Does the timing matter? The association between childhood adversity and internalizing and externalizing problems from childhood to adolescence and its sex differences

Abstract

Background: Childhood adversity (CA) is a well-known risk factor for mental distress, and its impacts may vary depending on its timing. However, relevant empirical studies are rare and ambiguous. Similarly, prior studies have given little attention to possible moderating effects by sex, particularly in the context of developmental stages. Objective: This study sought to identify when the impacts of CA on children's mental health become pronounced and the extent to which these relations and sensitive timing vary by gender. Participants and setting: Data were from the Young Women and Child Development Study (n = 360), covering ages 4.3 to 17.6. Methods: Time-varying effect models, including moderation by child gender, were evaluated. Results: The effect of CA on mental health surged during middle childhood (b = 0.93 at age 10 and 1.94 at age 9 for internalizing and externalizing problems, respectively) and peaked at age 15 (b = 2.35 and 3.53 for internalizing and externalizing problems, respectively). Gender interaction findings suggest that gender moderation effects were limited to between ages 10.3 (b = 0.88) and 14.3 (b = 1.11) for internalizing problems and between ages 5.3 (b = 1.06) and 7.0 (b = 1.31) for externalizing problems. For girls, the influence began escalating at an earlier age. Conclusions: Middle childhood and early adolescence should be considered key intervention points to prevent CA from worsening children's mental health. Intervention timing should be tailored by gender to effectively disrupt the impacts of childhood adversity on mental health. © 2025 Elsevier Ltd