Modeling life course pathways from adverse childhood experiences to adult mental health |
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| Institution: | 1. Policy and International Health Directorate, World Health Organization Collaborating Centre on Investment for Health and Wellbeing, Public Health Wales, Wrexham, UK;2. College of Human Sciences, Bangor University, Wrexham, UK;3. Violence and Injury Prevention, World Health Organization Regional Office for Europe, Copenhagen, Denmark;1. Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Institute for Child and Family Well-being, United States;2. University of Wisconsin-Milwaukee, Institute for Child and Family Well-being, United States;1. Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina;2. Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina;3. Health Equity and Rural Outreach Innovation Center, Charleston VA COIN, Ralph H. Johnson VA Medical Center, Charleston, South Carolina;1. College of Health and Behavioural Sciences, Bangor University, Bangor, UK;2. Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK;3. World Health Organization Regional Office for Europe, Division of NonCommunicable Diseases and Promoting Health through the Life-Course, Copenhagen, Denmark;4. World Health Organization, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, Geneva, Switzerland;5. Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK;6. Public Health Institute, Liverpool John Moores University, Liverpool, UK;7. School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia;1. University of Texas at Austin, Population Research Center, 1 University Station A2702, Austin, TX 78704, USA;2. Ohio State University, School of Social Work, 1947 North College Drive, 325B Stillman Hall, Columbus, OH 43210, USA |
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| Abstract: | Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects. |
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| Keywords: | Adverse childhood experiences Trauma Mental health Stress proliferation Stress embodiment |
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