Editorial: Elevating the Narrative About Adverse Events During Development

Abstract

United States middle- or high-school-age children are taught about the perils of cyber bullying in health classes. They learn that they are at risk of suicide because of online harassment behaviors and that resources are being expanded to prevent, report, or interrupt such bullying. However, the perspective that suicide victims likely have other salient predisposing or precipitating risk factors (eg, summarized comprehensively by Turecki and Brent¹) is usually not emphasized simultaneously. In the context of an abundance of studies documenting clear associations between childhood or adolescence adverse experiences and many aspects of health, as reviewed recently in The Lancet Public Health,² it is not an exaggeration to observe that a crucial axiom of first science classes, correlation is not causation, can be overlooked when a small number of specific adverse events emerges narratively as the major etiologic cause of much of psychopathology, including youth suicide. However, traumatic events, such as youth sexual victimization³ or physical punishment/maltreatment,⁴ have long been known to correlate to social contexts and/or heritable genotypes, which also might mediate or co-mediate the risk for adverse outcomes. That some methodologic designs are superior to others to disentangle such confounds and examine causation is well known in behavior genetics.⁵ This was highlighted 2 decades ago, in this very journal, by Dr. Naimah Weinberg of the National Institutes of Health, in an article reviewing the cognitive and behavioral deficits associated with parental alcohol use,⁶ where she noted the growing field of behavior genetics offers an approach to understanding such complex problems. This is a necessary perspective to move the science of child psychiatry forward.