Early childhood trauma and its long-term impact on cognitive and emotional development: a systematic review and meta-analysis

Childhood trauma has profound, long-term effects on cognitive and emotional development. This systematic review and meta-analysis sought to synthesis the evidence around the long-term impact of human childhood trauma on domains of cognition and emotion in order to inform interventions and public health strategies. We systematically reviewed 465 studies from PubMed, Cochrane Library, and Google Scholar, 9 studies were included after duplicates were removed and inclusion and exclusion criteria were applied, and all 9 studies were aimed at low-income people in the United States. Data on study design, trauma types, and cognitive/emotional outcomes were extracted. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias Tool (RoB 2). Random-effects meta-analysis and subgroup analyses (processing speed, attention, working memory, emotion regulation, executive function) were conducted using R software. Childhood trauma was associated with significant deficits in: Attention (SMD = 2.37, 95% CI: [5.75, 10.50]) Working memory (SMD = 3.55, 95% CI: [2.18, 9.28]) Emotion regulation (SMD = 1.25, 95% CI: [1.12, 3.62]) Executive function (SMD = 1.61, 95% CI: [0.06, 3.28]) Processing speed showed smaller deficits (SMD = −0.48, 95% CI: [−1.91, 0.94]). High heterogeneity (I²: 77–98%) reflected variability in trauma types and assessments. The pooled effect size (SMD = 1.57, 95% CI: [−0.12, 3.26]) highlighted trauma’s pervasive impact. Childhood trauma disproportionately impairs attention and working memory. These findings, however, point to the importance of early screening, trauma-informed care and targeted interventions to ameliorate the long-term consequences of trauma, even with high heterogeneity. Methodological variability should be addressed to inform prevention and treatment strategies in future research, as well as resilience factors explored.

童年创伤对认知与情感发展具有深远且长期的影响。本项系统综述与元分析旨在整合有关人类童年创伤对认知与情感领域长期影响的现有证据，以期为干预实践与公共卫生策略制定提供依据。我们系统检索了PubMed、考克兰图书馆（Cochrane Library）及谷歌学术（Google Scholar）中的465项研究，在剔除重复文献并严格遵循纳入排除标准筛选后，最终纳入9项研究，且所有纳入研究的研究对象均为美国低收入人群。研究人员提取了关于研究设计、创伤类型及认知/情感结局的相关数据。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale, NOS）与考克兰偏倚风险工具（Cochrane Risk of Bias Tool, RoB 2）对纳入研究的质量进行评估。使用R软件开展随机效应元分析与亚组分析，亚组分析涵盖加工速度、注意力、工作记忆、情绪调节、执行功能五个维度。分析结果显示，童年创伤与以下认知情感领域的显著功能缺损存在关联：注意力（标准化均数差（Standardized Mean Difference, SMD）=2.37，95%置信区间（Confidence Interval, CI）：[5.75, 10.50]）、工作记忆（SMD=3.55，95%CI：[2.18, 9.28]）、情绪调节（SMD=1.25，95%CI：[1.12, 3.62]）及执行功能（SMD=1.61，95%CI：[0.06, 3.28]）；加工速度的功能缺损程度相对较轻（SMD=−0.48，95%CI：[−1.91, 0.94]）。高异质性（I²：77%~98%）反映了不同研究在创伤类型与评估方式上的异质性。合并效应量（SMD=1.57，95%CI：[−0.12, 3.26]）进一步凸显了童年创伤的广泛影响。童年创伤对注意力与工作记忆的损害尤为显著。尽管纳入研究存在较高异质性，但本研究结果仍表明，早期筛查、创伤知情照护（trauma-informed care）与针对性干预措施，对于缓解童年创伤带来的长期不良后果具有重要意义。未来研究应致力于解决方法学异质性问题，以进一步完善创伤相关的预防与治疗策略，并探索影响个体复原力的相关因素。