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Cited by 855Child Abuse and TraumaPosttraumatic Stress Disorder ResearchChild and Adolescent Psychosocial and Emotional Development

Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults

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McLaughlin, K. A., Conron, K. J., Koenen, K. C., Gilman, S. E.·2010·Psychological Medicine
DOI 10.1017/s0033291709992121PMC PMC2891275
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Abstract

Background: Childhood adversity (CA) is associated with adult mental disorders, but the mechanisms underlying this association remain inadequately understood. Stress sensitization, whereby CA increases vulnerability to mental disorders following adult stressful life events, has been proposed as a potential mechanism. We provide a test of the stress sensitization hypothesis in a national sample. Method: We investigated whether the association between past-year stressful life events and the 12-month prevalence of major depression, post-traumatic stress disorder (PTSD), other anxiety disorders, and perceived stress varies according to exposure to CA. We used data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) ( n =34 653). Results: Past-year stressful life events were associated with an increased risk of major depression, PTSD, anxiety disorders, and perceived stress. However, the magnitude of the increased risk varied according to respondents' history of CA. For example, past-year major stressors were associated with a 27.3% increase in the 12-month risk of depression among individuals with ⩾3 CAs and a 14.8% increased risk among individuals without CAs. Stress sensitization effects were present for depression, PTSD, and other anxiety disorders in women and men, although gender differences were found in the threshold of past-year stress needed to trigger such effects. Stress sensitization was most evident among individuals with ⩾3 CAs. Conclusions: CA is associated with increased vulnerability to the deleterious mental health effects of adult stressors in both men and women. High levels of CA may represent a general diathesis for multiple types of psychopathology that persists throughout the life course.

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  • MDD was more prevalent among women, possibly related to gender discrimination, differential exposure to childhood or adult adversities such as sexual abuse, differential exposure to a complex host of different developmentally organized risk factors, or biologically different stress responses.

    “Major depressive disorder was more prevalent among women, possibly related to gender discrimination, 50 differential exposure to childhood or adult adversities 51 such as sexual abuse, 52 differential exposure to a complex host of different developmentally organized risk factors, 53 or biologically different stress responses.54”

    From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [50]

    Citation 51 is attached to differential exposure to childhood or adult adversities as a possible explanation for higher depression prevalence among women. The Results section, “Prevalence of Childhood Adversities and Stressful Life Events” (page unavailable), says childhood-adversity exposure was similar among men and women and found no gender differences in the prevalence of minor or major life events. The Discussion considers differences in event severity, but does not offer differential exposure as an explanation for higher depression prevalence among women. (LLM, conf=0.87)

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  • The amplification of stress sensitization by childhood adversity was moderated by gender, with fewer major life stressors necessary to trigger stress sensitization in liability for PTSD in women compared to men.

    “This pattern was moderated by gender, in that fewer major life stressors were necessary to trigger stress sensitization in liability for PTSD in women compared to men.”

    From The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management (2021) · cites this paper as [198]

  • The magnitude of influence of past-year stressful life events upon risk of anxiety disorders and PTSD was amplified by a history of childhood adversity, especially three or more childhood adversities.

    “data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) indicated that the magnitude of influence of past-year stressful life events upon risk of anxiety disorders and PTSD was amplified by a history of childhood adversity, especially three or more childhood adversities 198 .”

    From The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management (2021) · cites this paper as [198]

  • Individuals exposed to childhood adversity are more vulnerable to anxiety and related disorders from proximal stressors (i.e., stress sensitization).

    “Individuals exposed to childhood adversity are more vulnerable to anxiety and related disorders from proximal stressors (i.e., stress sensitization).”

    From The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management (2021) · cites this paper as [198]

  • Early adversity heightens reactivity to subsequent stressful events, a stress-sensitization pattern documented for depression, anxiety, aggression, and substance abuse.

    “One hypothesis posits that ELA increases sensitivity to the effects of later stressful life events (SLEs) that trigger or exacerbate psychopathology. This “stress sensitization” effect has been reported for depression, anxiety, aggression, and substance abuse (Bandoli et al., 2017; Espejo et al., 2007; McLaughlin et al., 2010; Myers et al., 2014; Roberts et al., 2011).”

    From Family-based care buffers the stress sensitizing effect of early deprivation on executive functioning difficulties in adolescence (2023) · cites this paper as McLaughlin et al., 2010

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Research works printed but not linked: 2

  1. Agretsi A Categorical data analysis 2002 2nd ed. Hoboken, NJ John Wiley & Sons
  2. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) 1994 Washington, DC American Psychiatric Press

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Authors
McLaughlin, K. A., Conron, K. J., Koenen, K. C., & Gilman, S. E.
Affiliations
Harvard University (US)
Corresponding author
McLaughlin, K. A.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2009-12-17
Volume
40
Issue
10
Pages
1647-1658
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291709992121
PMC
PMC2891275
OpenAlex
W2000852562
Cited by
855
References
54
Citations by year
2026: 61 · 2025: 50 · 2024: 70 · 2023: 82 · 2022: 84 · 2021: 92 · 2020: 93 · 2019: 49 · 2018: 47 · 2017: 59 · 2016: 32 · 2015: 52 · 2014: 25 · 2013: 15 · 2012: 23
FWCI
14.53
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Robert Wood Johnson Foundation
  • National Institute of Mental Health (MH 070627, MH087544, R01MH078928, R01MH087544, MH-078928, K08MH070627)
  • National Institute on Drug Abuse (DA080887, R03DA020887)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
childhood adversity, major depressive disorder, post-traumatic stress disorder, anxiety disorders, perceived stress, gender differences, diathesis
MeSH terms
Adult, Aged, Anxiety Disorders, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Life Change Events, Male, Middle Aged, Models, Psychological, Psychotic Disorders, Risk Factors, Stress Disorders, Post-Traumatic, Stress, Psychological, Logistic Models, Domestic Violence, Adult Survivors of Child Abuse, Young Adult

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