TABLE 2.

Study characteristics and key research findings analyses (student samples)

Study (author, year; country)	Population	Sample size (N); female %; mean age	Study design	Measurement of child adversity; definition of childhood adversity	Psychosocial mediating variable(s); measurement	Psychosocial moderating variable(s); measurement	Mental health outcomes; measurement	Type of mediation analysis; potential confounders or covariates considered (yes/no)	Mediation/moderation results/key findings (pathway total/partial mediation, direct effect [DE], indirect effect [IE], % total effect mediated)
Berman et al. (2019), USA	Female college students	252; 100%; 19.2	Cross‐sectional	ACE questionnaire; Child maltreatment	Negative beliefs; Posttraumatic Maladaptive Beliefs Scale (PMBS; Vogt, Shipherd & Resick, 2012)	None tested	Depression; Patient Health Questionnaire (PHQ‐9; Spitzer et al., 1999 Anxiety; Patient Health Questionnaire (PHQ; Spitzer et al., 1999) Posttraumatic symptoms; Posttraumatic Checklist for DSM‐5 (PCL‐5; Weathers et al., 2013)	Structural equation modelling (SEM). Bootstrapping; Yes	Significant indirect effect (IE) of child maltreatment (abuse and neglect subscales) (b = −0.09, p = 0.005) on internalizing symptoms (depression, anxiety and posttraumatic symptoms) via negative core beliefs. Partial mediation. Significant IE of household dysfunction (abuse and neglect subscales) (b = −0.11, p = 0.019) on internalizing symptoms via negative core beliefs. Complete mediation.
Brown et al. (2016), USA	Undergraduate students recruited from a public University in the Midwest United States.	339; 48.7%; 19	Cross‐sectional	CTQ‐SF; Child maltreatment	Alexithymia; Toronto Alexithymia Scale (TAS‐20; Bagby et al., 1994).	None tested	Depression; Short Mood and Feelings Questionnaire (SMFQ; Sharp et al., 2006) Anxiety; General Anxiety Disorder Scale (GAD‐7; Spitzer et al., 2006)	Bootstrapping; No	IE of emotional neglect on depression (b = 0.04, 95% CI = [0.003–0.07]) and anxiety (b = 0.07, BC 95% CI = [0.01–0.13]) via alexithymia.
Browne and Winkelman (2007), Australia	Psychology undergraduate students recruited from an Australian university.	219; 81.74%; 20.96	Cross‐sectional	CTQ‐SF; Childhood trauma	Adult attachment; Relationship Scales Questionnaire (RSQ; Griffin & Bartholomew, 1994) Cognitive distortions; Cognitive Distortions Scale (Briere, 2000)	None tested	Trauma symptoms; Trauma Symptom Inventory (Briere, 1995)	Structural equation modelling (SEM). Path analysis. Multiple mediation model; No	IE (=0.23) of childhood trauma on trauma symptoms via cognitive distortions. Associations found between childhood trauma and attachment dimensions which on their own were not significantly associated with trauma symptoms.
Corcoran and McNulty (2018), Ireland	University students recruited from Republic of Ireland universities.	190; 76.32%; 22.02	Cross‐sectional	ACE questionnaire; Adverse childhood experiences	Attachment; Experiences in close relationships − relationship structures scale (ECR‐RS; Fraley et al., 2011)	None tested	Depression‐Anxiety‐Stress; Depression anxiety & stress scales (DASS‐21; Lovibond & Lovibond, 1995)	Multiple mediation model. Bootstrapping (BC; 95% CI), PROCESS Macro (Preacher & Hayess (2004); No	Significant IE of childhood adversity on depression through attachment anxiety‐general (b = 0.33, BC 95% CI [0.19–0.53]), attachment anxiety‐friend (b = 0.09, BC 95% CI [0.01–0.23]) and attachment avoidance‐mother (b = 0.21, BC 95% CI [0.06–0.42]). Complete mediation. Significant IE of childhood adversity on anxiety via attachment anxiety‐general (b = 0.28, BC 95% CI [0.15–0.46]). Complete mediation.
