The association between childhood sexual abuse and posttraumatic stress disorder in justice-involved populations: a meta-analysis

Childhood sexual abuse and posttraumatic stress disorder are highly prevalent in justice-involved populations, yet evidence on the strength and variability of their association in offender samples remains fragmented. This meta-analysis aimed to quantitatively synthesize the association between childhood sexual abuse and posttraumatic stress disorder among juvenile and adult offender populations and to examine heterogeneity, moderators, and robustness. Following PRISMA guidelines, studies were identified through searches of Web of Science, Scopus, ProQuest, and PubMed from database inception to August 31, 2025, supplemented by hand-searching of reference lists. Eligible studies included juvenile or adult offender samples, assessed childhood sexual abuse before age 18, measured posttraumatic stress disorder, and reported sufficient data to compute an effect size. Only English-language studies were included. Thirty studies met the inclusion criteria, yielding 33 independent effect sizes. Effect sizes were converted to Pearson’s r , transformed to Fisher’s z , and synthesized using random-effects models. Heterogeneity, prediction intervals, subgroup analyses, and meta-regression were conducted. Publication bias and small-study effects were also examined. The pooled association between childhood sexual abuse and posttraumatic stress disorder was positive and moderate in magnitude (r = .312, 95% CI [.270, .352]). Heterogeneity was moderate (I 2 = 63.4%), and the 95% prediction interval remained positive ([.117, .484]), indicating that the association is expected to remain positive across comparable justice-involved samples, although its magnitude may vary. No coded moderator, including mean age, country, publication type, sample type, gender composition, justice setting, childhood sexual abuse measurement, or posttraumatic stress disorder measurement, significantly explained between-study variability. Publication-bias analyses suggested at most minor small-study effects. Childhood sexual abuse is moderately associated with posttraumatic stress disorder in justice-involved populations. These findings support trauma-informed assessment, routine screening, and therapeutic services in justice settings and highlight the need for more detailed reporting to better explain between-study variability.