Investigating mental and physical health and multimorbidity determinants throughout the lifespan

Benger, Lauren 2026. Investigating mental and physical health and multimorbidity determinants throughout the lifespan. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Multimorbidity, defined as the co-occurrence of more than two chronic conditions, substantially impacts individuals’ lives and places significant strain on healthcare systems. The co-occurrence of internalising conditions (ICs) and cardiometabolic conditions (CMCs) is particularly important given their high prevalence in older adults and evidence that early indicators emerge in young adulthood. This thesis examined early life risk factors, adverse childhood experiences (ACEs) and Attention Deficit Hyperactivity Disorder (ADHD), and their associations with indicators and diagnoses of these conditions across adulthood. In UK Biobank, a sample of mid-to-older adults, exposure to any ACE (emotional, physical, and sexual abuse, plus emotional and physical neglect) was associated with ICs, CMCs, and their multimorbid combinations (ICM-MM). Associations were stronger for ICs (OR 1.84) and ICM-MM (OR range 1.73–2.15) than for CMCs (OR range 1.08–1.44). In the Avon Longitudinal Study of Parents and Children (ALSPAC), involving individuals aged 23/24, ACE exposure (physical, psychological, and sexual abuse) was linked to increased depressive symptoms. Effects were strongest for psychological abuse (β = 3.84, p = 2.41E-17) and sexual abuse (β = 3.9, p = 4.62E-13), compared to physical abuse (β = 1.88, p = 9.81E-09). ACE exposure, particularly physical abuse, was also associated with higher BMI (β = 0.93, p = 5.95E-04). However, there was limited evidence that ACEs predicted early markers of future multimorbidity. When examining ADHD in ALSPAC, both childhood limited and persistent symptom trajectories were associated with reduced HDL cholesterol and apolipoprotein A. Persistent ADHD was additionally linked to higher triglycerides (β = 0.18, SE = 0.04, t = 4.54, p = 5.993E-06). Finally, ADHD showed limited associations with early indicators for increased risk of future multimorbidity, but these did not survive Bonferroni correction. Overall, these findings enhance understanding of early life contributors to multimorbidity across adulthood.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Medicine
Date of First Compliant Deposit:	29 July 2026
Last Modified:	29 Jul 2026 10:08
URI:	https://orca.cardiff.ac.uk/id/eprint/188593

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