Stressful life events (SLEs) have been associated with adjustment problems in adolescence (APA) in cross-sectional studies. Using a longitudinal cohort, we examined the influence of these events and predefined covariates on APA and compared internalizing and externalizing trajectories among children with many versus few SLEs.
Data were obtained from the Study of Early Child Care and Youth Development. One thousand three hundred sixty-four children and their families were followed from child's birth until age 15 years. Adjustment problems at age 15 years were defined as high (>60 T-score) internalizing and/or externalizing problems on the Youth Self-Report and Child Behavior Checklist. Stressful life events were evaluated at 54 months, and third and fifth grade. Categories created by mixture model analyses for covariates were used in logistic regressions to predict adjustment problems.
Mothers reported higher rates of adjustment problems than adolescents (21.1% vs 16.3%; p < 0.0001). Adjustment problems were associated with more SLEs (odds ratio [OR] = 1.7; p = 0.0042), male sex (OR = 1.9; p = 0.001), child's high emotional reactivity (OR = 1.6; p = 0.01), and paternal depression (OR = 2.1; p = 0.0165). Analysis using the mother's report of adjustment problems showed the same predictors, as well as lower maternal education level (OR = 3.5; p = 0.0003), and child's friendship quality (OR = 0.4; p = 0.005). Higher internalizing and externalizing T-scores were apparent in children with more SLEs from 2 years of age onward (ps < 0.0001).
After adjusting for multiple covariates, SLEs during childhood predicted adjustment problems. Our results suggest that emotional reactivity and paternal depression play a role in the development of APA.
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*Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland;
†Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Address for reprints: Carolina Donado, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, 333 Longwood Avenue 5th floor, Boston, MA, 02115; e-mail: Carolina.DonadoRincon@childrens.harvard.edu.
Supported by the Sara Page Mayo Endowment for Pediatric Pain Research, Education, and Treatment to C. B. Berde.
Disclosure: The authors declare no conflict of interest.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's web site (www.jdbp.org).
H. Koechlin and C. Donado contributed equally to this manuscript.
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Received August 11, 2017
Accepted May 30, 2018