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Childhood mental health problems resulting from early-life adversity drive poorer cognitive performance in adolescence, study suggests

Early-life adversity has long-term effects on children’s mental health, which in turn affects cognitive functioning as teenagers, say researchers. However, if mental health improves over time this outcome can be alleviated

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University of Cambridge


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Early-life adversity – such as poverty, illness or family conflict – has long been linked to mental health difficulties and poorer cognitive functioning as children grow up. But how these factors interact and evolve over time has so far been unknown.

Now, a new study by researchers at the University of Cambridge, together with colleagues in Nigeria, has revealed the interplay between early-life adversity, mental health difficulties and cognitive functioning over the course of childhood. The results, published today in the Journal of Child Psychology and Psychiatry, show that childhood mental health influences the extent to which early-life adversity impacts on later cognitive functioning.

Scientists analysed data from the ongoing Millennium Cohort Study, which has assessed 13,287 children on a variety of tests at ages three, five, seven, eleven and fourteen. They selected measures of early-life adversity (which they classified as taking place before the age of three), mental health and cognitive functioning – namely, working memory and vocabulary.

The team from the MRC Cognition and Brain Sciences Unit, University of Cambridge used a statistical technique designed to tease out the extent to which mental health affects the relationship between early-life adversity and cognitive functioning later in childhood.

They found that early-life adversity is associated with poorer performance on working memory and vocabulary through its impact on mental health across childhood. For example, poorer mental health across ages 3-14 resulting from early-life adversity accounted for 59% of the variance in poorer working memory performance at age 11 and explained 70% of poorer performance in vocabulary at age 14.  

The researchers showed that early-life adversity at age three strongly predicted poorer mental health across ages 3-14, with the association strongest at three but getting progressively weaker over time. In other words, children who experienced early-life adversity were most likely to experience mental health difficulties from age three to age fourteen, although poorer mental health was greater at age 3 than in the later years. This suggests that exposure to early-life adversity at this developmentally sensitive time has a negative long-term impact on mental health.

They also found that decreases in mental health difficulties over time were associated with improvements in working memory and vocabulary. This suggests that if behavioural and psychological difficulties can be addressed when children are young, the effects of early-life adversity on later cognition could be alleviated. This finding has important implications for clinicians, educators and parents involved in interventions.

“Our findings suggest that early-life adversity can lead to prolonged periods of poor mental health, which in turn may have lasting effects on cognitive performance, such as working memory and vocabulary,” said lead author Dr Tochukwu Nweze from the MRC Cognition and Brain Sciences Unit.

“We already know that poor mental health and cognition are associated with numerous behavioural problems which affect life quality and satisfaction. This reinforces the need for early interventions to give children the best possible life-outcomes.”

The researchers say that, at a time of rising mental health challenges among teenagers and young people, made worse by contemporary risk factors such as conflicts, pandemics and climate change, educators and clinicians need to focus on building resilience in children who have experienced early-life adversity.

“In this way, we can hope to break the self-sustaining mental health difficulties faced by individuals who have experienced early-life adversity,” said Dr Nweze.

The research was funded by Cambridge Trust under the Cambridge African Scholarship scheme.



Tochukwu Nweze et al., Childhood mental health difficulties mediate the long-term association between early-life adversity at age 3 and poorer cognitive functioning at ages 11 and 14, Journal of Child Psychology and Psychiatry, 8 February 2023, DOI: 10.1111/jcpp.13757

Contact details:

Charis Goodyear, Communications Coordinator, University of Cambridge Office of External Affairs and Communications

Tochukwu Nweze, University of Cambridge

About the University of Cambridge

The University of Cambridge is one of the world’s leading universities, with a rich history of radical thinking dating back to 1209. Its mission is to contribute to society through the pursuit of education, learning and research at the highest international levels of excellence.

Cambridge was second in the influential 2023 QS World University Rankings, the highest rated institution in the UK.

The University comprises 31 autonomous Colleges and over 100 departments, faculties and institutions. Its 20,000 students include around 9,000 international students from 147 countries. In 2022, 72.5% of its new undergraduate students were from state schools and more than 25% from economically disadvantaged backgrounds.

Cambridge research spans almost every discipline, from science, technology, engineering and medicine through to the arts, humanities and social sciences, with multi-disciplinary teams working to address major global challenges. In the Times Higher Education’s rankings based on the UK Research Excellence Framework, the University was rated as the highest scoring institution covering all the major disciplines.

The University sits at the heart of the ‘Cambridge cluster’, in which more than 5,200 knowledge-intensive firms employ more than 71,000 people and generate £19 billion in turnover. Cambridge has the highest number of patent applications per 100,000 residents in the UK.

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