Poster #23 - Can a Warm and Supportive Adult Protect Against Mental Health Problems After Childhood Adversity?

• In Event: Poster Session 03

Abstract

Background: Adverse childhood experiences (ACEs) are associated with mental health difficulties (Bevilacqua et al., 2021), but not all exposed children develop such difficulties. The presence of protective factors is one explanation for differences in mental health problems among children exposed to ACEs. In particular, a warm and supportive adult presence has been identified as a potential protective factor after ACEs (Crouch et al., 2019; Fritz et al., 2018). However, it is not clear whether the presence of a warm and supportive adult can causally protect against mental health problems, as previous research has not accounted for genetic confounding.
Methods: To address this research gap, the current study used the co-twin control design to examine the associations between maternal warmth and adult involvement and mental health outcomes at age 12 and 18 amongst participants with experience of ACEs. We studied a population representative cohort of 2,232 same-sex twins from the United Kingdom participating in the Environmental Risk (E-Risk) Longitudinal Twin Study. Participants were followed from birth to age 18 years, with 93% retention. ACEs, maternal warmth and adult involvement were prospectively assessed through parent and child reports between birth and age 12. Emotional and behavioural problems were assessed at age 12 through parent and teacher reports, and the generalised measure of psychopathology (p-factor) was assessed at age 18 through self-reports.
Firstly, associations were examined amongst all E-Risk participants with experience of ACEs (phenotypic level). Then the co-twin control design was used to test whether warm and supportive adult involvement protects against mental health difficulties in the context of adversity, independent of familial confounding.
Results: Phenotypic analyses suggested a protective effect of maternal warmth and supportive adult involvement on mental health outcomes after ACEs. In co-twin control analyses, monozygotic (MZ) twins who experienced more maternal warmth had slightly less behavioural difficulties at age 12 and lower p-factor scores at age 18 compared to their co-twins who experienced less maternal warmth. However, maternal warmth was not associated with emotional problems at age 12 in co-twin control analyses. Furthermore, in MZ co-twin control analyses, all associations between supportive adult involvement and mental health outcomes were fully attenuated.
Conclusions: To our knowledge this is the first study to use genetically informed designs to consider protective factors against mental health in adolescence, in the context of childhood adversity. At a phenotypic level, maternal warmth and adult involvement were associated with mental health outcomes in late childhood and early adulthood but associations were attenuated in co-twin control models.
It appears that the perceived protective effect of a warm and supportive adult presence is largely explained by familial confounding and thus may not causally protect against mental health difficulties following adversity.
Interventions which target heritable psychiatric vulnerabilities and family environmental risks may be more appropriate to boost resilience following adversity.

Authors

• Sarah Stock, University College London (UCL)
  Presenting Author

• Rebecca Lacey, University College London (UCL)

• Helen L Fisher, King's College London

• Jessie R Baldwin, University College London (UCL)