How psychological trauma shapes human decision-making: a systematic literature review of cognitive, emotional, and behavioral mechanisms

Abstract

sychological trauma is a public-health concern that cuts across emotional well-being and everyday decision-making. Both trauma and decision-making have been studied extensively, yet the mechanisms that connect adverse experiences to altered choice remain scattered across neuroscience, clinical psychology, and behavioral science. In this systematic literature review, we synthesize recent evidence on how trauma shapes human decision-making through cognitive, emotional, and behavioral pathways. The review follows PRISMA 2020. A structured Scopus search targeted English-language research articles published between 2022 and 2026. The search returned 886 records. After full-text assessment of 88 reports, 10 studies met the eligibility and quality criteria. Three convergent findings stand out. First, trauma disrupts value-based and reinforcement learning, which reduces behavioral flexibility and alters feedback sensitivity and belief updating. Second, greater threat appraisal, stronger stress reactivity, and impaired emotion regulation push decisions toward uncertainty avoidance and negative outcomes. Third, these shifts appear in risk-taking, substance-related choices, suicidality, and aggression. Overall, the evidence supports integrative models and trauma-informed, decision-focused clinical care.