SECTION 1 The Adult Consequences of Childhood Psychological Maltreatment: A Study of Object Relations, Internalized Shame, and Defense Style Childhood psychological maltreatment has recently emerged in the literature as a form of child abuse that has long-term mental health consequences affecting the child, adolescent, and adult. Psychological maltreatment is increasingly regarded as a core construct in all child maltreatment. Whereas its impact has been recognized in terms of its psychopathological sequelae, there is only limited understanding of the mechanisms by which psychological maltreatment in childhood comes to affect the adult. This study was undertaken with a view to elucidating the issue. A developmental and object relations paradigm was adopted, focusing on the impact of psychological maltreatment on object relations characteristics, the experience of internalized shame, and the use of cognitive defence mechanisms. The design compared a severe group of psychologically maltreated individuals with those who had experienced no maltreatment or less severe maltreatment with respect to their performance on measures of object relations, shame, self-esteem, and defence style. The severe group was distinguished by greater object relations deficits, higher internalized shame, lower self-esteem, and an immature defence style. Psychological maltreatment was also found to have a significant association with these phenomena. These results clearly point toward mediation hypotheses in future investigations. The implications of the study were discussed in terms of allocating a more central role to psychological maltreatment in all child maltreatment, and giving more attention in therapy to self and self-other phenomena. SECTION 2 ETHICS PROPOSAL An Investigation of Adult Cognitive, Affective, and Interpersonal Phenomena In Relation to Childhood Psychological Maltreatment Recent research indicates that abuse in childhood is associated with adult psychopathology. There is a growing consensus that the concept of psychological maltreatment, which comprises the cognitive, affective, and interpersonal aspects of child abuse, is a core issue in all child maltreatment. A research study is proposed with a view to investigating some of the cognitive, affective, and interpersonal phenomena that may be relevant to the development of adult sequelae in victims of childhood psychological maltreatment. The proposal comprises an introduction to the study, together with a discussion of the aims and plan of investigation. The appendices include information for participants and the questionnaire booklet. SECTION 3 REVIEW OF THE LITERATURE Childhood Psychological Maltreatment and its Developmental Consequences The review of the literature focuses on the cognitive, affective, and interpersonal phenomena that have been linked with childhood maltreatment and adult psychopathology. The concept and definition of psychological maltreatment, its role as a core issue in child maltreatment, and issues in measurement are discussed. Studies of the ii consequences of childhood psychological maltreatment are reviewed, indicating its association with a wide range of problems and conditions. The development of the child is considered in light of the impact of psychological maltreatment on the emerging sense of self and self in relation to others. This is discussed with reference to object relations and the development of mental representations of early experiences with attachment figures; the occurrence of shame in the child-parent relationship and its internalization as part of the child's identity; and the role of cognitive defences in protecting the developing self and regulating painful affect. SECTION 4 RESEARCH STUDY The Adult Consequences of Childhood Psychological Maltreatment: An Investigation of Object Relations, Internalized Shame, and Defence Style The evidence is summarized with respect to the psychopathological consequences of psychological maltreatment, including its effects on the child's development in terms of object relations, internalization of shame, and the employment of defensive strategies. A research study is described in which these effects were investigated with adult participants. It was observed that severely maltreated participants demonstrated greater object relations deficits, a higher level of internalized shame, lower self-esteem, and an immature defence style in comparison with participants who had experienced no, or less severe, psychological maltreatment. It was also noted that psychological maltreatment had a significant relationship with these phenomena. The potential impact of psychological maltreatment on interpersonal functioning and sense of self-worth may be inferred from this study. The conceptualization of psychological maltreatment as a core construct in all child maltreatment was supported. SECTION 5 CRITICAL REVIEW Critical Review of the Large Scale Research Project The background to the research study is described and its foundation in clinical practice. A commentary is provided on the processes involved and issues arising in the progressive stages of the study: in particular, the theoretical conceptualization of the research, its operationalization in terms of methodology, and the evaluation of outcome. The results of participants who scored high on the objective measure of psychological maltreatment but who denied it as an experience are discussed. This study points the way to a mediation design in future research. It also underlines the significant role of child-rearing in the development of psychopathology. SECTION 6 The general appendices comprise notes for contributors to the journals selected for the literature review and research study, a letter of approval from the School of Psychology Research Ethics Committee, and the word count.