The childhood roots of adult psychological distress: Interdisciplinary perspectives toward a better understanding of exposure to cumulative childhood adversity
Introduction
Decades of research documents that childhood adversity is associated with poor mental health, physical health, and socioeconomic outcomes during adulthood (e.g., Björkenstam et al., 2015; Green, Gruber, Sampson, Zaslavsky, & Kessler, 2010, Green, McLaughlin et al., 2010; Willson & Shuey, 2016). Exposure to adverse childhood experiences is not uncommon, with the majority of children experiencing at least one adversity (Friedman, Montez, Sheehan, Guenewald, & Seeman, 2015; Green, Gruber et al., 2010; Green, McLaughlin et al., 2010). However, it is the experience of multiple adversities that produces a context of disadvantage that increases the risk of various negative outcomes in adulthood (Chapman et al., 2004; Felitti et al., 1998; Nurius, Logan-Greene, & Green, 2012; Schilling, Aseltine, & Gore, 2007). While the persisting impacts of cumulative childhood adversity have been well-documented, previous measures of cumulative adversity consider a limited number of childhood stressors, overlook potential differences across experiences of adversity, and fail to measure the effects of multiple co-occurring childhood adversities. Furthermore, measures of cumulative childhood adversity generally have focused on acute adverse events and traumatic experiences within the familial domain while frequently overlooking the potential importance of chronic adverse childhood contexts that act as ongoing strains across various domains, and further provide an environment for additional childhood stressors to occur (Friedman et al., 2015). These limitations have led to inconsistent and incomplete conclusions regarding the overall impact of multiple adverse childhood experiences on an array of adult outcomes, such as mental health.
Utilizing data from the Panel Study of Income Dynamics’ Childhood Retrospective Circumstances Study (PSID-CRCS), this study assesses how the operationalization and modeling of exposure to cumulative childhood adversity impacts estimates of the association between cumulative childhood adversity and psychological distress in adulthood. A better understanding of how measurement of the heterogeneity in severity, type, and experience of adverse childhood experiences influences estimates of adult psychological distress provides important insight into the lasting imprint of early disadvantage.
Section snippets
Cumulative childhood adversity and adult outcomes
Childhood is an influential period of the life course in which cognitive, physical and emotional development is occurring (Monnat & Chandler, 2015; Schafer, Ferraro, & Mustillo, 2011). Experiences of adversity and stressors during this time can have a detrimental influence on a wide range of adult outcomes. Early studies of childhood adversity focused on the deleterious impact of single adverse childhood experiences such as parental divorce (Amato, 2000) or childhood poverty (Sobolewski &
Data and sample
The present study uses data from the Panel Study of Income Dynamics (PSID), a nationally representative sample of households in the United States (Panel Study of Income Dynamics, 2016). The first wave of data was collected in 1968 and was comprised of over 5000 American families. These families were interviewed annually until 1997, after which interviews were conducted biennially. The Childhood Retrospective Circumstances Study (CRCS) was collected in 2014 and consists of a representative
Results
Table 1 presents the weighted distribution of all variables. The majority of respondents (86.13%) in the sample were white, 58% of the sample was female, and the average age was 50. Almost half (46.21%) had a college degree. Less than 10% of the sample reported experiencing no childhood adversities. This is consistent with recent literature that finds that the majority of people will experience at least one adversity during their childhood (Chapman et al., 2004; Friedman et al., 2015; Surtees &
Discussion
The present study utilized data from the PSID-CRCS to construct multiple measures of CCA that consider the heterogeneity among childhood stressors and examine how differences in the operationalization of CCA can influence its association with mental health outcomes. A further contribution of this study is the inclusion of a broader range of adversities, addressing an important limitation of previous research by providing a more comprehensive measure of cumulative childhood adversity and
Funding
This research was supported by the Social Sciences and Humanities Research Council of Canada Doctoral Fellowship awarded to Heidinger.
References (55)
- et al.
Building a framework for global surveillance of the public health implications of adverse childhood experiences
American Journal of Preventive Medicine
(2010) - et al.
Cumulative exposure to childhood stressors and subsequent psychological distress: An analysis of US panel data
Social Science & Medicine
(2015) - et al.
