Impact of adverse life experiences on pain, depression, anxiety, and comorbidities: a youth longitudinal sample

Abstract Introduction: Exposure to adverse life experiences (ALEs) renders individuals vulnerable to the emergence of pain, depression, and anxiety. It remains unclear to what extent these symptom categories share common ALEs, especially in cases of comorbidity, and how these relationships manifest in developmental trajectories and neural pathways. Objectives: In this study, we investigated the impact of ALEs, considering their timing, quality, and quantity, as well as structural brain changes, on pain, depression, and anxiety symptoms, and their comorbidity from adolescence to young adulthood. Methods: We used prospective and retrospective questionnaires and magnetic resonance imaging data from a large European longitudinal cohort (N = 1700) spanning from 14 to 25 years. We conducted Latent-Class-Growth-Analysis for symptom levels of pain, depression, and anxiety, subsequent logistic regressions to explore prediction of ALEs on symptom classes, and mediation analysis to examine the role of insula in this association. Results: Physical illness unrelated to pain, bullying, and abuse-maltreatment were associated with pain; sexual abuse, bullying, parental violence, and deprivation with depression; bullying and deprivation with anxiety; substance abuse in the household and abuse-maltreatment with pain–depression comorbidity; deprivation with pain–anxiety comorbidity. Smaller insula volume in late adolescence was a significant mediator for the association between deprivation-related ALEs and the pain–anxiety, but not the pain–depression comorbidity. Conclusion: Together, although various and mainly different types of ALEs strongly impact pain, depression, and anxiety symptoms and their comorbidity, insula volume impacts are specific for pain–anxiety comorbidity. These findings may inform early screening and prevention for individuals affected by ALEs.