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Commentary |

As the Twig Is Bent, the Tree Inclines:  Adult Mental Health Consequences of Childhood Adversity

James Scott, MBBS, PhD,  FRANZCP; Daniel Varghese, MBBS,  FRANZCP; John McGrath, MD, PhD
Arch Gen Psychiatry. 2010;67(2):111-112. doi:10.1001/archgenpsychiatry.2009.188.
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Folk psychology has long appreciated the links between childhood trauma and both childhood and adult mental health problems. In this issue of Archives, 2 related articles from the National Comorbidity Survey Replication1 enhance this traditional wisdom with precise estimates, confidence intervals, and sophisticated modeling.2,3 Based on detailed interviews with 5692 adults, the researchers derived lifetime diagnoses for a range of mental health disorders. In addition, the respondents were asked to recall if they had been exposed to 12 different stressors prior to the age of 18 years. The prevalence of childhood adversities (CAs) was high—about half of all respondents endorsed at least 1 CA. The CAs were also highly intercorrelated. Factor analysis grouped the CAs into those reflecting maladaptive family functioning (parental mental illness, parental substance abuse, criminal behavior, domestic violence, physical abuse, sexual abuse, and neglect) and other CAs (parental death, parental divorce, other parental loss, childhood physical illness, and family economic adversity). Multiple childhood adversities were the norm in subjects exposed to any of the CAs that contributed to the maladaptive family functioning factor.

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