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This systematic review and meta\u2010analysis aimed to synthesize studies considering psychological mediators of the associations between ACEs\/BCEs and PTSD\/CPTSD. Databases (PsychINFO, PubMed, PTSDpubs, PsycARTICLES, and Web of Science) were searched from inception to August 2025 for peer reviewed studies of adult populations examining psychological mediators of the associations between ACEs or BCEs and PTSD or CPTSD. A total of 63 studies involving 31,540 participants met the inclusion criteria. Mediators were grouped into six categories: cognitive beliefs and appraisals (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a033), emotion regulation strategies (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a040), interpersonal relationships (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a07), spiritual and religious beliefs (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a02), attachment style (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a05), and dissociation symptoms (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a09), with mostly small effect sizes. Subcategory meta\u2010analysis revealed emotion regulation, \u03b2\u00a0=\u00a0.4, 95% CI [0.001, 0.78], and maladaptive coping strategies, \u03b2\u00a0=\u00a0.05, 95% CI [0.03, 0.07], significantly mediated the association between ACEs and PTSD. Risk of bias and quality of evidence were assessed. Overall, evidence was insufficient to determine how mediators function across pathways, and a paucity of literature is highlighted, considering BCEs and CPTSD.\n                  <\/jats:p>","DOI":"10.1002\/jts.70098","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:52:14Z","timestamp":1782395534000},"page":"785-800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychological mediators of the associations between adverse and benevolent childhood experiences and posttraumatic stress disorder (PTSD) and complex PTSD: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"39","author":[{"given":"Sarah Louise","family":"Guthrie","sequence":"first","affiliation":[{"name":"Edinburgh Napier University, School of Health &amp; Social Care  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanos","family":"Karatzias","sequence":"additional","affiliation":[{"name":"Edinburgh Napier University, School of Health &amp; Social Care  Edinburgh UK"},{"name":"NHS Lothian Rivers Centre for Traumatic Stress  Edinburgh Uk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shevlin","sequence":"additional","affiliation":[{"name":"Ulster University, School of Psychology  Derry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bak\u2010Klimek","sequence":"additional","affiliation":[{"name":"Edinburgh Napier University, School of Health &amp; Social Care  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Woodrow","sequence":"additional","affiliation":[{"name":"Edinburgh Napier University, School of Health &amp; Social Care  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer.14.29"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2024.108109"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191105283504"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental\u20102019\u2010300117"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260518801030"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2023.37.4.406"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2015.252"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12671\u2010016\u20100502\u20103"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.11.003"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u2010295x.103.4.670"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2007.02.011"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23614"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v080.i01"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","unstructured":"\u00c7a\u011flar A. &Kaya B.(2025).Positive childhood experiences and posttraumatic growth: The Mediating roles of self\u2010compassion and self\u2010esteem.Psychiatric Quarterly. 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