Social Support In Adulthood Mediates the Impact of Childhood Maltreatment History on Mental Health Outcomes: A Scoping Review

Background and Purpose: Childhood maltreatment (CM), including physical, emotional, and sexual abuse as well as neglect, is a significant public health issue with well-documented detrimental effects on long-term mental health and well-being. While the link between CM and adverse mental health outcomes is well established, less is known about the relational mechanisms underlying these pathways. Adult social support and social network characteristics are developmental outcomes influenced by CM exposure, and key mechanisms that influence subsequent mental health trajectories across the lifespan.The purpose of this scoping review was to map the state of the literature on associations between types of CM and adult social support and social networks.

Methods: We conducted a scoping review following Arksey and O’Malley’s (2005) framework, guided by PRISMA-ScR guidelines. Literature was searched in PsycINFO, Social Services Abstracts, and PubMed using terms related to childhood maltreatment, adult social support, social networks, and health outcomes. We included peer-reviewed, English-language empirical articles published within the past 20 years. While 661 records were identified, 23 studies met the inclusion criteria after screening and full-text review. Data were organized using a structured framework that captured study characteristics, maltreatment types, social outcomes, and the nature of associations (direct or mediated). Findings were synthesized using descriptive mapping and thematic analysis.

Results: Findings indicated two key patterns. First, CM was associated with diminished adult social resources. Individuals with CM histories reported lower perceived social support, smaller social networks, and poorer relationship quality in adulthood. Evidence supported links between physical CM and lower adult social support, while childhood neglect was associated with smaller social network size and diminished social support in adulthood.

Second, a substantial portion of these studies identified social support as a mechanism linking CM to adverse mental health outcomes. Across studies social support was implicated in pathways to depression, anxiety, posttraumatic stress symptoms, and intimate partner violence. Our review identified associations between CM history and lower family support in adulthood, which was in turn associated with an increased likelihood of PTSD, depression, and anxiety.

Studies varied in how they modeled social support, including as a direct outcome, mediator, or covariate. Most relied on cross-sectional or retrospective designs, though several prospective cohort studies offered stronger evidence of temporal pathways. Differences in study design and analytic approaches contributed to variability in the strength and consistency of the relationship between childhood maltreatment and social support. The literature also heavily relied on measures of perceived social support, with limited focus on the structural aspects of social networks.

Conclusion/Implications: Social support and social network structure are key relational factors linking CM to negative mental health outcomes across the lifespan. These findings highlight the need for clearer concepts and better measurement in the study of social support and networks, as well as greater focus on relational outcomes as essential, not secondary, effects of CM. Interventions that focus on improving relational skills and opportunities to build stable, supportive connections may be critical for achieving better long-term mental health outcomes for individuals with CM histories.