New Study Shows Childhood Adversities’ Impact on Mental Health, Cognitive Development in Youth

By identifying specific forms of adversity that differentially affect youth development, the research opens the door for precision-based approaches in early intervention and prevention efforts.

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A new study has revealed that different types of childhood adversities, such as family conflict and poverty, have distinct and lasting effects on mental health and cognitive development in youth.¹ While some adversities, like peer aggression, lead to worsening mental health, others, such as community threat, may result in adaptive suppression of symptoms, according to the research published today in JAMA Psychiatry.

The number of young people grappling with mental health conditions has surged by 28% since 2018, with an even more staggering increase of 48% observed in the number diagnosed with at least 2 mental health issues.² Over a quarter of parents surveyed disclosed that they have a child facing mental health challenges, whether diagnosed or undiagnosed, according to a report published earlier this year.

The new study, based on data from nearly 12,000 children, builds on the well-known Adverse Childhood Experiences (ACEs) framework by introducing a more nuanced and data-driven approach to understanding the effects of childhood adversity.¹ The investigation, published as part of the Adolescent Brain Cognitive Development (ABCD) research, identifies 8 distinct types of traumatic and adverse childhood experiences (TRACEs) and explores their varied influence on youth mental health and cognitive abilities.

While the traditional ACEs model highlights the negative mental health and cognitive outcomes linked to childhood adversity, its clinical utility is often limited by a lack of specificity. However, this study refines this understanding by categorizing 268 different childhood adversities into thematic components such as family conflict, interpersonal violence, and poverty. The investigators used a nonlinear principal components analysis in which TRACEs were found to have distinct and variable effects on youth development, emphasizing the complexity of how childhood trauma shapes mental health and cognitive function over time.

The authors analyzed data from 11,876 youth participants, aged 9 to 10 years at the start, who were enrolled in the ongoing ABCD study. The research covered a period from 2016 to 2021, with youth and their caregivers completing up to 4 annual behavioral assessments at 21 sites across the US. The team used mixed-effects and latent change score models to assess how TRACEs influenced mental health outcomes. These included internalizing (anxiety, depression, etc), externalizing (aggression, behavioral issues, etc), and cognitive ability throughout adolescence.

At the baseline assessment, nearly every form of adversity was linked to poorer mental health and lower cognitive ability. However, the study uncovered that different types of adversity influenced youth in diverse ways over time.

Family conflict and peer aggression were strongly associated with increasing mental health issues, including heightened internalizing and externalizing problems as the youth aged. Family conflict had a particularly high correlation (t = 5.67) with worsening mental health outcomes.

Community threat and poverty were linked to decreasing mental health issues over time. The authors suggest this may be due to adaptive mechanisms, where some youth, faced with chronic adversity, develop resilience and suppress symptoms of mental health disorders.

Resource deprivation adversities related to poverty and caregiver maladjustment showed a notable association with cognitive decline during early adolescence, underscoring the long-term impact of resource deprivation on cognitive development.

The study’s findings reveal that not all childhood adversities are created equal when it comes to predicting mental health and cognitive outcomes. By identifying specific forms of adversity that differentially affect youth development, the research opens the door for precision-based approaches in early intervention and prevention efforts. This could allow clinicians and policy makers to better target at-risk youth with tailored support strategies that address the unique impacts of the adversities they face, the study stated.

"ACEs are the most potent known preventable risk factor for negative mental health outcomes and are increasingly screened as a general marker of public health. However, translation of the ACEs framework into clinical practice necessitates a more precise delineation of adversity exposures, as well as their differential effects on psychopathology and cognitive development," the authors wrote. "This work describes a novel, data-driven approach to identifying thematic components of adversity through the distillation of a broad range of negative life experiences and circumstances."

References

1. Russell J, Heyn SA, Peverill M, DiMaio S, Herringa RJ. Traumatic and adverse childhood experiences and developmental differences in psychiatric risk. JAMA Psychiatry. Published online October 23, 2024. doi:10.1001/jamapsychiatry.2024.3231

2. Grossi G. Mental health diagnoses, care challenges rise among US youth, report finds. AJMC^®. April 26, 2024. Accessed October 23, 2024. https://www.ajmc.com/view/mental-health-diagnoses-care-challenges-rise-among-us-youth-report-finds