Peer-reviewed article

A systematic review and meta-analysis of fear conditioning in children who have experienced childhood trauma or maltreatment.

Meghan L Whalen, Abigail Beech, Megan Paterson, Manessa Riser, M Alexandra Kredlow · 8 Oct 2026

Abstract

Childhood trauma has been identified as a major risk factor for the development of fear-related disorders in adulthood. Exposure to trauma might impact fear learning and extinction processes, which in turn may increase risk for these disorders. A PubMed, PsycInfo, and Web of Science search was conducted through May 6, 2025. Studies that used classical fear conditioning paradigms, measured indicators of fear response, examined childhood trauma or maltreatment in populations aged 18 or younger were included. Effect sizes were calculated for response to threat cues, response to safety cues, and differential fear response during acquisition and extinction, if included. Ultimately, 14 studies met the criteria for the qualitative review and 12 were quantitatively meta-analyzed (aggregate n = 1094). Results showed that trauma exposure was significantly associated with blunted responses to the threat cue during early acquisition when compared to children with little or no trauma exposure (g = -0.40; p < 0.01; k = 4). When assessing trauma exposure continuously, greater trauma exposure was significantly associated with lower responding to the safety signal (r = -0.10; p < 0.05; k = 8) and more pronounced discrimination (r = 0.15; p < 0.001; k = 8) in early acquisition. No significant effects were observed for extinction albeit studies were limited (k = 4). Findings suggest that trauma-exposed children exhibit altered fear learning patterns during acquisition. Future research should examine the impact of early life trauma on the development of fear learning and potential for acquiring fear-related disorders into adulthood.