Childhood adversity and adolescent psychopathology: evidence for mediation in a national longitudinal cohort study

Br J Psychiatry. 2019 Sep;215(3):559-564. doi: 10.1192/bjp.2019.108.

Abstract

Background: Childhood adversity is a well-established risk factor for psychopathology; however, many who experience adversity do not go on to develop psychopathology. Poor self-concept and poor parental support are known risk factors for adolescent psychopathology, which may account for some of this mechanism.

Aims: To investigate candidate mediators in the relationship between childhood adversity and psychopathology.

Method: We used data from the age 9 and 13 waves of the child-cohort of the Growing Up in Ireland study. We undertook mediation analysis by path decomposition of the relationship between childhood adversity and psychopathology (internalising and externalising problems) at age 13 and persistent psychopathology. Candidate mediators were self-concept, parent-child relationship and hobby participation at age 9.

Results: Childhood adversity was reported by 28.2% of participants, and was significantly associated with internalising and externalising problems. Parent-child conflict mediated the relationship between childhood adversity and both age 13 and persistent psychopathology, accounting for 52.4% of the relationship between childhood adversity and persistent externalising problems (indirect odds ratio, 1.30; 95% CI 1.19-1.43) and 19.2% for persistent internalising problems (indirect odds ratio, 1.24; 95% CI 1.15-1.34). There was a small mediating effect of self-concept. Hobby participation and positive parent-child relationship did not mediate these relationships.

Conclusions: Parent-child conflict explains almost half the relationship between childhood adversity and persisting externalising problems in adolescence, and a fifth of the relationship with persisting internalising problems. This suggests parent-child conflict is a good target for interventions in childhood to prevent adolescent psychopathology.

Declaration of interest: None.

Keywords: Trauma; epidemiology; psychosocial interventions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Development / physiology*
  • Adverse Childhood Experiences*
  • Child
  • Child Development / physiology*
  • Female
  • Humans
  • Internal-External Control*
  • Ireland / epidemiology
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Parent-Child Relations*
  • Predictive Value of Tests
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / pathology
  • Psychotic Disorders / psychology*
  • Risk Factors
  • Self Concept
  • Surveys and Questionnaires