The influence of early familial adversity on adolescent risk behaviors and mental health: Stability and transition in family adversity profiles in a cohort sample.

Ruth Wadman,Rachel M Hiller,Michelle C St Clair

doi:10.1017/s0954579419000191

Ruth Wadman, Rachel M Hiller + Show 1 more

Open Access

https://doi.org/10.1017/s0954579419000191

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Abstract

Although familial adversity is associated with poorer outcomes in childhood and adulthood, little research has looked at the influence of stability or transition between distinct familial adversity subgroups or the impact in adolescence. Using data from the 9-month, 3-, 5-, and 14-year time waves of the Millennium Cohort Study (n > 18,000), we used latent class analysis to identify distinct classes of early familial adversity (marital instability/conflict, "suboptimal" parenting, economic disadvantage, and parental mental health problems) and the impact of these adversity classes on adolescent (a) mental health (including self-harm), (b) risk taking, (c) criminality, and (d) victimization. Four profiles were identified largely differing on economic hardship, family composition, and parental conflict. Across the first three time points, 72% of the sample remained stable, with the remainder transitioning between classes. Adolescents in the higher risk groups (particularly categorized by economic hardship or high parental conflict) had poorer outcomes in adolescence. Transitioning to a higher adversity group at any time in the first 5 years was associated with poorer outcomes but was particularly pronounced when the transition occurred when the child was under 3 years. These findings demonstrate the broad consequences of early familial adversity and the need for targeted early support for at-risk families.

Highlights

Adversity is a well-established risk factor for poor emotional adjustment and mental health outcomes later in life (Anda et al, 2002; Chapman et al, 2004; Dube et al, 2001; Dube, Anda, Felitti, Edwards, & Croft, 2002)
Two additional classes were characterized by a two-parent household, but with other elevated adversity risk factors that encompassed two distinct trajectories
Supporting the classification of early family adversity, we found that compared to the low-risk comparison group, adolescents in the groups categorized by higher rates of economic disadvantage demonstrated a range of poor outcomes by adolescence

Summary

Introduction

Adversity is a well-established risk factor for poor emotional adjustment and mental health outcomes later in life (Anda et al, 2002; Chapman et al, 2004; Dube et al, 2001; Dube, Anda, Felitti, Edwards, & Croft, 2002). At the most extreme end, child abuse and maltreatment predicts multiple problem outcomes across the life span, including poor mental health and risk behaviors such as alcohol and drug use and criminality (e.g., Kaplow & Widom, 2007; Norman et al, 2012; Thornberry, Ireland, & Smith, 2001). Behavioral difficulties, psychopathology, and mental health problems are typically examined as outcomes of early childhood family adversity. A New Zealand cohort study examining childhood predictors of adolescent suicidal behavior found that the risk of suicidality depended on accumulative exposure to social, family, and mental health adversity factors: those at greatest risk of suicidal behavior were young people whose family life was characterized by socioeconomic adversity, marital disruption, poor parent–child attachment, and exposure to sexual abuse (Fergusson, Woodward, & Horwood, 2000). Childhood adversities (assessed through retrospective reporting of stressful life events) have been found to have a cumulative impact on drug and alcohol use in adolescence and early adulthood, with both recent and early adversity being significantly and independently associated with increased risk for drug and alcohol use (Lloyd & Turner, 2008)

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