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Early-life adversity, later-life mental health, and resilience resources: a longitudinal population-based birth cohort analysis

  • Theodore D. Cosco (a1) (a2), Rebecca Hardy (a3), Laura D. Howe (a4) and Marcus Richards (a3)

Robust and persistent links between early-life adversities and later-life mental distress have previously been observed. Individual and social resources are associated with greater mental health and resilience. This study aimed to test these resources as moderators and mediators of the association between childhood psychosocial adversity and later-life mental distress.


Participant data came from the Medical Research Council National Survey of Health and Development, a nationally-representative birth cohort study. The General Health Questionnaire-28 (GHQ-28) captured mental distress at ages 53, 60–64, and 68–69. An eight-item cumulative psychosocial adversity score was created (0, 1, 2, ≥3 adversities). Individual (i.e., education, occupational status, physical activity) and social (i.e., social support, neighborhood cohesion) resources were examined as mediators and moderators of CPA and GHQ-28 in longitudinal multilevel models.


Greater adversity was associated with an average GHQ-28 score increase of 0.017, per unit adversity (β = 0·017, p < 0·001, 95% CI 0·011, 0·022). Lower mental distress was associated with higher levels of physical activity, occupational status, education, social support, and neighborhood cohesion. There was no evidence that resources moderated the relationship between GHQ-28 and adversity. All resources, save for physical activity and occupational status, partly mediated this relationship.


Individual and social resources were associated with lower mental distress. They did not modify, but partly mediated the association between childhood adversity and adult mental distress. Social support was the most important mediator, suggesting that interventions to promote greater social support may offset psychosocial adversities experienced in childhood to foster better mental health in older adults.

