May 3, 2004 — A lifetime of adversity takes a heavy toll. For many people, the result is clinical depression and anxiety disorders later on, new research shows.

Many studies have linked early trauma — like sexual abuse, physical violence, parents’ deaths, divorces, and substance abuse — with depression.

However, few have looked at the cumulative effects of a lifetime of adversity on an adult’s mental health, writes lead researcher R. Jay Turner, PhD, with Florida State University in Tallahassee.

His report shows that young people across four ethnic groups — blacks, whites, Cubans, and immigrants from the Caribbean Islands — who were commonly exposed to significant and traumatic events had a great risk of psychiatric problems. It appears in the May Archives of General Psychiatry.

Early Trauma and Emotional Illness

All the volunteers in Turner’s study were between 19 and 21 years old: 25% were Cuban, 25% were from the Caribbean Islands; 25% were African American; and 25% were white.

In face-to-face or telephone interviews with the 1,800 participants, each answered a variety of questions about their life experiences. Based on their answers, researchers diagnosed some of them as having a variety of psychiatric problems: clinical depression, generalized anxiety disorder, social phobia, panic disorder, alcohol dependence, drug abuse, post-traumatic stress disorder, or an antisocial personality disorder.

Among the traumatic events covered in the interviews:

• Did you ever fail a grade in school?
• Were you ever abandoned by one or both parents?
• Did your parents ever divorce or separate?
• Have you ever discovered that your spouse/boyfriend/girlfriend was unfaithful?
• Did you ever lose your home because of a natural disaster?
• Did you ever have sexual intercourse against your will?
• Were you regularly emotionally abused by a parent, step-parent, grandparent, or guardian?
• Have you ever been shot at with a gun or threatened with another weapon but not injured?
• Have you ever witnessed a serious accident or disaster?
• Did you witness your mother being regularly physically or emotionally abused?
• Has anyone else you knew died suddenly or been seriously hurt?
• Have you even been told that someone you knew killed himself or herself?

Turner found that:

• Early adversity was significantly linked with depression or anxiety. Men reported more accumulated adversities than women. Yet women across all ethnic groups had substantially higher incidence of depression and anxiety disorders during their lifetimes.
• Blacks were more likely to witness the most violence; they also experienced much higher levels of adversity than all other ethnic groups. However, blacks had significantly lower incidence of depression.
• The emotional impact of childhood traumas remained very much alive, even when compared with more recent traumas.

If other ethnic groups were exposed to as much adversity as blacks are, depression and anxiety rates would increase by 32%- 35% — rather than decrease, Turner notes. Clearly, there is a compelling relationship between cumulative adversity and risk of clinical depression or anxiety disorder, he writes.

However, the very fact that a lifetime of trauma created emotional problems for people across all ethnic groups makes it unlikely that blacks have any more resiliency, Turner notes. More likely, in some people, life stress shows itself in the development of physical disorders rather than clinical depression or anxiety.

SOURCE: Turner, R. Archives of General Psychiatry, May 2004: vol 61, pp 481-488.