Exploring the Impact of Adversity across the Life Span on Internalizing Symptoms in Adulthood: Analysis of Types, Repetition, Variety, and Timing of Past Adversity

Background and Purpose: Past studies have examined adversity and its association with depression and anxiety in adulthood. However, there has been little research simultaneously examining the impact of types, repetition, variety, and timing of adversity at different stages of the life course. This paper summarizes findings on whether certain forms of adversity are more harmful than others and whether repeated exposure to the same form of adversity leads to worse outcomes. Findings also pertain to the timing of these exposures concerning mental health outcomes.

Methods: Data are from the Lehigh Longitudinal Study (N=357), a prospective longitudinal study that spans more than five decades. In an adult wave of the study, participants reported on a range of past adversities, including parental physical abuse in childhood, witnessing parental violence in childhood, rape in childhood or adulthood, witnessing trauma to loved ones in childhood or adulthood, and the unexpected death of a loved one in childhood or adulthood. Participants also reported on adult depression and anxiety using Beck Depression Inventory and General Anxiety Disorder 7-item Scale. Analyses included multiple regressions in which gender, age, and adolescent depression were included as covariates. Analyses were conducted using SPSS and R.

Results: On average, participants experienced two out of five types of adverse events in childhood and adulthood. The most common adverse event was the unexpected death of a loved one (n=210; 59%), followed by exposure to parents’ IPV(n=147; 41%), witnessing trauma to loved ones (n=117; 33%), physical violence from parents in childhood (n=81; 23%) and rape (n=78; 22% ). The average age of first exposure to adverse events follows: 6 for physical violence from parents, 6 for exposure to parents’ IPV, 10 for rape, 17 for witnessing trauma, 22 for an unexpected death. Exposure to any form of adversity was associated with a significant increase in depression and anxiety in adulthood. The depression score mean differences were greatest between those with and without experiencing rape (MD=5.45, p<0.01), and the anxiety score mean differences were greatest between those with and without exposure to violence from parents (MD=3.51, p<0.01), compared for other forms of adversity. Repeated exposures to a specific form of the adverse event increased depression and anxiety among some types of adversity: rape (β=0.39, p<0.01; β=0.38, p<0.01), witnessing trauma to a loved one (β=0.26, p=0.01; β=0.32, p<0.01), and death of loved ones (β=0.20, p<0.01; β=0.15, p=0.02). The number of experiencing different types of adverse events in both childhood and adulthood was associated with higher depression scores (b=1.32, β=0.21, SE = 0.33, p < 0.001) and higher anxiety scores (b=0.99, β=0.21, SE =0.20, p<0.001) in adulthood. Experiencing the unexpected death of a loved one at a younger age (i.e., age 9) was strongly associated with an increase in depression compared to a later age (i.e., age 25) (β=-0.15, p=0.04). In other types of adversity, the timing was not linked to increased depression and anxiety scores.

Conclusion: The type/form and number of adversities across the lifespan increased the risk for depression and anxiety in adulthood.