Linking interpersonal childhood adversity to mental health: A scoping review of trust, mentalizing, agency and interpersonal emotion regulation as candidate social-transactional mechanisms.

OBJECTIVES

The neurocognitive social-transactional model posits that interpersonal adversity during childhood heightens risk for mental health difficulties by altering how individuals engage with their social world. We conducted a scoping review to map current evidence for four candidate mechanisms, Trust, Mentalizing, Agency and Interpersonal Emotion Regulation (IER), linking interpersonal childhood adversity to mental health outcomes.

METHODS

We followed PRISMA guidelines for scoping reviews and preregistered the protocol at https://osf.io/rt7cy. Through systematic searches, we identified quantitative studies that measured interpersonal Adverse Childhood Experiences (ACEs), at least one candidate mechanism, and mental health outcomes in the same sample. A second reviewer independently assessed 10% of records at each screening stage.

RESULTS

78 studies met inclusion criteria. For Trust (15 studies), ACEs were associated with greater distrust and credulity which in turn predicted internalizing, externalizing and personality disorder symptoms. For Mentalizing (37 studies), they were associated with heightened uncertainty and reduced accuracy in understanding mental states, which was linked with internalizing, externalizing, psychosis and personality disorder symptoms. For Agency (26 studies), they were associated with a more external locus of control, which was associated with internalizing and psychosis symptoms. Evidence for IER was limited (3 studies) but suggested potential links to internalizing symptoms. Across mechanisms, findings were largely cross-sectional and based on self-report, with few longitudinal or task-based studies.

CONCLUSION

Trust, Mentalizing and Agency emerged as promising transdiagnostic social-transactional mechanisms though which interpersonal childhood adversity may shape mental health outcomes, with more limited evidence for IER. Despite methodological gaps, these mechanisms may represent tractable targets for intervention research and trauma-informed clinical practice.