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Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6–17 years old US Children: Evidence from a Population-Based Study

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Abstract

We pooled data from four years (2016–2019) of the National Survey of Children’s Health (NSCH) and included a nationally representative sample of 6 to 17 years old US children (N = 94,369; Mean age = 11.53 years, Standard Deviation [SD] = 3.53). Among 6–17-year-old US children, about 48% had a lifelong exposure to at least one of nine Adverse Childhood Experiences (ACEs), and 18.7% had a current diagnosis of at least one of four mental disorders. We examined the association between ACEs, neighborhood support, and mental disorders using several logistic regression models. More types of lifelong ACEs and lower neighborhood support were associated with a higher diagnosis of internalizing (anxiety/depression) and externalizing (ADHD/behavior problems) mental disorders (odds ratio [OR] > 1, and p < .001 for all relationships). After controlling for neighborhood support in the models, the odds ratios for ACEs attenuated but remained significant in all models regardless of mental disorder type or age group. However, the odds ratios for neighborhood support were larger for the association with ADHD/behavior problems than anxiety/depression. Moreover, odds ratios for neighborhood support levels were higher for older children (12–17 years old) compared to younger (6–11 years old) children. Higher neighborhood support appears to mitigate the adverse effects of ACEs on mental disorders, especially externalizing mental disorders (anxiety/depression) among adolescents (12–17 years old).

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Fig. 1

source of medical care, usual source of emotional support, and race. These models are also adjusted for adults and family characteristics, including public assistance recipient, single mother family structure, adults’ mental health status, and immigrant status

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References

  • America's Health Rankings. (2020). Retrieved February 5, 2019 from AmericasHealthRankings.org

  • Bethell, C. D., Carle, A., Hudziak, J., Gombojav, N., Powers, K., Wade, R., & Braveman, P. (2017). Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice. Academic pediatrics. https://doi.org/10.1016/j.acap.2017.04.161

    Article  PubMed  PubMed Central  Google Scholar 

  • Bronfenbrenner, U. (1992). Ecological systems theory. Jessica Kingsley Publishers.

  • Brown, D. W., Anda, R. F., Felitti, V. J., Edwards, V. J., Malarcher, A. M., Croft, J. B., & Giles, W. H. (2010). Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study. BMC Public Health, 10(1), 20. https://doi.org/10.1186/1471-2458-10-20

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown, N. M. B., Suzette, N., Briggs, R., & D; Germán, Miguelina; Belamarich, Peter F; Oyeku, Suzette O. . (2017). Associations between adverse childhood experiences and ADHD diagnosis and severity. Academic pediatrics, 17(4), 349–355.

    Article  Google Scholar 

  • Butler, A. M., Kowalkowski, M., Jones, H. A., & Raphael, J. L. (2012). The Relationship of Reported Neighborhood Conditions With Child Mental Health. Academic pediatrics, 12(6), 523–531.

    Article  Google Scholar 

  • Castagnini, A. F., & Leslie; Caffo, Ernesto; Thomsen, Per Hove. . (2016). Early-adult outcome of child and adolescent mental disorders as evidenced by a national-based case register survey. European Psychiatry, 38, 45–50.

    Article  CAS  Google Scholar 

  • Caughy, M. O., Nettles, S. M., O’Campo, P. J., & Lohrfink, K. F. (2006). Neighborhood matters: racial socialization of African American children. Child Development, 77(5), 1220–1236. https://doi.org/10.1111/j.1467-8624.2006.00930.x

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2019). Data and Statistics on Children's Mental Health. Centers for Disease Control and Prevention. Retrieved September 13, 2019 from https://www.cdc.gov/childrensmentalhealth/data.html

  • Centers for Disease Control and Prevention. (2020). Positive Parenting Tips. Centers for Disease Control and Prevention. Retrieved February 5, 2019 from https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html

  • Child Adolescent Health Measurement Initiative. (2019). 2016–2017 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the US Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB). Retrieved October 17, 2018 from www. childhealthdata. org. CAHMI: www. cahmi. org

  • Choi, K. R., McCreary, M., Ford, J. D., RahmanianKoushkaki, S., Kenan, K. N., & Zima, B. T. (2019). Validation of the Traumatic Events Screening Inventory for ACEs. Pediatrics, 143(4), e20182546. https://doi.org/10.1542/peds.2018-2546

