Adverse Childhood Experiences Are Associated with Mental Health Problems Later in Life: An Umbrella Review of Systematic Review and Meta-Analysis
Bibliographic record
Abstract
INTRODUCTION: Evidence suggested a link between early adversity and mental health problems. However, it is unclear how much adverse childhood experiences (ACEs) contribute to mental health problems because researchers have produced inconsistent findings. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the effect of ACEs on the development of mental health problems later in life in the global context. METHODS: PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar which reported the effect of ACEs on the development of mental health problems was searched. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. RESULTS: Forty-three SRM with 14,707,614 study participants were included. The pooled effect of ACEs on the development of mental health problems later in life in the global context is found to be (AOR = 1.66 [1.46, 1.87]). Subgroup analysis based on country revealed (AOR = 1.67 [1.23, 2.11]) in UK, (AOR = 0.61 [0.41, 0.81]) in Canada, (AOR = 1.55 [1.40, 1.69]) in Brazil, (AOR = 5.65 [4.12, 7.18]) in Ethiopia, (AOR = 1.92 [1.45, 2.38]) in USA, (AOR = 2.30 [1.89, 2.72]) in Australia, and (AOR = 1.66 [1.46, 1.87]) in Ireland. While subgroup analysis based on types of adverse childhood adverse experience: domestic violence (AOR = 4.13 [1.96, 6.30]), maltreatment (AOR = 1.5 [0.79, 2.21]), physical abuse (AOR = 1.56 [1.43, 1.63]), sexual abuse (AOR = 2.07 [1.63, 2.51]), child abuse (AOR = 5.66 [4.12, 7.18]), parental mental health problem (AOR = 1.73 [1.39, 2.08]), bullying (AOR = 1.99 [1.69, 2.29], neglect (AOR = 2.11 [1.53, 2.69]), and parental divorce (AOR = 1.66 [1.46, 1.87]). Based on the type of mental health problem, the pooled effect size is 1.87 (1.45, 2.30) for depression and 1.67 (1.22, 2.13) for anxiety. CONCLUSION: This umbrella review revealed that ACE is significantly associated (with 66% increased risk) with anxiety and depression later in life in a global context. This association is most noticeable when one is subjected to domestic violence, maltreatment, physical abuse, sexual abuse, child abuse, parental mental health problems, bullying, neglect, and parental divorce. Childhood periods are a critical window of opportunity for reducing the risk of developing mental illness in the future and for implementing intervention measures. Preventing childhood maltreatment and addressing psychiatric risk factors can prevent psychopathology. Longitudinal studies are needed to optimize healthcare responses to ACEs. Increased awareness and public health interventions are needed to prevent childhood adversity and prevent mental problems among these victims. To optimize healthcare responses to unfavorable outcomes of childhood adversities, longitudinal and intervention research findings, more public health initiatives, and awareness are required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.084 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.026 |
| Bibliometrics | 0.014 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".