Old Scars Don't Hurt? A Systematic Review on the Association Between Child Maltreatment and Adult Social Functioning.

Social impairments are commonly reported by individuals with a history of child maltreatment (CM). However, a systematic review on the relationship between different types of CM and impairments across various domains of social functioning in adults with and without mental disorders that also addresses mediating and moderating factors is still missing. Therefore, we systematically searched the PsycINFO and Web of Science databases for peer-reviewed studies published from 2003 to February 2025 that examined the association between CM before the age of 18 and various clinically relevant impairments in social functioning in adulthood (≥18 years). A total of 281 articles were included and clustered in seven domains of social functioning. Most studies revealed negative associations between CM and social functioning, with small to moderate effect sizes. The strongest evidence was found for intimate partner violence, aggression, social connectedness, attachment, and early maladaptive schemas, while findings for other domains-such as sexuality, intimate partner relationships, and social-cognitive processes-were less consistent. Psychopathology, insecure attachment, and emotion regulation were the most frequently identified mediating or moderating factors. Taken together, CM and social dysfunctions need to be assessed and considered more systematically in psychotherapeutic treatment across disorders. Furthermore, longitudinal studies with standardized measures of social functioning are needed to identify transdiagnostic as well as disorder-specific targets for mechanism-based prevention and interventions for individuals with CM experiences.