Secondary analysis of retrospective and prospective reports of adverse childhood experiences and mental health in young adulthood: Filtered through recent stressors.

BACKGROUND

Evidence has identified the detrimental effects that adverse childhood experiences (ACEs) have on outcomes across the life course. We assess associations between prospective and retrospective ACEs and mental health in young adulthood and the influence of recent stressors.

METHODS

Secondary analysis of a sample of 1592 young adults from the Birth to Twenty Plus cohort, from 1990 to 2013, were assessed throughout their first 18 years for prospective ACEs. Retrospective ACEs and an assessment of mental health were collected at the 22-23-year data point.

FINDINGS

Prospective physical and sexual abuse are associated with an increased risk of depression (OR 1·7 [95% CI 1·37-1·93,  = 0·034], and OR 1·8 [95% CI 1·27-2·07,  = 0·018], respectively). Retrospective emotional abuse/neglect is associated with increased anxiety (OR 1·8 [95% CI 1·32-2·36,  = 0·000]), depression (OR 1·6 [95% CI 1·08-2·25,  = 0·018]) and overall psychological distress (OR 1·6 [95% CI 1·18-2·17,  = 0·002]). Prospectively reporting four or more ACEs is associated with a twofold increase in risk for overall psychological distress (OR 2·2 [95% CI 1·58-3.12,  = 0·008]). Retrospectively reporting four or more ACEs is associated with increased likelihood of somatization ( = 0·004), anxiety ( = 0·002), depression ( = 0·021), and overall psychological distress ( = 0·005).

INTERPRETATION

Both individual and combined retrospective and prospective ACEs are related to mental health in young adulthood. Recent stressors reinforce this relationship; the likelihood of those who report more ACEs experiencing psychological distress increases when adjusting for recent stressors.

FUNDING

Wellcome Trust (UK), South African Medical Research Council, Human Sciences Research Council, University of the Witwatersrand and supported by the DSI-NRF Centre of Excellence in Human Development.