Gong and Chan (2018), China	College students recruited from universities in China.	1,102; 73.14%; 20.46	Cross‐sectional	CTQ‐SF; Childhood maltreatment	Early maladaptive schemas; Young Schema Questionnaire, version 3 (YSQ‐3; Young et al., 2003). Chinese version	None tested	Depression; Zung Self‐Rating Depression Scale (SDS; (Zung, 1986) Anxiety; Zung Self‐Rating Anxiety Scale (SAS; Zung, 1971)	SEM. Bootstrapping (BC; 95% CI), PROCESS Macro (Preacher & Hayess (2004); No	Significant IEs of physical abuse (BC 95% CI [0.142–0.260]), emotional abuse (BC 95% CI [0.205–0.314]), and sexual abuse (BC 95% CI [0.069–0.176 3]) on psychological distress (depression and anxiety) through early maladaptive schemas. IEs of physical neglect (BC 95% CI [0.142–0.260]) and emotional neglect (BC 95% CI [0.177–0.282]) on depression and anxiety through early maladaptive schemas.
Kaloeti et al. (2019), Indonesia	Undergraduate students recruited from a University in Indonesia.	443; 73.45%; 18.60	Cross‐sectional	ACE questionnaire; Adverse childhood experiences	Resilience; Connor‐Davidson Resilience Scale (CD‐RISC; Connor & Davidson, 2003)	None tested	Depression; Beck Depression Inventory‐II (BDI‐II; Beck et al., 1996)	Path analysis	No DE of ACEs on resilience identified (b = 0.37, SE = 0.437, β = 0.04). Resilience did not mediate the ACEs‐depression relationship.
Makriyianis et al. (2019), USA	College students recruited from a public arts college in US.	305; 66.6%; 19.13	Cross‐sectional	ACE questionnaire; Adverse childhood experiences	Psychological Flexibility and Inflexibility; The Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al., 2016)	None tested	Depression; Patient Health Questionnaire (PHQ‐8; Kroenke et al., 2009) Anxiety; General Anxiety Disorder Scale (GAD‐7; Spitzer et al., 2006)	Bootstrapping (BC; 95% CI), PROCESS Macro (Hayes, 2018); Νο	Significant IE of ACEs on depression via inflexibility (b = 0.14, SE = 0.03, BC 95% CI [0.07–0.21]). 53% of variance in depression. Complete mediation. Significant IE of ACEs on anxiety via inflexibility (b = 0.13, SE = 0.03, BC 95% CI [0.07–0.20]). 49.2% of the variance. Complete mediation.
McCormick et al. (2017), USA	Students recruited from a south‐eastern university in US.	458; 61.3%; 20.70	Cross‐sectional	ACE questionnaire; Adverse childhood experiences	Religious/spiritual struggles; Religious and Spiritual Struggles Scale (RSSS; Exline et al., 2014)	None tested	Depression; Patient Health Questionnaire (PHQ‐8; Kroenke et al., 2001) PTSQ; Posttraumatic Stress Disorder Checklist‐Civilian Version (PCL‐C; Weathers et al., 1993)	Bootstrapping (BC; 95% CI), PROCESS macro. Sobel test; Yes (age, gender, ethnicity, traumatic life events)	Significant IE of ACEs on depressive symptoms through the meaning struggles (b = 0.154, BC 95% CI [0.059–0.291], z = 3.05, p = 0.002). Significant IE of ACEs on PTSD symptoms through the meaning struggles subscale of the RSSS (b = 0.35, BC 95% CI [0.138, 0.7], z = 3.024, p = 0.003).
Nowalis et al. (2020), USA	Students recruited from a north‐eastern university in US.	203; 52%; 19.85	Cross‐sectional	CTQ‐SF; Bernstein et al., 2003 Child maltreatment	None tested	Attachment; Experiences in Close Relationships–Revised (ECRR; Fraley et al., 2000)	Depression; Beck Depression Inventory–II (BDI‐II; Beck et al., 1996).	Path analysis in MPlus; Yes	Anxious attachment to primary caregiver significantly moderated the child maltreatment‐depression relationship (b = −0.16 p = 0.002, BC 95% CI = [−0.25 to −0.06]). 43.5% of variance. No significant effect identified for avoidant attachment to primary caregiver and for anxious or avoidant attachment to secondary caregiver.
