TY - JOUR
T1 - Childhood Adversity and Midlife Health
T2 - Shining a Light on the Black Box of Psychosocial Mechanisms
AU - Bourassa, Kyle J
AU - Moffitt, Terrie E
AU - Harrington, HonaLee
AU - Houts, Renate
AU - Poulton, Richie
AU - Ramrakha, Sandhya
AU - Rasmussen, Line J H
AU - Wertz, Jasmin
AU - Caspi, Avshalom
N1 - © 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/7
Y1 - 2023/7
N2 - Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the "black box" of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
AB - Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the "black box" of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
KW - Adult
KW - Adverse Childhood Experiences
KW - Child
KW - Health Status
KW - Humans
KW - Middle Aged
KW - Health
KW - Health behaviors
KW - Personality
KW - Adverse childhood experiences
KW - Perceived stress
KW - Stressful life events
UR - http://www.scopus.com/inward/record.url?scp=85137806894&partnerID=8YFLogxK
U2 - 10.1007/s11121-022-01431-y
DO - 10.1007/s11121-022-01431-y
M3 - Journal article
C2 - 36083434
SN - 1389-4986
VL - 24
SP - 817
EP - 828
JO - Prevention science : the official journal of the Society for Prevention Research
JF - Prevention science : the official journal of the Society for Prevention Research
IS - 5
ER -