Children who do not develop mental health problems early in life despite exposure to multiple adversities may experience such challenges in early adulthood, suggests a report in The American Journal of Psychiatry.
“Although resilient individuals may escape their childhood relatively unscathed, the stress of maintaining psychological health despite adversity may catch up with them later in development,” wrote William E. Copeland, Ph.D., of the University of Vermont and colleagues.
Copeland and colleagues examined data from The Great Smoky Mountains Study, a longitudinal study that tracked the outcomes of three cohorts of children (aged 9, 11, and 13 years), recruited from 11 counties in Western North Carolina. Annual assessments were conducted with the children and caregivers each year until the children reached 16; the young adults were assessed alone at ages 19, 21, 25, and 30. Up until 16, the youth answered questions about childhood adversities, which the researchers categorized into the following five domains:
- low socioeconomic status
- unstable family structure
- family dysfunction
- maltreatment
- peer victimization
The researchers estimated cumulative childhood exposure to adversity by counting the number of categories of adversity experienced.
Copeland and colleagues analyzed the reports of 1,266 participants, who answered questions about psychiatric disorders and functioning at ages 25 and/or 30. Of this group, 941 (74%) experienced psychiatric illnesses or subthreshold psychiatric symptoms by the age of 16. Of the 325 (26%) who did not meet criteria for a psychiatric diagnosis or subthreshold disorder by the age of 16, 63 of them had been exposed to multiple adversities in childhood. (The authors characterized these youth as “resilient”).
The researchers found that compared with children with limited exposure to adversity and no childhood disorders (low-risk/no disorders group), resilient children had nearly 3 times the risk of developing anxiety and 4.5 times the risk of developing depression in adulthood. In addition, the resilient group had worse physical and financial health compared with individuals in the low-risk/no disorders group. However, the resilient group had better functioning compared with the group of participants with childhood psychiatric problems in the domains of health and social functioning.
“Thus, the well-being of adults who had been characterized as resilient children was better than that of the adults with childhood psychiatric problems but sometimes worse than that of adults exposed to less childhood adversity,” the authors wrote. “[T]he development of some level of mental health problems is the normative response to significant adversity. Individual resilience followed by persistent mental health is rare and may not be a reasonable goal. Public health efforts should prioritize reducing risk and treating individuals who are ill.”
To read more on this topic, see the Psychiatric News article “Intervention, Resilience May Counter Poverty’s Impact on Brain Development.”
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