Childhood adversity and midlife health: Shining a light on the black box of psychosocial mechanisms

Kyle J. Bourassa, Terrie E. Moffitt, Honalee Harrington, Renate Houts, Richie Poulton, Sandhya Ramrakha, Line J. H. Rasmussen, Jasmin Wertz, Avshalom Caspi

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the “black box” of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
Original languageEnglish
JournalPrevention Science
Early online date9 Sept 2022
Publication statusE-pub ahead of print - 9 Sept 2022

Keywords / Materials (for Non-textual outputs)

  • adverse childhood experiences
  • stressful life events
  • health behaviors
  • personality
  • health
  • perceived stress


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