Associations Between Lifetime Stressor Exposure and Externalizing Problems in Youth at Risk for Huntington Disease

Children face significant stressors while growing up in families impacted by Huntington disease (HD). However, the sources of these stressors and how they are related to psychological difficulties have not been well-characterized in this population. In this study, we examined the lifetime stressors experienced by youth at risk for HD using a comprehensive measure of lifetime stressor exposure and investigated how these stressors relate to psychological difficulties.

Participants included 94 adolescents ages 10-18 years, 40 of whom were at genetic risk for HD (M_age = 13.7, SD = 2.9) and 54 of whom were community controls (M_age = 12.6, SD = 2.2). All participants completed the Stress and Adversity Inventory and Youth Self-Report. Bivariate correlations and linear regression analyses were performed to examine the relationships between stressors, demographic characteristics, and psychological difficulties.

Adolescents at risk for HD reported significantly more lifetime stressors than controls, including greater frequency and severity of both acute life events and chronic difficulties. In addition, at-risk participants reported more stressors involving Treatment/Health and Role Change/Disruption. Whereas lifetime stressors were primarily related to internalizing problems and anxiety for controls, stressor exposure in at-risk individuals was most prominently related to externalizing problems, including rule-breaking behavior.

These results demonstrate that youth at risk for HD experience significantly more lifetime stressor exposure than their peers and report greater externalizing problems when exposed to stress. These findings highlight the importance of assessing lifetime stressor exposure in this clinical population and suggest key differences in how at-risk youth may respond to stress.