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

Abstract

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.

Poor family functioning mediates the link between childhood adversity and adolescent nonsuicidal self‐injury

“…In a prior analysis, factor analysis did not suggest a unidimensional structure of exposure to these adversities, and model fit was poor for the two factor model (Dunn et al., 2011). We therefore used a mixture model perspective, which grouped individuals by their experience of multiple adversities using latent class analysis (LCA).…”

“…Childhood family adversity is robustly associated with a range of deviant outcomes including subsequent conduct and emotional disorders, drug misuse, and mental illness (Dunn et al., 2011; Fergusson, Boden, & Horwood, 2008; van Harmelen et al., 2016). As higher prevalence of NSSI is associated with almost all mental illnesses (Dunn et al., 2011; Nock & Kessler, 2006), NSSI may not be a direct response or consequence of CFA itself but arise from subsequent mental illness.…”

“…As higher prevalence of NSSI is associated with almost all mental illnesses (Dunn et al., 2011; Nock & Kessler, 2006), NSSI may not be a direct response or consequence of CFA itself but arise from subsequent mental illness.…”

“…Childhood family adversity can negatively impact family functioning and child‐parent relationships (Hughes, 2004), and often occur within a context of more pervasive, chronic suboptimal family environments (Dunn et al., 2011). This continued and more proximal family dysfunction during adolescence may increase the risk for subsequent NSSI (Gratz et al., 2002) as opposed to the earlier experiences of CFA.…”

Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK

“…T1 past-year mental health service contact (no or yes) was generated as an exposure variable, and any mental health services after T1 (no or yes, post-T1-3) as a confounder. Caregivers reported contacts with adolescent mental health services at T1 from a semi-structured interview, with high inter-rater agreement on core indicators (κ=0·7-0·9; Cambridge Early Experiences Interview 18 ) and from a self-reported questionnaire at T1 and T3. Adolescents were interviewed at T3 about mental health service contact before K-SADS-PL assessment.…”