Schilling EA, Aseltine RH, Gore S. The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations

Institute for Public Health Research, University of Connecticut Health Center, East Hartford, CT 06108, USA.
Social Science & Medicine (Impact Factor: 2.89). 04/2008; 66(5):1140-51. DOI: 10.1016/j.socscimed.2007.11.023
Source: PubMed


Research studies investigating the impact of childhood cumulative adversity on adult mental health have proliferated in recent years. In general, little attention has been paid to the operationalization of cumulative adversity, with most studies operationalizing this as the simple sum of the number of occurrences of distinct events experienced. In addition, the possibility that the mathematical relationship of cumulative childhood adversity to some mental health dimensions may be more complex than a basic linear association has not often been considered. This study explores these issues with 2 waves of data drawn from an economically and racially diverse sample transitioning to adulthood in Boston, Massachusetts, USA. A diverse set of childhood adversities were reported in high school and 3 mental health outcomes—depressed mood, drug use, and antisocial behavior—were reported 2 years later during the transition to adulthood.

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    • ", 2010 ; Pirkola et al . , 2005 ; Schilling , Aseltine , & Gore , 2008 ; Vanderfaeillie , Van Holen , Vanschoolandt , Robberechts , & Stroobants , 2013 ; Widom & Ames , 1994 ; Zlotnick , Tam , & Soman , 2012 ) . In addition to mental health and behavioral outcomes , many studies support a link between adult delinquency and high prevalence of prior exposure to childhood adversities among populations involved in criminal justice systems ( Jennings , Higgins , Tewksbury , Gover , & Piquero , 2010 ; Maldonado - Molina , Jennings , Tobler , Piquero , & Canino , 2010 ; Manasse & Ganem , 2009 ; Posick , 2013 ; Reid & Sullivan , 2012 ; Sarchiapone , Carli , Cuomo , Marchetti , & Roy , 2009 ; Silver , Piquero , Jennings , Piquero , & Leiber , 2011 ) . "
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    Police Quarterly 06/2015; DOI:10.1177/1098611115589291 · 0.68 Impact Factor
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    • "Along the same lines, an earlier study with a smaller sample had observed a relationship between childhood trauma and the development of depressive disorders, drug abuse, and antisocial behaviors in young adults. The study also concluded that this was more attributable to the severity of the individual traumas experienced by these patients with multiple childhood adversities than to the accumulation of traumas per se (Schilling et al. 2008). "
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    ABSTRACT: The study objective was to measure and compare the presence of childhood trauma and dissociative symptoms in a convenience sample of healthy controls and a probabilistic sample of outpatients with a diagnosis of schizophrenia. Patients reported more childhood trauma and more polytraumatization than the controls, and had a higher average dissociation score. In both cases and controls, the presence of childhood trauma was related to the intensity of the dissociation observed. Childhood trauma, clinical dissociation and schizophrenia are closely related, particularly when the patient has been the victim of more than one type of abuse.
    Community Mental Health Journal 07/2014; 51(1). DOI:10.1007/s10597-014-9755-2 · 1.03 Impact Factor
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    • "Persistent adult correlates of ACE could be an important individual biomarker, and influence mental illness trajectories and the need for clinical interventions across the lifespan of patients with OCD. The accumulation of childhood adversities has been associated with increased use of psychotropic drugs in adulthood [15], and our groups described opposite effects of ACE and psychopharmacological treatments on grey matter volumes in the caudate head of patients affected by obsessive compulsive disorder [14]: exposure to ACE increased and ongoing drug treatment decreased, caudate GM in OCD. Given that increased volume and metabolism of basal ganglia have been consistently associated with OCD [16], our findings suggested a detrimental effect of ACE on the brain underpinnings of OCD, with medications partly counteracting these effects. "
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    ABSTRACT: Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult brain structure and function. ACE could influence the use of psychotropic drugs in adulthood, and treatment seeking behaviors. We assessed the severity of ACE in a sample of 31 healthy controls and 66 patients with OCD who were consecutively referred for hospitalization and were either drug-naïve or drug-treated. In addition, we explored the possible clinical relevance of ACE with two additional analyses: (a) a discriminant function analysis with sex and ACE as factors, and (b) a logistic regression with use of medication as dependent variable and ACE as factor. Despite comparable age, years at school, age at onset of illness, duration of illness, and severity of illness (Y-BOCS), adult drug-naïve patients reported lower exposure to ACE and later contacts with mental health professionals than drug-treated. This effect was particularly evident in female patients compared to males. The interaction of gender with factors linked with the early familial environment biased access to psychiatric care and use of medication, independent of OCD-associated factors such as severity of symptoms or duration of illness. The need for medications of patients could be higher in families where OCD symptomatology is associated with ACE.
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