The significance of childhood for adult mental health
Professor Stephen Stansfeld assesses the impact of childhood stress on later life
27 February 2012
The importance of childhood on adult mental health is not a new idea – certainly not since the changes brought about by Freud in the early 20th century. But less well researched or documented is how specific external factors – such as low socioeconomic status, poor social networks, and low academic achievement – can ‘predict’ the likelihood of adult psychiatric disorders.
Psychiatrist Professor Stephen Stansfeld is an expert on the psychosocial factors that impact on mental health – with a particular interest in the patterns that emerge over the course of a life. He has led several projects analysing the data of large longitudinal surveys – surveys that extend over several years – and come to conclusions that make a strong case for early intervention and, where appropriate, psychological treatment for children and young people.
Socioeconomics and the 1958 birth cohort
The 1958 birth cohort is a very large-scale longitudinal survey that offers a wealth of data to researchers. The survey began as a perinatal mortality study, recruiting 98 per cent of all babies born in a single week in March in England, Wales, and Scotland. The cohort members were then followed up at ages 7, 11, 16, 23, 33, 42 – with a biomedical follow-up at age 45. Up to the age of 16, data was gathered from parents and schools, and after that, by personal interview. Some people have opted out or been excluded for other reasons – such as emigration or serving in the armed forces – while others have been included. These are people who were born elsewhere during the same week in March.
This survey data enabled Stephen Stansfeld and fellow researchers to look in depth at the ways in which repeated exposure to socioeconomic disadvantage could lead to mid-life psychiatric conditions such as anxiety and depression. Socioeconomic position (SEP) was mainly established by type of employment – with manual employment indicating a low SEP.
The effect of ill-health – both mental and physical was also considered in addition to the part played by socioeconomics. The idea being that: “early onset of both mental and physical illness may interfere with social and educational development and upward social mobility.” (Repeated exposure to socioeconomic disadvantage and health selection as life course pathways to mid-life depressive and anxiety disorders, Stephen Stansfeld, Charlotte Clark, Bryan Rodgers, Tanya Caldwell, Chris Power, read the paper)
The research showed that although there were some links between poverty and hardship in childhood – these did not necessarily lead to an increased risk of disorders such as anxiety and depression at age 45. However, when combined with other factors, such as poor health in childhood, particularly poor psychological health, the risk of mid-life psychiatric disorders was very much greater.
Stephen Stansfeld says, “findings like these suggest that identifying struggling children and offering them treatment if appropriate can be key to their later success as an adult.”
The value of getting off to a good start
Another large longitudinal survey, ‘Research with East London Adolescents: Community Health Survey’ (RELACHS) provided the data for research that further demonstrates the impact poor psychological health in childhood and adolescence can have – this time focusing on educational attainment.
RELACHS gathered data on 2,790 adolescents from the 11-12 year age group and followed them up two years later. The incidence of psychological distress and depressive symptoms at 14 was then mapped against performance and GCSE exam results at 16.
The results showed a clear correlation between psychological distress and poor educational achievement.
In a report about this study the recommendation is clear: “Low achievement at school can have a substantial effect on opportunities in adult life. This implies a greater need for support within the school for children with psychological difficulties in order to achieve the best possible outcomes in the long term.” (The impact of psychological distress on the educational achievement of adolescents at the end of compulsory education, Catherine Rothon, Jenny Head, Charlotte Clark, Emily Klineberg, Vicky Cattell, Stephen Stansfeld, read the paper)
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