Linking Early Family Adversity to Young Adult Mental Disorders

Abstract

Depression is one of the most common psychiatric disorders among youth and adults. It is considered to be a serious mental health problem due to its chronicity, severity, and social and health consequences (Cicchetti and Toth 1998; Kessler et al. 2005). Previous research on youth has shown that early stressful experiences contribute to the early onset of depressive disorder, with a trend toward an increasingly younger age of onset (Kessler et al. 2001; Kessler and Magee 1993; Wickrama et al. 2005). Research has also shown that depressive disorder tends to: (1) recur over time (homotypic continuity), (2) be co-morbid concurrently with other psychiatric disorders, and (3) influence the onset of other psychiatric disorders (heterotypic continuity) (Costello et al. 2003; Kessler et al. 2005). An increasing volume of research reveals that there are a number of socioeconomic consequences of adolescent depression, with particular implications for the successful transition to young adulthood (Stoep et al. 2002; Wickrama et al. 2008).

Earlier research on diagnosed depressive disorder, however, offers a very conservative evaluation of mental health problems. Although the diagnostic algorithms for most disorders are based on the intensity and duration of symptom experiences, symptom measures by themselves may provide additional dimensional information about mental health problems. Thus, information about depressive disorder should be supplemented with dimensional information on symptom severity (Gotlib et al. 1995; Kessler 2002).

Although researchers have a good understanding of the continuity of psychiatric disorders and psychiatric symptom trajectories, potential mutual influences between these two facets of a mental health problem are less known, especially over the early life course. Even less is known about (1) how the inter-play between symptoms and disorders progress as youth move from early adolescence to young adulthood and (2) how this process is initiated and shaped by childhood and early adolescent stressful experiences. The linking of early stressful family experiences, stress-response trajectories over adolescence and emerging adulthood, social failures/attainment and young adult psychiatric disorder in young adulthood is consistent with what Pearlin et al. (2005) have called the stress process over the life course. This theoretical advancement, an alliance of stress process perspective (Pearlin 1989) with life course perspective (Elder et al. 1996), provides the theoretical guidance to understand dynamic temporal associations between stressful family experiences, youth stress-response trajectories and subsequent young adult socioeconomic and mental health outcomes. Such a comprehensive investigation requires researchers to follow the same youth over a long period of time because they alone are the best source of information about this process (Costello et al. 2003).