Childhood mental health difficulties mediate the long-term association between early-life adversity at age 3 and poorer cognitive functioning at ages 11 and 14

Typologies of childhood maltreatment and associations with internalizing symptoms among university students in Singapore: A latent class analysis

This study used Latent Class Analysis to identify typologies of childhood maltreatment (CM) and the associations of CM with five internalizing symptoms. A sample of 1,042 university students in Singapore answered online self-report questionnaires, inclusive of Childhood Trauma Questionnaire, a modified version of the 14-item Center for Epidemiologic Studies Depression Scale derived from the CES-D, Beck Anxiety Inventory, Post-traumatic Stress Disorder Checklist, Eating Disorder Examination-Questionnaire (version 6.0), and Suicidal Ideation Attributes Scale. These measures respectively assessed CM and current internalizing symptoms, namely, depressive symptoms, anxiety symptoms, PTSD, eating disorder, and suicidal ideation. The most common type of CM was childhood emotional neglect (74.6%), followed by childhood emotional abuse (61%). Men were more likely to experience childhood physical abuse compared to women; contrarily, women were two times more likely to report childhood emotional abuse compared to men. The findings of Latent Class Analysis revealed four distinct latent classes of CM: Low CM, high/multiple CM, moderate to high abuse/victimization, and moderate to high neglect. Students in the latter three CM classes were more likely than those in the Low CM class to report the internalizing symptoms. These findings indicate the importance of protecting children from CM and cushioning the adverse effects of CM on victims by providing timely intervention, both of which would be best achieved with the education of professionals, caregivers and the public alike, and improvements to current programs and practices.

Research Review: Assessment of early-life adversity and trauma - cumulative risk and dimensional approaches

In this research review, we present approaches and recommendations for assessing early-life adversity and childhood trauma aligned with two leading conceptual models of adversity: cumulative risk and dimensional models. We summarize the measurement implications of each conceptual model and common approaches for assessing early-life adversity in studies utilizing each of these models. We consider other critical components in the assessment of early-life adversity and trauma, including retrospective and prospective reporting, objective and subjective measurement, and caregiver and child reporting. Finally, we briefly summarize the existing interview and questionnaire measures that are widely used to assess early-life adversity and trauma using both cumulative risk and dimensional approaches. This work suggests that there is greater heterogeneity in measures used to assess the dimensional model relative to those used to assess the cumulative risk model, which allows for more flexibility in the assessment of early-life adversity. In addition, we observed that more detailed measures were available to assess experiences of threat compared to experiences of deprivation. Measures that assess adversity experiences in terms of frequency and severity across multiple dimensions of experience within a single measure are needed to facilitate consistent and reliable assessment of early-life adversity and trauma, particularly when applying dimensional models.

Cumulative stressor exposure and cognitive functioning in late childhood: The role of inflammation

This study examined whether the experience of stressors since infancy is related to executive function and social communication in late childhood via inflammation, using data from 4457 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). It explored whether the effect of stressful life events (from 6 months to 8.5 years) on working memory, response inhibition, selective attention, attentional control, communication problems and social cognition (at ages 10-11 years) was mediated by inflammation (interleukin 6 and C-reactive protein) at age 9 years. While the study did not find evidence for mediation, it showed that, in the general child population, inflammation was related to executive function impairments, and stressful life events were related to social communication difficulties. These associations were small but robust to confounder adjustment. If causal, they suggest that reducing inflammation could improve executive functioning, the prerequisite to any purposeful and goal-directed action.

Perinatal risk factors for young adults to be not engaged in employment, education or training (NEET) and its mediators: longitudinal analysis of the QLSCD cohort study

PURPOSE

In 2019, 31% and 14% of young women and men worldwide - respectively - reported being not engaged in employment, education, or training (NEET), an important indicator of long-term socioeconomic vulnerability. This study examined the developmental pathways leading to NEET status in young adulthood by investigating the association between perinatal adversities and NEET status and the mediating role of adolescent externalizing behaviours.

METHODS

Data were from the Québec Longitudinal Study of Child Development (QLSCD, n = 974). Latent class analysis identified four profiles of exposures to 30 perinatal adversities: Low adversity, the reference group; Fetal growth adversity, which includes participants experiencing adversity related to growth problems in utero and after birth; Delivery complications, which includes participants - or their mothers - who experience complications during birth; and Familial adversity, which includes participants who experienced adversity related to their family life. The associations between the perinatal profiles, NEET status - which was self-reported at age 21 years - and the putative mediating role of externalizing behavioural problems (self-reported at ages 15 and 17) were investigated using structural equation modeling.

