Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication II

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Abstract
Significant associations between retrospectively reported childhood adversities (CAs) and diverse adult mental disorders have been documented in numerous epidemiological surveys.1-4 These associations are substantial, with more than 30% of adult mental disorders estimated to be directly related to CAs.5,6 Previous studies7-9 have suggested that the associations are due to increased stress sensitivity that persists into adulthood, making individuals with a history of CAs especially vulnerable to mental disorders triggered by adult stressors. If this is the case, we would expect that CAs would be associated with disorder persistence because most adult episode onsets are recurrences rather than first onsets.10-12 However, previous epidemiological studies have largely focused on prevalent disorders1,13-15 or lifetime disorders,15-17 with no attempt to distinguish associations of CAs with disorder first onset vs persistence. It would be useful to make this distinction to advance our understanding of the associations of CAs with adult mental disorders. A companion article6 to this one takes a first step in doing this by analyzing data from the National Comorbidity Survey Replication (NCS-R)18 and showing that the number of CAs is, in fact, associated with first onsets of a wide range of DSM-IV disorders throughout the life course. The present study takes the next logical step in this line of investigation by examining associations of CAs with persistence of the same DSM-IV disorders in the NCS-R.