BackgroundAdverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.MethodsWe used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.ResultsAmong children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.ConclusionsThe apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.

中文翻译：

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一个热情和支持性的成年人能否保护有逆境经历的儿童免受心理健康问题的影响？双差异研究


背景童年不良经历 （ACE） 与心理健康问题有关，但许多经历过 ACE 的儿童并没有出现此类困难。童年时期温暖和支持性的成人存在与暴露于 ACE 后出现心理健康问题的可能性较低有关。然而，目前尚不清楚这种关联是否是因果关系，因为以前的研究没有考虑遗传和环境混杂。方法我们使用双差异设计来加强因果推断，即温暖和支持性的成人存在是否能保护暴露于 ACE 的儿童免受心理健康问题的影响。参与者来自环境风险 （E-Risk） 纵向双胞胎研究，这是一个由 2,232 名同性双胞胎组成的英国人口代表性出生队列。ACEs 在 5 至 12 岁之间进行前瞻性测量。在 5 岁和 10 岁时通过产妇言语样本评估产妇的温暖。在 12 岁时通过儿童报告评估成人抚养费。通过在 12 岁时与父母和老师以及 18 岁的参与者进行访谈来评估心理健康问题。在单卵双差分析中，与表型分析相比，母体温暖和成人支持对心理健康的保护作用减弱了 70%，成人支持减弱了 81%。与他们的同胞双胞胎相比，经历更多母性温暖和成人支持的双胞胎在心理健康方面的差异很小或没有差异，这与 ACE 暴露一致。结论一个温暖、支持性的成年人对 ACEs 后心理健康问题的明显保护作用在很大程度上是由遗传和环境混杂来解释的。这表明，提高母性温暖和成人支持的干预措施应辅以解决更广泛的家庭环境和暴露于逆境中的儿童的遗传脆弱性的内容，以改善心理健康。