Skip to main content

Advertisement

SpringerLink
Log in

Childhood poverty and mental health disorders in early adulthood: evidence from a Brazilian cohort study

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Background

We examined the association between childhood poverty and mental health disorders (MHD) in childhood and early adulthood. We also investigated whether the association between poverty in childhood and MHD is mediated by exposure to stressful life events (SLE).

Methods

We used data from a prospective community cohort of young people assessed at baseline (M = 9.7 years, SD = 1.9), first (M = 13.5 years, SD = 1.9), and second (M = 18.2 years, SD = 2.0) follow-ups (N = 1,590) in Brazil. Poverty was assessed using a standardized classification. Exposure to 20 different SLE was measured using the Life History instrument. Psychiatric diagnoses were evaluated using the Development and Well-Being Assessment. Latent growth models investigated the association between poverty at baseline and the growth of any MHD, externalizing, and internalizing disorders. Mediation models evaluated whether the association between childhood poverty and MHD in early adulthood was mediated by exposure to SLE.

Results

Poverty affected 11.4% of the sample at baseline and was associated with an increased propensity for presenting externalizing disorders in adolescence or early adulthood (standardized estimate = 0.27, p = 0.016). This association was not significant for any disorder or internalizing disorders. Childhood poverty increased the likelihood of externalizing disorders in early adulthood through higher exposure to SLE (OR = 1.07, 95 CI% 1.01–1.14). Results were only replicated among females in stratified analyses.

Conclusions

Childhood poverty had detrimental consequences on externalizing MHD in adolescence, especially among females. Poverty and SLE are preventable risk factors that need to be tackled to reduce the burden of externalizing disorders in young people.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and material

CZ have full access to all the data used in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Data were provided by the Brazilian High-Risk Cohort study and are available upon request in the Open Science Framework public repository (https://osf.io/ktz5h/).

Code availability

Please, contact the corresponding author.

References

  1. United Nations (2020) Ending poverty. https://www.un.org/en/sections/issues-depth/poverty/index.html. Accessed 31 Jul 2020

  2. UNICEF (2021) Child poverty. https://www.unicef.org/social-policy/child-poverty. Accessed 18 Feb 2021

  3. Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31. https://doi.org/10.1016/j.socscimed.2013.04.026

    Article  PubMed  Google Scholar 

  4. Levesque AR, MacDonald S, Berg SA, Reka R (2021) Assessing the impact of changes in household socioeconomic status on the health of children and adolescents: a systematic review. Adolesc Res Rev. https://doi.org/10.1007/s40894-021-00151-8

    Article  PubMed  PubMed Central  Google Scholar 

  5. Knapp M, King D, Healey A, Thomas C (2011) Economic outcomes in adulthood and their associations with antisocial conduct, attention deficit and anxiety problems in childhood. J Ment Health Policy Econ 14:137–147

    PubMed  Google Scholar 

  6. Kim-Cohen J, Caspi A, Moffitt TE et al (2003) Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 60:709–717. https://doi.org/10.1001/archpsyc.60.7.709

    Article  PubMed  Google Scholar 

  7. Richards M, Abbott R (2009) Childhood mental health and life chances in post-war Britain. Insights from three national birth cohort studies. The Smith Institute, Sainsbury Centre for Mental Health & Unison, London

  8. Chen H, Cohen P, Kasen S et al (2006) Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later. Arch Pediatr Adolesc Med 160:93. https://doi.org/10.1001/archpedi.160.1.93

    Article  PubMed  Google Scholar 

  9. Fergusson DM, John Horwood L, Ridder EM (2005) Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. J Child Psychol Psychiatry 46:837–849. https://doi.org/10.1111/j.1469-7610.2004.00387.x

    Article  PubMed  Google Scholar 

  10. Miech RA, Caspi A, Moffitt TE et al (1999) Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. Am J Sociol 104:1096–1131. https://doi.org/10.1086/210137

    Article  Google Scholar 

  11. Slopen N, Fitzmaurice G, Williams DR, Gilman SE (2010) Poverty, food insecurity, and the behavior for childhood internalizing and externalizing disorders. J Am Acad Child Adolesc Psychiatry 49:444–452. https://doi.org/10.1016/j.jaac.2010.01.018

    Article  PubMed  Google Scholar 

  12. McLaughlin KA, Breslau J, Green JG et al (2011) Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample. Soc Sci Med 73:1088–1096. https://doi.org/10.1016/j.socscimed.2011.06.011

