Associations Of Childhood Adversities Research Articles

Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions.

The physical health consequences of childhood psychosocial adversities may be as substantial as the mental health consequences, but whether this is the case remains unclear because much prior research has involved unrepresentative samples and a selective focus on particular adversities or physical outcomes. The association between early-onset mental disorders and subsequent poor physical health in adulthood has not been investigated. To investigate whether childhood adversities and early-onset mental disorders are independently associated with increased risk of a range of adult-onset chronic physical conditions in culturally diverse samples spanning the full adult age range. Cross-sectional community surveys of adults in 10 countries. General population. Adults (ie, aged ≥18 years; N=18303), with diagnostic assessment and determination of age at onset of DSM-IV mental disorders, assessment of childhood familial adversities, and age of diagnosis or onset of chronic physical conditions. Risk (ie, hazard ratios) of adult-onset (ie, at age >20 years) heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache as a function of specific childhood adversities and early-onset (ie, at age <21 years) DSM-IV depressive and anxiety disorders, with mutual adjustment. A history of 3 or more childhood adversities was independently associated with onset of all 6 physical conditions (hazard ratios, 1.44 to 2.19). Controlling for current mental disorder made little difference to these associations. Early-onset mental disorders were independently associated with onset of 5 physical conditions (hazard ratios, 1.43 to 1.66). These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life. They require confirmation in a prospectively designed study. The long course of these associations has theoretical and research implications.

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

BackgroundAlthough significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders.AimsTo examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries.MethodNationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI).ResultsChildhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries.ConclusionsChildhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

BackgroundPsychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest.We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy.MethodsTwo systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk.ResultsWe included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life.ConclusionsTaken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as traumata and childhood adversities for the future risk of type 2 diabetes or obesity is too small to draw conclusions. Thus, more population-based longitudinal studies and international standards to assess psychosocial factors are needed to clarify the mechanisms leading to the observed health disparities.

Association of childhood adversities with the first onset of mental disorders in Japan: Results from the World Mental Health Japan, 2002–2004

It is well known that childhood adversities (CAs) are a significant risk factor for mental disorders in later life. However, it is uncertain whether a similar association between CAs and mental disorders can be found in Japan. Few studies have employed an appropriate statistical model that takes into account the high comorbidity of CAs. The purpose of this study is to elucidate the association between CAs and the onset of mental disorders in Japan. We used the data from the World Mental Health Japan, 2002–2004 ( n = 1722). Respondents completed diagnostic interviews (the World Health Organization Composite International Diagnostic Interview) that assessed lifetime prevalence of 15 Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV) disorders. Associations of 12 retrospectively reported CAs with the lifetime prevalence of mental disorders were estimated using discrete-time survival analysis. Of the study sample, 32% reported as having experienced at least 1 CA during childhood. The studied CAs were highly comorbid. Parental mental illness showed significant sub-additive effects. The presence of 3 CAs showed a significant interactive effect on any mental health disorder. The number of CAs had a strong interactive effect on the onset of anxiety disorders. Predictive effects of CAs were found only among childhood onset mental disorders. It was confirmed that CAs are one of predictors of the onset of DSM-IV mental disorders, especially during childhood, in Japan.

Does the Influence of Childhood Adversity on Psychopathology Persist Across the Lifecourse? A 45-Year Prospective Epidemiologic Study

Prospective evidence about whether the association of childhood adversity and psychopathology attenuates across the lifecourse and whether effects on mid-life psychopathology are mediated through adolescent and early adulthood psychopathology is limited. Data were from the 1958 British Birth Cohort, a 45-year study of 98% of births in 1 week in 1958 in England, Scotland, and Wales. Outcomes included International Statistical Classification of Diseases (ICD-10) diagnoses for affective and anxiety disorders at 45 years and psychopathology at 16 years and 23 years. Multiple multi-informant measures of childhood adversity were available at 7, 11, and 16 years, with additional retrospective measures of parental sexual and physical abuse at 45 years. Analyses were determined on the basis of N = 9377; 59% of the surviving sample. After adjustment for socioeconomic covariates, childhood adversities were associated with adolescent, early adulthood, and mid-life psychopathology: most associations did not attenuate with age. Mid-life associations were significantly fully or partially mediated by early adulthood psychopathology: cumulative adversity, illness, sexual abuse, and physical abuse remained significantly associated with mid-life psychopathology. The findings confirm the importance of preventing exposure to adversity and suggest that effects of adversity on mid-life psychopathology may operate through psychopathology in early adulthood. Future research is needed to examine other intermediary factors which may explain these associations.

