A new framework for understanding adolescents' experience of adversity

Adolescence (age 10-24 years) is a period of social development which can coincide with exposure to adverse experiences – potentially traumatic events, such as abuse or neglect. Bullying is a common adverse experience for adolescents: a survey of almost 300,000 adolescents aged 12-17 years found 30 per cent reported having been bullied in the past 30 days. These adolescents are nearly three times more likely to experience depression compared to adolescents who have not experienced bullying.

Prevention of bullying may be key to reducing incidence of depression and improving mental health outcomes for young people.

Identifying the causes of mental health conditions is a top priority for research. Over 60 per cent of these conditions arise before the age of 25, with an average peak onset of 14.5 years. To establish how and why mental health issues arise we need research that goes beyond drawing on associations. We need systematic approaches, representative datasets studying young people over time, and innovative methods that allow us to tease apart the potential causes of mental health conditions.

To understand how adversity shapes development we need to start with a framework: a structure that turns a concept into something we can test and study in research. Current adversity frameworks focus primarily on caregivers and experiences in the family home. These are typically separated into abuse (e.g., psychological abuse by a parent or adult in the household) and household dysfunction (e.g., substance abuse in the household).

Our research has shown that adolescents report high rates of adversities that more often occur outside of the home. We analysed data from two UK-based cohorts including over 15,000 adolescents. Around 17-22 per cent of participants reported experiencing several social adversities, including peer relationship problems and school issues. We have also found in another study that emotional abuse experienced outside of the home was associated with later mental health issues.

We have proposed the Adolescent Adverse Experiences (AAEs) framework to characterise adversities in adolescence and how they might shape development. The framework considers each level of the environment that might interact and influence human development, based on the ecological systems theory of development. In other words, we recognise that we are embedded within our communities and within society, which brings challenges at multiple levels.

Our AAEs framework captures adverse experiences at each level: experiences reflecting personal factors like the consequences of risk taking (intrapersonal), experiences arising from relationships like bullying (interpersonal), experiences in the community like neighbourhood safety (community), and structural issues like discrimination and social inequalities (societal).

The AAEs framework can be used to develop research to understand how different types of adversities shape adolescent development. We can use this tool as a guide to capturing the breadth and depth of adolescent experiences. This will allow us to identify strategies and targets for prevention of mental and physical health issues.

In our research, we are applying the framework to better understand how adversity shapes brain development, mental health and cognition. This framework can also be used to conceptualise adversities in other life stages with social and neurodevelopmental changes, such as childhood and adulthood.