Social and school connectedness in early secondary school as predictors of late substance use, mental health, and academic outcomes
Journal of Adolescent Health
(2007) - et al.
Adverse childhood experiences and the risk of depressive disorders in adulthood
Journal of Affective Disorders
(2004) - et al.
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study
American Journal of Preventive Medicine
(1998) - et al.
The influence of childhood adversity on social relations and mental health at mid-life
Journal of Affective Disorders
(2011) - et al.
Does a College Education Reduce Depressive Symptoms in American Young Adults?
Social Science & Medicine
(2015) - et al.
Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis
Child Abuse & Neglect
(2015) - et al.
Neighborhood racial composition and trajectories of child self-rated health: An application of longitudinal propensity scores
Social Science and Medicine
(2014) - et al.
The impact of cumulative childhood adversity on young adult mental health: Measures, models and interpretations
Social Science and Medicine
(2008)
The shackles of misfortune: Social adversity assessment and representation in a chronic disease epidemiological setting
Social Science & Medicine
Factor analysis and AIC
Psychometrika
The consequences of divorce for adults and children
Journal of Marriage and the Family
Bullying victimization in youths and mental health problems: ‘Much ado about nothing’?
Psychological Medicine
Incorporating children’s lives into a life course perspective on stress and mental health
Journal of Health and Social Behavior
Evaluation of 2 measures of psychological distress as screeners for depression in the general population
The Canadian Journal of Psychiatry
Latent class and latent transition analysis
Childhood adversities and adult cardiometabolic health: Does the quantity, timing, and type of adversity matter?
Journal of Aging and Health
Early life course pathways of adult depression and chronic pain
Journal of Health and Social Behavior
Improving the K6 shot scale to predict serious emotional disturbance in adolescents in the USA
International Journal of Methods in Psychiatric Research
Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey Replication I: Associations with first onset of DSM-IV disorders
Archives of General Psychiatry
Chronic and acute stress and the prediction of major depression in women
Depression and Anxiety
Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence
Association for Child Psychology and Psychiatry
Health selection and the process of social stratification: The effect of childhood health on socioeconomic attainment
Journal of Health and Social Behavior
Linking family economic hardship to early childhood health: An investigation of mediating pathways
Maternal and Child Health Journal
Understanding links between adolescent health and educational attainment
Demography
Short screening scales to monitor population prevalences and trends in non-specific psychological distress
Psychological Medicine
Cited by (16)
The different role of adversity before and after birth in adolescent depression
2024, Journal of Affective DisordersApproaches for measuring cumulative childhood adversity: A study of youth from 5 sub-Saharan African countries
2023, Child Abuse and NeglectResilience-Based Intervention to Promote Mental and Behavioral Health in Children
2022, Pediatric Clinics of North AmericaCitation Excerpt :Such a multilevel resilience framework provides an important perspective on resilience research. Childhood adversity tends to occur together.48 For example, children who grow up in socioeconomically disadvantaged families may also be more likely to experience other adversities, such as childhood maltreatment,49 compared with those from high socioeconomic backgrounds.
The dimensionality of adverse childhood experiences: A scoping review of ACE dimensions measurement
2021, Child Abuse and NeglectCitation Excerpt :For example, persons with four or more ACEs have 60% increased odds to be severely obese (BMI ≥ 35) as compared to those with no ACEs (95% CI:1.2–2.1) (Felitti et al., 1998); having four or more ACEs increases the risk for attempted suicide by 2900% (OR: 30.1, 95% CI:14.7–61.7; Hughes et al., 2017). Starting with the groundbreaking ACE-Study and its 10-item ACE-Study Questionnaire (Dube et al., 2001; Felitti et al., 1998), the majority of ACE research focuses on the aggregation of different adverse experiences (Hughes et al., 2017), also called “additive adversity” (Heidinger & Willson, 2019). Most ACE research uses tools to assess a varying number of types of adversity, also called ACE domains, and then totals the number of experiences for an accumulation index.
Associations between Configurations of Childhood Adversity and Adult Mental Health Disorder Outcomes
2024, Society and Mental Health