Childhood Origins of Cardiometabolic Disease: Psychosocial Predictors of Risk and Resilience

Abstract

A growing body of work suggests that the roots of cardiometabolic health may trace back to the first decades of life, with positive and negative early experiences setting the stage for health in adulthood. While prior research has examined psychosocial pathways of risk and resilience in relation to adult cardiometabolic outcomes, no studies have assessed their impact on health and well-being earlier in the life course. Therefore, this dissertation investigates whether these pathways might begin to show effects on health as early as childhood and adolescence. Paper 1 uses data from the Avon Longitudinal Study of Parents and Children to examine whether children with higher versus lower levels of positive psychological and behavioral assets are more likely to be in optimal cardiometabolic health by age 17 years. Results indicated that childhood assets cumulatively predicted cardiometabolic health by adolescence, with impacts observed across multiple physiologic systems. Paper 2 assesses whether poor mental health at age 5 years contributes to declines in cardiometabolic functioning from early to middle childhood using data from the Generation R Study. Although mental health did not appear to be associated with cardiometabolic functioning in early childhood, findings indicated that higher levels of mental health problems predicted declines in cardiometabolic functioning by age 9 years. Finally, Paper 3 uses data from the Generation R Study to investigate associations of ethnic-based intergroup threat reported by mothers with children’s mental health to identify intergenerational pathways of risk that likely precede emotion-related alterations in cardiometabolic functioning. Results found evidence of adverse intergenerational effects on mental health among children whose mothers experienced a strong sense of intergroup threat, irrespective of ethnic minority status. The three studies in this dissertation indicate that psychosocial factors can influence pathways of cardiometabolic risk and resilience in ways that are evident prior to adulthood. Therefore, it is possible that the health benefits of childhood assets and the deteriorative effects of poor mental health may contribute to previously documented associations between psychosocial factors in childhood and adult health outcomes. Taken together, these studies highlight potential new targets for childhood intervention that may help delay the onset of chronic disease or prevent it altogether.