Does Child Maltreatment Reduce or Increase Empathy? A Systematic Review and Meta-analysis

Arguments about the associations between child maltreatment and empathy remain controversial. This systematic review and meta-analysis aim to estimate the direction and magnitude of the relationships between child abuse and neglect and empathy. Four English databases (Web of Science, PsycInfo, PubMed, and Cochrane Library), three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu), and grey literature were systematically searched. We extracted data related to the associations between child maltreatment and empathy and pooled them using random effects models. A total of 24 eligible studies involving 22,580 participants and 176 estimates were included in the analyses. Overall, child maltreatment was significantly related to reduced empathy ($\stackrel{\_}{r}$ = -0.15, 95% CI [-0.17, -0.13]). Specifically, the rank-order mean effect size of subtypes of maltreatment on empathy is: emotional neglect ($\stackrel{\_}{r}$ = -0.18, 95% CI [-0.25, -0.12]) > physical neglect ($\stackrel{\_}{r}$ = -0.16, 95% CI [-0.23, -0.09]) > emotional abuse ($\stackrel{\_}{r}$ = -0.15, 95% CI [-0.21, -0.10]) > physical abuse ($\stackrel{\_}{r}$ = -0.12, 95% CI [-0.17, -0.07]) > sexual abuse ($\stackrel{\_}{r}$ = -0.07, 95% CI [-0.14, -0.01]). Furthermore, the meta-regression results suggested that the aggregated associations between child maltreatment and empathy were not inflated by publication bias, but they were moderated by the age of respondents, sample size, publication language, empathy measurement, and maltreatment type. The results indicate that general maltreatment and its subtypes are associated with reduced empathy. Parent training and empathy enhancement programs should be designed to help children with a history of childhood maltreatment, respectively, from an early stage.