Adverse childhood experiences and child mental health: an electronic birth cohort study
Abstract Background Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related p...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-021-02045-x |
| _version_ | 1818904974416936960 |
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| author | Emily Lowthian Rebecca Anthony Annette Evans Rhian Daniel Sara Long Amrita Bandyopadhyay Ann John Mark A. Bellis Shantini Paranjothy |
| author_facet | Emily Lowthian Rebecca Anthony Annette Evans Rhian Daniel Sara Long Amrita Bandyopadhyay Ann John Mark A. Bellis Shantini Paranjothy |
| author_sort | Emily Lowthian |
| collection | DOAJ |
| description | Abstract Background Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member. Methods We analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors. Results There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34–2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52–1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant. Conclusion The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families. |
| first_indexed | 2024-12-19T21:15:58Z |
| format | Article |
| id | doaj.art-2256caee8e404f279c91b085c012a984 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-19T21:15:58Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-2256caee8e404f279c91b085c012a9842022-12-21T20:05:20ZengBMCBMC Medicine1741-70152021-08-0119111310.1186/s12916-021-02045-xAdverse childhood experiences and child mental health: an electronic birth cohort studyEmily Lowthian0Rebecca Anthony1Annette Evans2Rhian Daniel3Sara Long4Amrita Bandyopadhyay5Ann John6Mark A. Bellis7Shantini Paranjothy8Population Data Science, Swansea University Medical SchoolDECIPHer, 1 – 3 Museum Place, School of Social Sciences, Cardiff UniversityDivision of Population Medicine, Neuadd Meirionnydd, University Hospital of WalesDivision of Population Medicine, Neuadd Meirionnydd, University Hospital of WalesDECIPHer, 1 – 3 Museum Place, School of Social Sciences, Cardiff UniversityNational Centre for Population Health and Wellbeing Research, Swansea University Medical SchoolPopulation Data Science, Swansea University Medical SchoolCollege of Human Sciences, Bangor UniversityUniversity of Aberdeen, Aberdeen Health Data Science Centre, Institute of Applied Health SciencesAbstract Background Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member. Methods We analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors. Results There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34–2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52–1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant. Conclusion The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families.https://doi.org/10.1186/s12916-021-02045-xAdverse childhood experiencesMental healthCohortWalesSurvival analysisAdministrative data |
| spellingShingle | Emily Lowthian Rebecca Anthony Annette Evans Rhian Daniel Sara Long Amrita Bandyopadhyay Ann John Mark A. Bellis Shantini Paranjothy Adverse childhood experiences and child mental health: an electronic birth cohort study BMC Medicine Adverse childhood experiences Mental health Cohort Wales Survival analysis Administrative data |
| title | Adverse childhood experiences and child mental health: an electronic birth cohort study |
| title_full | Adverse childhood experiences and child mental health: an electronic birth cohort study |
| title_fullStr | Adverse childhood experiences and child mental health: an electronic birth cohort study |
| title_full_unstemmed | Adverse childhood experiences and child mental health: an electronic birth cohort study |
| title_short | Adverse childhood experiences and child mental health: an electronic birth cohort study |
| title_sort | adverse childhood experiences and child mental health an electronic birth cohort study |
| topic | Adverse childhood experiences Mental health Cohort Wales Survival analysis Administrative data |
| url | https://doi.org/10.1186/s12916-021-02045-x |
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