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Affiliation(s)
- Cavan V Bonner
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Ill
| | - Brent W Roberts
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Ill
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Copeland WE, Halvorson-Phelan J, McGinnis E, Shanahan L. Adult Mental Health, Substance Use Disorders, and Functional Outcomes of Children Resilient to Early Adversity. Am J Psychiatry 2023; 180:906-913. [PMID: 37941330 DOI: 10.1176/appi.ajp.20230038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Some children are unaffected by mental illness despite exposure to childhood adversity. These children are typically considered resilient. The objective of this study was to follow up such resilient children in adulthood to characterize mental health status, substance use, and functional outcomes. METHODS The analysis was based on the prospective, representative Great Smoky Mountains Study (N=1,420). Participants were assessed for psychiatric disorders and exposure to adversity with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9-16; 6,674 observations). In total, 1,266 participants (86.3%) were followed up in adulthood at ages 25 and 30 to assess psychiatric disorders, substance use disorders, and functional outcomes. RESULTS Seventy-five percent of the sample had met criteria for a psychiatric disorder or displayed subthreshold psychiatric problems by age 16. The number of adverse childhood experiences was strongly associated with childhood psychiatric status. Of children exposed to multiple adversities (N=650), 12.2% (N=63) did not display psychiatric problems. This group meets common definitions of childhood resilience. In adulthood, these individuals showing childhood resilience had greater risk of anxiety (risk ratio=2.9, 95% CI=1.0-9.1) and depressive (risk ratio=4.5, 95% CI=1.1-16.7) disorders, as well as worse physical health (means ratio=0.7, 95% CI=0.5-0.9) and financial or educational functioning (means ratio=0.6, 95% CI=0.5-0.7), compared with individuals exposed to fewer childhood adversities. These individuals showing childhood resilience did not have elevated risk for substance use disorders. CONCLUSIONS Resilience to childhood adversity was uncommon. Individuals who appeared resilient in childhood were at risk for delayed poorer outcomes in adulthood. Public health efforts should prioritize minimizing early adversity exposure over promoting resilience.
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Affiliation(s)
- William E Copeland
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Julia Halvorson-Phelan
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Ellen McGinnis
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
| | - Lilly Shanahan
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington (Copeland, Halvorson-Phelan); Department of Public Health Sciences, Wake Forest University, Winston-Salem, N.C. (McGinnis); Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich (Shanahan)
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van Harmelen AL, Blakemore S, Goodyer IM, Kievit R. The interplay between adolescent friendship quality and resilient functioning following childhood and adolescent adversity. Advers Resil Sci 2021; 2:37-50. [PMID: 37915317 PMCID: PMC7615274 DOI: 10.1007/s42844-020-00027-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/03/2023]
Abstract
Background Child and adolescent adversity ('CA') is a major predictor of mental health problems in adolescence and early adulthood. However, not all young people who have experienced CA develop psychopathology; their mental health functioning can be described as resilient. We previously found that resilient functioning in adolescence following CA is facilitated by adolescent friendships.However, during adolescence, friendships undergo significant change. It is unknown whether resilient functioning after CA fluctuates with these normative changes in friendship quality. Methods We used Latent Change Score Modelling in a large sample of adolescents (i.e. the ROOTS cohort; N=1238) to examine whether and how emergent friendship quality and resilient functioning at ages 14 and 17 inter-relate and change together. Results We found that friendships quality and resilient functioning had strong associations at age 14, although friendships at 14 did not predict higher resilient functioning at 17. Higher resilient functioning in 14-year-olds with a history of CA was associated with a positive change in friendships from age 14 to 17. Finally, improvements in friendship quality and resilient functioning went hand in hand, even when taking into account baseline levels of both, the change within friendship quality or resilient functioning over time, and the association between resilient functioning and change in friendship quality over time. Conclusions We show that friendship quality and resilient functioning after CA inter-relate and change together between ages 14 and 17. Our results suggest that improving friendship quality or resilient functioning within this timeframe may benefit this vulnerable adolescent group, and this should be tested in future research.
