Unraveling Childhood Predictors of Mental Health: A Cross-National Analysis of 22 Nations

Childhood experiences profoundly shape mental health across the lifespan, yet much of the existing research is limited to specific regions, neglecting the broader cultural and socioeconomic contexts that influence these associations. This study examines the impact of 13 childhood predictors on adult self-rated mental health (SRMH) using data from the Global Flourishing Study, encompassing over 200,000 individuals from 22 culturally and geographically diverse countries. SRMH was assessed on a 0–10 scale, and childhood predictors included parental relationships, financial stability, abuse, health, and religious practices. Random-effects meta-analyses were conducted to account for cross-national variations, and E-values assessed robustness to unmeasured confounding. Strong parental relationships, financial security, and regular childhood religious attendance were associated with higher adult SRMH, while childhood abuse and feelings of familial exclusion were linked to lower SRMH. Childhood abuse emerged as a consistent predictor of lower adult SRMH across most of the countries. Results were modestly robust to unmeasured confounding, with E-values indicating strong support for key findings. This study highlights the enduring effects of both adverse and positive childhood experiences on mental health, with consistent global patterns alongside cultural nuances. These findings emphasize the universal need to prevent childhood adversities and promote protective factors such as family support and social belonging. This study underscores the enduring global importance of nurturing supportive and protective childhood environments to enhance lifelong mental health, while highlighting the need for additional research to understand and address cultural and societal factors that shape these experiences.