Reiser et al. (2014), Canada	University students recruited through an undergraduate research pool website.	264; 81.06%; 22.56	Cross‐sectional	ACE questionnaire; Adverse childhood experiences	None tested	Negative affect; Positive and Negative Affect Schedule‐Negative Affect (PANAS‐NA) subscale; Watson, Clark, & Tellegen, 1988) Trait Anxiety; Trait form of the State–Trait Anxiety Inventory for adults‐form Y (STAI‐T; (Spielberger et al., 1983)	Health anxiety Short Health Anxiety Index (SHAI; (Salkovskis et al., 2002)	Multiple hierarchical regression. Baron and Kenny (1086). Sobel test. Bootstrapping. (Preacher & Hayes, 2004); No	Negative affect fully mediated the relationship between ACEs and health anxiety. Direct effect of ACEs on health anxiety not significant after controlling for negative affect (p = 0.716). Bootstrapping estimates CI = (3,697 to −0. 9,186) and Sobel test, (z = 4.93, p < 0.001) confirmed statistical significance of IE. Trait anxiety fully mediated the relationship between ACEs and health anxiety. DE of ACEs on health anxiety not statistical significant (p = 0.51). Sobel test demonstrated statistical significance of IE (z = 4.45, p < 0.001).
Ross et al. (2019), USA	Community sample and students recruited through posters in the community and campus.	244; 75.10%; 20.80	Cross‐sectional	CTQ‐SF; Childhood maltreatment	Self‐compassion; Self‐compassion scale (Neff, 2003) Shame; Internalized Shame Scale (ISS; Cook, 1994, 2001)	None tested	Depression; Center for Epidemiological Studies Depression Scale‐Revised (CESD‐R; Eaton et al., 2004)	Multiple mediation model; Path models with R package covRobust (Wang & Raftery, 2002). Bootstrapping (95% CI); Yes	Significant IE of emotional abuse on depression through self‐compassion and shame (b = 0.084 [0.032], BC 95% CI [0.03–0.13), p = 0.008). DE of emotional abuse on shame (β = 0.131[0.049], 95% CI [0.04–0.23], p = 0.008). IE of emotional abuse on depression through shame (b = 0.089 [0.033], 95% CI [0.01–0.15]. = 0.008, p = 0.008) Significant effect of emotional neglect on depression through self‐compassion followed by shame (b = 0.178 [0.034], BC 95% CI [0.11–0.25] p < 0.001). Shame accounted for 14.8% and emotional abuse accounted for 1.5% of variance in depressive symptoms. Shame is a stronger predictor
Song et al. (2020), China	Undergraduate students recruited from two medical colleges in China.	7,643; 74.12%; 19.67	Cross‐sectional	CTQ‐SF; Childhood maltreatment	Coping styles; Coping style questionnaire (CSQ; Xiao & Dai, 2018).	None tested	Depression; Center for Epidemiological Studies Depression Scale (CES‐D; Radloff, 1977)	Multiple mediation model. Bootstrapping (95% CI), PROCESS (Hayes, 2013); Yes	IEs of child maltreatment on depression though problem solving (b = −0.913), self‐blame (b = 1.307), help‐seeking (b = − 0.493), problem avoidance (b = 0.104) and rationalization (β = 0.158) in the whole group. IEs of child maltreatment on depression though problem solving (b = −0.836), self‐blame (b = 1.261), help‐seeking (b = − 0.517), problem avoidance (b = 0.138) and rationalization (b = 0.173) in the female group. IEs of child maltreatment on depression through problem solving (b = −1.127), self‐blame (b = 1.468) and help‐seeking (b = −0.419) in male participants. Self‐blame had the strongest intervening effect (b = 1.307) in total. No intervening effect identified for fantasy.
Taylor et al. (2021), USA	College students recruited from a south‐western university.	504; 64.9%; 19.83	Cross‐sectional	ACE questionnaire; Childhood adversity	Repetitive negative thinking; Perseverative thinking questionnaire (PTQ; Ehring et al., 2011)	Executive control; Attentional control scale (ACS; Derryberry & Reed, 2002)	Anxiety/Worry; Penn state worry questionnaire (PSQW; Meyer et al., 1990)	Moderated mediation model. Bootstrapping (95% CI), PROCESS; No	Significant IE of ACES on anxiety symptoms through repetitive negative thinking (b = 1.15, BC 95% CI = [0.64–1.78]). Significant effect of attentional control‐focusing on the relationship between repetitive negative thinking and worry (b = 0.02, p < 0.05, BC 95% CI = [0.004–0.035]). Attentional control moderated the IE of ACEs on worry through repetitive negative thinking (b = 0.02, p < 0.05, BC 95% CI = [0.004–0.035]).