    Article  PubMed  Google Scholar 

  • Cosgrove, V. E., Rhee, S. H., Gelhorn, H. L., Boeldt, D., Corley, R. C., Ehringer, M. A., Young, S. E., & Hewitt, J. K. (2011). Structure and Etiology of Co-occurring Internalizing and Externalizing Disorders in Adolescents. Journal of Abnormal Child Psychology, 39(1), 109–123. https://doi.org/10.1007/s10802-010-9444-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Danielson, M. L. B., Rebecca, H., Ghandour, R., & M; Holbrook, Joseph R; Kogan, Michael D; Blumberg, Stephen J. . (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among US children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199–212.

    Article  Google Scholar 

  • DeSocio, J., & Hootman, J. (2004). Children’s mental health and school success. The Journal of School Nursing, 20(4), 189–196. https://doi.org/10.1177/10598405040200040201

    Article  PubMed  Google Scholar 

  • Eiraldi, R. B., Power, T. J., Karustis, J. L., & Goldstein, S. G. (2000). Assessing ADHD and comorbid disorders in children: the Child Behavior Checklist and the Devereux Scales of Mental Disorders. Journal of Clinical Child Psychology, 29(1), 3–16. https://doi.org/10.1207/S15374424jccp2901_2

    Article  CAS  PubMed  Google Scholar 

  • Engle, W. A. (2006, 2006/02/01/). A Recommendation for the Definition of “Late Preterm” (Near-Term) and the Birth Weight–Gestational Age Classification System. Seminars in Perinatology, 30(1), 2–7. https://doi.org/https://doi.org/10.1053/j.semperi.2006.01.007

  • Fatori, D., Salum, G., Itria, A., Pan, P., Alvarenga, P., Rohde, L. A., Bressan, R., Gadelha, A., de Jesus Mari, J., Conceicao do Rosario, M., Manfro, G., Polanczyk, G., Miguel, E. C., & Graeff-Martins, A. S. (2018, Dec). The economic impact of subthreshold and clinical childhood mental disorders. J Ment Health, 27(6), 588–594. https://doi.org/https://doi.org/10.1080/09638237.2018.1466041

  • Fergusson, D. M., & Woodward, L. J. (2002, Mar). Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry, 59(3), 225–231. https://doi.org/https://doi.org/10.1001/archpsyc.59.3.225

  • Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019, Mar). Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children. J Pediatr, 206, 256–267 e253. https://doi.org/https://doi.org/10.1016/j.jpeds.2018.09.021

  • Ghandour, R. M. J., Jessica R.; Lebrun-Harris, Lydie A.; Minnaert, Jessica; Blumberg, Stephen J.; Fields, Jason; Bethell, Christina; Kogan, Michael D. (2018, 2018/08/01). The Design and Implementation of the. (2016). National Survey of Children’s Health. Maternal and Child Health Journal, 22(8), 1093–1102. https://doi.org/10.1007/s10995-018-2526-x

    Article  Google Scholar 

  • Huang, X., King, C., & McAtee, J. (2018). Nov). Exposure to violence, neighborhood context, and health-related outcomes in low-income urban mothers. Health & Place, 54, 138–148. https://doi.org/10.1016/j.healthplace.2018.09.008

    Article  Google Scholar 

  • Hunt, T. K. A., Slack, K. S., & Berger, L. M. (2017). May). Adverse childhood experiences and behavioral problems in middle childhood. Child Abuse and Neglect, 67, 391–402. https://doi.org/10.1016/j.chiabu.2016.11.005

    Article  PubMed  Google Scholar 

  • Jensen, C. M., & Steinhausen, H. C. (2015). Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Atten Defic Hyperact Disord, 7(1), 27–38. https://doi.org/10.1007/s12402-014-0142-1

    Article  PubMed  Google Scholar 

  • Kasehagen, L. O., & Laurel; Bailey, Melissa; Biss, Charlie; Holmes, Breena; Kelso, Patsy Tassler. . (2018). Relationship of adverse family experiences to resilience and school engagement among Vermont youth. Maternal and Child Health Journal, 22(3), 298–307.

