Profiles of family-focused adverse experiences through childhood and early adolescence: The ROOTS project a community investigation of adolescent mental health

BackgroundAdverse family experiences in early life are associated with subsequent psychopathology. This study adds to the growing body of work exploring the nature and associations between adverse experiences over the childhood years.MethodsPrimary carers of 1143 randomly recruited 14-year olds in Cambridgeshire and Suffolk, UK were interviewed using the Cambridge Early Experiences Interview (CAMEEI) to assess family-focused adversities. Adversities were recorded retrospectively in three time periods (early and later childhood and early adolescence). Latent Class Analysis (LCA) grouped individuals into adversity classes for each time period and longitudinally. Adolescents were interviewed to generate lifetime DSM-IV diagnoses using the K-SADS-PL. The associations between adversity class and diagnoses were explored.ResultsLCA generated a 4-class model for each time period and longitudinally. In early childhood 69% were allocated to a low adversity class; a moderate adversity class (19%) showed elevated rates of family loss, mild or moderate family discord, financial difficulties, maternal psychiatric illness and higher risk for paternal atypical parenting; a severe class (6%) experienced higher rates on all indicators and almost exclusively accounted for incidents of child abuse; a fourth class, characterised by atypical parenting from both parents, accounted for the remaining 7%. Class membership was fairly stable (~ 55%) over time with escape from any adversity by 14 years being uncommon. Compared to those in the low class, the odds ratio for reported psychopathology in adolescents in the severe class ranged from 8 for disruptive behaviour disorders through to 4.8 for depressions and 2.0 for anxiety disorders. Only in the low adversity class did significantly more females than males report psychopathology.ConclusionsFamily adversities in the early years occur as multiple rather than single experiences. Although some children escape adversity, for many this negative family environment persists over the first 15 years of life. Different profiles of family risk may be associated with specific mental disorders in young people. Sex differences in psychopathologies may be most pronounced in those exposed to low levels of family adversities.

[1]  M. Shapiro The Social Origins of Depression by G. W. Brown and T. Harris: its methodological philosophy. , 1979, Behaviour research and therapy.

[2]  I. Goodyer,et al.  First-episode major depression in adolescents. Affective, cognitive and endocrine characteristics of risk status and predictors of onset. , 2000, The British journal of psychiatry : the journal of mental science.

[3]  Christopher G. Davis,et al.  Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey , 1997, Psychological Medicine.

[4]  F. Brown Depression and Childhood Bereavement , 1961 .

[5]  B. Rodgers Pathways between parental divorce and adult depression. , 1994, Journal of child psychology and psychiatry, and allied disciplines.

[6]  Milena Falcaro,et al.  Riskplot: A Graphical aid to Investigate the Effect of Multiple Categorical Risk Factors , 2010 .

[7]  R. Kessler,et al.  Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: Associations with functional impairment related to DSM-IV disorders , 2009, Psychological Medicine.

[8]  M. Pembrey,et al.  ALSPAC--the Avon Longitudinal Study of Parents and Children. I. Study methodology. , 2001, Paediatric and perinatal epidemiology.

[9]  M. Medina-Mora,et al.  Descriptive epidemiology of chronic childhood adversity in Mexican adolescents. , 2009, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[10]  Re Waller,et al.  Principles of Exposure Measurement in Epidemiology , 1994 .

[11]  N. Ryan,et al.  Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[12]  M. Rutter,et al.  Research report: Isle of Wight Studies, 1964-1974. , 1976, Psychological medicine.

[13]  K. Sher,et al.  Investigation of Profiles of Risk Factors for Adolescent Psychopathology: A Person-Centered Approach , 2006, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[14]  K. Bandeen-Roche,et al.  Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology, and other family-level stressors , 2004, Social Psychiatry and Psychiatric Epidemiology.

[15]  Corinne May-Chahal,et al.  Measuring child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect. , 2005, Child abuse & neglect.

[16]  David M. Fergusson,et al.  The Christchurch Health and Development Study: Review of Findings on Child and Adolescent Mental Health , 2001, The Australian and New Zealand journal of psychiatry.

[17]  B. Muthén,et al.  Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. , 2000, Alcoholism, clinical and experimental research.

[18]  E. Costello,et al.  Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents. , 2008, Journal of child psychology and psychiatry, and allied disciplines.

[19]  E. Costello,et al.  Configurations of common childhood psychosocial risk factors. , 2009, Journal of child psychology and psychiatry, and allied disciplines.

[20]  M. Rutter,et al.  Attainment and Adjustment in Two Geographical Areas , 1975, British Journal of Psychiatry.

[21]  Tim Croudace,et al.  Cohort Profile: Risk patterns and processes for psychopathology emerging during adolescence: the ROOTS project , 2010, International journal of epidemiology.

[22]  T. Harris,et al.  Validity of retrospective measures of early maltreatment and depressive episodes using the Childhood Experience of Care and Abuse (CECA) instrument -- A life-course study of adult chronic depression - 2. , 2007, Journal of affective disorders.

[23]  R. Kessler,et al.  Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. , 2010, Archives of general psychiatry.

[24]  D. Sheehan,et al.  The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. , 1998, The Journal of clinical psychiatry.

[25]  K. Kendler,et al.  Stressful life events and major depression: risk period, long-term contextual threat, and diagnostic specificity. , 1998, The Journal of nervous and mental disease.

[26]  Adrian Angold,et al.  Childhood and adolescent psychiatric disorders as predictors of young adult disorders. , 2009, Archives of general psychiatry.

[27]  Brien Riley,et al.  The interaction of stressful life events and a serotonin transporter polymorphism in the prediction of episodes of major depression: a replication. , 2005, Archives of general psychiatry.

[28]  L. Sroufe,et al.  When more is not better: the role of cumulative risk in child behavior outcomes. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[29]  Phil A. Silva,et al.  From child to adult : the Dunedin multidisciplinary health and development study , 1996 .

[30]  R. Kessler,et al.  Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders. , 2010, Archives of general psychiatry.

[31]  Allan L. McCutcheon,et al.  Applied Latent Class Analysis: Basic Concepts and Procedures in Single- and Multiple-Group Latent Class Analysis , 2002 .

[32]  M. Rutter,et al.  Isle of Wight Studies, 1964–1974 , 1976, Psychological Medicine.

[33]  A. Pickles,et al.  Do high-threat life events really provoke the onset of psychiatric disorder in children? , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[34]  Guilherme Borges,et al.  Chronic childhood adversity and onset of psychopathology during three life stages: childhood, adolescence and adulthood. , 2010, Journal of psychiatric research.

[35]  T. Heeren,et al.  Relationship between Multiple Forms of Maltreatment by a Parent or Guardian and Adolescent Alcohol Use. , 2009, The American journal on addictions.