Adverse childhood experiences-household stressors and children's mental health: a single centre retrospective review

BMJ Paediatr Open. 2021 Aug 17;5(1):e001209. doi: 10.1136/bmjpo-2021-001209. eCollection 2021.

Abstract

Objective: To determine the prevalence of reported 'household stressor' adverse childhood experiences (ACEs) in families of children presenting with neurodevelopmental, behavioural or emotional difficulties and to determine whether family vulnerabilities, individually or cumulatively, were associated with particular clinical symptomatology.

Design: Retrospective chart review followed by statistical analysis of family stressors and clinical symptomatology.

Setting: A community paediatric clinic in Australia.

Participants: All 267 children who attended an initial paediatric appointment during 2018.

Results: 162 (60.7%) children had been exposed to one or more household stressor ACEs, including 116 (43.4%) children exposed to parental mental illness. Behavioural disturbance occurred in 144 (53.9%) children and externalising behaviours (other than attention deficit hyperactivity disorder) were more frequent than internalising behaviours. Externalising and internalising behaviours were associated with individual and cumulative household stressor ACEs. Most other symptomatology apart from genetic/neurological conditions, autistic symptoms and some developmental delays appeared to be partially associated with ACEs.

Conclusion: Household stressor ACEs were common, frequently occurred concurrently, and were associated with much of the symptomatology, in this cohort. Parental mental illness was the most prevalent stressor and behavioural disturbance the most prevalent symptomatology. These findings may have implications for clinical practice and service provision.

Keywords: child psychiatry; health services research; psychology; social work.

MeSH terms

  • Adverse Childhood Experiences*
  • Child
  • Child Health
  • Humans
  • Mental Health
  • Parents
  • Retrospective Studies