Systematic review evaluates childhood adversity's impact on adult psychiatric disorders, suggesting critical intervention needs.
Childhood adversity is highly prevalent worldwide, with population surveys consistently indicating that roughly 60% to 70% of adults report at least one adverse childhood experience, yet the field has lacked a single comprehensive synthesis that quantifies risk across major adult psychiatric disorders while simultaneously examining key moderators. To address this gap, this dissertation conducted a systematic review and meta-analysis following PRISMA principles to evaluate associations between childhood adversity and adult psychopathology. The final corpus included 58 studies representing 967,602 participants, and random-effects models were used to accommodate expected methodological and population heterogeneity. Across seven outcome categories, pooled odds ratios indicated robust elevations in risk among adversity-exposed individuals: depression (OR = 2.25), anxiety (OR = 2.18), posttraumatic stress disorder (OR = 3.17), psychosis (OR = 2.59), personality disorders (OR = 2.94), substance use disorders (OR = 2.17), and suicidality (OR = 3.06). PTSD demonstrated the strongest pooled association, followed by suicidality and personality pathology. Subgroup analyses further showed that abuse exposures were associated with larger pooled effects than neglect exposures, and cumulative adversity patterns (multiple ACEs) were linked to particularly elevated risk profiles. Gender moderation analyses suggested statistically meaningful differences for depression and anxiety, with stronger pooled effects in women than men. Overall, findings support a robust transdiagnostic association between childhood adversity and adult psychiatric disorders while also demonstrating clinically relevant heterogeneity across exposure types and population strata. These results underscore the need for routine adversity-informed mental health screening, trauma-informed and gender-responsive care pathways, and sustained prevention and policy investment aimed at reducing childhood maltreatment and its long-term psychiatric burden.
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Laszlo Pokorny (2026) studied this question.
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