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; A Russell; L Howe; A Herbert; A.D.A.C. Smith; Helen Fisher; Jessie Baldwin; Louise Arseneault; Andrea Danese; B 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

Bushra Farooq, A Russell, L Howe, A Herbert, A.D.A.C. Smith, Helen Fisher, Jessie Baldwin, Louise Arseneault, Andrea Danese, B Mars

University of Exeter

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

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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.

Original language	English
Journal	Journal of Child Psychology and Psychiatry
Early online date	13 Apr 2024
DOIs	https://doi.org/10.1111/jcpp.13986
Publication status	E-pub ahead of print - 13 Apr 2024

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ACEs self-harm and depression_19-01-24_AAMAccepted author manuscript, 406 KBLicence: CC BY

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Farooq, B., Russell, A., Howe, L., Herbert, A., Smith, A. D. A. C., Fisher, H., Baldwin, J., Arseneault, L., Danese, A., & Mars, B. (2024). 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 . Journal of Child Psychology and Psychiatry. Advance online publication. https://doi.org/10.1111/jcpp.13986

@article{90a437158e764696825465230cfce949,

title = "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 ",

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.",

author = "Bushra Farooq and A Russell and L Howe and A Herbert and A.D.A.C. Smith and Helen Fisher and Jessie Baldwin and Louise Arseneault and Andrea Danese and B Mars",

note = "Funding Information: Funding: This work was supported in part by grant MR/N0137941/1 for the GW4 BIOMED DTP, awarded to the Universities of Bath, Bristol, Cardiff and Exeter from the Medical Research Council (MRC)/UKRI. B.M. is funded by a fellowship from the Medical Research Foundation (MRF\u2010058\u20100017\u2010F\u2010MARS\u2010C0869). This report is in part independent research supported by the National Institute for Health Research NIHR Advanced Fellowship\u2014Stage 2, Dr Abigail Russell, NIHR300591. The UK Medical Research Council (MRC) and the Wellcome Trust (grant ref: 217065/Z/19/Z), and the University of Bristol provide core support for ALSPAC. A comprehensive list of grant funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant\u2010acknowledgements.pdf ); this research was specifically funded by Wellcome Trust and MRC (grant ref: GR067797MA; grant ref: 092731; grant ref: G0701594), and NIH (grant ref: PD301198\u2010SC101645). The Environmental Risk (E\u2010Risk) Longitudinal Twin Study is funded by the UK Medical Research Council (grant refs: G1002190 and MR/X010791/1). Additional support was provided by the National Institute of Child Health and Human Development (grant ref: HD077482) and by the Jacobs Foundation. The MCS is funded by the Economic and Social Research Council (ESRC) through grants awarded to the Centre for Longitudinal Studies (CLS). The ESRC award has been supplemented since the inception of the MCS by funding from a consortium of government funders, through a contract held with the Office for National Statistics. A.D. is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. H.L.F. is supported by the ESRC Centre for Society and Mental Health at King's College London (grant ref: ES/S012567/1). J.R.B. and A.H. are supported by separate Sir Henry Wellcome Postdoctoral Fellowships from the Wellcome Trust (grant refs: 215917/Z/19/Z and 224114/Z/21/Z). L.D.H. and A.H. work in a unit that receives funding from the University of Bristol and the UK Medical Research Council [MC_UU_12013/2]. Publisher Copyright: {\textcopyright} 2024 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.",

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day = "13",

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language = "English",

journal = "Journal of Child Psychology and Psychiatry",

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Farooq, B, Russell, A, Howe, L, Herbert, A, Smith, ADAC, Fisher, H , Baldwin, J , Arseneault, L , Danese, A & Mars, B 2024, '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 ', Journal of Child Psychology and Psychiatry. https://doi.org/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 . / Farooq, Bushra; Russell, A; Howe, L et al.
In: Journal of Child Psychology and Psychiatry, 13.04.2024.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression

T2 - Findings from three UK prospective population-based cohorts

AU - Farooq, Bushra

AU - Russell, A

AU - Howe, L

AU - Herbert, A

AU - Smith, A.D.A.C.

AU - Fisher, Helen

AU - Baldwin, Jessie

AU - Arseneault, Louise

AU - Danese, Andrea

AU - Mars, B

N1 - Funding Information: Funding: This work was supported in part by grant MR/N0137941/1 for the GW4 BIOMED DTP, awarded to the Universities of Bath, Bristol, Cardiff and Exeter from the Medical Research Council (MRC)/UKRI. B.M. is funded by a fellowship from the Medical Research Foundation (MRF\u2010058\u20100017\u2010F\u2010MARS\u2010C0869). This report is in part independent research supported by the National Institute for Health Research NIHR Advanced Fellowship\u2014Stage 2, Dr Abigail Russell, NIHR300591. The UK Medical Research Council (MRC) and the Wellcome Trust (grant ref: 217065/Z/19/Z), and the University of Bristol provide core support for ALSPAC. A comprehensive list of grant funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant\u2010acknowledgements.pdf ); this research was specifically funded by Wellcome Trust and MRC (grant ref: GR067797MA; grant ref: 092731; grant ref: G0701594), and NIH (grant ref: PD301198\u2010SC101645). The Environmental Risk (E\u2010Risk) Longitudinal Twin Study is funded by the UK Medical Research Council (grant refs: G1002190 and MR/X010791/1). Additional support was provided by the National Institute of Child Health and Human Development (grant ref: HD077482) and by the Jacobs Foundation. The MCS is funded by the Economic and Social Research Council (ESRC) through grants awarded to the Centre for Longitudinal Studies (CLS). The ESRC award has been supplemented since the inception of the MCS by funding from a consortium of government funders, through a contract held with the Office for National Statistics. A.D. is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. H.L.F. is supported by the ESRC Centre for Society and Mental Health at King's College London (grant ref: ES/S012567/1). J.R.B. and A.H. are supported by separate Sir Henry Wellcome Postdoctoral Fellowships from the Wellcome Trust (grant refs: 215917/Z/19/Z and 224114/Z/21/Z). L.D.H. and A.H. work in a unit that receives funding from the University of Bristol and the UK Medical Research Council [MC_UU_12013/2]. Publisher Copyright: © 2024 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

PY - 2024/4/13

Y1 - 2024/4/13

N2 - 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.

AB - 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.

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U2 - 10.1111/jcpp.13986

DO - 10.1111/jcpp.13986

M3 - Article

SN - 0021-9630

JO - Journal of Child Psychology and Psychiatry

JF - Journal of Child Psychology and Psychiatry

ER -

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

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