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Affiliation(s)
- A.-L. van Harmelen
- Education and Child Studies, Leiden University, The Netherlands
- Department of Psychiatry, University of Cambridge, UK
| | - S.J. Blakemore
- Department of Psychology, University of Cambridge, UK
- UCL Institute of Cognitive Neuroscience, London, UK
| | - IM Goodyer
- Department of Psychiatry, University of Cambridge, UK
| | - R.A. Kievit
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
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Seo J, Lee CS, Lee YJ, Lee MS, Bhang SY, Lee D. The Mediating Effect of Depressive Symptoms on the Relationship between Adverse Childhood Experiences and Problematic Internet Use in Children and Adolescents. J Korean Med Sci 2020; 35:e282. [PMID: 32776724 PMCID: PMC7416000 DOI: 10.3346/jkms.2020.35.e282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to evaluate the mediating effect of depressive symptoms on the relationship between adverse childhood experiences (ACEs) and problematic internet use. The study participants were 180 students between the ages of 9 and 18 years. Path analysis was performed to measure the relationships among ACEs, depressive symptoms and problematic internet use. ACEs significantly affected depressive symptoms (standardized regression weight, 0.36; P < 0.01), and depressive symptoms also affected problematic internet use (standardized regression weight, 0.40; P < 0.01). We found that depressive symptoms had a significant mediating effect on the relationship between problematic internet use and ACEs. The management of depressive symptoms would be important to prevent problematic internet use in children and adolescents with ACEs.
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Affiliation(s)
- Jiyeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Cheol Soon Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Young Ji Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Mi Sun Lee
- Department of Meditation Psychology, Nungin University, Hwaseong, Korea
| | - Soo Young Bhang
- Department of Psychiatry, Eulji University Hospital, Eulji University School of Medicine, Seoul, Korea.
| | - Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea.
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Zhang A, Price JL, Leonard D, North CS, Suris A, Javors MA, Adinoff B. Alcohol Use Disorder Masks the Effects of Childhood Adversity, Lifetime Trauma, and Chronic Stress on Hypothalamic-Pituitary-Adrenal Axis Reactivity. Alcohol Clin Exp Res 2020; 44:1192-1203. [PMID: 32491213 DOI: 10.1111/acer.14334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/28/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) and those who have experienced traumas or chronic stress exhibit dysregulated hypothalamic-pituitary-adrenal (HPA) axis reactivity. Whether and how trauma and stress histories interact with AUD to affect HPA axis reactivity has not been assessed. METHODS In the present study, 26 healthy male controls and 70 abstinent men with AUD were administered a pharmacologic probe [ovine corticotropin-releasing hormone (oCRH)] and psychosocial stressor to assess HPA axis reactivity. Plasma adrenocorticotropin hormone (ACTH) and cortisol were assessed every 10-20 minutes. Hierarchical clustering of multiple measures of trauma and stress identified 3 distinct clusters: childhood adversity, lifetime trauma, and chronic stress. General linear model procedures were used to examine main effects of group (AUD/control) and interaction effects of the 3 clusters upon net-integrated ACTH and cortisol response. RESULTS We found that higher levels of childhood adversity, lifetime trauma, and chronic stress were each associated with blunted oCRH-induced ACTH reactivity in controls, but not in the AUD group. Recent chronic stress within the prior 6 months had the strongest influence upon ACTH reactivity in the control group, and lifetime trauma, the least. CONCLUSIONS Childhood adversity, lifetime trauma, and chronic stress likely exert persistent, measurable effects upon HPA axis functioning in healthy controls. This association appears to be masked in individuals with AUD, potentially confounding studies examining the effects of stress, adversity, and/or trauma upon the HPA axis in this population during the protracted withdrawal phase of recovery. Future work targeting stress exposure and reactivity should consider the heightened effect of previous alcohol use relative to past adversity and trauma.
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Affiliation(s)
- Alice Zhang
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Julianne L Price
- Department of Psychology, University of Florida, Gainesville, Florida.,Department of Psychiatry, University of Florida, Gainesville, Florida
| | - David Leonard
- David Leonard Statistical Consulting, Wichita Falls, Texas
| | - Carol S North
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alina Suris
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.,Mental Health, VA North Texas Health Care System, Dallas, Texas
| | - Martin A Javors
- Departments of Psychiatry and Pharmacology, University of Texas Health Science Center-San Antonio, San Antonio, Texas
| | - Bryon Adinoff
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.,Mental Health, VA North Texas Health Care System, Dallas, Texas.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
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You DS, Albu S, Lisenbardt H, Meagher MW. Cumulative Childhood Adversity as a Risk Factor for Common Chronic Pain Conditions in Young Adults. Pain Med 2019; 20:486-494. [PMID: 30011037 PMCID: PMC6387984 DOI: 10.1093/pm/pny106] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Multiple and specific types of childhood adverse events are risk factors for chronic pain conditions. Although both can covary, no study has evaluated one aspect while controlling for the other. Therefore, the current study examined whether more adverse events would be a risk factor for common chronic pain conditions and pain medication use in young adults after controlling for different adversity types such as physical, emotional, and sexual traumatic events or vice versa. METHODS This cross-sectional study recruited 3,073 undergraduates (72% female, mean age = 18.8 years, SD = 1.4 years) who completed the survey for current health status and early life traumatic events. RESULTS More adverse events were associated with a 1.2-1.3-fold increase in the odds of any chronic pain, chronic back pain, headache, and dysmenorrhea with adjusting for adversity types, but they were not associated with the risk of comorbid pain conditions and use of pain medications. In contrast, specific adversity types were unrelated to chronic pain conditions when controlling for the number of adverse events. CONCLUSIONS Cumulative childhood adverse events may be a more relevant risk factor for chronic pain conditions than the experience of a specific type of adverse event. Clinicians and researchers need to evaluate cumulative childhood adversity when assessing its link to chronic pain.
