Childhood adversity contributes more strongly than cognition to transdiagnostic mental health symptoms in young adults

Abstract Childhood adversity is associated with a broad range of mental health problems and may contribute to transdiagnostic risk via effects on cognitive development. However, it remains unclear how adversity and cognition jointly contribute to symptoms. Using the IMAGEN community sample (n = 827, mean age = 18.5), we examined cross-sectional associations between adversity, cognition and current symptoms in young adults. Three partial least squares regression models were compared: Adversity-only (threat and deprivation derived from Childhood Trauma Questionnaire); Cognition-only (CANTAB® performance); and combined Adversity-and-Cognition. When modelling symptoms across nine disorders, adversity emerged as the dominant predictor; the Adversity-and-Cognition model provided only modest improvement over Adversity-only for within-sample (R² = 0.189 vs 0.181) and out-of-sample predictive performance (R² = 0.056 vs 0.054). Adversity-and-Cognition showed a disorder-specific predictive value for depression, conduct disorder and hyperactivity/inattention (ADHD symptoms). However, for social phobia, specific phobia, agoraphobia, OCD and PTSD, incorporating cognition did not improve predictive performance beyond adversity alone.