Early adversity, maternal depression linked to teen mental health risk

September 30, 2024
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Concept illustration of a depressed teen. Image credit: Nicole Smith, made with Midjourney

Teens who faced high levels of emotional and multidimensional adversity in their early years are at the most significant risk for mental health challenges, a comprehensive 15-year study revealed.

These teens also exhibit significant differences in brain activity related to emotion processing, according to the University of Michigan research published in JAMA Network Open.

The study tracked over 4,000 youths from birth to age 15, examining how a range of childhood adversities—such as maltreatment, family violence and maternal depression—affect later mental health and brain function.

Boxplots Comparing Levels of Internalizing and Externalizing SymptomsThe maternal depression (MD) and high-adversity profiles did not differ for internalizing symptoms but differed among all profiles for externalizing symptoms. Center line of box indicates the median value; edges of boxes, upper and lower quartiles; and whiskers, the minimum and maximum values. NS indicates not significant. Image credit: JAMA Network
Boxplots Comparing Levels of Internalizing and Externalizing SymptomsThe maternal depression (MD) and high-adversity profiles did not differ for internalizing symptoms but differed among all profiles for externalizing symptoms. Center line of box indicates the median value; edges of boxes, upper and lower quartiles; and whiskers, the minimum and maximum values. NS indicates not significant. Image credit: JAMA Network

The findings showed that youth exposed to high levels of adversity in multiple contexts (home, family, neighborhood) suffered worse mental health outcomes and altered brain function. Notably, maternal depression alone could produce similar negative effects, even when other adversities were only moderate.

Using a clustering method, researchers identified four profiles of childhood adversity:

  1. Low adversity: Minimal exposure to adverse experiences
  2. Medium adversity: Moderate levels across various domains
  3. Maternal depression: Moderate adversity with high levels of maternal depression
  4. High adversity: Significant adversity across all measured domains
Christopher Monk
Christopher Monk

“Adverse childhood experiences occurring within and outside the home are considered pervasive risk factors for poor health,” said Christopher Monk, professor of psychology and psychiatry and research professor at the U-M Institute of Social Research.

“However, there are important variations in the adverse environments that children are exposed to. While many studies have examined the impact of adverse experiences, little is known about how these different combinations of adversities can shape individuals’ mental health and brain function.”

Brain Connectivity and Profile-Specific NetworksA, The default mode network (DMN) included the bilateral inferior parietal lobule, posterior cingulate cortex, and medial temporal gyrus. The salience network (SN) included the bilateral insula, amygdala, and dorsal anterior cingulate cortex. The frontoparietal network (FPN) included the bilateral dorsolateral prefrontal cortex, anterior inferior parietal lobule, and posterior parietal cortex. B, Center line of boxplot indicates the median value; edges of boxes, upper and lower quartiles; and whiskers, the minimum and maximum values. C, Paths within each network map represent subgroup-specific connections. P values were adjusted for multiple comparisons. MD indicates maternal depression; NS, not significant. Image credit: JAMA Network
Brain Connectivity and Profile-Specific NetworksA, The default mode network (DMN) included the bilateral inferior parietal lobule, posterior cingulate cortex, and medial temporal gyrus. The salience network (SN) included the bilateral insula, amygdala, and dorsal anterior cingulate cortex. The frontoparietal network (FPN) included the bilateral dorsolateral prefrontal cortex, anterior inferior parietal lobule, and posterior parietal cortex. B, Center line of boxplot indicates the median value; edges of boxes, upper and lower quartiles; and whiskers, the minimum and maximum values. C, Paths within each network map represent subgroup-specific connections. P values were adjusted for multiple comparisons. MD indicates maternal depression; NS, not significant. Image credit: JAMA Network

Using a combination of two statistical techniques—the Latent Profile Analysis and Group Iterative Multiple Model Estimation—researchers were able to pinpoint how different adversities, such as maternal depression, lead to specific mental health outcomes and changes in brain function during adolescence.

Felicia Hardi
Felicia Hardi

“The impact of adverse childhood experiences unfortunately can span years of development,” said U-M alum Felicia Hardi, now a postdoctoral fellow at Yale University. “Individuals at the greatest risk of harm are those who are growing up in environments with many different risk factors and those with parents who have poor mental health.”

According to Monk, Hardi and colleagues, even in the absence of high levels of other types of adversities, youth growing up with mothers with depression showed similar mental health symptoms and emotion-related brain connectivity patterns to those youth exposed to the highest risk factors. This underscores the critical contribution of maternal mental health on children’s emotional development.

“Effective policies and interventions should address multiple risks and emphasize support for mothers to promote the long-term mental health of youth,” Hardi said.

Researchers are continuing to follow these youths into young adulthood, allowing future studies to explore the long-term effects of early adversity on health outcomes throughout life.