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Childhood adversity and subsequent mental health status in adulthood: screening for associations using two linked surveys

  • S. B. Patten (a1) (a2) (a3), T. C. R. Wilkes (a2), J. V. A. Williams (a1), D. H. Lavorato (a1), N. el-Guebaly (a2), T. C. Wild (a4), I. Colman (a5) and A. G. M. Bulloch (a1) (a2) (a3)...

Abstract

Aims.

Accumulating evidence links childhood adversity to negative health outcomes in adulthood. However, most of the available evidence is retrospective and subject to recall bias. Published reports have sometimes focused on specific childhood exposures (e.g. abuse) and/or specific outcomes (e.g. major depression). Other studies have linked childhood adversity to a large and diverse number of adult risk factors and health outcomes such as cardiovascular disease. To advance this literature, we undertook a broad examination of data from two linked surveys. The goal was to avoid retrospective distortion and to provide a descriptive overview of patterns of association.

Methods.

A baseline interview for the Canadian National Longitudinal Study of Children and Youth collected information about childhood adversities affecting children aged 0–11 in 1994. The sampling procedures employed in a subsequent study called the National Population Health Survey (NPHS) made it possible to link n = 1977 of these respondents to follow-up data collected later when respondents were between the ages of 14 and 27. Outcomes included major depressive episodes (MDE), some risk factors and educational attainment. Cross-tabulations were used to examine these associations and adjusted estimates were made using the regression models. As the NPHS was a longitudinal study with multiple interviews, for most analyses generalized estimating equations (GEE) were used. As there were multiple exposures and outcomes, a statistical procedure to control the false discovery rate (Benjamini–Hochberg) was employed.

Results.

Childhood adversities were consistently associated with a cluster of potentially related outcomes: MDE, psychotropic medication use and smoking. These outcomes may be related to one another since psychotropic medications are used in the treatment of major depression, and smoking is strongly associated with major depression. However, no consistent associations were observed for other outcomes examined: physical inactivity, excessive alcohol consumption, binge drinking or educational attainment.

Conclusions.

The conditions found to be the most strongly associated with childhood adversities were a cluster of outcomes that potentially share pathophysiological connections. Although prior literature has suggested that a very large number of adult outcomes, including physical inactivity and alcohol-related outcomes follow childhood adversity, this analysis suggests a degree of specificity with outcomes potentially related to depression. Some of the other reported adverse outcomes (e.g. those related to alcohol use, physical inactivity or more distal outcomes such as obesity and cardiovascular disease) may emerge later in life and in some cases may be secondary to depression, psychotropic medication use and smoking.

Copyright

Corresponding author

*Address for correspondence: Dr S. B. Patten, Department of Community Health Sciences, University of Calgary, TRW Building, 3280 Hospital Drive NW, Calgary, AB, Canada. (Email: patten@ucalgary.ca)

