Childhood Maltreatment and Its Long-Term Psychosocial Outcomes: An Umbrella Review of Meta-Analyses

Despite multiple meta-analyses investigating the consequences of childhood maltreatment, the scope, validity and credibility of the evidence remain fragmented and inconsistent. This umbrella review aimed to quantify its impact on various psychosocial outcomes; compare effects across subcategories of maltreatment; and assess the quality of existing evidence. We searched 11 databases from inception to December 24, 2024, for meta-analyses on childhood maltreatment and psychosocial consequences. Summary effect sizes were converted to odds ratios (ORs). A two-level hierarchical meta-analytic model was used alongside prediction intervals, excess significance testing, and population-attributable risk fractions (PARFs). Evidence quality was appraised using a measurement tool to assess systematic reviews and modified umbrella review criteria. We identified 25 meta-analyses encompassing 31 psychosocial outcomes and 1,288,971 participants. Specifically, any childhood abuse was related to 16 psychosocial outcomes (ORs: 1.07-12.47), physical abuse to 10 outcomes (ORs: 1.23-3.14), sexual abuse to 20 outcomes (ORs: 0.46-3.36), emotional abuse to 7 outcomes (ORs: 1.20-3.73), neglect to 8 psychosocial outcomes (ORs: 1.09-3.54). Only the association between emotional neglect and suicide attempts had the strongest evidence. No evidence suggests that any subtype of childhood maltreatment had a stronger impact. Assuming causality, PARFs ranged from -4.28% for sexual function to 26.82% for nonsuicidal self-injury. While childhood maltreatment correlates with several psychosocial outcomes, high-quality evidence is deficient. To enhance evidence-based quality, future research should adopt prospective designs and standardized methodologies. Interventions addressing suicidality and policies supporting family-, school-, and community-based prevention efforts are essential to mitigate the long-term burden of childhood maltreatment.