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The impact of cumulative childhood adversity on young adult mental health: Measures, models, and interpretations


  • Schilling, Elizabeth A.
  • Aseltine, Robert H.
  • Gore, Susan


Research studies investigating the impact of childhood cumulative adversity on adult mental health have proliferated in recent years. In general, little attention has been paid to the operationalization of cumulative adversity, with most studies operationalizing this as the simple sum of the number of occurrences of distinct events experienced. In addition, the possibility that the mathematical relationship of cumulative childhood adversity to some mental health dimensions may be more complex than a basic linear association has not often been considered. This study explores these issues with 2 waves of data drawn from an economically and racially diverse sample transitioning to adulthood in Boston, Massachusetts, USA. A diverse set of childhood adversities were reported in high school and 3 mental health outcomes--depressed mood, drug use, and antisocial behavior--were reported 2 years later during the transition to adulthood. Our results suggest that both operationalization and statistical modeling are important and interrelated and, as such, they have the potential to influence substantive interpretation of the effect of cumulative childhood adversity on adult mental health. In our data, total cumulative childhood adversity was related to depressive symptoms, drug use, and antisocial behavior in a positive curvilinear manner with incremental impact increasing as adversities accumulate, but further analysis revealed that this curvilinear effect was an artifact of the confounding of high cumulative adversity scores with the experience of more severe events. Thus, respondents with higher cumulative adversity had disproportionately poorer mental health because of the severity of the adversities they were exposed to, not the cumulative number of different types of adversities experienced. These results indicate that public health efforts targeting prevention of childhood adversities would best be aimed at the most severe adversities in order to have greatest benefit to mental health in young adulthood.

Suggested Citation

  • Schilling, Elizabeth A. & Aseltine, Robert H. & Gore, Susan, 2008. "The impact of cumulative childhood adversity on young adult mental health: Measures, models, and interpretations," Social Science & Medicine, Elsevier, vol. 66(5), pages 1140-1151, March.
  • Handle: RePEc:eee:socmed:v:66:y:2008:i:5:p:1140-1151

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    References listed on IDEAS

    1. Turner, Heather A. & Finkelhor, David & Ormrod, Richard, 2006. "The effect of lifetime victimization on the mental health of children and adolescents," Social Science & Medicine, Elsevier, vol. 62(1), pages 13-27, January.
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    Cited by:

    1. Eiji Yamamura, 2011. "Differences in the effect of social capital on health status between workers and non-workers," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 58(4), pages 385-400, December.
    2. Ishida, Kanako & Stupp, Paul & Melian, Mercedes & Serbanescu, Florina & Goodwin, Mary, 2010. "Exploring the associations between intimate partner violence and women's mental health: Evidence from a population-based study in Paraguay," Social Science & Medicine, Elsevier, vol. 71(9), pages 1653-1661, November.
    3. Oshio, Takashi & Umeda, Maki & Kawakami, Norito, 2011. "Mediating effects of social support and socioeconomic status on the association between childhood interpersonal adversity and adulthood mental health in Japan," CIS Discussion paper series 523, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    4. Slopen, Natalie & Williams, David R. & Seedat, Soraya & Moomal, Hashim & Herman, Allen & Stein, Dan J., 2010. "Adversities in childhood and adult psychopathology in the South Africa Stress and Health Study: Associations with first-onset DSM-IV disorders," Social Science & Medicine, Elsevier, vol. 71(10), pages 1847-1854, November.
    5. Corrales, Tatiana & Waterford, Michelle & Goodwin-Smith, Ian & Wood, Leanne & Yourell, Todd & Ho, Coco, 2016. "Childhood adversity, sense of belonging and psychosocial outcomes in emerging adulthood: A test of mediated pathways," Children and Youth Services Review, Elsevier, vol. 63(C), pages 110-119.
    6. repec:eee:cysrev:v:85:y:2018:i:c:p:117-126 is not listed on IDEAS
    7. Fletcher, Jason M., 2009. "Childhood mistreatment and adolescent and young adult depression," Social Science & Medicine, Elsevier, vol. 68(5), pages 799-806, March.


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