Childhood Adversities and First Onset of Psychiatric Disorders in a National Sample of US Adolescents

Abstract

Context Although childhood adversities (CAs) are known to be highly co-occurring, most research examines their associations with mental disorders one at a time. Recent evidence from adult studies suggests, though, that the associations of multiple CAs with mental disorders are non-additive, arguing for the importance of multivariate analysis of multiple CAs. No attempt has yet been made to carry out a similar kind of analysis among children or adolescents. Objective To examine the multivariate associations of 12 CAs with first onset of mental disorders in a national sample of US adolescents. Design US national survey of adolescents (ages 13–17) assessing DSM-IV anxiety, mood, behavior, and substance disorders and CAs. The CAs include parental loss (death, divorce, other separations), maltreatment (physical, sexual, and emotional abuse, neglect), parental maladjustment (psychopathology, substance abuse, criminality, violence) and economic adversity. Setting Dual-frame household-school samples. Participants 6,483 adolescents-parent pairs. Main outcome measure Lifetime DSM-IV disorders assessed with the WHO Composite International Diagnostic Interview. Results 58.3% of adolescents reported at least one CA, among whom 59.7% reported multiple CAs. CAs reflecting maladaptive family functioning (MFF) were more strongly associated than other CAs with disorder onsets. The best-fitting model included terms for type and number of CAs and distinguished between MFF and Other CAs. CAs predicted behavior disorders most strongly and fear disorders least strongly. The joint associations of multiple CAs were sub-additive. The population-attributable risk proportions for disorder classes ranged from 15.7% for fear disorders to 40.7% for behavior disorders. CAs were associated with 28.2% of all onsets. Conclusions CAs are common, highly co-occurring, and strongly associated with onset of mental disorders among US adolescents. The sub-additive multivariate associations of CAs with disorder onsets have implications for targeting interventions to reduce exposure to CAs and to mitigate the harmful effects of CAs to improve population mental health.

Trauma is a public health issue

“…Exposure to trauma is particularly detrimental when it occurs in childhood or adolescence, disrupting numerous aspects of development in cognitive, emotional, and social domains, leading to adverse mental health and educational outcomes (Cicchetti & Toth, 1995; Koenen, Moffit, Caspi, Taylor, & Purcell, 2003) with long-term consequences for learning and memory (Teicher, Anderson, & Polcari, 2012), emotional functioning (De Bellis et al, 1994; McCrory et al, 2011; McLaughlin & Hatzenbuehler, 2009; Pollak & Sinha, 2002; Pollak, Vardi, Putzer Bechner, & Curtin, 2005), social relationships, elevated risk of re-victimization (Cole & Putnam, 1992; DiLillo, 2001; Follette, Polusney, Bechtle, & Naugle, 1996), and mental disorders (Kilpatrick et al, 2003; McLaughlin et al, 2012, 2013). …”

Childhood maltreatment, psychopathology and well-being: The mediator role of global self-esteem, attachment difficulties and substance use

“…Several studies have shown that childhood physical abuse, sexual abuse, and witnessing family or community violence are factors that may lead to impaired mental health in adolescence Helweg-Larsen, Frederiksen, & Larsen, 2011;McLaughlin et al, 2012;Mills et al, 2013), as well as later in life Chapman et al, 2004;Franzese, Covey, Tucker, McCoy, & Menard, 2014;. Studies of childhood abuse in the Norwegian general population have reported a prevalence of physical abuse of 5-6% (both sexes) and of sexual abuse of 10-14% (girls) and 3-4% (boys) .…”

“…Structured psychiatric interviews are considered to be the most reliable method to estimate the prevalence of psychiatric diagnoses in a study population, yet the majority of previous studies are based on self-report questionnaires Helweg-Larsen et al, 2011;Peltonen, Ellonen, Larsen, & Helweg-Larsen, 2010) and conducted on general adult Green et al, 2010) or adolescent (McLaughlin et al, 2012) populations.…”

No gene-by-environment interaction of BDNF Val66Met polymorphism and childhood maltreatment on anxiety sensitivity in a mixed race adolescent sample

“…CM and AS have both consistently been implicated as risk factors for psychopathology, including anxiety disorders (Collishaw et al, 2007; Kessler, McLaughlin et al, 2010; McLaughlin et al, 2007, 2012). We have previously determined, in a sample of secondary school-attending adolescents, that CM is significantly and positively associated with anxiety-related temperamental traits such as AS and trait anxiety (Martin, Viljoen, Kidd, & Seedat, 2014).…”