    Article  Google Scholar 

  • Kessler, R. C., Angermeyer, M., Anthony, J. C., De Graaf, R., Demyttenaere, K., Gasquet, I., De Girolamo, G., Gluzman, S., Gureje, O., Haro, J. M., Kawakami, N., Karam, A., Levinson, D., Medina Mora, M. E., Oakley Browne, M. A., Posada-Villa, J., Stein, D. J., Adley Tsang, C. H., Aguilar-Gaxiola, S., … Ustün, T. B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World psychiatry : official journal of the World Psychiatric Association (WPA), 6(3), 168–176.

    Google Scholar 

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174588/

  • Kingsbury, M., Clayborne, Z., Colman, I., & Kirkbride, J. B. (2020). The protective effect of neighbourhood social cohesion on adolescent mental health following stressful life events. Psychological Medicine, 50(8), 1292–1299. https://doi.org/10.1017/S0033291719001235

    Article  PubMed  Google Scholar 

  • Kohen, D. E., Leventhal, T., Dahinten, V. S., & McIntosh, C. N. (2008). Neighborhood disadvantage: pathways of effects for young children. Child Development, 79(1), 156–169. https://doi.org/10.1111/j.1467-8624.2007.01117.x

    Article  PubMed  Google Scholar 

  • Kwong, T. Y., & Hayes, D. K. (2017). Adverse family experiences and flourishing amongst children ages 6–17 years: 2011/12 National Survey of Children’s Health. Child abuse & neglect, 70, 240–246.

    Article  Google Scholar 

  • Lange, B. C. L., Callinan, L. S., & Smith, M. V. (2019). Adverse Childhood Experiences and Their Relation to Parenting Stress and Parenting Practices. Community Mental Health Journal, 55(4), 651–662. https://doi.org/10.1007/s10597-018-0331-z

    Article  PubMed  Google Scholar 

  • Lanier, P., Maguire-Jack, K., Lombardi, B., Frey, J., & Rose, R. A. (2018). Adverse Childhood Experiences and Child Health Outcomes: Comparing Cumulative Risk and Latent Class Approaches. Maternal and Child Health Journal, 22(3), 288–297. https://doi.org/10.1007/s10995-017-2365-1

    Article  PubMed  Google Scholar 

  • LaNoue, M., Graeber, D., de Hernandez, B. U., Warner, T. D., & Helitzer, D. L. (2012). Direct and Indirect Effects of Childhood Adversity on Adult Depression. Community Mental Health Journal, 48(2), 187–192. https://doi.org/10.1007/s10597-010-9369-2

    Article  PubMed  Google Scholar 

  • Lima, J., Caughy, M., Nettles, S. M., & O'Campo, P. J. (2010, Oct). Effects of cumulative risk on behavioral and psychological well-being in first grade: moderation by neighborhood context. Soc Sci Med, 71(8), 1447–1454. https://doi.org/https://doi.org/10.1016/j.socscimed.2010.06.022

  • Loe, I. M. F., & Heidi, M. (2007). Academic and educational outcomes of children with ADHD. Journal of pediatric psychology, 32(6), 643–654.

    Article  Google Scholar 

  • Logan-Greene, P. T., Robert L ;Nurius, Paula S ;Borja, Sharon. (2017). Adverse childhood experiences, coping resources, and mental health problems among court-involved youth. Child & Youth Care Forum,

  • Ma, C. T., Gee, L., & Kushel, M. B. (2008, 2008/01/01/). Associations Between Housing Instability and Food Insecurity With Health Care Access in Low-Income Children. Ambulatory Pediatrics, 8(1), 50–57. https://doi.org/https://doi.org/10.1016/j.ambp.2007.08.004

  • Marmot, M., Friel, S., Bell, R., Houweling, T. A., Taylor, S., Health, C., & o. S. D. o. . (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet, 372(9650), 1661–1669.

    Article  Google Scholar 

  • Meltzer, H. V., & Panos; Goodman, Robert; Ford, Tamsin. . (2007). Children’s perceptions of neighbourhood trustworthiness and safety and their mental health. Journal of child psychology and psychiatry, 48(12), 1208–1213.

