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

Kessler, Kenneth; McLaughlin, Katie A.; Green, Jennifer; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Aguilar-Gaxiola, A.; Obaid-Alhamzawi, A.; Alonso, Jordi; Angermeyer, Matthias C.; Benjet, Corina; Bromet, Evelyn J.; Chatterji, Somnath; Girolamo, Giovanni de; Kemyttenaere, K.; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Haro, Josep María; Hu, Chiyi; Karam, Elie G.; Kawakami, Norito; Lee, S.; Lépine, Jean‐Pierre; Ormel, Johan; Posada‐Villa, José; Sagar, Rajesh; Tsang, Adley; Üstün, T. Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, Daniel

doi:10.1192/bjp.bp.110.080499

Cited by 2,131 publications

(1,703 citation statements)

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“…Although ongoing research is investigating pathways leading to such generalized vulnerability (Daskalakis, Bagot, Parker, Vinkers, & de Kloet, 2013; Levy-Gigi, Richter-Levin, Okon-Singer, Kéri, & Bonanno, 2016; Rutter, 2012), we know of no work on differential effects of trauma types in this regard. However, suggestive related evidence exists on differences in associations of childhood adversities with adult mental disorders across different childhood adversity types (Kessler et al, 2010; Pirkola et al, 2005) and profiles (McLafferty et al, 2015; Putnam, Harris, & Putnam, 2013). …”

Section: Discussionmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

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Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’ Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.

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Section: Discussionmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

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1,036

720

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“…While the interplay of these factors (positive and negative) can be complex, it is well established that the accumulation of risks and adversities over childhood and adolescence increases the risk of poor mental health and developing a mental illness 2, 3, 4, 5, 6. Exposure to major life stresses, such as extreme poverty, family violence, child abuse and neglect, and homelessness, in the early stages of life can be particularly harmful to the developing brain7, 8 and to psychological health in childhood with negative consequences for mental health and well‐being across the lifespan and intergenerationally 9.…”

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confidence: 99%

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

et al. 2017

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Policy Points: The developmental origins understanding of mental illness suggests the possibility of prevention, through addressing childhood adversities.More than 43% of Indigenous Australian children aged 6 to 10 years have 6 or more risk factors for mental illness in adulthood, and 23% are experiencing current psychological distress.Substantial risk is already present in infancy (eg, 67% exposed to 3 or more stressful family life events, and 42.5% are not living with both birth parents).An integrated service system response that can both offer high‐level therapeutic services and address associated multiple adversities, from conception to late adolescence, is urgently needed to address current psychological distress in Indigenous Australian children and to reduce the future burden of mental illness. ContextMental illness is a high source of disease burden across the globe. Mental illness is now understood as largely developmental, with its genesis at least in part in adverse childhood experiences. We sought to estimate the prevalence of childhood risks for poor mental health in Indigenous Australian children, noting that Indigenous Australians by virtue of their history of traumatic colonization and dispossession, child removal, and racism are potentially at greater risk.MethodsWe conducted a descriptive study of the modifiable risks and adversities associated with mental illness in Australian Indigenous children (infancy to 10 years), using data from the Longitudinal Study of Indigenous Children (LSIC), a cohort of 1,671 infants enrolled in 2008 and followed up annually. Risk factors of interest were identified from a comprehensive literature review of childhood determinants of adult mental illness by Fryers and Brugha (2013). The age‐category prevalence of individual risks and a multiple‐risk score were computed using data extracted from 6 waves of LSIC.FindingsThe analytic data comprised 8,378 person‐observations from the first 6 waves. Children in LSIC experience high rates of adversities. In utero, nearly 50% were exposed to smoking and 22% to alcohol. As infants, 42.5% were not living with both birth parents. Over two‐thirds of survey children were in households that had experienced, in the previous 12 months, 3 or more major life events; 22% to 26% lived in households with a drug or alcohol problem; and 18% were exposed to domestic violence (41% were ever‐exposed to age 10). At school, nearly 40% of children were bullied. Over 45% of children aged 6 to 10 years were exposed to 6 or more risks for mental illness. Few children (< 2%) were exposed to low parental warmth and, despite the high exposure to adversities, less than 5% of children report low self‐confidence. This suggests considerable resilience. More than 1 in 4 children had conduct problems in the clinical range and more than 1 in 5 were experiencing high psychological distress.ConclusionsIndigenous children in Australia face extreme levels of multiple disadvantage, exposing many to current psychological distress and high risk of developing me...

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“…To understand activation within a network, we consider the idea of reciprocal interaction as the best explanation of the roles of trait anger, anger rumination, and PTSD symptoms regarding maintenance and exacerbation of symptoms. Again, our sample is characterized by the experience of extensive traumatic events throughout childhood and lifetime polyvictimization, which is not the case for most other traumatized populations (Kessler et al, 2010). As the majority of our sample experienced all five types of child abuse and neglect, possible specific associations of types of abuse with adult psychopathology may be difficult to differentiate in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Childhood abuse (CA) and neglect pose a great risk for various mental health and psychosocial problems in the later adult’s life (Kessler et al, 2010; Norman et al, 2012). CA includes various types of violence against children such as sexual, emotional, and physical abuse and/or emotional and physical neglect (Vachon, Krueger, Rogosch, & Cicchetti, 2015).…”

Section: Introductionmentioning

confidence: 99%

A network analysis of anger, shame, proposed ICD-11 post-traumatic stress disorder, and different types of childhood trauma in foster care settings in a sample of adult survivors

Glück

Knefel

2017

European Journal of Psychotraumatology

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Background: Anger and shame are aspects that are specifically associated with psychopathology and maladaptation after childhood abuse and neglect. They are known to influence symptom maintenance and exacerbation; however, their interaction is not fully understood. Objective: To explore with network analysis the association and interaction of prolonged, complex interpersonal childhood abuse and neglect in institutional foster care settings [institutional abuse (IA)] with anger, shame, and the proposed 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) post-traumatic stress disorder (PTSD) symptoms in adult survivors. Method: Adult survivors of IA (N = 220, mean age = 57.95 years) participated in the study and were interviewed using the Childhood Trauma Questionnaire, the International Trauma Questionnaire, the State–Trait Anger Expression Inventory, the Displaced Aggression Questionnaire, and shame-related items. To identify the most central aspects, we used a staged network analysis and centrality analysis approach: (1) on the scale level; (2) on the item/symptom level; and (3) with modularity analysis to find communities within the item-level network. Results: Trait anger, anger rumination, emotional abuse, and PTSD re-experiencing symptoms played the most important roles on a scale level and were then further analyzed on the item/symptom level. The most central symptom on the item level was anger rumination related to meaningful past events. The modularity analysis supported discriminant validity of the included scales. Conclusions: Anger is an important factor in the psychopathological processes following childhood abuse. Anger rumination is closely related to PTSD symptoms; however, anger is not a part of the proposed ICD-11 PTSD in the present study.

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

Abstract: Childhood 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.

Cited by 2,131 publications

References 48 publications

Trauma and PTSD in the WHO World Mental Health Surveys

Trauma and PTSD in the WHO World Mental Health Surveys

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

A network analysis of anger, shame, proposed ICD-11 post-traumatic stress disorder, and different types of childhood trauma in foster care settings in a sample of adult survivors

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