the online realm, exacerbating the traditional impacts of bullying (Brown & Lee, 2023). Coercion and control tactics further complicate emotional abuse, involving manipulation, threats, and intimidation to undermine autonomy (Johnson & Thompson, 2021).

Emotional Abuse’s Impact on Adolescent Mental Health

The impact of emotional abuse on adolescent mental health is profound, influencing both immediate and long-term well-being. Adolescents subjected to emotional abuse are more likely to experience symptoms of anxiety, depression, and post-traumatic stress disorder (Hartman & Green, 2021). Emotional abuse disrupts critical developmental tasks, such as trust-building and identity formation, posing significant challenges as adolescents transition into adulthood (Turner et al., 2022). The cumulative effect of experiencing multiple forms of abuse, including physical and sexual abuse, intensifies the risk of severe mental health issues (Wilson & Davis, 2021). Despite these challenges, some adolescents exhibit resilience, underscoring the importance of identifying and strengthening protective factors (Hartman & Green, 2021).

The Interplay Between Emotional Abuse and Other Forms of Abuse

Emotional abuse frequently co-occurs with physical and sexual abuse, creating a compounded and complex form of trauma that significantly impacts the victims (Wilson & Davis, 2021). The interplay between these different types of abuse intensifies the adverse mental health consequences, highlighting the need for comprehensive and multifaceted intervention strategies (Hartman & Green, 2021). When emotional abuse is combined with physical or sexual abuse, the cumulative effect can exacerbate psychological damage, leading to more severe mental health issues such as chronic depression, anxiety, and post-traumatic stress disorder (PTSD). This underscores the importance of an integrated approach to treatment that addresses all forms of abuse concurrently, ensuring that the victims receive holistic care that encompasses their physical, emotional, and psychological needs.

Certain populations, including LGBTQ+ adolescents and those from racial and ethnic minority backgrounds, face unique and significant challenges related to emotional abuse. These groups often experience higher rates of abuse that stem from deeply ingrained societal prejudices and discrimination (Lopez et al., 2022; Garcia & Johnson, 2023). For LGBTQ+ adolescents, emotional abuse may involve homophobic or transphobic remarks, exclusion, and other forms of discriminatory behaviour that attack their identity and self-worth. Similarly, adolescents from minority backgrounds may encounter racial slurs, cultural invalidation, and other forms of abuse that undermine their cultural identity and self-esteem. Recognizing and understanding these intersectional factors is crucial for developing tailored support and intervention strategies. By considering the unique experiences and challenges faced by these populations, interventions can be more effectively designed to address their specific needs, ensuring that support services are inclusive and culturally sensitive.

Recognizing emotional abuse during adolescence is critical for effective intervention and support. Emotional abuse can manifest in various forms, including verbal abuse, manipulative behaviours, social isolation, emotional neglect, threats, and drastic mood swings (Johnson & Martinez, 2022). Adolescents subjected to such abuse may exhibit signs such as withdrawal, anxiety, depression, changes in behaviour or academic performance, and difficulty in forming healthy relationships. Educating individuals, including parents, teachers, and peers, about these warning signs is essential in breaking the cycle of abuse. Promoting open communication and awareness about emotional abuse helps in early detection and timely intervention, which are crucial for mitigating long-term mental health impacts. This education can empower bystanders to take action and provide support to those in need, creating a more supportive environment for adolescents.

Schools and educators play a pivotal role in addressing emotional abuse by recognizing the signs, establishing robust support systems, and fostering a culture of respect and empathy. Training educators to identify and respond to emotional abuse is a crucial step in creating a safe and supportive school environment. Schools can implement comprehensive training programs that equip teachers and staff with the knowledge and skills to detect and address emotional abuse effectively. Providing access to counselling services is another critical measure. School counsellors can offer a safe space for students to express their concerns and receive professional support. Implementing peer support programs can also be beneficial. These programs encourage students to support each other, fostering a sense of community and mutual respect (Robinson & White, 2023). By taking these steps, schools can create an environment where students feel safe and supported, which is essential for their overall well-being and academic success.

Technology, particularly social media and online platforms, introduces new challenges in addressing emotional abuse. Cyberbullying and digital harassment are forms of emotional abuse that have become increasingly prevalent with the rise of technology. These forms of abuse can exacerbate the impact of traditional face-to-face abuse, making it relentless and pervasive (Brown & Lee, 2023). Adolescents may face harassment, threats, and emotional manipulation through digital platforms, which can be particularly harmful due to the constant connectivity and potential anonymity of perpetrators. Prevention strategies that include digital literacy programs and online safety initiatives are essential in empowering adolescents to navigate the digital landscape safely. Educating young people about the risks associated with online interactions and equipping them with tools to protect themselves can help mitigate the impact of digital harassment. These programs can teach students about privacy settings, how to report abuse, and how to support peers who may be victims of cyberbullying (Robinson & White, 2023). By promoting digital literacy and online safety, we can create a safer online environment for adolescents, reducing the risk of emotional abuse in the digital realm.

