Dimensions of Early-Life Adversity and Attention Biases in Childhood and Adolescence: A Systematic Review

Dimensional models of adversity posit partially distinct mechanisms linking dimensions of early-life adversity (ELA) to mental health. Although evidence supports some of these mechanistic differences, there has yet to be a review that centers on development of attention biases to emotional stimuli. This systematic review examined associations between the dimensions of early-life threat and deprivation with attention biases in childhood and adolescence across nine different task types. Articles were identified using six online databases organized using Covidence with our search spanning from inception to June 17, 2025. Forward and backward snowball searches were conducted to identify additional articles. Articles were selected for inclusion if: (1) participants were aged 0-18 years; (2) participants had experienced at least one form of ELA with a non-exposed comparison group (or ELA measured continuously); (3) at least one measure of attention bias indexed; (4) they were written in the English language; and (5) they were published in a peer-reviewed journal. PRISMA guidelines were used to inform data extraction, which was conducted by multiple independent reviewers. A total of 46 articles were identified for extraction. Evidence was heterogeneous and revealed that, across different dimensions of ELA, significant associations tended to be conditional on specific study characteristics such as participant age, stimulus presentations time, and emotion type. Overall, partial support for the dimensional model was found, though reliable patterns were hampered by inconsistencies in study design and sampling. Recommendations for future investigation are provided.