The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression: Findings from three UK prospective population-based cohorts

Bushra Farooq*, Abigail Russell , Laura D Howe, Annie Herbert, Andrew Smith, Helen Fisher, Jessie Baldwin, Louise Arseneault, Andrea Danese, Becky Mars

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
Adverse childhood experiences (ACEs) are well-established risk factors for self-harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co-occurring self-harm and depression.
Methods
Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14 to 18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS), and the Environmental Risk (E-Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four-category outcome: no self-harm or depression, self-harm alone, depression alone, and self-harm with co-occurring depression. A Structured Life Course Modelling Approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self-harm and depression in adolescence.
Results
The majority of ACEs were associated with co-occurring self-harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co-occurring self-harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10-1.25) and MCS (1.18, 1.11-1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co-occurring self-harm and depression, and ACE occurrence in early childhood and adolescence were more important in the MCS.
Conclusion
Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long-term exposure to ACEs contributing to risk of self-harm and depression in adolescence.
Original languageEnglish
Number of pages19
JournalJournal of Child Psychology and Psychiatry
Early online date13 Apr 2024
DOIs
Publication statusE-pub ahead of print - 13 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Structured keywords

  • ALSPAC
  • SASH

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