Preventing Emotional Abuse in Adolescence: A Holistic Approach

Preventing emotional abuse in adolescence necessitates a comprehensive and holistic approach that integrates multiple strategies and involves various stakeholders. School-based programs play a critical role in this preventive strategy. These programs should incorporate awareness campaigns, workshops, and integrated curricula that focus on emotional health and well-being. By educating students about the signs of emotional abuse, the importance of mental health, and ways to seek help, schools can create an environment that is more aware and supportive. Robinson and White (2023) emphasize the need for such educational initiatives to be a core component of school curricula, ensuring that all students receive this vital information.

Parental education is another crucial element in preventing emotional abuse. Parents and caregivers must be equipped with the knowledge and skills to create supportive and nurturing home environments. Educational programs for parents can guide recognizing the signs of emotional abuse, effective communication strategies, and methods for fostering emotional resilience in their children. These programs can also offer resources and support for parents who may be struggling with their own emotional or mental health issues, which can, in turn, impact their parenting (Robinson & White, 2023).

Policy and legislation form the backbone of a robust framework for preventing emotional abuse. Effective policies must clearly define emotional abuse, establish protocols for identifying and reporting cases, and ensure that appropriate interventions are available. Legislation should mandate training for educators, healthcare providers, and other professionals who work with adolescents, enabling them to recognize and respond to signs of emotional abuse. Additionally, policies must protect the rights of adolescents and ensure that they have access to necessary support services. Hartman and Green (2021) highlight the importance of comprehensive legal frameworks that address the multifaceted nature of emotional abuse and provide clear guidelines for intervention.

Promoting healthy relationships is fundamental to preventing emotional abuse. Within families, fostering open communication, mutual respect, and emotional support can create a safe and nurturing environment for adolescents. Schools and communities should also promote healthy relationship practices among peers and educators. Initiatives that encourage empathy, conflict resolution, and positive social interactions can help build a culture of respect and understanding. Programs that focus on developing emotional intelligence and resilience can equip adolescents with the skills needed to navigate relationships healthily and constructively (Lopez et al., 2022; Garcia & Johnson, 2023).

By adopting a holistic approach that integrates school-based programs, parental education, policy and legislation, and the promotion of healthy relationships, we can create a supportive environment that helps prevent emotional abuse and fosters the well-being of adolescents. This comprehensive strategy ensures that all aspects of an adolescent’s environment are addressed, providing a strong foundation for their emotional and mental health.

DISCUSSION

The findings of this research underscore the critical issue of emotional abuse in adolescence and its profound impact on young individuals’ mental health. This section delves into the implications of the results, contextualizes the broader landscape of emotional abuse, and proposes future research and intervention directions.

The study reveals that the prevalence of emotional abuse among adolescents is alarmingly high, with estimates ranging between 20% and 40%. A significant proportion of cases, however, remain unreported, complicating efforts to provide adequate support and intervention. The underreporting is influenced by the covert nature of emotional abuse, fear of retaliation, and cultural and societal factors that stigmatize discussions about abuse. Addressing this underreporting is crucial to ensure that affected adolescents receive the necessary support.

The identification of various forms of emotional abuse, including verbal abuse, psychological manipulation, and digital harassment, illustrates the multifaceted nature of this issue. Emotional abuse is not confined to face-to-face interactions but extends into the digital realm, where it becomes pervasive and relentless. This understanding is essential for developing tailored prevention and intervention strategies that address both traditional and modern forms of abuse.

The research findings highlight the severe and enduring consequences of emotional abuse on adolescent mental health. Adolescents exposed to emotional abuse exhibit higher incidences of anxiety, depression, and post-traumatic stress disorder (PTSD). Additionally, emotional abuse disrupts crucial developmental tasks such as trust-building and identity formation. The co-occurrence of emotional abuse with other forms of abuse, like physical and sexual abuse, exacerbates these risks, emphasizing the need for comprehensive support systems that address multiple facets of abuse.

This study also underscores the unique challenges faced by vulnerable populations, including LGBTQ+ adolescents and those from minority communities. These groups are more susceptible to emotional abuse due to prejudice, discrimination, and cultural dynamics. Recognizing the intersectionality of emotional abuse is essential for providing tailored support and interventions that consider the specific needs of these populations.

The research highlights the potential of prevention and intervention strategies, such as school-based programs, parental education, and robust legal frameworks, in mitigating emotional abuse among adolescents. These efforts raise awareness, promote healthy relationships, and offer legal protections. However, further research is needed to evaluate the long-term effectiveness of these strategies and to identify best practices for their implementation.

