The hallmarks of childhood abuse and neglect: A systematic review

Abstract

Background Studies on the impacts of child maltreatment (CM) have been conducted in diverse areas. Mechanistic understanding of the complex interplay between factors is lacking. Hallmarking is an approach which identifies common factors across studies and highlights the most robust findings. Objectives In a review of systematic reviews and meta-analyses, we addressed the following questions: 1) What are the hallmarks associated with exposure to CM across the bio-ecological spectrum? 2) What is the strength of evidence to support each hallmark? 3) What are the gaps that future research should address? Methods A comprehensive literature search was carried out to find relevant systematic reviews or meta-analyses. 269 articles were read in full and 178 articles, encompassing more than 6000 original papers, were included in the final synthesis. All reviews were independently rated for quality by at least 2 reviewers using AMSTAR-2. Results Of 178 review articles, 6 were rated as high quality (all meta-analyses) and 46 were rated as medium quality. Most were from high income countries. Conclusions Based on the most commonly reported high-quality research findings we propose that the hallmarks of exposure to child maltreatment are: Increased risk of psychopathology; Increased risk of obesity; Increased risk of high- risk sexual behaviours, Increased risk of smoking; and Increased risk of child maltreatment in children with disabilities. Research gaps include a lack of focus on complexity and resilience. Little can be concluded about directions of causality or mechanisms. Adequately powered prospective studies are required to move the field forward.

A meta-analysis of childhood maltreatment in relation to psychopathic traits

“…During the past decade, researchers have become increasingly aware of the importance of CM as a risk factor for psychopathology generally (for recent reviews, see for example: [ 30 , 119 ]). The notion that CM causes phenotypic alterations to the developing brain [ 120 , 121 ], which are subsequently impacted by further epigenetic and developmental changes, is starting to impact psychiatric nosology [ 30 ].…”

Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample

“…Childhood maltreatment (i.e., emotional neglect, physical neglect, emotional abuse, physical abuse, and sexual abuse) is a major concern that substantially affects millions of people and has been shown to be significantly associated with poor mental health [ 1 , 2 ]. In a recent review of several meta-analyses of the sequelae of childhood maltreatment, an increased risk for psychopathology was identified as one of the five hallmarks (i.e., increased risk of obesity; increased risk of high-risk sexual behaviors, increased risk of smoking, and increased risk of child maltreatment in children with disabilities) of childhood maltreatment [ 3 ]. Although the association between childhood maltreatment and psychopathology is well researched, less is known about the causal relationships and the underlying pathways by which childhood maltreatment might lead to an increased risk for mental health problems.…”

Investigating childhood maltreatment as a modifier of genetic risk for cardiovascular disease in the UK Biobank

“…Positive associations between childhood maltreatment and CVD subtypes and BMI have been reported extensively 5,36 but associations with other CVD risk factors such as blood pressure and lipids are less established. 36 We replicated previously observed associations between maltreatment increasing BMI [32][33][34] , smoking behaviour 6,37 , and decreasing SBP. 38,39 Interpretability of interactions and effect modifications Interaction and effect modification are terms commonly used interchangeably despite representing subtly different concepts.…”

“…Positive associations between childhood maltreatment and CVD subtypes and BMI have been reported extensively 5,36 but associations with other CVD risk factors such as blood pressure and lipids are less established. 36 We replicated previously observed associations between maltreatment increasing BMI 32–34 , smoking behaviour 6,37 , and decreasing SBP. 38,39…”