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Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey



To examine patterns of childhood adversity, their long-term consequences and the combined effect of different childhood adversity patterns as predictors of subsequent psychopathology.


Secondary analysis of data from the US National Epidemiologic Survey on alcohol and related conditions. Using latent class analysis to identify childhood adversity profiles; and using multinomial logistic regression to validate and further explore these profiles with a range of associated demographic and household characteristics. Finally, confirmatory factor analysis substantiated initial latent class analysis findings by investigating a range of mental health diagnoses.


Latent class analysis generated a three-class model of childhood adversity in which 60 % of participants were allocated to a low adversity class; 14 % to a global adversities class (reporting exposures for all the derived latent classes); and 26 % to a domestic emotional and physical abuse class (exposed to a range of childhood adversities). Confirmatory Factor analysis defined an internalising-externalising spectrum to represent lifetime reporting patterns of mental health disorders. Using logistic regression, both adversity groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology.


We identified underlying patterns in the exposure to childhood adversity and associated mental health. These findings are informative in their description of the configuration of adversities, rather than focusing solely on the cumulative aspect of experience. Amelioration of longer-term negative consequences requires early identification of psychopathology risk factors that can inform protective and preventive interventions. This study highlights the utility of screening for childhood adversities when individuals present with symptoms of psychiatric disorders.

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This study was carried out as part of a Ph.D. placement through a Department of Education and Learning (DEL) Northern Ireland award to the corresponding author. DEL had no further role in producing this paper for publication.

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Correspondence to Emma Curran.

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Curran, E., Adamson, G., Stringer, M. et al. Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey. Soc Psychiatry Psychiatr Epidemiol 51, 647–657 (2016).

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  • Childhood adversity
  • Internalising
  • Externalising
  • Mental illness
  • Latent class analysis