Umbrella Review of the Mental Health and Neurodevelopmental Sequelae of Child Maltreatment

• In Event: Harsh Parenting in the 21st Century: Exploring Genetics, Cultural Factors, and the Mental Health Sequelae

Abstract

Numerous meta-analytic reviews have established associations between child maltreatment and mental health and neurodevelopmental sequelae throughout the lifespan. However, variation exists between reviews regarding the magnitude of the predictions. A systematic 'umbrella review' (i.e. meta-analysis of meta-analyses) of the global literature was undertaken to help us understand the strength of the associations between various types of child maltreatment (i.e. physical abuse, emotional abuse, sexual abuse, neglect, prenatal substance misuse, adverse childhood experiences and intimate partner violence) and various mental health issues and developmental outcomes. We analysed effect sizes from 98 quantitative reviews comprising more than 11 million participants, published between January 1, 2016, and July 19, 2021. We examined the associations between child maltreatment and the following outcomes: 1) externalising problems 2) internalising problems 3) thought disorders 4) developmental disorders, including transdiagnostic elements of neuropsychological functioning such as executive functioning 5) suicide and related behaviours 6) substance abuse 7) psychological maladjustment 8) being subject to intimate partner violence or related harms. Child maltreatment was associated with all outcomes, with associations tending to be in the moderate range (i.e. r=0.20 – 0.30). Moreover, these effect sizes tended to be remarkably similar for different forms of child maltreatment. This umbrella synthesis is the largest analysis ever undertaken of the associations of child maltreatment with mental health and developmental conditions. The evidence in this review demonstrates that child maltreatment is persistently associated with various mental health issues and developmental conditions across the lifespan, and these associations tend to be of similar magnitude. However, this review also highlights the remarkable psychological resilience of many survivors of child abuse. The theories of ‘equifinality’, ‘multifinality’ and ‘differential susceptibility’ provide useful developmental frameworks to explain these findings. For practitioners and service providers, the umbrella results may point at the broad spectrum of mental health issues in the wake of childhood maltreatment as well as the notable presence of resilience in many maltreatment survivors.

Authors

• Barry Coughlan, University of Cambridge
  Presenting Author

• Robbie Duschinsky, University of Cambridge

• Lianne Bakkum, University of Cambridge

• Guy Skinner, University of Cambridge

• Alfred Markham, University of Southampton

• Helen Beckwith, University of Oxford

• Marian J Bakermans-Kranenburg, ISPA Lisbon

• Marinus H. van IJzendoorn, University College London (UCL)