References

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Afifi, TO, Mota, N, MacMillan, HL, Sareen, J (2013). Harsh physical punishment in childhood and adult physical health. Pediatrics 132, e333e340.
Anda, RF, Brown, DW, Felitti, VJ, Bremner, JD, Dube, SR, Giles, WH (2007). Adverse childhood experiences and prescribed psychotropic medications in adults. American Journal of Preventive. Medicine 32, 389394.
Beck, CA, Williams, JVA, Wang, JL, Kassam, A, el-Guebaly, N, Currie, SR, Maxwell, CJ, Patten, SB (2005). Psychotropic medication use in Canada. Canadian Journal of Psychiatry 50, 605613.
Centre for Addiction and Mental Health (2010). Low – Risk Drinking Guidelines. Centre for Addiction and Mental Health: Toronto. Accessed 22 June 2014 http://www.camh.net/About_Addiction_Mental_Health/Drug_and_Addiction_Information/low_risk_drinking_guidelines.html.
Chaiton, MO, Cohen, JE, O'Loughlin, J, Rehm, J (2009). A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health 9, 356.
Chapman, DP, Wheaton, AG, Anda, RF, Croft, JB, Edwards, VJ, Liu, Y, Sturgis, SL, Perry, GS (2011). Adverse childhood experiences and sleep disturbances in adults. Sleep Med 12, 773779.
Colman, I, Garad, Y, Zeng, Y, Naicker, K, Weeks, M, Patten, SB, Jones, PB, Thompson, AH, Wild, TC (2013). Stress and development of depression and heavy drinking in adulthood: moderating effects of childhood trauma. Social Psychiatry Psychiatric Epidemiology 48, 265274.
Felitti, VJ, Anda, RF, Nordenberg, D, Williamson, DF, Spitz, AM, Edwards, V, Koss, MP, Marks, JS (1998). 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 14, 245258.
Kessler, RC, Andrews, G, Mroczek, D, Ustun, B, Wittchen, HU (1998). The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF). International Journal of Methods in Psychiatric Research 7, 171185.
Kessler, RC, McLaughlin, KA, Green, JG, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Aguilar-Gaxiola, S, Alhamzawi, AO, Alonso, J, Angermeyer, M, Benjet, C, Bromet, E, Chatterji, S, De, GG, Demyttenaere, K, Fayyad, J, Florescu, S, Gal, G, Gureje, O, Haro, JM, Hu, CY, Karam, EG, Kawakami, N, Lee, S, Lepine, JP, Ormel, J, Posada-Villa, J, Sagar, R, Tsang, A, Ustun, TB, Vassilev, S, Viana, MC, Williams, DR (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. British Journal of Psychiatry 197, 378385.
McEwen, BS (2003). Mood disorders and allostatic load. Biological Psychiatry 54, 200207.
McLaughlin, KA, Conron, KJ, Koenen, KC, Gilman, SE (2010). Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults. Psychological Medicine 40, 16471658.
Meaney, MJ, Szyf, M, Seckl, JR (2007). Epigenetic mechanisms of perinatal programming of hypothalamic-pituitary-adrenal function and health. Trends in Molecular Medicine 13, 269277.
Patten, SB (2013). Childhood and adult stressors and major depression risk: interpreting interactions with the sufficient-component cause model. Social Psychiatry and Psychiatric Epidemiology 48, 927933.
Poulin, C, Hand, D, Boudreau, B (2005). Validity of a 12-item version of the CES-D used in the National Longitudinal Study of Children and Youth. Chronic Diseases in Canada 26, 6572.
Radloff, LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.
Stata Corporation (2012). Stata, Version 12.1. Stata Corporation: College Station, TX.
Statistics Canada (2012). National Population Health Survey – Household Component – Longitudinal (NPHS). Statistics Canada: Ottawa. Accessed 22 June 2014 http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3225&Item_Id=1213.
Szyf, M, McGowan, P, Meaney, MJ (2008). The social environment and the epigenome. Environmental and Molecular Mutagenesis 49, 4660.
Taylor, SE (2010). Mechanisms linking early life stress to adult health outcomes. Proceedings of the National Academy of Sciences 107, 85078512.
Taylor, SE, Lerner, JS, Sage, RM, Lehman, BJ, Seeman, TE (2004). Early environment, emotions, responses to stress, and health. Journal of Personality 72, 13651393.
Thiessen, D, Steinberg, L, Kuang, D (2002). Quick and easy implementation of the Benjamini–Hochberg procedure for controlling the false positive rate in multiple comparisons. Journal of Educational and Behavioural Statistics 27, 7783.
Weaver, IC, Cervoni, N, Champagne, FA, D'Alessio, AC, Sharma, S, Seckl, JR, Dymov, S, Szyf, M, Meaney, MJ (2004). Epigenetic programming by maternal behavior. Nature Neuroscience. 7, 847854.

Keywords

Childhood adversity and subsequent mental health status in adulthood: screening for associations using two linked surveys

  • S. B. Patten (a1) (a2) (a3), T. C. R. Wilkes (a2), J. V. A. Williams (a1), D. H. Lavorato (a1), N. el-Guebaly (a2), T. C. Wild (a4), I. Colman (a5) and A. G. M. Bulloch (a1) (a2) (a3)...

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