RESULTS

The risk of becoming NEET at age 21 was higher for children who experienced familial (OR = 3.19 [95% CI: 2.31-4.40], p < 0.001) and fetal growth (2.03 [1.11-3.71], p = 0.022) adversity. Externalizing behaviour problems mediated the association between familial adversity and NEET status (1.17 [1.05-1.30], p = 0.004).

CONCLUSION

Interventions targeting perinatal risk factors and adolescent mental health can contribute to efforts to prevent NEET status in young adulthood.

Developmental Trajectory of Depressive Symptoms among Left-behind Children in Rural China: The Roles of Family Adversity and Personal Growth Initiative

The adversity faced by left-behind children due to parental migration affects their depressive symptoms, but little is known about the mechanism underlying this association and protective factors from a dynamic perspective. The present study examined the association between family adversity and the developmental trajectory of depressive symptoms, and the potential mediating and moderating role of personal growth initiative in this association among left-behind children. A total of 363 left-behind children (48.8% female; Mage = 12.97 at T1, SDage = 0.55) from five rural middle schools in the Hunan Province of China participated in this three-wave study, employing one-year intervals between assessments. The results indicated the initial level of personal growth initiative mediated the association between family adversity at T1 and the development of depressive symptoms, while the growth rate of personal growth initiative both mediated and moderated this association, with consistent effects across sexes. These findings underscore the critical role of personal growth initiative in the association between family adversity and depressive symptoms among left-behind children.

Sex Differences in the Associations Among Early Life Adversity, Inflammation, and Cognition

Early life adversity (ELA) has long been recognized to negatively impact a variety of health outcomes, with increasingly recognized long-term implications for neurocognitive function. ELA may affect the brain through multiple mechanisms, including chronic inflammation. One potential moderator of the pathway from ELA to neuroinflammation to cognitive dysfunction is sex. ELA may leave females potentially even more vulnerable to cognitive impairment in later life. This review discusses the influence of ELA on cognitive function across much of the lifespan, how inflammation is implicated in this process, and the current state of knowledge regarding sex differences in these relationships. We conclude with a discussion of unanswered questions and suggestions for future research, including the incorporation of genetic data.

The Impact of Adverse Childhood Experiences on the Development of Adolescent Risk-Taking: The Mediating Effect of Self-Control and Moderating Effect of Genetic Variations

Risk-taking is a concerning yet prevalent issue during adolescence and can be life-threatening. Examining its etiological sources and evolving pathways helps inform strategies to mitigate adolescents' risk-taking behavior. Studies have found that unfavorable environmental factors, such as adverse childhood experiences (ACEs), are associated with momentary levels of risk-taking in adolescents, but little is known about whether ACEs shape the developmental trajectory of risk-taking. Even less research has investigated the underlying mechanisms. Drawing on the self-regulation theory, this study examined the associations between ACEs and the developmental trajectory of adolescent risk-taking. Moreover, it also explored self-control as a mediator and genetic variations as a moderator from a "gene × environment" approach. Participants were 564 Chinese adolescents (48.40% males, Mage = 14.20 years, SD = 1.52). Adolescents reported their ACEs and self-control at T1 and risk-taking three times, with a six-month interval between each time point. Adolescents' saliva was collected at T1 for genetic extraction, and polygenetic index was created based on the gene-by-environment interaction between SNPs and ACEs for self-control via the leave-one-out machine learning approach. Findings of latent growth modeling revealed that adolescents' risk-taking decreased over time. ACEs were directly and indirectly through self-control associated with high initial levels of, and a rapid decrease in, risk-taking, especially for those with a higher polygenetic index compared to those with a lower polygenetic index. Theoretically, these results suggest a tripartite model of adolescent risk-taking, such that risk-taking is the combined function of adverse experiences in early years, low self-control, and carriage of sensitive genes. Practically, intervention strategies should reduce childhood adversities, build up self-control, and consider the potential impacts of genetic plasticity.

School connectedness as a protective factor between childhood adversity and adolescent mental health outcomes

School connectedness may offset mental health risks associated with childhood adversity. The present study examined the potential protective effects of school connectedness against childhood adversity when predicting adolescent mental health outcomes in 9,964 individuals (51% female, 81% white) from the Millennium Cohort Study. Structural equation models were fitted to examine the longitudinal relationships between childhood adversity, school connectedness, and adolescent mental health. Childhood adversity was a risk factor, predicting greater internalizing and externalizing problems and lower levels of positive mental health. School connectedness was a promotive factor as it predicted fewer mental health problems and greater positive mental health. Furthermore, school connectedness at age 11 was protective against childhood adversity when predicting internalizing and externalizing problems at age 14. That is, students with a history of adversity who felt more connected to school were less likely to exhibit internalizing and externalizing symptoms than those who felt less connected to school. Only school connectedness at age 11 was protective against childhood adversity, indicating that feeling connected to school at younger ages may disrupt processes linking childhood adversity to adolescent mental health. Schools should foster students' feelings of connectedness to protect vulnerable individuals and benefit all pupils' mental health.

