Childhood adversity linked to anxiety and depression in older adults

Can the shadows of childhood trauma extend far into an individual’s twilight years? Recent research published in the Journal of Affective Disorders suggests a resounding yes, with findings indicating that childhood adversities have a sustained, detrimental impact on mental health into older adulthood. Specifically, the study shows that experiences of adversity during childhood are linked to higher instances of depression and anxiety in later years.

Childhood is a pivotal stage in personal development, and adversity during this time—such as abuse, neglect, and household dysfunction—has long been recognized as a significant risk factor for later mental health issues. Previous studies have established a robust link between adverse childhood experiences and various psychological conditions, ranging from mood disorders to substance abuse and suicidality in adulthood. This relationship is thought to stem from the negative effects of early stress on emotional regulation and stress response systems.

Despite considerable evidence of the impact of childhood adversity on adult populations, there has been a relative lack of focus on how these experiences affect the mental health of older adults—a growing concern given the aging global population. Older adults face unique challenges, including increased disability, diminished quality of life, and higher healthcare costs associated with mental illness, which often goes unrecognized and untreated.

“I’ve always been interested in how our lives are shaped by our childhood experiences,” said study author James Lian of the University of New South Wales and Neuroscience Research Australia. “With our ageing population, I was motivated to explore how early adversities could impact individuals as they age. This information could help inform parenting practices and guide more effective interventions for improving quality of life for older adults.”

The researchers utilized data from the Personality and Total Health (PATH) Through Life Study, a long-term project based in Australia that tracks health outcomes across different stages of life. The study analyzed responses from over 2,500 participants aged 60-66, focusing on their exposure to childhood adversities and current mental health status.

Participants provided information on a wide range of childhood adversities, including emotional and physical neglect, parental mental health issues, and abuse. The researchers employed two primary analytical methods: a cumulative risk approach, which sums up various adversities to gauge their overall impact, and latent class analysis , which identifies patterns among different types of adversities to see how specific combinations affect mental health outcomes.

over half of the participants (52.5%) reported not experiencing any adverse childhood experiences. Nearly a quarter (23.8%) of the participants reported facing one form of adversity during childhood, while 12.1% encountered two adversities. A smaller, yet significant portion of the sample, 18.1%, reported experiencing three or more adverse childhood experiences.

The cumulative risk approach demonstrated that as the number of adversities increased, so did the severity of mental health symptoms. This dose-response relationship suggested a linear trend where each additional adversity contributed to worsening mental health outcomes.

However, this trend appeared to plateau at a certain point (between three and four adversities). This indicates that once an individual has experienced a certain number of adversities, the additional impact of further adversities diminishes, suggesting a potential ceiling effect in the psychological impact of accumulated stress.

On the other hand, the latent content analysis provided insights into how different patterns of adversity affect mental health outcomes. The analysis identified four distinct classes of adversity experience:

• High Parental Dysfunction: Comprising 27.68% of the sample, this group reported significant levels of parental mental illness, household conflict, parental divorce, poverty, and witnessing household abuse.
• High Adversity: This was the smallest group, making up 4.83% of the sample, characterized by a high probability of endorsing nearly all ACE items.
• Moderate Parental Dysfunction: Accounting for 32.04% of the sample, participants in this class reported similar but less severe experiences compared to Class 1, with lower levels of other ACEs.
• Low Adversity: The largest group, making up 35.45% of the sample, members of this class reported low levels of all ACE items.

The results showed that individuals in higher adversity classes reported significantly worse mental health outcomes compared to those in lower adversity classes. Less than 7% of the low adversity and moderate parental dysfunction groups met the screening criteria for major depression, whereas 13% and 20% of the high parental dysfunction and high adversity groups, respectively, likely had depression.

Similarly, for anxiety, less than 6% of the low adversity and moderate parental dysfunction groups met the criteria for generalized anxiety disorder, compared to 11% and 15% in the high parental dysfunction and high adversity groups, respectively.

“The key takeaway is that childhood adversities have a long-lasting impact, potentially increasing the risk of anxiety and depression throughout the lifespan,” Lian told PsyPost. “This emphasises the importance of preventing and addressing such adversities early on. Moreover, mental health screenings for older adults could benefit by including assessments of early life stressors.”

One significant limitation of the study is its reliance on retrospective self-reporting for gathering data on childhood adversities. This approach can introduce recall bias, as participants may not accurately remember or may choose to underreport traumatic events from decades earlier. Moreover, the cross-sectional design of the study limits the ability to draw causal inferences about the relationship between childhood adversities and later mental health outcomes.

For future research could employ longitudinal studies to track individuals over time to better understand how the relationships between childhood adversities and mental health evolve over time. Exploring mediators such as social support, coping strategies, or biological impacts could provide deeper insights into how adversities influence mental health outcomes.

“My long-term goal is to better understand the pathways in which our childhood conditions impacts mental and cognitive health,” Lian said. “For my next steps, I plan to identify resilience factors that my protect against the adverse effects of early adversity.”

The study, “Childhood adversity is associated with anxiety and depression in older adults: A cumulative risk and latent class analysis,” was authored by James Lian, Kim M. Kiely, Bridget L. Callaghan, and Kaarin J. Anstey.