Article2013

Synergistic Childhood Adversities and Complex Adult Psychopathology

191 citations0/0 files storedJournal of Traumatic Stress

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Child Abuse and Trauma Child and Adolescent Psychosocial and Emotional Development Posttraumatic Stress Disorder Research

Abstract

Numerous studies find a cumulative effect of different types of childhood adversities on increasing risk for serious adult mental and medical outcomes. This study uses the National Comorbidity Survey-Replication sample to investigate the cumulative impact of 8 childhood adversities on complex adult psychopathology as indexed by (a) number of lifetime diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994); (b) number of 4 DSM-IV disorder categories (mood, anxiety, impulse control, and substance abuse disorders); and (c) coexistence of internalizing and externalizing disorders. Seven of the 8 childhood adversities were significantly associated with complex adult psychopathology. Individuals with 4 or more childhood adversities had an odds ratio of 7.3, 95% confidence interval [4.7, 11.7] for 4 disorder categories. Additive and multiplicative synergistic effects increasing adult psychopathology were found for specific pairwise combinations of childhood adversities. Synergistic patterns differed by gender suggesting that women are more impacted by sexual abuse and men by economic hardship. The absence of childhood adversities was protective, in that it significantly decreased an individual's risk for subsequent adult mental illness. The results support the clinical impression that increased childhood adversity is associated with more complex adult psychopathology.

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References

1998Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults 1988The Composite International Diagnostic Interview 2020Diagnostic and Statistical Manual of Mental Disorders 2003Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study 2001Childhood Abuse, Household Dysfunction, and the Risk of Attempted Suicide Throughout the Life Span 2004Adverse childhood experiences and the risk of depressive disorders in adulthood 1999The Structure of Common Mental Disorders 2004The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction

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2017Adolescent Victimization and Early-Adult Psychopathology: Approaching Causal Inference Using a Longitudinal Twin Study to Rule Out Noncausal Explanations 2021Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms 2017Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims 2016Adverse Childhood Experiences and Adult Well-Being in a Low-income, Urban Cohort

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