Adverse childhood experiences and child mental health: an electronic birth cohort study

Emily Lowthian* (Corresponding Author), Rebecca Anthony, Annette Evans, Rhian Daniel, Sara Long, Amrita Bandyopadhyay, Ann John, Mark A. Bellis, Shantini Paranjothy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
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Adverse Childhood Experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member.


We analysed data from a population-level electronic cohort of children in Wales, UK, (N= 191,035) between the years of 1998 - 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include four categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g., learning disability), and (iv) other (e.g., eating disorder, personality disorders). Our analyses were adjusted for social deprivation and perinatal risk factors.


There were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g., gestational weight at birth), and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34 – 2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52 – 1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant.


The increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families.
Original languageEnglish
Article number172
Pages (from-to)1-13
Number of pages13
JournalBMC medicine
Early online date6 Aug 2021
Publication statusPublished - 6 Aug 2021


  • Adverse Childhood Experiences
  • Mental Health
  • Cohort
  • Wales
  • Survival Analysis
  • Administrative Data


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