    Article  PubMed  PubMed Central  Google Scholar 

  13. Costello EJ, Compton SN, Keeler G, Angold A (2003) Relationships between poverty and psychopathology. JAMA 290:2023. https://doi.org/10.1001/jama.290.15.2023

    Article  CAS  PubMed  Google Scholar 

  14. Ravens-Sieberer U, Erhart M, Gosch A, Wille N (2008) Mental health of children and adolescents in 12 European countries—results from the European KIDSCREEN study. Clin Psychol Psychother 15:154–163. https://doi.org/10.1002/cpp.574

    Article  PubMed  Google Scholar 

  15. Ozer EJ, Fernald LCH, Manley JG, Gertler PJ (2009) Effects of a conditional cash transfer program on children’s behavior problems. Pediatrics 123:e630–e637. https://doi.org/10.1542/peds.2008-2882

    Article  PubMed  Google Scholar 

  16. Anselmi L, Menezes AMB, Hallal PC et al (2012) Socioeconomic changes and adolescent psychopathology in a Brazilian birth cohort study. J Adolesc Heal 51:S5–S10. https://doi.org/10.1016/j.jadohealth.2012.06.026

    Article  Google Scholar 

  17. Barch DM, Belden AC, Tillman R et al (2018) Early childhood adverse experiences, inferior frontal gyrus connectivity, and the trajectory of externalizing psychopathology. J Am Acad Child Adolesc Psychiatry 57:183–190. https://doi.org/10.1016/j.jaac.2017.12.011

    Article  PubMed  Google Scholar 

  18. Curran PJ, Hussong AM (2003) The use of latent trajectory models in psychopathology research. J Abnorm Psychol 112:526–544. https://doi.org/10.1037/0021-843X.112.4.526

    Article  PubMed  PubMed Central  Google Scholar 

  19. Masyn KE, Petras H, Liu W (2014) Growth curve models with categorical outcomes. Encyclopedia of criminology and criminal justice. Springer, New York, pp 2013–2025

    Chapter  Google Scholar 

  20. Lee TK, Wickrama K, O’Neal CW (2018) Application of latent growth curve analysis with categorical responses in social behavioral research. Struct Equ Model Multidiscip J 25:294–306. https://doi.org/10.1080/10705511.2017.1375858

    Article  Google Scholar 

  21. Reiss F, Meyrose A-K, Otto C et al (2019) Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS ONE 14:e0213700. https://doi.org/10.1371/journal.pone.0213700

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. McLaughlin KA, Weissman D, Bitrán D (2019) Childhood adversity and neural development: a systematic review. Annu Rev Dev Psychol 1:277–312. https://doi.org/10.1146/annurev-devpsych-121318-084950

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cooper S, Lund C, Kakuma R (2012) The measurement of poverty in psychiatric epidemiology in LMICs: critical review and recommendations. Soc Psychiatry Psychiatr Epidemiol 47:1499–1516. https://doi.org/10.1007/s00127-011-0457-6

    Article  PubMed  Google Scholar 

  24. World Health Organization (2020) Adolescent mental health. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. Accessed 22 Feb 2021

  25. Kessler RC, Angermeyer M, Anthony JC et al (2007) Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 6:168–176

    PubMed  PubMed Central  Google Scholar 

  26. United Nations (2016) Human development report: human development for everyone

  27. Salum GA, Gadelha A, Pan PM et al (2015) High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results. Int J Methods Psychiatr Res 24:58–73. https://doi.org/10.1002/mpr.1459

    Article  PubMed  Google Scholar 

  28. Weissman MM, Wickramaratne P, Adams P et al (2000) Brief screening for family psychiatric history: the family history screen. Arch Gen Psychiatry 57:675–682. https://doi.org/10.1001/pubs.Arch

    Article  CAS  PubMed  Google Scholar 

  29. Associação Brasileira de Empresas de Pesquisa (2018) Critério de Classificação Econômica Brasil. http://www.abep.org/criterio-brasil. Accessed 15 Apr 2020

  30. Kamakura W, Mazzon JA (2016) Critérios de estratificação e comparação de classificadores socioeconômicos no Brasil. Rev Adm Empres 56:55–70. https://doi.org/10.1590/S0034-759020160106

    Article  Google Scholar 

  31. Confortin SC, Ribeiro MRC, Barros AJD et al (2021) RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. Cad Saude Publica. https://doi.org/10.1590/0102-311x00093320

