How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms
Figures

Sample characterization and ACE assessment instruments used in the studies included in the review on an association between ACEs and threat (n=38; A, C, E,G, I in blue) and reward (n=43; B, D, F, H, J in orange) learning processes.
Numbers represent the number of studies to which a specific characteristic applies (note that these do not add up to the total number of studies as multiple characteristics may apply to a single study). Total sample sizes of the individual studies range from N=19 to N=11,360 (see Figure 1—figure supplement 1 for details). 1 Refers to participants aged 17–19 years; 2 Includes studies that assess ACEs dimensionally across all participants as well as studies that excluded participants with psychological disorders. 3 Includes studies that assess ACEs that cannot be classified as either threat or deprivation. Figure 1—figure supplement 1. Distribution of sample sizes across studies.

Paradigm specifications as well as outcome measures used in the studies included in this review for threat- (A, C, E, in blue) and reward-related learning (B, D, F, in orange) including paradigm type (A, B), type of threat or reward (C, D), and outcome measures used (E, F).
Numbers represent the number of studies to which a certain specification applies (note that these do not add up to the total number of studies as multiple specifications may apply to a single study).

Distinct adversity types that were assessed in the 38 articles from the threat learning field.
Numbers refer to the studies listed below the figure. The colored dots represent the adversity types listed in the legend on the right. Shades of red correspond to threat-related experiences, while blue dots correspond to deprivation-related experiences and green dots correspond to household dysfunction. Adversity types that did not fit into any of these categories were colored in gray. We included all adversity types that were considered as early adversity according to the studies and were assessed accordingly. The adversity types are being captured rather roughly as they represent the content of the assessment instruments as a whole or its subscales but not individual items.
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Figure 3—source data 1
Threat learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-fig3-data1-v1.docx

Distinct adversity types that were assessed in the 43 studies from the reward learning field.
Numbers refer to the studies listed below the figure. The colored dots represent the adversity types listed in the legend on the right. Shades of red correspond to threat-related experiences, while dots in shades of blue correspond to deprivation-related experiences and dots in shades of green correspond to household dysfunction. Adversity types that did not fit into any of these categories were colored in gray. We included all adversity types that were considered as early adversity according to the studies and were assessed accordingly. The adversity types are being captured rather roughly as they represent the content of the assessment instruments as a whole or its subscales but not individual items. Studies Reward Learning.
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Figure 4—source data 1
Reward learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-fig4-data1-v1.docx
Additional files
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Supplementary file 1
Details on the systematic literature search, PRISMA flow chart.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp1-v1.docx
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Supplementary file 2
List of questionnaires used in the included studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp2-v1.docx
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Supplementary file 3
Sample specifications of the threat learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp3-v1.docx
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Supplementary file 4
Sample specifications of the reward learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp4-v1.docx
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Supplementary file 5
Paradigm specifications of the threat learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp5-v1.docx
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Supplementary file 6
Paradigm specifications of the reward learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp6-v1.docx
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Supplementary file 7
Quality assessment tool.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp7-v1.docx
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Supplementary file 8
Quality assessment of the threat learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp8-v1.xlsx
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Supplementary file 9
Quality assessment of the reward learning studies.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp9-v1.xlsx
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Supplementary file 10
Likelihood ratio tests.
- https://cdn.elifesciences.org/articles/92700/elife-92700-supp10-v1.docx