The Lasting Psychological Impact of Childhood Adversity

At a glance

Childhood trauma linked to higher psychosis risk: People exposed to early adversity, especially emotional abuse and neglect—are two to three times more likely to develop psychosis later in life.
Neglect may be as harmful as abuse: Deprivation-related experiences, like emotional or cognitive neglect, showed a slightly stronger link to psychosis than direct threats such as abuse or violence.
Early screening and trauma-informed care are essential: Identifying and supporting those with childhood trauma could help prevent or delay psychosis, especially in vulnerable groups.
MQ Have produced a free evidence-based guide for parents on way's they can support their child's (and their own) mental health.

A major new analysis has found that people who experience significant adversity in childhood are two to three times more likely to develop psychosis or experience psychotic symptoms later in life. The findings come from the largest and most detailed study ever conducted on the topic, offering compelling evidence of the lasting impact early trauma can have on mental health.

The research, led by Dr Marieke J.H. Begemann at the University of Groningen in the Netherlands, reviewed data from 183 prior studies, encompassing over 349,000 individuals. Published in the American Journal of Psychiatry, the analysis confirms earlier findings from a 2012 meta-analysis but provides what the authors describe as "a more precise estimate" due to the vastly expanded data set. As the team wrote,

“Our main finding confirms the increased risk of psychosis among individuals exposed to adversities early in life,”

noting that their calculated risk—an odds ratio of 2.80—was “strikingly similar” to the earlier study.

The types of trauma analysed included sexual, physical, and emotional abuse; neglect; bullying; and major disruptions within the family. All were associated with an elevated risk of psychosis, but emotional abuse and physical neglect stood out as particularly significant. Emotional abuse was linked to a 3.53-fold increase in risk, while physical neglect carried a 3.26-fold increase. The researchers noted that emotional abuse has been consistently linked to higher risk in a wide range of mental health conditions, not just psychosis.

To better understand how adversity affects individuals, the team grouped different forms of trauma into two broad categories. The first involved "threats" to physical or emotional safety, such as abuse or exposure to violence. The second centred on "deprivation"—the absence of expected social, emotional, or cognitive input during childhood. Interestingly, the deprivation-related adversities had a slightly stronger association with psychosis than threat-related ones, suggesting that neglect may be just as damaging as abuse in certain cases.

Although the researchers did not find statistically significant differences in risk between men and women, they observed that women showed slightly stronger associations between psychosis and overall adversity, especially in relation to sexual abuse. Another striking discovery was that people who experienced childhood adversity tended to develop psychotic symptoms around nine to ten months earlier than those who did not. This suggests that early trauma may accelerate the onset of psychosis in vulnerable individuals.

While the study cannot prove that adversity causes psychosis, the links are clear and complex. Traumatic experiences may lead to psychological consequences such as insecure attachment, negative thought patterns, and self-stigma. On a biological level, they can affect the brain’s development, immune and stress response systems, and even gene expression. The researchers also acknowledged that other factors—like genetics, substance use, socio-economic conditions, and access to healthcare—are likely involved.

For clinicians and mental health professionals, the study’s implications are clear. The researchers argue that early screening for childhood trauma should be standard practice when assessing patients with psychosis or those at high risk. They also emphasised the value of trauma-informed care and treatment approaches that account for the long-term psychological impact of early life experiences.

As the team concluded, “Early identification and support for individuals with a history of childhood adversity may be crucial for mitigating the risk of psychosis.” They also suggest that prevention efforts aimed at reducing childhood trauma—especially in families already facing challenges like poverty or genetic risk—could make a meaningful difference. Supporting children through enriched environments and teaching strong coping strategies could help protect mental health and reduce long-term risks.

MQ has contributed to an All-party parliamentary Group report that is calling on the UK government to ‘unlock the trauma trap’ of Adverse Childhood experiences (ACEs) and free the nation’s children with a population-wide public health strategy.

Find out more here.