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Adverse childhood experiences and child mental health: an electronic birth cohort study

Lowthian, Emily, Anthony, Rebecca, Evans, Annette, Daniel, Rhian, Long, Sara, Bandyopadhyay, Amrita, John, Ann, Bellis, Mark A. and Paranjothy, Shantini 2021. Adverse childhood experiences and child mental health: an electronic birth cohort study. BMC Medicine 19 , 172. 10.1186/s12916-021-02045-x

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Publisher: BioMed Central
ISSN: 1741-7015
Funders: ESRC
Date of First Compliant Deposit: 28 June 2021
Date of Acceptance: 23 June 2021
Last Modified: 17 Aug 2021 09:45
URI: http://orca.cardiff.ac.uk/id/eprint/142200

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