Trajectories of childhood adversity and the risk of depression in young adulthood: Results from the Avon Longitudinal Study of Parents and Children.

BACKGROUND: The significance of the timing and chronicity of childhood adversity for depression outcomes later in life is unclear. Identifying trajectories of adversity throughout childhood would allow classification of children according to the accumulation, timing, and persistence of adversity, and may provide unique insights into the risk of subsequent depression. METHODS: Using data from the Avon Longitudinal Study of Parents and Children, we created a composite adversity score comprised of 10 prospectively assessed domains (e.g., violent victimization, inter-parental conflict, and financial hardship) for each of eight time points from birth through age 11.5 years. We used semiparametric group-based trajectory modeling to derive childhood adversity trajectories and examined the association between childhood adversity and depression outcomes at the age of 18 years. RESULTS: Among 9,665 participants, five adversity trajectories were identified, representing stable-low levels (46.3%), stable-mild levels (37.1%), decreasing levels (8.9%), increasing levels (5.3%), and stable-high levels of adversity (2.5%) from birth through late childhood. Approximately 8% of the sample met criteria for probable depression at 18 years and the mean depression severity score was 3.20 (standard deviation = 3.95, range 0-21). The risk of depression in young adulthood was elevated in the decreasing (odds ratio [OR] = 1.72, 95% confidence interval [CI] = 1.19-2.48), increasing (OR = 1.81, 95% CI = 1.15-2.86), and stable-high (OR = 1.80, 95% CI = 1.00-3.23) adversity groups, compared to those with stable-low adversity, when adjusting for potential confounders. CONCLUSIONS: Children in trajectory groups characterized by moderate or high levels of adversity at some point in childhood exhibited consistently greater depression risk and depression severity, regardless of the timing of adversity.

Childhood Adversity Trajectories and Violent Behaviors in Adolescence and Early Adulthood.

Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention.

The mitigating effects of maternal social support and paternal involvement on the intergenerational transmission of violence.

Childhood maltreatment is a strong risk factor for subsequent violence, including violent behaviors in young adulthood and offspring maltreatment after becoming a parent. Little is known about the specific circumstances under which supportive relationships may help disrupt this cycle of violence throughout the life course. We conducted two complementary analyses to assess whether maternal social support in early childhood, and also paternal involvement in middle childhood, could prevent the intergenerational transmission of violence, using data from the Avon Longitudinal Study of Parents and Children (n=11,384). We found that higher levels of maternal social support in the postpartum period reduced the odds of offspring maltreatment at ages 0-8 years (OR=0.95, 95% CI 0.93-0.96). When classifying mothers according to their abuse history, this protective association of social support was observed among mothers with no history of childhood maltreatment and among those with only childhood maltreatment (and not postpartum intimate partner violence [IPV]), but not among mothers who reported IPV since the child's birth. We then extended our analysis of these offspring forward in time and found that paternal involvement at ages 9-10 years was associated with a reduced risk of offspring self-reported violent perpetration at ages 18-20 years (OR=0.85, 95% CI=0.77-0.94). This protective association was generally apparent among all subgroups of children, including those with a history of childhood maltreatment. Together these results highlight the protective influence of supportive relationships against the intergenerational transmission of violence, depending on abuse history, context, and timing, with important implications for the prevention of childhood maltreatment and mitigation of its negative effects.