Impact of early work start on mental health outcomes in older adults: A cross-sectional study from Ecuador

OBJECTIVE

This study assesses the impact of the age at which individuals first begin working on the odds of developing mental health disorders among older adults in Ecuador.

METHODS

Data from the 2009 Survey of Health, Well-being, and Aging (SABE) encompassing 3093 elderly participants from mainland Ecuador were analyzed. We employed binary logistic regression to explore the association between the age at which individuals started working and their subsequent mental health status.

RESULTS

Participants who started working between ages 5-12 and 26-35 had lower odds of mental health disorders compared to those who began at ages 18-25, while those who started working between ages 13-17 and 36-80 exhibited higher odds compared to the same baseline group. These associations are net of various demographic and health-related factors.

CONCLUSION

The results indicate mixed associations between the age at which individuals started working and their mental health outcomes in older age. While some age groups demonstrate lower odds of mental health disorders, others do not, suggesting a complex relationship that warrants further investigation.

IMPLICATIONS

This research supports the development of healthcare policies aimed at providing mental health education and services tailored to populations affected by early labor, to mitigate the enduring impacts of child labor on mental health in older age.

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories

BACKGROUND

Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems.

METHODS

This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle.

RESULTS

Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys.

LIMITATIONS

The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data.

CONCLUSIONS

This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

Leveraging multivariate approaches to advance the science of early-life adversity

Since the landmark Adverse Childhood Experiences (ACEs) study, adversity research has expanded to more precisely account for the multifaceted nature of adverse experiences. The complex data structures and interrelated nature of adversity data require robust multivariate statistical methods, and recent methodological and statistical innovations have facilitated advancements in research on childhood adversity. Here, we provide an overview of a subset of multivariate methods that we believe hold particular promise for advancing the field's understanding of early-life adversity, and discuss how these approaches can be practically applied to explore different research questions. This review covers data-driven or unsupervised approaches (including dimensionality reduction and person-centered clustering/subtype identification) as well as supervised/prediction-based approaches (including linear and tree-based models and neural networks). For each, we highlight studies that have effectively applied the method to provide novel insight into early-life adversity. Taken together, we hope this review serves as a resource to adversity researchers looking to expand upon the cumulative approach described in the original ACEs study, thereby advancing the field's understanding of the complexity of adversity and related developmental consequences.

Trajectories of cortical structures associated with stress across adolescence: a bivariate latent change score approach

BACKGROUND

Stress exposure in childhood and adolescence has been linked to reductions in cortical structures and cognitive functioning. However, to date, most of these studies have been cross-sectional, limiting the ability to make long-term inferences, given that most cortical structures continue to develop through adolescence.

METHODS

Here, we used a subset of the IMAGEN population cohort sample (N = 502; assessment ages: 14, 19, and 22 years; mean age: 21.945 years; SD = 0.610) to understand longitudinally the long-term interrelations between stress, cortical development, and cognitive functioning. To these ends, we first used a latent change score model to examine four bivariate relations - assessing individual differences in change in the relations between adolescent stress exposure and volume, surface area, and cortical thickness of cortical structures, as well as cognitive outcomes. Second, we probed for indirect neurocognitive effects linking stress to cortical brain structures and cognitive functions using rich longitudinal mediation modeling.

RESULTS

Latent change score modeling showed that greater baseline adolescence stress at age 14 predicted a small reduction in the right anterior cingulate volume (Std. β = -.327, p = .042, 95% CI [-0.643, -0.012]) and right anterior cingulate surface area (Std. β = -.274, p = .038, 95% CI [-0.533, -0.015]) across ages 14-22. These effects were very modest in nature and became nonsignificant after correcting for multiple comparisons. Our longitudinal analyses found no evidence of indirect effects in the two neurocognitive pathways linking adolescent stress to brain and cognitive outcomes.

CONCLUSION

Findings shed light on the impact of stress on brain reductions, particularly in the prefrontal cortex that have consistently been implicated in the previous cross-sectional studies. However, the magnitude of effects observed in our study is smaller than that has been reported in past cross-sectional work. This suggests that the potential impact of stress during adolescence on brain structures may likely be more modest than previously noted.