Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication I: Associations With First Onset of DSM-IV Disorders
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CONTEXT: Although significant associations of childhood adversities (CAs) with adult mental disorders have been documented consistently in epidemiological surveys, these studies generally have examined only 1 CA per study. Because CAs are highly clustered, this approach results in overestimating the importance of individual CAs. Multivariate CA studies have been based on insufficiently complex models. OBJECTIVE: To examine the joint associations of 12 retrospectively reported CAs with the first onset of DSM-IV disorders in the National Comorbidity Survey Replication using substantively complex multivariate models. DESIGN: Cross-sectional community survey with retrospective reports of CAs and lifetime DSM-IV disorders. SETTING: Household population in the United States. PARTICIPANTS: Nationally representative sample of 9282 adults. MAIN OUTCOME MEASURES: Lifetime prevalences of 20 DSM-IV anxiety, mood, disruptive behavior, and substance use disorders assessed using the Composite International Diagnostic Interview. RESULTS: The CAs studied were highly prevalent and intercorrelated. The CAs in a maladaptive family functioning (MFF) cluster (parental mental illness, substance abuse disorder, and criminality; family violence; physical abuse; sexual abuse; and neglect) were the strongest correlates of disorder onset. The best-fitting model included terms for each type of CA, number of MFF CAs, and number of other CAs. Multiple MFF CAs had significant subadditive associations with disorder onset. Little specificity was found for particular CAs with particular disorders. Associations declined in magnitude with life course stage and number of previous lifetime disorders but increased with length of recall. Simulations suggest that CAs are associated with 44.6% of all childhood-onset disorders and with 25.9% to 32.0% of later-onset disorders. CONCLUSIONS: The fact that associations increased with length of recall raises the possibility of recall bias inflating estimates. Even considering this, the results suggest that CAs have powerful and often subadditive associations with the onset of many types of largely primary mental disorders throughout the life course.
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Early adversity leads to psychiatric disorders such as psychosis, PTSD, borderline personality, anxiety, depression, and suicide.
“Early adversity also leads to psychiatric disorders such as psychosis, PTSD, borderline personality, anxiety, depression, and suicide [reviews in Ref. (38, 42–44)].”
From The Stress Acceleration Hypothesis of Nightmares (2017) · cites this paper as [44]
The Results (page not specified) associate childhood adversities with the onset of mood and anxiety disorders; the Methods include major depression and PTSD among the disorders assessed. But psychosis, borderline personality disorder, and suicide were not assessed as outcomes. The Comment (page not specified) explicitly cautions that these associations do not establish causation, so the claim that adversity ‘leads to’ these outcomes overstates the evidence. (LLM, conf=0.89)
Experimental — accuracy not yet measuredA broad range of childhood adversities have demonstrated stress sensitization with the risk of psychopathology.
“Although a broad range of childhood adversities have demonstrated stress sensitization with the risk of psychopathology”
From Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis (2017) · cites this paper as Green et al. 2010
The Results section reports associations between multiple childhood adversities and the onset of psychiatric disorders. It does not demonstrate stress sensitization—heightened psychopathology risk in response to later stress—and the Comment section cautions that the findings do not establish causal effects. The term appears in the References as the title of another study, not as a finding of this paper (page numbers unavailable). (LLM, conf=0.87)
Experimental — accuracy not yet measuredChildhood trauma is regarded as one of the major risk factors for psychopathology and has been associated with many mental disorders.
“Psychologically, childhood trauma is regarded as one of the major risk factors for psychopathology. Childhood trauma has been associated with many mental disorders (11).”
From Epigenetic Modifications in Stress Response Genes Associated With Childhood Trauma (2019) · cites this paper as [11]
Select adversities (including family violence, physical abuse, sexual abuse, and neglect) have shown stronger independent effects with mental disorder onset.
“select adversities (including family violence, physical abuse, sexual abuse, and neglect) have shown stronger independent effects with mental disorder onset (Green et al. 2010).”
From Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis (2017) · cites this paper as Green et al. 2010
Childhood adversity is common and is strongly associated with later psychopathology in childhood, adolescence, and adulthood.
“Evidence from population-based epidemiological studies indicates that childhood adversity is common and associated strongly with the subsequent onset of psychopathology not only in childhood, but also in adolescence and adulthood (Cohen et al., 2001; Green et al., 2010; Kessler et al., 1997; McLaughlin et al., 2012).”
From Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience (2014) · cites this paper as Green et al., 2010
Exposure to childhood adversity explains more than 30% of mental disorders in the U.S. population.
“exposure to childhood adversity has been shown to explain more than 30% of mental disorders in the U.S. population (Green et al., 2010; McLaughlin et al., 2012)”
From Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience (2014) · cites this paper as Green et al., 2010
Different types of adverse experiences often co-occur, so most individuals exposed to childhood adversity have experienced multiple adverse experiences.
“different types of adverse experiences frequently co-occur, meaning that most individuals exposed to childhood adversity have experienced multiple adverse experiences (Dong et al., 2004; Finkelhor et al., 2007; Green et al., 2010; McLaughlin et al., 2012).”
From Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience (2014) · cites this paper as Green et al., 2010
The exposures that give rise to experiences of deprivation and threat co-occur at high rates in children and adolescents.
“The exposures that give rise to experiences of deprivation and threat co-occur at high rates in children and adolescents”
From Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience (2014) · cites this paper as Green et al., 2010
Child maltreatment raises the risk that youths will develop nearly all common internalizing and externalizing psychiatric disorders.
“Population-based studies indicate that child maltreatment is associated with elevated risk for the onset of virtually all commonly occurring forms of internalizing and externalizing psychopathology in youths, including anxiety, mood, substance use, and disruptive behavior disorders (Brown et al. 1999; Cohen et al. 2001; Green et al. 2010; McLaughlin et al. 2012).”
From Childhood maltreatment exposure and disruptions in emotion regulation: A transdiagnostic pathway to adolescent internalizing and externalizing psychopathology (2016) · cites this paper as Green et al. 2010
Childhood adversity and trauma exposure are transdiagnostically associated with the onset of psychopathology for anxiety and substance use as well as gambling pathology.
“In fact, childhood adversity and trauma exposure (e.g., abuse, neglect) are transdiagnostically associated with the onset of psychopathology for anxiety and substance use (J. G. Green et al., 2010) as well as gambling pathology (Felsher, Derevensky, & Gupta, 2004).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as J. G. Green et al., 2010
Childhood adversity is a major risk factor for multiple forms of psychopathology.
“Childhood adversity is a major risk factor for multiple forms of psychopathology”
From Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis (2022) · cites this paper as Green et al., 2010
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“…between exposure to severe stress in childhood and substance abuse; however, much of the published evidence linking adverse childhood experiences to substance abuse outcomes has originated from clinical samples (Bennett & Kemper, 1994; Downs & Harrison, 1998; Dube et al., 2003; Green et al., 2010).”
BackgroundCorral-Frías, N. S., Nikolova, Y. S., Michalski, L. J., Baranger, D. A. A., Hariri, A. R., & Bogdan, R. (2015) · Psychological Medicine · doi:10.1017/s0033291715000525 · Cited by 132 · see citing works
- Authors
- Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C.
- Affiliations
- Harvard University (US)
- University of Michigan (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2010-02-01
- Volume
- 67
- Issue
- 2
- Pages
- 113
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC2822662
- OpenAlex
- W2117055846
- Semantic Scholar
- 0ef6cd18ca025f2d30ddcf9e22329d5cc7319e72
- Cited by
- 2,323
- References
- 81
- Citations by year
- 2026: 100 · 2025: 151 · 2024: 139 · 2023: 162 · 2022: 173 · 2021: 182 · 2020: 183 · 2019: 187 · 2018: 169 · 2017: 145 · 2016: 137 · 2015: 162 · 2014: 105 · 2013: 101 · 2012: 105
- FWCI
- 112.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01MH077883, U01-MH-60220, R01MH061905, R01MH059575, U13MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- Fogarty International Center (R03TW006481)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- childhood adversity, mental illness, parental mental illness, domestic violence, physical abuse, sexual abuse, neglect, substance abuse, criminality, anxiety disorders, mood disorders, disruptive behavior disorders, substance use disorders, recall bias, life course, National Comorbidity Survey Replication
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Mental Disorders, Child, Child, Preschool, Cross-Sectional Studies, Family, Female, Humans, Life Change Events, Male, Severity of Illness Index, United States, Comorbidity, Prevalence, Age of Onset, Attention Deficit and Disruptive Behavior Disorders, Mood Disorders, Substance-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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