Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland.
Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA.
J Trauma Stress. 2021 Feb;34(1):124-136. doi: 10.1002/jts.22617. Epub 2020 Nov 16.
Childhood adversity (CA) and adulthood traumatic experiences (ATEs) are common and unequally distributed in the general population. Early stressors may beget later stressors and alter life-course trajectories of stressor exposure. Gender differences exist regarding the risk of specific stressors. However, few studies have examined the associations between specific types of CA and ATEs. Using a large-scale sample of older adults, we aimed to (a) determine if specific or cumulative CA increased the risk for specific or cumulative ATEs and (b) examine whether these associations were moderated by gender. In a sample from the U.S. Health and Retirement Study (N = 15,717; M = 67.57 years, SD = 10.54), cross-sectional Poisson and logistic regression models were fitted to assess the specific and cumulative associations between CA and ATEs. Overall, cumulative CA was associated with a larger risk ratio of ATEs, adjusted for covariates: aRRRs = 1.28, 1.63, and 1.97 for 1, 2, and 3-4 adverse events in childhood, respectively. Cumulative CA was particularly strongly associated with adulthood physical attacks, aOR = 5.66, and having a substance-abusing spouse or child, aOR = 4.00. Childhood physical abuse was the strongest independent risk factor for cumulative ATEs, aRRR = 1.49, and most strongly associated with adulthood physical attacks, aOR = 3.41. Gender moderated the association between cumulative CA and cumulative ATEs, with slightly stronger associations between cumulative CA and ATEs for women than men. Given that CA and ATEs perpetuate health disparities worldwide, reducing their incidence and effects should be major priorities for public health.
童年逆境 (CA) 和成年创伤经历 (ATE) 在普通人群中很常见且分布不均。早期压力源可能会引发后来的压力源,并改变压力暴露的生命轨迹。性别差异存在于特定压力源的风险方面。然而,很少有研究检查过特定类型的 CA 与 ATE 之间的关联。本研究使用了一项大规模的老年人样本,旨在:(a) 确定特定或累积 CA 是否会增加特定或累积 ATE 的风险;(b) 检查这些关联是否受性别影响。在来自美国健康与退休研究(N = 15717;M = 67.57 岁,SD = 10.54)的样本中,使用横截面泊松和逻辑回归模型来评估 CA 与 ATE 之间的特定和累积关联。总体而言,在调整了协变量后,累积 CA 与 ATE 的风险比相关,分别为 1、2 和 3-4 个不利事件的 aRRRs = 1.28、1.63 和 1.97。累积 CA 与成年期身体攻击特别强烈相关,aOR = 5.66,与有滥用药物的配偶或孩子相关,aOR = 4.00。童年期身体虐待是累积 ATE 的最强独立风险因素,aRRR = 1.49,与成年期身体攻击的关联最强,aOR = 3.41。性别调节了累积 CA 与累积 ATE 之间的关联,女性与累积 CA 和 ATE 之间的关联略强于男性。鉴于 CA 和 ATE 在全球范围内导致健康差距,减少其发生率和影响应成为公共卫生的主要优先事项。