Objective and Subjective Measures of Adverse Childhood Experiences and Their Associations with Psychopathology: a Meta-analysis

• In Event: The Effect of Adverse Childhood Experiences on Adolescent and Young Adult Psychopathology

Abstract

Background
Researchers interchangeably use self-report or objective measures, such as official records, to understand the long-lasting impact of childhood adversity on mental ill health. Emerging evidence suggests that subjective self-reports of childhood adversity may show stronger associations with psychopathology relative to objective measures (Danese & Widom, 2020). However, there is yet to be a systematic evaluation of whether objective and subjective measures of childhood adversity (1) capture the same individuals, and (2) differentially predict psychopathology.

Methods
To assess this, we carried out a pre-registered meta-analysis to examine the agreement between objective and subjective measures of childhood adversity, and their prediction of mental health outcomes. We searched in PubMed, PsycINFO, and Embase for articles with both objective measures of childhood adversity (comprising official records, or reports from multiple informants unrelated to the target individual) and subjective measures (comprising self-reports), and measures of mental health outcomes.

Results
We identified 22 studies (n=18,163) with objective and subjective measures of childhood adversities (including maltreatment, bullying and neighbourhood adversities), of which 17 (n=14,789) reported associations with psychopathology outcomes. First, we found poor agreement between objective and subjective measures of childhood adversities. Second, we found that individuals who self-report bullying, and maltreatment had a greater risk of psychopathology, independently of objective measures. In contrast, objective measures of childhood adversities were not associated with psychopathology, independent of corresponding subjective measures.

Discussion
Our findings suggest that perception and memories of childhood adversity might be key in mediating the effects of objective adverse experiences on risk for psychopathology. If subjective appraisal of childhood adversity directly contributes to psychopathology, then therapeutic approaches which target perceptions and memories could help to reduce and prevent psychopathology. Alternatively, the stronger association between subjective measures of childhood adversity and psychopathology may reflect bias such as reverse causation, shared method variance, or confounding. Future research is discussed that can distinguish between these alternative explanations.

Authors

• Emma Ruby Francis, University College London (UCL)
  Presenting Author

• Sarah Stock, University College London (UCL)

• Anna Tsaligopoulou

• Jean-Baptiste Pingault

• Jessie R Baldwin, University College London (UCL)