    Article  PubMed  Google Scholar 

  32. de Silva F, de Queiroz RC, dos Branco M et al (2020) Bolsa Família program and incomplete childhood vaccination in two Brazilian cohorts. Rev Saude Publica 54:98. https://doi.org/10.11606/s1518-8787.2020054001774

    Article  PubMed  PubMed Central  Google Scholar 

  33. Goodman R, Ford T, Richards H et al (2000) The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41:645–655

    Article  CAS  PubMed  Google Scholar 

  34. Fleitlich-Bilyk B, Goodman R (2004) Prevalence of child and adolescent psychiatric disorders in southeast Brazil. J Am Acad Child Adolesc Psychiatry 43:727–734. https://doi.org/10.1097/01.chi.0000120021.14101.ca

    Article  PubMed  Google Scholar 

  35. Martel MM, Pan PM, Hoffmann MS et al (2017) A general psychopathology factor (P factor) in children: structural model analysis and external validation through familial risk and child global executive function. J Abnorm Psychol 126:137–148. https://doi.org/10.1037/abn0000205

    Article  PubMed  Google Scholar 

  36. Williamson DE, Birmaher B, Ryan ND et al (2003) The Stressful Life Events Schedule for children and adolescents: development and validation. Psychiatry Res 119:225–241. https://doi.org/10.1016/S0165-1781(03)00134-3

    Article  PubMed  Google Scholar 

  37. Sheehan D, Lecrubier Y, Sheehan K et al (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59:22–33

    PubMed  Google Scholar 

  38. Seaman SR, White IR (2013) Review of inverse probability weighting for dealing with missing data. Stat Methods Med Res 22:278–295. https://doi.org/10.1177/0962280210395740

    Article  PubMed  Google Scholar 

  39. StataCorp (2019) STATA Base reference manual release 16®. In: StataCorp LLC

  40. Muthén L, Muthén B (2021) Mplus user’s guide, 8th edn. Muthen & Muthen, Los Angeles

    Google Scholar 

  41. Brown T (2015) Confirmatory Factor Analysis for Applied Research. Guilford Press, New York

    Google Scholar 

  42. MacKinnon DP, Lockwood CM, Williams J (2004) Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behav Res 39:99–128. https://doi.org/10.1207/s15327906mbr3901_4

    Article  PubMed  PubMed Central  Google Scholar 

  43. Rodriguez JDM, da Silva AAM, Bettiol H et al (2011) The impact of perinatal and socioeconomic factors on mental health problems of children from a poor Brazilian city: a longitudinal study. Soc Psychiatry Psychiatr Epidemiol 46:381–391. https://doi.org/10.1007/s00127-010-0202-6

    Article  PubMed  Google Scholar 

  44. La Maison C, Munhoz TN, Santos IS et al (2018) Prevalence and risk factors of psychiatric disorders in early adolescence: 2004 Pelotas (Brazil) birth cohort. Soc Psychiatry Psychiatr Epidemiol 53:685–697. https://doi.org/10.1007/s00127-018-1516-z

    Article  PubMed  PubMed Central  Google Scholar 

  45. Wong YJ, Rew L, Slaikeu KD (2006) A Systematic Review of recent research on adolescent religiosity/spirituality and mental health. Issues Ment Health Nurs 27:161–183. https://doi.org/10.1080/01612840500436941

    Article  PubMed  Google Scholar 

  46. Devenish B, Hooley M, Mellor D (2017) The pathways between socioeconomic status and adolescent outcomes: a systematic review. Am J Community Psychol 59:219–238. https://doi.org/10.1002/ajcp.12115

    Article  PubMed  Google Scholar 

  47. Lund C, Breen A, Flisher AJ et al (2010) Poverty and common mental disorders in low- and middle-income countries: a systematic review. Soc Sci Med 71:517–528. https://doi.org/10.1016/j.socscimed.2010.04.027

    Article  PubMed  PubMed Central  Google Scholar 

  48. March-Llanes J, Marqués-Feixa L, Mezquita L et al (2017) Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis. Eur Child Adolesc Psychiatry 26:1409–1422. https://doi.org/10.1007/s00787-017-0996-9

    Article  PubMed  Google Scholar 

  49. Amone-P’Olak K, Ormel J, Huisman M et al (2009) Life stressors as mediators of the relation between socioeconomic position and mental health problems in early adolescence: the TRAILS study. J Am Acad Child Adolesc Psychiatry 48:1031–1038. https://doi.org/10.1097/CHI.0b013e3181b39595

