Skip to main content
Full access
Articles
Published Online: 11 January 2023

Childhood Maltreatment and Mental Health Problems: A Systematic Review and Meta-Analysis of Quasi-Experimental Studies

Publication: American Journal of Psychiatry

Abstract

Objective:

Childhood maltreatment is associated with mental health problems, but the extent to which this relationship is causal remains unclear. To strengthen causal inference, the authors conducted a systematic review and meta-analysis of quasi-experimental studies examining the relationship between childhood maltreatment and mental health problems.

Methods:

A search of PubMed, PsycINFO, and Embase was conducted for peer-reviewed, English-language articles from database inception until January 1, 2022. Studies were included if they examined the association between childhood maltreatment and mental health problems using a quasi-experimental method (e.g., twin/sibling differences design, children of twins design, adoption design, fixed-effects design, random-intercept cross-lagged panel model, natural experiment, propensity score matching, or inverse probability weighting).

Results:

Thirty-four quasi-experimental studies were identified, comprising 54,646 independent participants. Before quasi-experimental adjustment for confounding, childhood maltreatment was moderately associated with mental health problems (Cohen’s d=0.56, 95% CI=0.41, 0.71). After quasi-experimental adjustment, a small association between childhood maltreatment and mental health problems remained (Cohen’s d=0.31, 95% CI=0.24, 0.37). This adjusted association between childhood maltreatment and mental health was consistent across different quasi-experimental methods, and generalized across different psychiatric disorders.

Conclusions:

These findings are consistent with a small, causal contribution of childhood maltreatment to mental health problems. Furthermore, the findings suggest that part of the overall risk of mental health problems in individuals exposed to maltreatment is due to wider genetic and environmental risk factors. Therefore, preventing childhood maltreatment and addressing wider psychiatric risk factors in individuals exposed to maltreatment could help to prevent psychopathology.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 117 - 126
PubMed: 36628513

History

Received: 23 February 2022
Revision received: 16 June 2022
Accepted: 27 June 2022
Published online: 11 January 2023
Published in print: February 01, 2023

Keywords

  1. Environmental Risk Factors
  2. Genetics/Genomics
  3. Violence/Aggression
  4. Child/Adolescent Psychiatry

Authors

Details

Jessie R. Baldwin, Ph.D. [email protected]
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Biyao Wang, Ph.D.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Lucy Karwatowska, M.Sc.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Tabea Schoeler, Ph.D.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Anna Tsaligopoulou, B.A.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Marcus R. Munafò, Ph.D.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).
Jean-Baptiste Pingault, Ph.D.
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò).

Notes

Send correspondence to Dr. Baldwin ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Drs. Munafò and Pingault share senior authorship.
This research was funded in whole or in part by the Wellcome Trust (grant 215917/Z/19/Z). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Dr. Baldwin is funded by a Wellcome Trust Sir Henry Wellcome fellowship (grant 215917/Z/19/Z). Dr. Schoeler is funded by a Wellcome Trust Sir Henry Wellcome fellowship (grant 218641/Z/19/Z). Dr. Munafò is part of the MRC Integrative Epidemiology Unit (MC_UU_00011/7). Dr. Pingault has received funding from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 863981) and is supported by the Medical Research Foundation 2018 Emerging Leaders First Prize in Adolescent Mental Health (MRF-160-0002-ELP-PINGA). The funding organizations were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - American Journal of Psychiatry

PPV Articles - American Journal of Psychiatry

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share