Article

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

ABSTRACT

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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    • "Sexual trauma was also a risk factor for the Distress dimension. Consequently, these observations further supportSchilling et al. (2008)) evidence that some low impacting traumatic experiences such as vicarious trauma dilute the effects of other high impacting trauma such as severe domestic and sexual trauma in cumulative trauma research. Moreover, this may inform clinicians of the trajectory that some individuals may take as a result of a particular cluster of risk factors. "
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    ABSTRACT: Co-occurring psychological disorders are highly prevalent among children and adolescents. To date, the most widely utilised factor model used to explain this co-occurrence is the two factor model of internalising and externalising (Achenbach 1966). Several competing models of general psychopathology have since been reported as alternatives, including a recent three factor model of Distress, Fear and Externalising Dimensions (Krueger 1999). Evidence for the three factor model suggests there are advantages to utilising a more complex model. Using the British Child and Adolescent Mental Health Survey 2004 data (B-CAMHS; N = 7997), confirmatory factor analysis was used to test competing factor structure models of child and adolescent psychopathology. The B-CAMHS was an epidemiological survey of children between the ages of 5 and 16 in Great Britain. Child psychological disorders were assessed using the Strength and Difficulties Questionnaire (Goodman 1997), and the Development and Wellbeing Assessment (Goodman et al. 2000). A range of covariates and risk variables including trauma, parent mental health and family functioning where subsequently utilised within a MIMIC model framework to predict each dimension of the 2 and three factor structure models. Two models demonstrated acceptable fit. The first complimented Achenbach's Internalising and Externalising structure. The three factor model was found to have highly comparable fit indices to the two factor model. The second order models did not accurately represent the data nor did an alternative three factor model of Internalising, Externalising and ADHD. The two factor and three factor MIMIC models observed unique profiles of risk for each dimension. The findings suggest that child and adolescent psychopathology may also be accurately conceptualised in terms of distress, fear and externalising dimensions. The MIMIC models demonstrated that the Distress and Fear dimensions have their own unique etiological profile of risk. This study directly informs future measurement models of child and adolescent psychopathology and demonstrates the effectiveness of a three factor model.
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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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    • "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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