Social, Psychological, And Biological Mechanisms Underlying The Impact Of Early Life Adversity On Anxiety-related Disorders: Causal Analysis Of Cohorts From The UK And Brazil

Adverse childhood experiences (ACEs, e.g. family violence, parental mental health problems, bullying) carry an elevated risk of anxiety-related disorders, yet underlying mechanisms that might be targeted in interventions remain unclear. We will use cohort studies in the UK and Brazil to assess the mechanisms linking ACEs to anxiety-related disorders. The depth and breadth of measurements in the cohorts enables us to examine: 1) multiple levels of causation: social, psychological, biological, plus within- and between-level interactions, 2) the developmental trajectory of onset and persistence of anxiety following ACEs, and how this might be prevented or interrupted, 3) the role of commonly co-occurring conditions (e.g. depression, neurodivergence), and 4) consistency/specificity of mechanisms across ACEs and anxiety-related disorders. Comparisons across generations and across the UK and Brazil, where social contexts and levels of ACEs vary, will enable assessment of the degree to which causal pathways are culturally and generationally specific. Multiple analysis approaches drawing on longitudinal and genetic data will enhance causal inference. Where possible, we will triangulate across multiple methods. The research has been co-designed, and will be co-produced by, UK-based people with lived experience of anxiety, and we will develop and evaluate lived experience involvement in Brazil.