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Affiliation(s)
- Dokyoung S You
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station TX 77843, USA
| | - Sergiu Albu
- Institute Guttmann, Neurorehabilitation Hospital, Badalona, Barcelona, Spain
| | - Hans Lisenbardt
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station TX 77843, USA
| | - Mary W Meagher
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station TX 77843, USA
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Simmons JG, Badcock PB, Whittle SL, Byrne ML, Mundy L, Patton GC, Olsson CA, Allen NB. The lifetime experience of traumatic events is associated with hair cortisol concentrations in community-based children. Psychoneuroendocrinology 2016; 63:276-81. [PMID: 26529051 DOI: 10.1016/j.psyneuen.2015.10.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 10/04/2015] [Accepted: 10/05/2015] [Indexed: 12/23/2022]
Abstract
Adversity early in life can disrupt the functioning of the hypothalamic-pituitary-adrenal axis (HPAA) and increase risk for negative health outcomes. Recent research suggests that cortisol in scalp hair represents a promising measure of HPAA function. However, little is known about the relationship between early exposure to traumatic events and hair cortisol concentrations (HCC) in childhood, a critical period of HPAA development. The current study measured HCC in scalp hair samples collected from 70 community-based children (14 males, mean age=9.50) participating in the Imaging Brain Development in the Childhood to Adolescence Transition Study (iCATS). Data were also collected on lifetime exposure to traumatic events and current depressive symptoms. Lifetime exposure to trauma was associated with elevated HCC; however, HCC was not associated with current depressive symptoms. Consistent with some prior work, males were found to have higher HCC than females, although results should be treated with caution due to the small number of males who took part. Our findings suggest that hair cortisol may represent a biomarker of exposure to trauma in this age group; however, further study is necessary with a particular focus on the characterization of trauma and other forms of adversity.
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Affiliation(s)
- Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia.
| | - Paul B Badcock
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia.
| | - Sarah L Whittle
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia.
| | - Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, OR, USA.
| | - Lisa Mundy
- Centre for Adolescent Health, Murdoch Childrens Research Institute, and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia.
| | - George C Patton
- Centre for Adolescent Health, Murdoch Childrens Research Institute, and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia.
| | - Craig A Olsson
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia; Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia.
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, OR, USA.
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Sartor CE, Wang Z, Xu K, Kranzler HR, Gelernter J. The joint effects of ADH1B variants and childhood adversity on alcohol related phenotypes in African-American and European-American women and men. Alcohol Clin Exp Res 2014; 38:2907-14. [PMID: 25410943 DOI: 10.1111/acer.12572] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 09/06/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The ADH1B gene has consistently been implicated in problem drinking, but rarely incorporated into gene by environment investigations of alcohol phenotypes. This study examined the joint effects of variation in ADH1B and childhood adversity-a well-documented risk factor for alcohol problems and moderator of genetic liability to psychiatric outcomes-on maximum drinks consumed in a 24-hour period (maxdrinks) and alcohol use disorder (AUD) symptoms. METHODS Data were drawn from 2,617 African-American (AA) and 1,436 European-American (EA) participants (42% female) in a multisite genetic study of substance dependence. We tested the most significant ADH1B single nucleotide polymorphisms for alcohol dependence from a genomewide association study with this sample, ADH1B-rs1229984 (Arg48His) and ADH1B-rs2066702 (Arg370Cys), in EA and AA subsamples, respectively. RESULTS Ordinal regression analyses conducted separately by sex and population revealed significant main effects for childhood adversity for both alcohol phenotypes in AA women and men and for maxdrinks in EA women. A significant rs1229984 by childhood adversity interaction was observed for AUD symptoms in EA men. Unexposed His-allele carriers reported a mean of 3.6 AUD criteria, but adversity-exposed His-allele carriers endorsed approximately the same number (6.3) as those without the protective allele (6.3 and 7.0 for adversity-exposed and -unexposed groups, respectively). CONCLUSIONS Results suggest that under conditions of childhood adversity, the His allele does not exert its protective effects in EA men (OR = 0.57, CI: 0.32 to 1.01; p = 0.056). Findings highlight the robust risk effect conferred by childhood adversity and the importance of considering population and sex in genetically informative investigations of its association with alcohol outcomes.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry , Yale University School of Medicine, New Haven, Connecticut
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