Maltreatment and executive functioning in childhood and adolescence - A multilevel meta-analysis

Child maltreatment (CM) is associated with deficits in cognitive development, particularly in core executive functioning (EF; cognitive flexibility, inhibitory control, working memory). However, due to limited meta-analytic evidence, it remains unclear whether CM dimensions (abuse, neglect) differentially relate to core EF development.

We conducted a pre-registered meta-analysis on studies comparing core EF performance between maltreated and nonmaltreated children and adolescents, examining CM dimensions, subtypes, sample-, and study-related characteristics as potential moderators.

A systematic search in PsycINFO and PubMed (May 2022, updated March 2023) identified eligible peer-reviewed studies per pre-registered criteria. We conducted a multilevel mixed-effects meta-analysis, including subgroup analyses to explore EF domains and CM dimensions as moderators. Additional moderators (age, female ratio, CM subtypes, study quality) were examined via meta-regressions. Publication bias was assessed using funnel plots and Egger's test.

We included 59 studies with 92 effect sizes, comprising 13,022 individuals (M_Age = 12.0 years, SD = 2.8; 50.2 % female).

Maltreated individuals showed moderate EF deficits across domains (Hedge's g = -0.43, 95 % CI [-0.53, -0.34], p < .001), with substantial heterogeneity (Q(91) = 390.57, p < .001), partially explained by EF domain differences. CM dimensions did not explain this heterogeneity, whereas sex emerged as a significant moderator.

Our findings suggest a cumulative, multifinal relationship between CM and EF domain deficits. However, the substantial heterogeneity observed across studies and limited methodological details constrain this conclusion. Further research is needed to elucidate how different maltreatment experiences impact EF development.