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Childhood Adversities and First Onset of Psychiatric Disorders in a National Sample of US Adolescents
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CONTEXT: Although childhood adversities (CAs) are known to be highly co-occurring, most research examines their associations with psychiatric disorders one at a time. However, recent evidence from adult studies suggests that the associations of multiple CAs with psychiatric disorders are nonadditive, arguing for the importance of multivariate analysis of multiple CAs. To our knowledge, no attempt has been made to perform a similar kind of analysis among children or adolescents. OBJECTIVE: To examine the multivariate associations of 12 CAs with first onset of psychiatric disorders in a national sample of US adolescents. DESIGN: A US national survey of adolescents (age range, 13-17 years) assessing DSM-IV anxiety, mood, behavior, and substance use disorders and CAs. The CAs include parental loss (death, divorce, and other separations), maltreatment (neglect and physical, sexual, and emotional abuse), and parental maladjustment (violence, criminality, substance abuse, and psychopathology), as well as economic adversity. SETTING: Dual-frame household-school samples. PARTICIPANTS: In total, 6483 adolescent-parent pairs. MAIN OUTCOME MEASURES: Lifetime DSM-IV disorders assessed using the World Health Organization Composite International Diagnostic Interview. RESULTS: Overall, exposure to at least 1 CA was reported by 58.3% of adolescents, among whom 59.7% reported multiple CAs. The CAs reflecting maladaptive family functioning were more strongly associated than other CAs with the onset of psychiatric disorders. The best-fitting model included terms for the type and number of CAs and distinguished between maladaptive family functioning and other CAs. The CAs predicted behavior disorders most strongly and fear disorders least strongly. The joint associations of multiple CAs were subadditive. The population-attributable risk proportions across DSM-IV disorder classes ranged from 15.7% for fear disorders to 40.7% for behavior disorders. The CAs were associated with 28.2% of all onsets of psychiatric disorders. CONCLUSIONS: Childhood adversities are common, highly co-occurring, and strongly associated with the onset of psychiatric disorders among US adolescents. The subadditive multivariate associations of CAs with the onset of psychiatric disorders have implications for targeting interventions to reduce exposure to CAs and to mitigate the harmful effects of CAs to improve population mental health.
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“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 McLaughlin et al., 2012
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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 McLaughlin et al., 2012
In the citing paper
“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 McLaughlin et al., 2012
In the citing paper
“White matter changes have also been observed, consistent with evidence from animal models, including reduced volume of the posterior corpus callosum(129, 136), and reduced FA in white matter tracts linking the PFC with the temporal lobe (e.g., uncinate fasiculus, superior longitudinal fasciculus) and striatum (e.g., internal and external capsule).(136–138)”
From Neglect as a violation of species-expectant experience: neurodevelopmental consequences (2017) · cites this paper as [138]
In the citing paper
“Consistent with our hypotheses and prior studies on child trauma (Lansford et al. 2002; McLaughlin et al. 2012), we found strong associations between physical, sexual, and emotional abuse and both internalizing and externalizing symptoms in the sample of youths for whom maltreatment exposure was more prevalent.”
From Childhood maltreatment exposure and disruptions in emotion regulation: A transdiagnostic pathway to adolescent internalizing and externalizing psychopathology (2016) · cites this paper as McLaughlin et al. 2012
In the citing paper
“Greater exposure to ELA is associated with elevated risk of a wide range of mental and physical health outcomes across the lifespan, including depression, anxiety, substance abuse, cardiovascular disease, cancer, type 2 diabetes, respiratory diseases, chronic pain, gastrointestinal and metabolic disorders, and neurological and musculoskeletal problems,4–14 as well as premature mortality.15,16”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [4]
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“Evidence from opulation-based epidemiological studies indicates that childhood dversity is common and associated strongly with the subsequent nset of psychopathology not only in childhood, but also in adoescence and adulthood (Cohen et al., 2001; Green et al., 2010; essler et al., 1997; McLaughlin et al., 2012).”
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“…behaviors, unemployment and economic instability, and lack of social support), many of which are known risk factors for child abuse (Brown, Cohen, Johnson, & Salzinger, 1998; Stoltenborgh, Bakermans-Kranenburg, & Van Ijzendoorn, 2013) and the onset of psychopathology (McLaughlin et al., 2012).”
BackgroundSelf-citation
Metadata
- Authors
- McLaughlin, K. A., Greif Green, J., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C.
- Affiliations
- Boston Children's Hospital (US)
- Boston University (US)
- Corresponding author
- Kessler, Ronald C.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2012-11-01
- Volume
- 69
- Issue
- 11
- Pages
- 1151
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC3490224
- OpenAlex
- W2001620133
- Cited by
- 992
- References
- 69
- Citations by year
- 2026: 86 · 2025: 106 · 2024: 102 · 2023: 93 · 2022: 105 · 2021: 90 · 2020: 82 · 2019: 68 · 2018: 65 · 2017: 63 · 2016: 45 · 2015: 39 · 2014: 29 · 2013: 15 · 2012: 2
- FWCI
- 30.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- SRA International
- Kaiser Permanente
- Janssen Scientific Affairs
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- National Institute of Mental Health (R13-MH-066849, R01-MH66627, R01MH066627, R01‐MH070884, R01MH077883, K01MH085710, U01-MH-60220, K01MH092526, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (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 › Sociology and Political Science › Child Welfare and Adoption
- Keywords
- childhood adversity, adolescents, subadditivity, parental loss, child abuse, economic adversity, behavior disorders, anxiety disorders, mood disorders, substance use disorders, population attributable risk
- MeSH terms
- Adolescent, Anxiety Disorders, Mental Disorders, Child, Child Behavior Disorders, Cross-Sectional Studies, Female, Health Surveys, Humans, Life Change Events, Male, Personality Assessment, Risk Factors, United States, Comorbidity, Multivariate Analysis, Odds Ratio, Age of Onset, Mood Disorders, Substance-Related Disorders
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