Wang et al. (2020), China	College students recruited from universities in China.	404; 53.2%; 20.12	Cross‐sectional	CTQ‐SF; Childhood trauma	Personality Traits‐ Neuroticism; The NEO‐Five Factor Inventory (NEO‐FFI; Costa and McCrae, 1992)	Resilience; Conner‐Davidson Resilience Scale (CD‐RISC; (Connor & Davidson, 2003)	Depression; Beck Depression Inventory–II (BDI‐II; Beck et al., 1996).	Multiple linear regression (Baron & Kenny, 1986). Bootstrapping (BC; 95% CI), PROCESS Macro (Hayes, 2013); Yes (gender, age)	Significant IE of childhood trauma on later depression through neuroticism (BC 95% CI [0.094–0.219]. Partial mediation (b = 0.271, p < 0.001). IE of low resilience on the relationship between childhood trauma and neuroticism (IE = 0.146, SE = 0.032, 95% CI = [0.091–0.216]). IE not significant when higher levels of resilience: (IE = 0.028, SE = 0.035, 95% CI = [−0.041–0.094]).
Watt et al. (2020), USA	Students recruited from a south‐east university in US.	404; 73.6%; 19.87	Cross‐sectional	ACE questionnaire; Childhood trauma (if 4 or >4 ACEs	Perceived social support; ENRICH Social Support Index (ESSI; Vaglio et al., 2004)	None tested	Depression; Patient Health Questionnaire (PHQ‐8; Kroenke et al., 2001) Anxiety; General Anxiety Disorder Scale (GAD‐7; Spitzer et al., 2006	SEM (using Mplus 7); Yes (age, gender, parents level of education, race or ethnicity)	IE of ACES (4 or >4) on depression (.789, p = 0.001) and anxiety (0.626, p = 0.002) through perceived social support.
Wells et al. (2014), USA	Students with no history of psychiatric disorders recruited from the University of Texas.	155; 53.5%; 18.8	Cross‐sectional	CTQ‐SF; Childhood abuse	Cognitive vulnerability/ information processing bias; Dysfunctional Attitudes Scale (DAS; Weissman & Beck, 1978) Scrambled Sentences Test (SST; Wenzlaff & Bates, 1998)	None tested	Depression; CES‐D (Radloff, 1977) (baseline depression scoring)	Hierarchical linear regression. PRODCLIN programme (MacKinnon et al., 2007) for Significance testing; No	Effect of childhood abuse on baseline depression non‐significant (β = 0.12, t = 1.48, p = 0.14). Significant mediational effect of child abuse on baseline depression scores through dysfunctional attitudes (95% CI = [0.014–0.0642]). Dysfunctional attitudes mediated the association of emotional maltreatment and depression (BC 95% CI = [0.002–0.087]). No significant effect was found for physical maltreatment Follow up mediation analysis showed that child abuse may contribute to cognitive vulnerability and this may lead to increased symptoms of depression (95% CI = [0.007–1.07]).
Wilson and Newins (2018), USA	Participants recruited through a mid‐Atlantic public university psychology subject pool.	336; 70.2%; 22.81	Cross‐sectional	CTQ Childhood maltreatment	Anxiety sensitivity; Anxiety Sensitivity Index‐3 (ASI‐3; Taylor et al., 2007)	None tested	PTSD Checklist for DSM‐5 (PCL‐5; Weathers et al., 2013)	Bootstrapping (BC; 95% CI), PROCESS Macro (Hayes, 2013); Yes (alcohol dependence, suicidal ideation)	Significant IE of child maltreatment on PTSD via anxiety sensitivity (β = 0.08, BC 95% CI [0.27–0.131]). DE of child maltreatment remained significant. Alcohol dependence, suicidal ideation entered in the model as covariates.

Abbreviations: ACE questionnaire, CDC‐Kaiser Permanente Adverse Childhood Experience Questionnaire; Felitti et al., ¹⁹⁹⁸; BC, bias corrected; CI, confidence interval; CTQ, Childhood Trauma Questionnaire (Bernstein & Fink, 1998; Bernstein et al., 2003); CTQ‐SF, Childhood Trauma Questionnaire short form; DI, direct effect; IE, indirect effect; PTSD, post‐traumatic stress disorder.