    Article  Google Scholar 

  • Merikangas, K. R. H., & Jian-ping; Burstein, Marcy; Swanson, Sonja A; Avenevoli, Shelli; Cui, Lihong; Benjet, Corina; Georgiades, Katholiki; Swendsen, Joel. . (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

    Article  Google Scholar 

  • Mmari, K., Marshall, B., Hsu, T., Shon, J. W., & Eguavoen, A. (2016). A mixed methods study to examine the influence of the neighborhood social context on adolescent health service utilization. BMC Health Services Research, 16(1), 433. https://doi.org/10.1186/s12913-016-1597-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Murray, J., Farrington, D. P., & Sekol, I. (2012). Children’s antisocial behavior, mental health, drug use, and educational performance after parental incarceration: a systematic review and meta-analysis. Psychological Bulletin, 138(2), 175.

    Article  Google Scholar 

  • Plass-Christl, A. K., & F; Otto, C; Barkmann, C; Hölling, H; Klein, Toni; Wiegand-Grefe, S; Schulte-Markwort, M; Ravens-Sieberer, U. . (2017). Mental Health Care Use in Children of Parents with Mental Health Problems: Results of the BELLA Study. Child Psychiatry & Human Development, 48(6), 983–992.

    Article  CAS  Google Scholar 

  • Shaw, C. R., & McKay, H. D. (1942). Juvenile delinquency and urban areas.

  • Stempel, H., Cox-Martin, M., Bronsert, M., Dickinson, L. M., & Allison, M. A. (2017). Chronic School Absenteeism and the Role of Adverse Childhood Experiences. Acad Pediatr, 17(8), 837–843. https://doi.org/https://doi.org/10.1016/j.acap.2017.09.013

  • Storksen, I., Roysamb, E., Moum, T., & Tambs, K. (2005). Adolescents with a childhood experience of parental divorce: a longitudinal study of mental health and adjustment. Journal of Adolescence, 28(6), 725–739. https://doi.org/10.1016/j.adolescence.2005.01.001

    Article  PubMed  Google Scholar 

  • Tan, T. X. W., & Yan; Ruggerio, Adryona D. . (2017). Childhood adversity and children’s academic functioning: Roles of parenting stress and neighborhood support. Journal of Child and Family Studies, 26(10), 2742–2752.

    Article  Google Scholar 

  • The United States Census Bureau, A. D. o. D. P.;National Survey of Children’s Health,. (2019). 2018 National Survey of Children’s Health Frequently Asked Questions. https://mchb.hrsa.gov/data/national-surveys/data-use

  • Turney, K. W., & Christopher. . (2015). Detrimental for some? Heterogeneous effects of maternal incarceration on child wellbeing. Criminology & Public Policy, 14(1), 125–156.

    Article  Google Scholar 

  • Weitzman, C., Edmonds, D., Davagnino, J., & Briggs-Gowan, M. J. (2014). Young child socioemotional/behavioral problems and cumulative psychosocial risk. Infant Ment Health J, 35(1), 1–9. https://doi.org/10.1002/imhj.21421

    Article  PubMed  Google Scholar 

  • Wilkerson, A., Carlson, N. E., Yen, I. H., & Michael, Y. L. (2011). Neighborhood Physical Features and Relationships With Neighbors: Does Positive Physical Environment Increase Neighborliness? Environment and Behavior, 44(5), 595–615. https://doi.org/10.1177/0013916511402058

    Article  Google Scholar 

  • Wood, S. L., & Sommers, M. S. (2011). Consequences of intimate partner violence on child witnesses: a systematic review of the literature. Journal of Child and Adolescent Psychiatric Nursing, 24(4), 223–236. https://doi.org/10.1111/j.1744-6171.2011.00302.x

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA

    Ahmad Khanijahani

  2. Department of Public Affairs, University of Central Florida, Orlando, FL, USA

    Kenan Sualp

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  1. Ahmad Khanijahani
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AK—full access to all the data in the study and takes responsibility for the data integrity and the accuracy of the data analysis. AK—study conception and design; acquisition, analysis, and interpretation of data; and study supervision. AK and KS—drafting, writing, and reviewing manuscript.

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Correspondence to Ahmad Khanijahani.

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We used the publicly available de-identified version of NSCH data inthis study. The Institutional Review Board at the first author’s institution determined this study to be exempt.

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Khanijahani, A., Sualp, K. Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6–17 years old US Children: Evidence from a Population-Based Study. Community Ment Health J 58, 166–178 (2022). https://doi.org/10.1007/s10597-021-00808-7

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