The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders

Background Although several studies have shown that life adversities play an important role in the etiology and maintenance of both depressive and anxiety disorders, little is known about the relative specificity of several types of life adversities to different forms of depressive and anxiety disorder and the concurrent role of neuroticism. Few studies have investigated whether clustering of life adversities or comorbidity of psychiatric disorders critically influence these relationships. Methods Using data from the Netherlands Study of Depression and Anxiety (NESDA), we analyzed the association of childhood adversities and negative life experiences across the lifespan with lifetime DSM-IV-based diagnoses of depression or anxiety among 2288 participants with at least one affective disorder. Results Controlling for comorbidity and clustering of adversities the association of childhood adversity with affective disorders was greater than that of negative life events across the life span with affective disorders. Among childhood adversities, emotional neglect was specifically associated with depressive disorder, dysthymia, and social phobia. Persons with a history of emotional neglect and sexual abuse were more likely to develop more than one lifetime affective disorder. Neuroticism and current affective disorder did not affect the adversity–disorder relationships found. Limitations Using a retrospective study design, causal interpretations of the relationships found are not warranted. Conclusions Emotional neglect seems to be differentially related to depression, dysthymia and social phobia. This knowledge may help to reduce underestimation of the impact of emotional abuse and lead to better recognition and treatment to prevent long-term disorders.

Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders.

Although significant associations of childhood adversities (CAs) with adult mental disorders have been widely documented, associations of CAs with onset and persistence of disorders have not been distinguished. This distinction is important for conceptual and practical purposes. To examine the multivariate associations of 12 retrospectively reported CAs with persistence of adult DSM-IV disorders in the National Comorbidity Survey Replication. Cross-sectional community survey. Household population in the United States. Nationally representative sample of 5692 adults. Recency of episodes was assessed separately for each of 20 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance use disorders in respondents with a lifetime history of these disorders using the Composite International Diagnostic Interview. Predictors of persistence were examined using backward recurrence survival models to predict time since most recent episode controlling for age at onset and time since onset. The CAs involving maladaptive family functioning (parental mental illness, substance use disorder, criminality, family violence, physical and sexual abuse, and neglect) but not other CAs were significantly but modestly related to persistence of mood, substance abuse, and anxiety disorders. Number of maladaptive family functioning CAs had statistically significant, but again substantively modest, subadditive associations with the same outcomes. Exposure to multiple other CAs was significantly associated with persistence of mood and anxiety disorders. Associations remained statistically significant throughout the life course, although the substantive size of associations indicated by simulations showing time to most recent episode would increase by only 1.6% (from a mean of 8.3 years to a mean of 8.4 years) in the absence of CAs. The overall statistically significant associations of CAs with adult DSM-IV/Composite International Diagnostic Interview disorders are due largely to component associations with onsets rather than with persistence, indirectly suggesting that the greatest focus of public health attention on CAs should be aimed at primary rather than secondary prevention.

Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication I

Although significant associations of childhood adversities (CAs) with adult mental disorders have been documented consistently in epidemiological surveys, these studies generally have examined only 1 CA per study. Because CAs are highly clustered, this approach results in overestimating the importance of individual CAs. Multivariate CA studies have been based on insufficiently complex models.To examine the joint associations of 12 retrospectively reported CAs with the first onset of DSM-IV disorders in the National Comorbidity Survey Replication using substantively complex multivariate models.Cross-sectional community survey with retrospective reports of CAs and lifetime DSM-IV disorders.Household population in the United States.Nationally representative sample of 9282 adults.Lifetime prevalences of 20 DSM-IV anxiety, mood, disruptive behavior, and substance use disorders assessed using the Composite International Diagnostic Interview.The CAs studied were highly prevalent and intercorrelated. The CAs in a maladaptive family functioning (MFF) cluster (parental mental illness, substance abuse disorder, and criminality; family violence; physical abuse; sexual abuse; and neglect) were the strongest correlates of disorder onset. The best-fitting model included terms for each type of CA, number of MFF CAs, and number of other CAs. Multiple MFF CAs had significant subadditive associations with disorder onset. Little specificity was found for particular CAs with particular disorders. Associations declined in magnitude with life course stage and number of previous lifetime disorders but increased with length of recall. Simulations suggest that CAs are associated with 44.6% of all childhood-onset disorders and with 25.9% to 32.0% of later-onset disorders.The fact that associations increased with length of recall raises the possibility of recall bias inflating estimates. Even considering this, the results suggest that CAs have powerful and often subadditive associations with the onset of many types of largely primary mental disorders throughout the life course.

In This Issue

In This Issue