Strengths and Limitations

This review provides valuable insights into the prevalence and impact of emotional abuse on adolescent mental health, drawing on a comprehensive analysis of recent studies. However, several limitations must be acknowledged. The reliance on literature published between 2021 and 2023 means that the study may not capture the latest developments in the field. The potential for publication bias exists, as studies with negative or non-significant results may be underrepresented. The heterogeneity of the included studies, in terms of methodologies, sample sizes, and populations, poses challenges for generalizing the findings. The prevalence and impact of emotional abuse may be underestimated due to the underreporting of abuse cases.

The review does not deeply explore the cultural and contextual nuances of emotional abuse, potentially overlooking important variations and challenges. Additionally, the research primarily relies on secondary sources, which may introduce bias and limit the depth of analysis. The experiences of vulnerable populations, such as LGBTQ+ adolescents and minority communities, are highlighted, but the included literature may not comprehensively cover the wide range of unique challenges these groups face. The research does not include a longitudinal analysis of emotional abuse, which could provide deeper insights into the long-term consequences of abuse. Lastly, the focus on English-language publications may exclude relevant research conducted in other languages, potentially leading to a bias towards English-language perspectives.

Comparison with Other Reviews

The findings of this review align with and expand upon previous systematic reviews and meta-analyses on emotional abuse, confirming its high prevalence among adolescents and its significant impact on their mental health.

For instance, Taillieu and Brownridge (2016) conducted a meta-analysis on childhood emotional abuse and its psychological consequences. Similar to our review, their study revealed high prevalence rates and a strong association between emotional abuse and mental health issues such as depression and anxiety. However, this review extends their work by including more recent studies that capture the evolving nature of emotional abuse, particularly within digital platforms like social media.

Norman et al. (2012), in their systematic review, explored the mental health effects of emotional maltreatment, finding increased risks for conditions like depression and suicidal ideation. While our findings are consistent with theirs, our review goes further by highlighting the impact of emotional abuse in vulnerable populations, focusing on factors such as gender, ethnicity, and socioeconomic status. This adds an intersectional dimension that enriches the understanding of how emotional abuse affects different groups of adolescents.

Spinazzola et al. (2014) examined the complexity of emotional abuse and its co-occurrence with other forms of abuse, emphasizing the profound psychological damage caused. Our review builds on this by integrating recent studies that explore how emotional abuse often intersects with other forms of violence or neglect, providing a more holistic view of the factors that exacerbate its effects on adolescents.

Lastly, Finkelhor et al. (2015) explored the emerging phenomenon of cyber-emotional abuse, particularly in the context of adolescents’ internet use. Our review supports and expands its findings by presenting more recent evidence on the rise of emotional abuse in the digital age, focusing on the vulnerabilities that adolescents face in online environments, such as cyberbullying and emotional manipulation.

In sum, this review not only aligns with previous research but also advances the existing body of knowledge by incorporating new data on digital emotional abuse and by offering an intersectional perspective that considers how emotional abuse interacts with various demographic and social factors.

Implications for Practice

The practical implications of these findings are significant. Educators, mental health professionals, and policymakers must prioritize addressing emotional abuse in adolescence. Schools should implement comprehensive programs that educate students and staff about emotional abuse, promote healthy relationships, and provide support systems for affected individuals. Parental education programs are essential to equip caregivers with the skills needed to recognize and address emotional abuse. Legal frameworks must be strengthened to ensure adequate protection for adolescents and to facilitate reporting and intervention.

Implications for Research

Future research should address the limitations identified in this review. Longitudinal studies are needed to explore the long-term consequences of emotional abuse and the effectiveness of various intervention strategies. Research should also delve into the cultural and contextual nuances of emotional abuse to develop culturally sensitive approaches. Additionally, studies should focus on the unique challenges faced by vulnerable populations, such as LGBTQ+ adolescents and minority communities, to ensure that interventions are inclusive and effective. Expanding the scope to include non-English language research will provide a more comprehensive understanding of emotional abuse globally.

CONCLUSION

The main conclusions of this review are that emotional abuse is a pervasive and significant issue among adolescents, with severe and lasting impacts on their mental health. The multifaceted nature of emotional abuse, including its digital manifestations, underscores the need for comprehensive and tailored prevention and intervention strategies. Despite the limitations, this review provides valuable insights into the prevalence and consequences of emotional abuse and highlights the importance of addressing this issue holistically.

Based on the findings, the following recommendations are proposed: Educators and schools should implement comprehensive programs to raise awareness and provide support for emotional abuse. Parental education programs are essential to equip caregivers with the skills to recognize and address emotional abuse. Legal frameworks must be strengthened to ensure adequate protection for adolescents and facilitate reporting and intervention. Future research should focus on longitudinal studies, cultural and contextual nuances, and the unique challenges faced by vulnerable populations to develop inclusive and effective interventions. By addressing emotional abuse through a multi-faceted and collaborative approach, we can create a safer and healthier environment for adolescents, fostering their emotional well-being and development.

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