Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood

AbstractBackgroundExperience of child-parent separation predicts adverse outcomes in later life. We conducted a detailed epidemiological examination of this complex relationship by modelling an array of separation scenarios and trajectories and subsequent risk of self-harm.MethodsThis cohort study examined persons born in Denmark during 1971–1997. We measured child-parent separations each year from birth to 15th birthday via complete residential address records in the Civil Registration System. Self-harm episodes between 15th birthday and early middle age were ascertained through linkage to psychiatric and general hospital registers. Incidence rate ratios (IRRs) from Poisson regression models were estimated against a reference category of individuals not separated from their parents.ResultsAll exposure models examined indicated an association with raised self-harm risk. For example, large elevations in risk were observed in relation to separation from both parents at 15th birthday (IRR 5.50, 95% CI 5.25–5.77), experiencing five or more changes in child-parent separation status (IRR 5.24, CI 4.88–5.63), and having a shorter duration of familial cohesion during upbringing. There was no significant evidence for varying strength of association according to child's gender.LimitationsMeasuring child-parent separation according to differential residential addresses took no account of the reason for or circumstances of these separations.ConclusionsThese novel findings suggest that self-harm prevention initiatives should be tailored toward exposed persons who remain psychologically distressed into adulthood. These high-risk subgroups include individuals with little experience of familial cohesion during their upbringing, those with the most complicated trajectories who lived through multiple child-parent separation transitions, and those separated from both parents during early adolescence

Health, employment and relationships: Correlates of personal wellbeing in young adults with and without a history of childhood language impairment

Objective: We examine the potential associations between self-rated health, employment situation, relationship status and personal wellbeing in young adults with and without a history of language impairment (LI). Methods: A total of 172 24-year-olds from the UK participated. Approximately half (N = 84) had a history of LI. Personal wellbeing was measured using ratings from three questions from the Office for National Statistics regarding life satisfaction, happiness and life being worthwhile. Results: There were similarities between individuals with a history of LI and their age-matched peers in self-rated personal wellbeing. However, regression analyses revealed self-rated health was the most consistent predictor of personal wellbeing for individuals with a history of LI in relation to life satisfaction (21% of variance), happiness (11%) and perceptions that things one does in life are worthwhile (32%). None of the regression analyses were significant for their peers. Conclusions: Similarities on ratings of wellbeing by young adults with and without a history of LI can mask heterogeneity and important differences. Young adults with a history of LI are more vulnerable to the effects of health, employment and relationship status on their wellbeing than their peers

Full spectrum of mental disorders linked with childhood residential mobility

AbstractAlthough links between childhood residential mobility and subsequently increased risks of psychopathology have been well documented, associations across the full spectrum of psychiatric disorders are unknown. We conducted a population-based study of all 1,439,363 persons born in Denmark during 1971–1997 to investigate relationships between childhood cross-municipality residential moves from year of birth to age 14 years and the development of a range of psychiatric disorders from mid-adolescence to early middle age. We examined: (1) Any substance misuse disorders; specifically alcohol misuse, and cannabis misuse; (2) Any personality disorders; specifically antisocial, and borderline personality disorders; (3) Schizophrenia and related disorders; specifically schizophrenia, and schizoaffective disorder; (4) Any mood disorders; specifically bipolar disorder, and depressive disorder; (5) Any anxiety and somatoform disorders; specifically obsessive compulsive disorder; (6) Any eating disorders; specifically anorexia nervosa. Childhood residential mobility was associated with elevated risks of developing most psychiatric disorders, even after controlling for potential confounders. The associations generally rose with increasing age at moving and were stronger for multiple moves in a year compared to a single move. Links were particularly strong for antisocial personality disorder, any substance misuse disorder, and cannabis misuse in particular, for which the highest increases in risks were observed if relocation occurred during adolescence. Childhood residential change was not linked to subsequent risk of developing an eating disorder. Frequent residential mobility could be a marker for familial adversities. Mental health services and schools need to be vigilant of the psychosocial needs of children, particularly adolescents, who have recently moved homes

Adverse Outcomes to Early Middle Age Linked With Childhood Residential Mobility

IntroductionLinks between childhood residential mobility and multiple adverse outcomes through to maturity, and effect modification of these associations by familial SES, are incompletely understood.MethodsA national cohort of people born in Denmark in 1971–1997 were followed from their 15th birthdays until their early forties (N=1,475,030). Residential moves during each age year between birth and age 14 years were examined, with follow-up to 2013. Incidence rate ratios for attempted suicide, violent criminality, psychiatric illness, substance misuse, and natural and unnatural deaths were estimated. The analyses were conducted during 2014–2015.ResultsElevated risks were observed for all examined outcomes, with excess risk seen among those exposed to multiple versus single relocations in a year. Risks grew incrementally with increasing age of exposure to mobility. For violent offending, attempted suicide, substance misuse, and unnatural death, sharp spikes in risk linked with multiple relocations in a year during early/mid-adolescence were found. With attempted suicide and violent offending, the primary outcomes, a distinct risk gradient was observed with increasing age at exposure across the socioeconomic spectrum.ConclusionsThe links between childhood residential mobility and negative outcomes in later life appear widespread across multiple endpoints, with elevation in risk being particularly marked if frequent residential change occurs during early/mid-adolescence. Heightened vigilance is indicated for relocated adolescents and their families, with a view to preventing longer-term adverse outcomes in this population among all socioeconomic groups. Risk management will require close cooperation among multiple public agencies, particularly child, adolescent, and adult mental health services