Childhood trauma linked to risky health behaviors in late adolescence

Experiencing childhood trauma appears to increase a young person’s likelihood of smoking, substance use and developing unhealthy eating habits by contributing to behavioral problems during adolescence, such as impulsivity and poor self-control. This is the finding of new research led by the University of Bath in the UK and colleagues at the University of Sao Paulo in Brazil.

Addressing these mental health difficulties early could help reduce some of the long-term physical health consequences of childhood trauma, such as heart disease and other serious health problems.

The researchers analyzed data from more than 4,000 participants in the 2004 Pelotas Birth Cohort – one of the world’s largest and most detailed long-running studies following people from birth into adulthood. The team tracked exposure to potentially traumatic events during childhood, mental health in adolescence and health-related behaviors at age 18.

Unlike many previous studies, which rely on adults recalling traumatic experiences that happened to them many years ago, this research followed young people over time from childhood into early adulthood, thereby providing a clearer picture of how trauma, mental health and later health behaviors may be connected.

The findings from the new study, published today in the Journal of Child Psychology and Psychiatry, suggest that ‘externalising’ mental health problems, such as impulsive, aggressive or disruptive behaviors, partly explain the link between childhood trauma and later smoking, illicit drug use, problematic alcohol consumption and diets high in ultra-processed foods.

There was little evidence that internalising problems (such as anxiety and depression) played a similarly important role.

Early interventions

Interventions that help trauma-exposed youth regulate their emotions and behaviors better could have benefits beyond reducing mental health difficulties.

They might also reduce harmful behaviors that contribute to cardiovascular disease and other physical health problems later in life.”

Dr Sophie Townend, lead author, Department of Psychology, University of Bath

Professor Graeme Fairchild, also from the Department of Psychology at Bath, said: “The relationship between childhood trauma and later health outcomes appears to be more complex than we previously thought.

“Some mental health problems, like anxiety, surprisingly seem relatively unrelated to later risky behavior, while behavior problems and issues with anger seemed to explain much of the effect of childhood trauma on risky health behaviors later in life. This strengthens the case for increasing the availability and effectiveness of interventions for mental health problems amongst trauma-exposed youth.”

Dr Alicia Matijasevich, from the Department of Preventive Medicine at the University of São Paulo and co-senior author of the study, said: “Childhood trauma and health-risk behaviors are often studied separately. What this study adds is evidence that mental health during adolescence may be part of the pathway linking experiences earlier in childhood with health-related behaviors at age 18.

“Following the same individuals over time allowed us to examine how traumatic experiences, mental health and behaviors are connected across different stages of development, providing a better understanding of how childhood trauma may be linked to health-related behaviors in late adolescence.”

Though the new study focused on people living in Brazil, the researchers believe their analysis has implications well beyond this country. Childhood adversity remains a major public health challenge across Europe and the UK, with research from the Bristol-based ALSPAC birth cohort finding that around one in six children experienced physical abuse during childhood. Concerns about children’s mental health have risen sharply in recent years.

The universal benefits of physical activity

One perhaps surprising finding from the study was that externalising problems were also associated with higher levels of movement and physical activity, suggesting the consequences of childhood trauma and mental health difficulties are not uniformly negative across all health behaviors.

Dr Townend said: “Future interventions could explore ways of channelling this energy into structured, health-promoting activities, such as team sports, that support physical wellbeing and may provide positive alternatives to risky health behaviors.”

The team plans to continue investigating how childhood experiences shape long-term health, including exploring how trauma may be linked to early signs of heart and metabolic disease in late adolescence, such as higher resting heart rate and blood pressure, increased body weight, and unhealthy cholesterol and fat levels in the blood.