Effects of childhood trauma on executive function, impulsivity, rumination and worry: An umbrella review

Neurocognitive changes in executive function and emotion regulation due to the chronic exposure to stress from childhood trauma can act as transdiagnostic risk factors for the development and maintenance of psychopathology. This pre-registered umbrella review (PROSPERO: CRD42024628582) aimed to identify the strength of the relationships between childhood trauma and modifiable targets (executive function, impulsivity, and perseverative cognition - worry and rumination) to inform strategies to minimize the impact of childhood trauma on health outcomes. Twenty-two systematic reviews and meta-analyses, encompassing 639 unique primary studies, were eligible. Across included reviews, an enduring impact of childhood trauma on these transdiagnostic risk factors was identified. Most reviews (n = 16; 73%) focussed on executive function, found a negative association between childhood trauma and cognition. Most consistent evidence was found for executive function domains working memory and processing speed. Importantly, childhood trauma uniquely contributes to these impairments, regardless of clinical status. Fewer reviews considered impulsivity (n = 2; 9%) and perseverative cognition (n = 4; 18%) but consistently reported positive associations between childhood trauma and these risk factors. Given these associations, interventions ought to target these modifiable factors to disrupt the downstream impacts of childhood trauma. Longitudinal cohort studies aiming to identify the impact of childhood trauma, and trials of interventions to limit the impact of childhood trauma on, and to prevent the development of, psychopathology should be future research priorities.