The association of chronic adversity with psychiatric disorder and disorder severity in adolescents

The purpose of this paper is to estimate the impact of chronic adversity on psychopathology in adolescents, taking into account
the type of adversity, number of adversities experienced and type of psychiatric disorder, as well as to estimate the impact
on severity of the disorder. A total of 3,005 male and female adolescents from the Mexican Adolescent Mental Health Survey
aged 12–17 years were interviewed in a stratified multistage general population probability survey. Assessment of 20 DSM-IV
disorders, disorder severity and 12 chronic childhood adversities were assessed with the adolescent version of the World Mental
Health Composite International Diagnostic Interview (WMH-CIDI-A). Family dysfunction adversities including abuse presented
the most consistent associations between chronic adversity and psychopathology and their impact was generally non-specific
with regard to the type of disorder. Parental divorce, parental death and economic adversity were not individually associated
with psychopathology. Among those with a psychiatric disorder, sexual abuse and family violence were associated with having
a seriously impairing disorder. The odds of having a psychiatric disorder and a serious disorder increased with increasing
numbers of adversities; however, each additional adversity increased the odds at a decreasing rate. While the study design
does not allow for conclusions regarding causality, these findings suggest general pathways from family dysfunction to psychopathology
rather than specific associations between particular adversities and particular disorders, and provide further evidence for
the importance of family-focused intervention and prevention efforts.