Aims: Childhood abuse has been shown to be associated with a range of aspects of social
cognition in adulthood. Among them, mentalization – the ability to attend to and interpret one’s
own behavior and the behavior of others in terms of mental states – has been a popular topic
of research. However, the literature remains limited to single dimensions of mentalization, as
opposed to the broader multi-dimensional concept, and there has been no systematic review
or meta-analysis on this topic.
Methods: This multilevel meta-analysis provides a synthesis of all empirical literature
examining the relationship between childhood abuse and mentalization abilities in the general
adult population. Mentalization was operationalized using 8 distinct constructs: reflective
functioning, mentalization, mind-mindedness, insightfulness, social cognition, theory of mind,
alexithymia, and emotion recognition. Systematic electronic searches were conducted across
5 databases, and 57 outcomes across a total of 27 studies were included. An additional metaanalysis
was also conducted examining the relationship between general childhood
maltreatment, as distinct childhood from abuse, and mentalization in adulthood.
Results: A significant weighted average correlation of r=.14, 95%CI [.09, .19] was found for
the relationship between childhood abuse and adult mentalization, representing a small effect
size. Moderation analyses revealed that younger participants, members of minority groups,
and female participants reported poorer mentalization in adulthood after childhood abuse. An
additional meta-analysis examining the relationships between general childhood maltreatment
and mentalization in adulthood reviewed 18 studies and yielded a significant weighted average
correlation of r=0.17, 95%CI [.07, .27].
Conclusions: The current meta-analysis confirms that childhood abuse and childhood
maltreatment are both associated with poorer mentalization in adulthood. The results contribute clinically to the shape and form of early interventions and treatments. Future research may seek to compare the effects of abuse and neglect, and account for a clinical population.