Saint Louis University College of Public Health and Social Justice associate professor of health management and policy, SangNam Ahn, Ph.D., recently published a paper in Journal of Clinical Psychology which examines the relationship between childhood adversity and psychiatric decline as well as adult adversity and psychiatric and cognitive decline. His team found that just one incident of adversity in childhood can increase the incidence of mental illness later in life, and adverse events in adults can lead to a greater likelihood of both mental illness and cognitive decline later in life.
Life is very complex, very dynamic. I really wanted to highlight the importance of looking at the lasting impact of adversity on health, not only in childhood but also in adulthood on health outcomes, particularly physical health and psychiatric and cognitive health. There have been other studies in the past, but this is one of the first to look at these issues comprehensively.”
SangNam Ahn, Ph.D., associate professor of health management and policy, Saint Louis University
Ahn, along with his team of researchers, looked at data from more than 3,500 people over the course of 24 years. The team took the longitudinal data and assessed it using a list of potential traumatic events over the course of a lifetime.
The research group included childhood adversities such as moving due to economic hardship, a family in need of financial assistance, a parent experiencing unemployment, problems with law enforcement before age 18, repeating school, physical abuse, and parental drug abuse, or alcohol. Adverse adulthood events included death of a child, death of a spouse, experience of a natural disaster after age 17, firing a weapon in combat, partner who abused drugs or alcohol, victim of physical assault after age 17, spouse or child who struggling with a serious illness, receiving Medicaid or food stamps, and experiencing unemployment.
The study determined that nearly 40 percent of all individuals experienced some form of childhood adversity, with that number rising to nearly 80 percent for adulthood adversity. Those who experienced adversity in childhood were also 17% more likely to experience adversity in adulthood. Only 13 percent of those sampled reported two or more forms of childhood adversity, while 52 percent of adults experienced two or more forms of adult adversity.
In cases of childhood adversity or adulthood adversity, researchers found that people who experienced adversity were also more likely to experience anxiety and depression later in life, and in the case of adulthood adversity, they were also more likely to experience cognitive decline later in life.
Those with one childhood adversity experience were five percent more likely to suffer from anxiety, and those with two or more childhood adversities had 26 percent and 10 percent higher odds of depression and anxiety, respectively. People who experienced two adulthood adversities were 24 percent more likely to develop depression, while also experiencing 3 percent cognitive decline later in life.
While most of the results were expected or not surprising, one area that stood out to Ahn was education. Individuals studied who reported higher levels of education saw a decrease in the number of adversity experiences. Ahn hopes to study this avenue more to learn how education might be able to mitigate or prevent these declines.
“Before we included education, there was a significant association between childhood adversity and cognitive decline,” Ahn said. “But when we included education as a covariate, that significant association disappeared. Interesting. So there were significant effects here. Education and schooling, people could do better even if they were exposed to adversity in their childhood. It’s likely to learn positive coping mechanisms, which may help avoid reliance on unhealthy coping mechanisms such as smoking or excessive alcohol or drug use.
“Education is very important in terms of health outcomes,” Ahn added. “If I’m educated, I’m more likely to get a better job, have a higher income, and live in areas with less crime. I’m more likely to buy a gym membership or exercise regularly. I’m more likely to shop at Whole Foods and get a proper diet.” All of that helps combat those adversities that we mentioned in the study. So education and health outcomes are already closely linked, and that’s what we saw in our study.”
Ahn also encourages clinicians and everyday people to discuss their stress. Clinicians can learn more about their patients and have a better approach to their physical and mental health, while others could potentially relate to shared experiences. But through awareness and recognition, these adverse experiences could potentially have less severe, lasting effects.
“Public health is very interested in stress,” Ahn said. “But we’re still looking at how everyday stress affects our long-term health outcomes. So to see the results here in the study, I want people to pay attention to their stress and treat it proactively. Clinicians they should have deep conversations with their patients about stress and their mental state. And these topics can be approached in other areas, such as the classroom or the dining room table. The more we become aware of stress and discuss stress us, the better we can handle any adversities we encounter in life.”
Source:
Journal Reference:
Ahn, S., et al. (2024). Life adversity predicts depression, anxiety, and cognitive impairment in a nationally representative sample of older adults in the United States. Journal of Clinical Psychology. doi.org/10.1002/jclp.23642.
