Although there is strong evidence from many studies that persons who are exposed to childhood adversities are at increased risk of mental disorders during their adult years, our understanding of these long-term effects is limited in at least three major ways. First, little is known about the joint effects of multiple adversities because most previous research has studied only one adversity at a time, Second, little is known about differences in the effects of adversities on different adult disorders because most previous research has studied only one outcome at a time. Third, little is known about the causal pathways involved in the long-term effects of childhood adversities due to both a dearth of studies on mediators and a pervasive specification bias in those studies that have examined mediators. This proposal seeks support for research that would address these limitations and advance our understanding of the long-term effects of childhood adversities on adult mental disorders. The research would involve analyzing data from the National Comorbidity Survey (NCS). There are three specific aims. (1) We would assess the separate and joint effects of childhood adversities, reported retrospectively by adolescents and adults in the NCS, on the full range of psychiatric disorders assessed in the NCS. For example, we would trace the effects of childhood sexual abuse on a wide range of adult mental disorders. We would also attempt to sort out the separate and joint effects of family distress and parental divorce on adult disorders. (2) We would also disaggregate significant effects into components associated with early onset, later onset, and chronicity of adult disorders. This would allow us to pinpoint where in the life course the effects of childhood adversities are actively at work while controlling for effects on earlier phases of the disorders. (3) Finally, we would evaluate the importance of a wide range of mediating variables on the associations between childhood adversities and adult disorders. For example, we would use survival models that use dated information concerning first onset of mental disorders and age at marriage to evaluate the hypothesis advanced by previous researchers that success in forming a secure marriage protects against the long-term effects of childhood adversity on adult mental disorder. The results of the proposed research would be significant in advancing theory, in providing needed direction for future empirical research, and in informing intervention efforts.
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