Association between Adverse Childhood Experiences and Psychiatric Conditions in Childhood

Adverse childhood experiences have been linked to a variety of health outcomes in adulthood. Less in known about how these experiences shape medical conditions in childhood. Using the National Survey of Children's Health from 2011, a national survey of caretakers of over 90,000 children, we analyzed the association between cumulative childhood adversity exposure and the following conditions: attention deficit hyperactivity disorder (ADHD/attention deficit disorder (ADD), depression, anxiety, and oppositional defiant disorder (ODD). Based on a modified version of the Adverse Childhood Experiences (ACE) Study’s ACE Score, we calculated a cumulative score of children’s childhood stress exposure. We then used this score in logistic models to predict having a diagnosis of each of the psychiatric conditions, while controlling for age, gender, and race/ethnicity, there was a positive association between the number of adverse experiences and a psychiatric diagnosis, with more experiences being significantly associated with a greater odds of having each of the four conditions tested. Children with four or more adverse experiences  were 3.5, 8.7, 4.9, and 7.1 times more likely than those with no adverse experiences to have ADHD/ADD, depression, anxiety, and ODD, respectively. As studies have suggested that exposure to stress is linked to the development of psychiatric conditions, this nationally representative study supports this hypothesis, and suggests a dose response relationship. While the interplay of social, environmental, and genetic influences of developing each of these conditions is complex, this study suggests that part of the developmental conditions may have to do with cumulative exposure to adverse experiences.