Sequelae of child maltreatment: Umbrella synthesis of 148 meta‐analyses on the mental health correlates

Abstract

Abstract Background Numerous meta‐analyses have established associations between child maltreatment (CM) and mental health difficulties (MH). However, variation exists between meta‐analyses regarding the magnitude of these predictions. Methods A systematic, quantitative umbrella synthesis (i.e., meta‐analysis of meta‐analyses) was undertaken to describe the associations between various types of CM and MH. Meta‐analyses were included if they examined CM, including but not limited to retrospective reports in adulthood, and MH at any point. Included forms of CM were: physical abuse, emotional abuse, sexual abuse, neglect, and exposure to intimate partner violence. MH outcomes were: externalising problems, internalising problems, thought problems, suicidal distress, substance misuse, and other psychological difficulties. Searches were run in January 2024. Random effects models were created in R version 4.2.0. Results We analysed and combined effect sizes from 148 quantitative meta‐analyses, including 668 effect sizes and over 9.5 million data points. CM was associated with all MH outcomes: (1) externalising problems ( r = 0.21; 95% CI = 0.18–0.24; k = 32), (2) internalising problems ( r = 0.22; 95% CI = 0.20–0.24; k = 46), (3) thought problems ( r = 0.24; 95% CI = 0.21–0.27; k = 38), (4) suicidal distress ( r = 0.23; 95% CI 0.18–0.28; k = 19), (5) substance misuse ( r = 0.19; 95% CI = 0.13–0.26; k = 13), (6) other psychological difficulties ( r = 0.24; 95% CI = 0.20–0.28; k = 50). Associations tend to be of similar magnitude for different forms of CM. Conclusion CM is robustly associated with MH. A parsimonious explanation for these findings would be a common mechanism(s) or a general psychopathology factor conferring high‐risk for different mental health difficulties following CM. The results possibly question the conventional wisdom that suggests some forms of maltreatment are intrinsically more harmful to mental health than others. However, further work is required to understand how potentially confounding factors (e.g., age, measurement of CM) influence these associations. Key points What's known Child maltreatment (CM) is regarded as an important risk factor for various adverse outcomes, especially mental health issues. What's new This umbrella synthesis found strong, often equivalent, associations between CM and all examined forms of mental ill‐health. Different types of CM appear to have comparably negative effects on mental health at the population level. What's relevant If replicated, these findings may make us reconsider conventional wisdom that some forms of CM are less harmful than others.