Sequelae of Child Maltreatment: Umbrella synthesis on mental health correlates in over 11 million participants

Numerous meta-analyses have established associations between child maltreatment and mental health. However, variation exists between reviews regarding the magnitude of these predictions. A systematic, quantitative umbrella synthesis (i.e. meta-analysis of meta-analyses) was undertaken to describe the associations between various types of maltreatment (i.e. physical abuse, emotional abuse, sexual abuse, neglect, prenatal substance misuse, adverse childhood experiences and intimate partner violence) and mental health issues including executive functioning. We analysed and combined effect sizes from 97 quantitative meta-analyses comprising more than 11 million participants, published between January 1, 2016, and July 19, 2021. Child maltreatment was associated with all examined outcomes: 1) externalizing problems (r = 0.21), 2) internalizing problems (r = 0.21), 3) thought problems (r = 0.33), 4) executive functioning (r = 0.23), 5) suicide and related behaviors (r = 0.24), 6) substance misuse (r = 0.20), 7) interpersonal violence (r = 0.25) and 8) other psychological difficulties (r = 0.22). Findings demonstrate that maltreatment is associated with various psychological difficulties, and these associations tend to be of similar magnitude for different forms of maltreatment. A parsimonious explanation for these findings would be a common mechanism(s) or a general psychopathology factor conferring high risk for different mental health problems following child maltreatment. For practitioners and service providers, these results indicate a comparable degree of mental health difficulties across all forms measured in the wake of maltreatment. The results call into question the conventional wisdom that suggests some forms of maltreatment are intrinsically more harmful to mental health than others.