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 E Russell; Laura D Howe; Annie Herbert; Andrew D A C Smith; Helen L Fisher; Jessie R Baldwin; Louise Arseneault; Andrea Danese; Becky Mars

doi:10.1111/jcpp.13986

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

J Child Psychol Psychiatry. 2024 Apr 13. doi: 10.1111/jcpp.13986. Online ahead of print.

Authors

Bushra Farooq¹, Abigail E Russell², Laura D Howe³, Annie Herbert³, Andrew D A C Smith⁴, Helen L Fisher^{5

6}, Jessie R Baldwin^{5

7}, Louise Arseneault⁴, Andrea Danese^{5

8

9}, Becky Mars^{1

10}

Affiliations

¹ Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, UK.
² Children and Young People's Mental Health Research Collaboration, University of Exeter Medical School, Exeter, UK.
³ MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol Medical School, Bristol, UK.
⁴ Mathematics and Statistics Research Group, University of the West of England, Bristol, UK.
⁵ Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁶ ESRC Centre for Society and Mental Health, King's College London, London, UK.
⁷ Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, UK.
⁸ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁹ National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK.
¹⁰ National Institute for Health and Care Research, Biomedical Research Centre, Bristol, UK.

PMID: 38613494
DOI: 10.1111/jcpp.13986

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 14-18 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 was more important in the MCS.

Conclusions: 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.

Keywords: ALSPAC; Adverse childhood experiences; E‐Risk; MCS; accumulation of risk; cohort; depression; developmental timing; self‐harm.

Abstract

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