Key highlights in this article:
- Adolescents exposed to multiple adversities or elevated maternal depression showed worse mental health outcomes and altered brain connectivity.
- Four childhood adversity profiles were identified: low, medium, high adversity, and high maternal depression, with the latter two having the most severe symptoms.
- Interventions addressing multiple risks, especially maternal mental health, could improve mental health outcomes in children facing adversity.
Background
Worse mental health outcomes and different neural connectivity in adolescence were observed among children who experienced multiple adversities or only elevated maternal depression, according to a study published in JAMA Network Open.1
Childhood adversity experiences, which are prevalent risk factors for health across the lifespan, have been previously linked with differences in brain function during emotion processing in both human and animal research according to investigators. These associations "provide insight into how adversity could disrupt critical domains of development that contribute to psychopathology later in life," said the study authors, led by Felicia Hardi, PhD, of the Department of Psychology at the University of Michigan and Yale University.
"This study aimed to characterize heterogeneity in mental health and network function during emotion processing among subgroups of youths with different profiles of childhood adversity," said Hardi and colleagues.
Study details and results
The design was a population-based birth cohort that used data for children who were born in 20 large cities (more than 200,000 people) in the United States between 1998 and 2000. According to the authors, families were interviewed when children were born and at ages, 1, 3, 5, 9, and 15, years. At the 15-years-of-age interview, neuroimaging data were collected from a subset of participants.
The primary outcome of the study was internalizing and externalizing symptoms at age 15 years, using parent- and youth-reported measures. "Profile-specific functional magnetic resonance imaging connectivity across the default mode network (DMN), salience network (SN), and frontoparietal network (FPN)," stated the investigative team.
Latent profiles of childhood adversity were defined by family and neighborhood risks from ages 0 to 9 years. Adverse childhood experiences were represented by indicators in and out of the home that contribute to youth mental health problems:
- Childhood maltreatment (emotion, physical abuse, neglect)
- Intimate partner violence
- Maternal depression
- Parental stress
- Residential moves
- Neighborhood violence
- Lack of protective influences
"Internalizing and externalizing problems were measured using second-order multi-informant latent factors, based on both parent and youth reports at age 15 years," stated the study authors. "Latent profile analysis (LPA) was performed on the full sample of 4210 participants using Mplus version 8.8... to identify profiles of childhood adversity."
Using data from 4210 individuals, of which 52.5% were male, revealed 4 childhood adversity profiles:
- Low-adversity (1230 individuals [29.2%])
- Medium-adversity (1973 [46.9%])
- High-adversity (457 [10.9%])
- High maternal depression (MD; 550 [13.1%])
Results demonstrated that high-adversity then MD profiles had the highest symptoms. Internalizing symptoms did not differ between these profiles even though the MD profile showed adversity levels most similar to the medium-adversity profile (mean difference, 0.11; 95% CI, −0.03 to 0.26).
Among 167 individuals who made up the neuroimaging subsample, high-adversity and MD profiles had lower SN density, relative to the low-adversity profile (mean difference, −0.02; 95% CI, −0.04 to −0.003), along with the highest FPN density among all profiles (F(3,163) = 18.96; P < .001). Differences were specific to brain connectivity during an emotion task, however, not during rest.
Conclusion
Those who had experienced multiple adversities during childhood, or those who experienced only elevated MD, had worse mental health and different neural connectivity amid adolescence. "Interventions targeting multiple risk factors, with a focus on maternal mental health, could produce the greatest benefits," the study authors concluded.
Reference:
Hardi FA, Beltz AM, McLoyd V, et al. Latent profiles of childhood adversity, adolescent mental health, and neural network connectivity. JAMA Netw Open. 2024;7(8):e2430711. doi:10.1001/jamanetworkopen.2024.30711