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Adverse childhood experiences and child mental health: an electronic birth cohort study

Lowthian, E, Anthony, R, Evans, A, Daniel, R, Long, S, Bandyopadhyay, A, John, A, Bellis, MA and Paranjothy, S (2021) Adverse childhood experiences and child mental health: an electronic birth cohort study. BMC Medicine, 19 (1). ISSN 1741-7015

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Open Access URL: http://dx.doi.org/10.1186/s12916-021-02045-x (Published version)

Abstract

Background: Adverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member.
Methods: We analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors.
Results: There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34–2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52–1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant.
Conclusion: The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families.

Item Type: Article
Uncontrolled Keywords: Humans; Cohort Studies; Anxiety; Mental Health; Pregnancy; Electronics; Adult; Child; Infant, Newborn; Female; Adverse Childhood Experiences; Administrative data; Adverse childhood experiences; Cohort; Mental health; Survival analysis; Wales; Adult; Adverse Childhood Experiences; Anxiety; Child; Cohort Studies; Electronics; Female; Humans; Infant, Newborn; Mental Health; Pregnancy; 11 Medical and Health Sciences; General & Internal Medicine
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Public Health Institute
Publisher: BioMed Central
SWORD Depositor: A Symplectic
Date Deposited: 18 Jan 2023 12:34
Last Modified: 14 Feb 2023 15:27
DOI or ID number: 10.1186/s12916-021-02045-x
URI: https://researchonline.ljmu.ac.uk/id/eprint/18675
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