Development of an individualized risk calculator for poor functioning in young people victimized during childhood: A longitudinal cohort study

Abstract

BackgroundChildhood victimization elevates the average risk of developing functional impairment in adulthood. However, not all victimized children demonstrate poor outcomes. Although research has described factors that confer vulnerability or resilience, it is unknown if this knowledge can be translated to accurately identify the most vulnerable victimized children.ObjectiveTo build and internally validate a risk calculator to identify those victimized children who are most at risk of functional impairment at age 18 years.ParticipantsWe utilized data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2232 UK children born in 1994–95.MethodsVictimization exposure was assessed repeatedly between ages 5 and 12 years along with a range of individual-, family- and community-level predictors. Functional outcomes were assessed at age 18 years. We developed and evaluated a prediction model for psychosocial disadvantage and economic disadvantage using the Least Absolute Shrinkage and Selection Operator (LASSO) regularized regression with nested 10-fold cross-validation.ResultsThe model predicting psychosocial disadvantage following childhood victimization retained 12 of 22 predictors, had an area under the curve (AUC) of 0.65, and was well-calibrated within the range of 40–70% predicted risk. The model predicting economic disadvantage retained 10 of 22 predictors, achieved excellent discrimination (AUC = 0.80), and a high degree of calibration.ConclusionsPrediction modelling techniques can be applied to estimate individual risk for poor functional outcomes in young adulthood following childhood victimization. Such risk prediction tools could potentially assist practitioners to target interventions, which is particularly useful in a context of scarce resources.

Effects Of Early Trauma and Recent Stressors on Depression, Anxiety, and Anger

“…Moreover, adulthood anxiety in victims of early trauma has been reported to vary depending on the person’s resilience ( 59 – 61 ). Those with low resilience become sensitized to emotional difficulties by childhood adversity, whereas others may even achieve posttraumatic growth after similar experiences ( 62 , 63 ).…”

Childhood maltreatment and poor functional outcomes at the transition to adulthood: a comparison of prospective informant- and retrospective self-reports of maltreatment

“…NEET status, parenthood, and cautions and convictions were naturally dichotomous; all other variables were dichotomised. For variables with no predetermined cut-off (social isolation, low life satisfaction, loneliness, and low sleep quality) we defined poor functioning as being among the 20% worst scoring participants for an outcome (as previously used in this cohort [30,31]).…”

“…Accordingly, we created two age-18 outcome variables capturing whether individuals had any: (i) psychosocial disadvantage (1 = yes; 0 = no), or (ii) vocational disadvantage (1 = yes; 0 = no). These functioning factors have been used previously in this cohort to minimise multiple testing [30].…”

Understanding practitioners’ and young people’s views of a risk calculator for future psychopathology and poor functioning in young people victimised during childhood

“…As such, these findings are of limited practical use to health and social care practitioners who assess individual children and therefore seek insight into that particular child's level of future vulnerability or resilience. Our recent work to translate this current knowledge into a risk calculator screening tool that makes individual-level predictions is therefore notable (Latham et al, 2019;Meehan et al, 2020). Although this tool needs to be validated in external samples before being implemented, our initial evidence demonstrates its potential to support practitioners to accurately identify which victimised children are at high risk of developing poor outcomes at the transition to adulthood.…”