    Article  PubMed  Google Scholar 

  50. Leban L (2021) The effects of adverse childhood experiences and gender on developmental trajectories of internalizing and externalizing outcomes. Crime Delinq 67:631–661. https://doi.org/10.1177/0011128721989059

    Article  Google Scholar 

  51. Leve LD, Kim HK, Pears KC (2005) Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17. J Abnorm Child Psychol 33:505–520. https://doi.org/10.1007/s10802-005-6734-7

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lund C, Stansfeld S, De SM (2013) Social determinants of mental health. Global mental health. Oxford University Press, Oxford, pp 116–136

    Google Scholar 

  53. Ribeiro WS, de Mari J, Quintana MI et al (2013) The impact of epidemic violence on the prevalence of psychiatric disorders in Sao Paulo and Rio de Janeiro, Brazil. PLoS ONE 8:e63545. https://doi.org/10.1371/journal.pone.0063545

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Blattman C, Jamison JC, Sheridan M (2017) Reducing crime and violence: experimental evidence from cognitive behavioral therapy in liberia. Am Econ Rev 107:1165–1206. https://doi.org/10.1257/aer.20150503

    Article  PubMed  Google Scholar 

Download references

Funding

The research presented in this article was supported by the National Institute of Developmental Psychiatry for Children and Adolescents, a science and technology institute funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; National Council for Scientific and Technological Development; Grant numbers 573974/2008–0 and 465550/2014–2) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP Grant number 2008/57896–8 and 2014/50917–0). CZ receives a Young Talent Research Scholarship by the Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil, Grant number 88887.575201/2020–00).

Author information

Authors and Affiliations

  1. Departamento de Psiquiatria, Universidade Federal de São Paulo. Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brasil

    Carolina Ziebold, Laís Fonseca, Matheus Barbosa, Pedro Mario Pan, Rodrigo Bressan, Jair de Jesus Mari & Ary Gadelha

  2. Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK

    Sara Evans-Lacko

  3. Universidade Federal de São João del-Rei, São João del-Rei, Minas Gerais, Brazil

    Mário César Rezende Andrade

  4. Universidade Federal de Santa Maria, Santa Maria, Brazil

    Maurício Hoffmann

  5. National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil

    Pedro Mario Pan, Euripedes Miguel, Rodrigo Bressan, Luis Augusto Rohde, Giovanni Salum, Julia Schafer, Jair de Jesus Mari & Ary Gadelha

  6. Universidade de São Paulo, São Paulo, Brazil

    Euripedes Miguel

  7. Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil

    Luis Augusto Rohde, Giovanni Salum & Julia Schafer

Authors
  1. Carolina Ziebold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sara Evans-Lacko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mário César Rezende Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maurício Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laís Fonseca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matheus Barbosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pedro Mario Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Euripedes Miguel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rodrigo Bressan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Luis Augusto Rohde
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Giovanni Salum
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Julia Schafer
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Jair de Jesus Mari
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ary Gadelha
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CZ and AG participated in the conception and analytic strategies of the current study. CZ and JS did the analysis. CZ drafted the manuscript. PMP, EM, RAB, GS, JM, LAR, JS, and AG, developed and conducted the BHRC. All authors made substantial contributions to the interpretation of the data and revision of the text. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Carolina Ziebold.

Ethics declarations

Conflict of interest

CZ, SEL, MCRA, MH, LF, MB, PMP, EM, RAB, GS, JS, and JM have no conflict of interest to declare. LAR has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Aché, Bial, Medice, Novartis/Sandoz, Pfizer/Upjohn, and Shire/Takeda in the last three years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr LAR have received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Novartis/Sandoz and Shire/Takeda. Dr LAR has received authorship royalties from Oxford Press and ArtMed. AG has been a consultant and/or advisor to or has received honoraria from Aché, Daiichi-Sankyo, Torrent, Cristalia, and Janssen.

Ethics approval

All procedures were approved by the Ethics Committee of the Federal University of São Paulo and Hospital de Clínicas de Porto Alegre.

Consent to participate

Child assent and parental informed consent were obtained from all the research subjects.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 300 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ziebold, C., Evans-Lacko, S., Andrade, M.C.R. et al. Childhood poverty and mental health disorders in early adulthood: evidence from a Brazilian cohort study. Eur Child Adolesc Psychiatry 32, 903–914 (2023). https://doi.org/10.1007/s00787-021-01923-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-021-01923-2

Keywords

Search

Navigation