A troubled childhood may leave an imprint for life

Factors linked to lower risks of health and socioeconomic disadvantages in the general population – most notably education – may also offer protection for individuals with a high burden of childhood adversity, such as those placed in out-of-home care, the study shows.

Childhood adversity is more than just a rough start – it can shape the course of a person’s entire life. From mental health diagnoses like anxiety and depression to serious physical conditions such as cardiovascular disease and cancer, the effects of a troubled childhood can be severe. Moreover, individuals who experience adversity in childhood are at a higher risk of socioeconomic disadvantage, facing obstacles like unemployment and an increased likelihood of early exit from the labour market.

While it is well known that childhood adversity is associated with an increased risk of different disadvantages, it is less understood how these disadvantages group together when considering both health and socioeconomic outcomes.

However, childhood adversity does not inevitably lead to health and socioeconomic difficulty. In her thesis Beating the odds of a bad hand: Studies of health and socioeconomic disadvantage in adults with experience of childhood adversity, Lisa Bornscheuer at Stockholm University investigates the diversity of outcomes following early adversity.

The cycle can be broken

“While it is well known that childhood adversity is associated with an increased risk of different disadvantages, it is less understood how these disadvantages group together when considering both health and socioeconomic outcomes. It is also important to highlight that many people with experience of early adversity do not go on to suffer severe negative consequences. This suggests that resilience processes are at play – and raises the question: What factors support that resilience?”, Bornscheuer says. 

This thesis explores how childhood adversity can affect a person throughout their lifetime, and how this cycle of disadvantage can be broken. The first of four studies is a scoping review of existing research on resilience in the context of childhood adversity. The remaining three studies use data from the Stockholm Birth Cohort Multigenerational Study, with a follow-up using register data until age 68.

Individual resilience factors are important

The scoping review focused on mediators and moderators of childhood adversity, and revealed a strong focus on individual level resilience factors, such as coping strategies and attachment patterns. Social support networks were also considered relatively frequently, and emerged in many studies as buffer of adversity.

However, Bornscheuer identified several knowledge gaps in the literature. “In the context of resilience research, there is limited evidence on how structural factors, like the education system, can mitigate the impact of childhood adversity. And, additionally, gender is not an aspect that is considered often enough,” she says.

Therefore, in one of the studies in the thesis, Bornscheuer explored differences in disadvantage patterns between men and women. She examined what typical patterns in the longitudinal development of several disadvantages exist, focusing on individuals who had been placed in out-of-home care during their childhood. The findings suggest that men might be more likely than women to fall into trajectories marked by particularly complex forms of disadvantage, characterized by the presence of multiple health and socioeconomic problems. Education was associated with a lower risk of experiencing some forms of disadvantage.

Different patterns for boys and girls

In another study Bornscheuer investigated pathways linking early adversity, again measured through out-of-home care placements, and psychiatric diagnoses in adulthood. For boys, a bigger part of the association was explained by delinquent behavior, while in girls, early parenthood was a stronger contributor. Educational achievement also played a mediating role, to a similar extent in both boys and girls. 

The final study focused on early labour market exits, for example via long-term unemployment and disability pension. It showed that individuals who had been placed in out-of-home care were more likely to leave the workforce early, which can imply greater financial insecurity. Again, education lowered the risk of some forms of early exit, both in the general population and in those with experience of out-of-home care.
The thesis underscores the complexity of disadvantage after childhood adversity, while also pointing to potential solutions – most notably, education as a possible point for intervention.

Håkan Soold

Facts

Lisa Bornscheuer defended her thesis Beating the odds of a bad hand: Studies of health and socioeconomic disadvantage in adults with experience of childhood adversity on June 4 at the Department of Public Health Sciences, Stockholm University.
https://su.diva-portal.org/smash/record.jsf?pid=diva2%3A1951312&dswid=5944

The thesis consists of four studies:
Mapping resilience: a scoping review on mediators and moderators of childhood adversity with a focus on gender patterns 

Adulthood trajectories of resilience and vulnerability: exploring gender differences in disadvantage after experience of out-of-home care

The role of extra-familial factors in adolescence for the association between out-of-home care and adult psychiatric disorders–A birth cohort study

Labour market exits in a former out-of-home care population: A birth cohort-based sequence analysis processes (not published yet)