Do childhood adversities cluster in predicatable ways? A systematic review.

Prior research has established that childhood adversities are potentially associated with a range of subsequent difficulties in childhood, adolescence and adulthood, including depression, suicide, behaviour problems, anxiety and physical health conditions. It has also been generally accepted that adversities do not occur in isolation, with multiple adversities being the norm. However, whether the experience of combinations of adversities during childhood forms a consistent pattern has not been established. The aim of this study was to systematically review prior research which has investigated whether childhood adversities occur in predictable clusters. A systematic search of published research investigating this issue was completed using 10 library databases for the period of January 1980 through February 2011. Eleven of the 12 studies included in the review found that childhood adversities did cluster in predictable ways. However, the revealed clusters were highly inconsistent across the studies. This may be due to variation in the number and type of adversities examined, in the definition of ÒchildhoodÓ, in the methodologies and criteria used to identify childhood adversities and in the analyses applied to the data. It was suggested in several of the studies that adversities centring on family functioning were most salient in predicting future mental health and behavioural difficulties. Research in this area needs to maximise the comprehensiveness of the measurement of childhood adversities within available resources while minimising the subjective qualities of extensive questionnaires. Practitioners and interventions should not focus on a single adversity but consider those that commonly co-occur and address them as a collective whole.

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