Early adversity in firstborns associated with higher mental health risk in younger sibling associated with higher mental health risk

Early adversity in firstborns associated with higher mental health risk in younger sibling associated with higher mental health risk

UCL's ground-breaking research shows that adverse childhoods for first-borns increase mental health outcomes for all siblings, highlighting the need for early intervention and ongoing family support

A recent study led by researchers at University College London, UK, found that firstborns who had adverse childhood experiences were 71% more likely to have siblings with mental health problems.

The study, funded by the National Institute for Health and Care Research Policy Research Research Program, is published inThe Lancet Public Health.

background

Traumatic, violent, or neglectful childhood experiences are common in families and can have serious long-term and intergenerational effects on the mental health of family members.

Existing evidence shows that these adverse childhood experiences influence multiple siblings in a family. However, it remains largely unknown how adverse childhood experiences in firstborns and mothers influence the mental health of other children in the same family.

In this study, researchers sought to address this knowledge gap by analyzing linked GP and hospital practices of 333,048 first-time mothers and their 534,904 children, including both first-borns and siblings born in England between 2002 and 2018.

They followed the entire study cohort from one year before birth to 18 years after birth in primary and secondary health care settings. They specifically focused on six types of adverse childhood experiences among firstborns, including child maltreatment, intimate partner violence, maternal abuse, maternal mental health problems, adverse family environments, and high-risk child maltreatment presentations.

They primarily aimed to examine the association between firstborns exposed to adverse childhood experiences from conception to two years of age (1000 days) and mental health risk in multiple children from the same mother (siblings).

Important observations

The study found that about 20% of mothers included in the study have at least one child with a mental health problem and 1.7% of mothers have two or more children with mental health problems between the ages of five and 18.

Among first-borns included in the study, about 37% had at least one adverse childhood experience, and 10.9% had at least two adverse childhood experiences in the first 1,000 days of their lives.

The most common childhood adversities were a mother with mental health problems, followed by undesirable family environments such as parental criminality and homelessness.

Specifically, the study found that mothers with firstborns exposed to adverse childhood experiences had a 71% increased risk of having children with mental health problems, compared to mothers whose firstborns did not experience adversity.

This resulted in 12 additional children with mental health problems per 100 mothers with first-born children exposed to adverse childhood experiences.

Mothers with firstborns who were exposed to adversity had significantly more children with mental health problems (on average, 30 children per 100 mothers) than mothers with firstborns who were not exposed to adversity (on average, 17 children per 100 days).

The study found consistently similar risk of mental health problems among siblings in families with first-born children exposed to adverse childhood experiences. There were no differences in mental health problems between the second-born and the first-born or the third-born and the first-born.

In terms of mental health outcomes, the study found that in families with firstborns facing adversity, about 53% of children have at least one hospital emergency room visit for some reason. 10% have at least one primary care-related mental health encounter; and 5% have a mental health hospital contact.

Investigate significance

This unique study reports that children in families with first-borns who are exposed to adverse childhood experiences are significantly more likely to develop mental health problems and have higher rates of emergency admissions and mental health-related health care.

Another significant finding of the study is that mothers with first-born children exposed to three or more adversities are at highest risk of having multiple children with mental health problems.

Shabeer Syed, the lead author of the article, said while previous research has focused on the impact of adverse childhood experiences on individual children. Our study shows a cascading health risk that extends beyond the individual and also impacts the health of siblings. This is likely due to the continuation of adverse childhood experiences within the family. When a child or parent presents with mental health problems, violence or other forms of adversity, it is important to ask about the broader family context. “

Jessica Deighton, Professor at the Anna Freud National Center for Children and Families and University College London, said: "With escalating rates of children and young people in contact with mental health services, early and effective prevention strategies are key to improving wellbeing. These results show that when we come across children facing significant challenges such as domestic abuse or poverty, we can Need to expand focus to the entire family, including siblings. This would help ensure that all children and young people in families dealing with adversity receive appropriate care as early as possible. “

To achieve this, we would like to see increased funding for prevention programs and community assets such as GPS and local organizations that are critical to identifying and meeting the needs of vulnerable young people. There should also be the development of a comprehensive mental health prevention strategy in collaboration with various groups of children and young people. “

As noted by researchers, the study could not assess negative childhood experiences related to fathers' mental health or substance use because fathers' health records are typically not linked to their children.

Additionally, electronic health records often underestimate intimate partner violence and child abuse due to non-disclosure or detection and under-detection by clinicians.

Overall, the study highlights the importance of early identification and sustained support for vulnerable first-time parents and their newborns to reduce long-term mental health problems, health needs and health costs for the entire family.

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