Corresponding author
Correspondence should be addresses to: Theodore D. Cosco, Department of Gerontology, and Gerontology Research Centre, Simon Fraser University, 2800-515 Hastings Street, Vancouver BC V6B 5K3, Canada. Phone: 7787825915. Email:
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Baron, R. M. and Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182. doi: 10.1037/0022-3514.51.6.1173.
Caleyachetty, R. et al. (2018). Modeling exposure to multiple childhood social risk factors and physical capability and common affective symptoms in later life. Journal of Aging and Health, 30, 386407. doi: 10.1177/0898264316680434.
Chrysikou, E., Rabnett, R. and Tziraki, C. (2016). Perspectives on the role and synergies of architecture and social and built environment in enabling active healthy aging. Journal of Aging Research, 2016, 7. doi: 10.1155/2016/6189349.
Cicchetti, D. and Rogosch, F. A. (1997). The role of self-organization in the promotion of resilience in maltreated children. Development and Psychopathology, 9, 797815. doi: 10.1017/S0954579497001442.
Comijs, H. C., Beekman, A. T. F., Smit, F., Bremmer, M., van Tilburg, T. and Deeg, D. J. H. (2007). Childhood adversity, recent life events and depression in late life. Journal of Affective Disorders, 103, 243246. doi: 10.1016/j.jad.2007.01.012.
Dickens, A. P., Richards, S. H., Greaves, C. J. and Campbell, J. L. (2011). Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 11, 647. doi: 10.1186/1471-2458-11-647.
Ford, E., Clark, C. and Stansfeld, S. A. (2011). The influence of childhood adversity on social relations and mental health at mid-life. Journal of Affective Disorders, 133, 320327. doi: 10.1016/j.jad.2011.03.017.
Goldberg, D. P. and Hillier, V. F. (1979). A scaled version of the general health questionnaire. Psychological Medicine, 9, 139145. doi: 10.1017/S0033291700021644.
Green, J. G. et al. (2010). 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, 67, 113123. doi: 10.1001/archgenpsychiatry.2009.186.
Hatch, S. L., Jones, P. B., Kuh, D., Hardy, R., Wadsworth, M. E. and Richards, M. (2007). Childhood cognitive ability and adult mental health in the British 1946 birth cohort. Social Science & Medicine, 64, 22852296. doi: 10.1016/j.socscimed.2007.02.027.
Heinonen, E., Knekt, P., Härkänen, T., Virtala, E. and Lindfors, O. (2018). Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood. Psychiatry Research, 264, 366373. doi: 10.1016/j.psychres.2018.04.011.
Hill, T. D., Kaplan, L. M., French, M. T. and Johnson, R. J. (2010). Victimization in early life and mental health in adulthood: an examination of the mediating and moderating influences of psychosocial resources. Journal of Health and Social Behavior, 51, 4863. doi: 10.1177/0022146509361194.
Kenward, M. G. and Carpenter, J. R. (2008) Multiple imputation. In: M., Davidian, G., Fitzmaurice, G., Verbeke and G., Molenberghs (eds.), Longitudinal Data Analysis: A Handbook of Modern Statistical Methods (pp. 477500). London, UK: Chapman & Hall/CRC.
Kessler, R. C., Davis, C. G. and Kendler, K. S. (1997). Childhood adversity and adult psychiatric disorder in the US National comorbidity survey. Psychological Medicine, 27, 11011119. doi: 10.1017/S0033291797005588.
Kestila, L., Maki-Opas, T., Kunst, A. E., Borodulin, K., Rahkonen, O. and Prattala, R. (2015). Childhood adversities and socioeconomic position as predictors of leisure-time physical inactivity in early adulthood. Journal of Physical Activity and Health, 12, 193199. doi: 10.1123/jpah.2013-0245.
Kuh, D., Cooper, R., Hardy, R., Richards, M. and Ben-Shlomo, Y. (Eds.) (2014). A Life Course Approach to Healthy Ageing. Oxford: Oxford University Press.
Kuh, D. et al. (2016). The MRC National Survey of Health and Development reaches age 70: maintaining participation at older ages in a birth cohort study. European Journal of Epidemiology, 31, 11351147. doi: 10.1007/s10654-016-0217-8.
Logan-Greene, P., Green, S., Nurius, P. S. and Longhi, D. (2014). Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health. Social Work in Health Care, 53, 776797. doi: 10.1080/00981389.2014.944251.
Oshio, T., Umeda, M. and Kawakami, N. (2013). Impact of interpersonal adversity in childhood on adult mental health: how much is mediated by social support and socio-economic status in Japan?. Public Health, 127, 754760. doi: 10.1016/j.puhe.2013.05.005.
Pearlin, L. I., Lieberman, M. A., Menaghan, E. G. and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337356. doi: 10.2307/2136676.
Rodgers, B. (1990). Adult affective disorder and early environment. British Journal of Psychiatry, 157, 539550. doi: 10.1192/bjp.157.4.539.
Rodgers, B. (1996a). Reported parental behaviour and adult affective symptoms. 1. Associations and moderating factors. Psychological Medicine, 26, 5161. doi: 10.1017/S0033291700033717.
Rodgers, B. (1996b). Reported parental behaviour and adult affective symptoms. 2. Mediating factors. Psychological Medicine, 26, 6377. doi: 10.1017/S0033291700033729.
Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316331. doi: 10.1111/j.1939-0025.1987.tb03541.x.
Rutter, M. (2000). Resilience reconsidered: conceptual considerations, empirical findings, and policy implications. In: Handbook of Early Childhood Intervention (pp. 651682). Cambridge: Cambridge University Press.
Tavakol, M. and Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 5355. doi: 10.5116/ijme.4dfb.8dfd.
Thoits, P. A. (1995). Stress, coping, and social support processes: where are we? What next?. Journal of Health and Social Behavior, 35, 5379. doi: 10.2307/2626957.
Veldman, K., Bültmann, U., Almansa, J. and Reijneveld, S. A. (2015). Childhood adversities and educational attainment in young adulthood: the role of mental health problems in adolescence. Journal of Adolescent Health, 57, 462467. doi: 10.1016/j.jadohealth.2015.08.004.
Von Hippel, P. T. (2007). Regression with missing Ys: an improved strategy for analyzing multiply imputed data. Sociological Methodology, 37, 83117. doi: 10.1111/j.1467-9531.2007.00180.x.
Wadsworth, M., Kuh, D., Richards, M. and Hardy, R. (2006). Cohort profile: the 1946 National Birth Cohort (MRC National Survey of Health and Development). International Journal of Epidemiology, 35, 4954. doi: 10.1093/ije/dyi201.
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International Psychogeriatrics
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