Childhood emotional maltreatment and trauma-related outcomes: a systematic review and multilevel meta-analysis.

TL;DR

Systematic review and meta-analysis of 62 studies found a modest but consistent positive association between childhood emotional maltreatment and PTSD/CPTSD (r = .27), with emotional abuse showing stronger association than emotional neglect. Certainty of evidence was low due to predominant cross-sectional designs and self-report bias.

Key findings

• Emotional abuse associated more strongly with PTSD/CPTSD (r = .29) than emotional neglect (r = .24)
• Effect sizes similar between CPTSD and PTSD diagnoses; no moderation by sex, age, or clinical vs non-clinical status
• Cognitive, affective, physiological, and interpersonal mechanisms identified as potential mediators of the CEM-trauma relationship
• Higher effect estimates in high-income and more developed contexts; substantial heterogeneity across studies limits generalizability

Why this matters at the bedside

Supports systematic assessment of childhood emotional maltreatment in clinical settings as a relevant risk factor for trauma-related disorders; highlights need for differentiation between subtypes of emotional maltreatment in both assessment and intervention planning.