Lifetime Abuse Victimization and Prospective Health Outcomes in Older Adults.

Objectives: The current study examined the associations between lifetime abuse victimization and prospective health outcomes in late adulthood. Methods: Data from 4907 older adults (mean age = 80) from the Wisconsin Longitudinal Study were analyzed. Multivariate analyses examined the associations of lifetime abuse victimization with depression, physical health status, and memory. Results: Greater exposure to lifetime abuse was associated with a significantly higher risk of depression (OR = 1.13, CI: [1.08, 1.19], p < .001) and a greater number of limitations in physical functioning (b = .08, SE = .02, p < .001), but not with memory performance (b = .01, SE = .14, p > .05). Discussion: Our results support the interrelations of interpersonal violence across the life course and the lasting health effects of exposure to lifetime abuse. Findings highlight the need for a life course-based, trauma-informed approach in prevention and intervention programs for older adults.

Sibling support exchange in late adulthood moderates the long-term impact of childhood neglect on psychological outcomes.

Objectives: Sibling relationships are often the longest-lasting and serve as a source of support and comfort for many older adults. The current study examined the moderating effect of sibling support exchange in the association between childhood maltreatment and mental health outcomes.Method: Using data from the Wisconsin Longitudinal Study (WLS), we analyzed a sample of older adults whose selected sibling was alive across the three data collections (baseline N = 4,041). Longitudinal multilevel regression models were estimated.Results: Key results showed that a history of neglect was associated with decreased psychological well-being, and all three forms of childhood maltreatment were related to increased depressive symptoms. We also found that sibling support exchange mitigated the negative mental health effects of childhood neglect.Conclusion: Our findings suggest that siblings may be uniquely positioned to support older adults who grew up in a neglectful family environment. Older adults may be encouraged to promote resilience by strengthening their sibling relationships.

Filial Caregiving and Chinese Adults' Depressive Symptoms: Do Early-Life Parent-Child Relationships Matter?

This study investigated the association between caregiving time and depressive symptoms among Chinese adult children aged 45 and above, and whether early-life relationships with parents moderated the association. We used data from the 2011, 2013, and 2018 waves of China Health and Retirement Longitudinal Study (CHARLS) and the 2014 CHARLS Life History Survey, which included 4781 respondents with living mothers and 2710 respondents with living fathers. Results from multilevel models showed that caregiving time for mothers or fathers was not significantly associated with adults' depressive symptoms in general. However, more caregiving time for mothers was significantly associated with more depressive symptoms among respondents experiencing more frequent maternal childhood physical abuse. Altogether, childhood maltreatment may affect levels of caregiving stress decades later. Filial caregivers with a history of childhood physical abuse may require support.

Sexual and Marital Satisfaction in Older Adulthood: Effects of Childhood and Adulthood Violence Exposure.

BACKGROUND AND OBJECTIVES: Guided by the life course perspective and traumagenic dynamics theory, the current study examines (a) the long-term effects of childhood sexual abuse (CSA) and other adverse childhood experiences (ACEs) on older adults' sexual and marital outcomes, (b) the mediating role of intimate partner violence (IPV) victimization in the association between childhood adversities and sexual and marital satisfaction, and (c) whether gender moderates the mediational association. RESEARCH DESIGN AND METHODS: We examined 5,391 adults in their early 70s who participated in the 2010-2011 Wisconsin Longitudinal Study. A series of structural equation models was performed to examine the direct and indirect effect of CSA and other ACEs on sexual and marital outcomes in later life. RESULTS: CSA was directly associated with lower levels of sexual and marital satisfaction in late adulthood. Other ACEs were associated with currently not being married and greater numbers of marriages. Furthermore, other ACEs were significantly associated with low levels of marital satisfaction through IPV victimization. The moderated mediational analysis showed that the negative indirect effect of other ACEs on marital satisfaction via IPV victimization was stronger for women than men. DISCUSSION AND IMPLICATIONS: Using a population-based sample, this is one of the first studies demonstrating that distal life events such as CSA and ACEs can undermine older adults' sexual and marital health, and revictimization in adulthood may serve as a mechanism for the association. Timely intervention is needed to prevent persistent negative effects of childhood violence.

Brief Report: Child Sexual Abuse and Somatic Symptoms in Older Adulthood for Men.

Somatic symptom disorders are often misdiagnosed or minimized among men, especially in middle and older adulthood. Previous research investigating links between somatic disorders and early trauma, such as childhood sexual abuse (CSA), have mostly been based on small, non-representative, female samples using cross-sectional designs. The current study used data from the Wisconsin Longitudinal Study to assess associations between CSA and somatic symptom severity among men in middle- and late-adulthood (mid-50s to early 70s) with histories of CSA (n = 129) and a matched, non-abused comparison group (n = 2,322). Childhood (e.g., co-occurring adversities and parental education) and demographic background variables (e.g., marital status, self-rated health, and income) were controlled. Growth curve modeling was used to explore trajectories of somatic symptoms over time. Results indicated that the CSA group had higher somatic symptom severity than the non-abused group (γ01 = .10, p < .05); symptoms decreased over time for both groups with no significant differences in the rate of change. Healthcare providers should include CSA in assessments for men. Because contemporary somatic symptoms may represent unresolved early life course trauma, mental health support services should be expanded for this population. Future research should explore gender-appropriate treatment modalities for older men with histories of CSA.

Exploring Factors Associated with Perceived Changes in Severity of Elder Abuse: A Population-Based Study of Older Adults in Korea.

Elder abuse is a pressing problem that demands social attention in South Korea. This study aims to examine the characteristics of older adults and their family perpetrators that may influence the perceived severity of abuse by older adults using a nationally representative sample among older Koreans. We analyzed 952 community-dwelling older Koreans from a population-based survey of the Survey of Elderly Care and Welfare Need. The analytic sample of this study consisted of older adults who self-reported having been emotionally, physically, and financially abused or neglected by their family members or other primary caregivers. We used multinomial logistic regression models to predict perceived change in severity of abuse. Results showed that the abuse type and duration of abuse were significantly associated with the perceived change in the severity of abuse. Older victims' age, being female, and being married were also associated with greater risk for increased severity of abuse relative to no change, while older adults' better health status was associated with lower risk for increased severity of abuse. The findings of this study can help social work professionals identify older adults with heightened risk of abuse and protect the human rights of the most vulnerable aging population.

Childhood abuse and adult relationships with perpetrating parents: impacts on depressive symptoms of caregivers of aging parents.

Objectives: Combining the stress process model of caregiving and life course perspective, this study examined the long-term associations among childhood abuse, relationships between perpetrating parents and adult children, and adult children's well-being in the context of caregiving for a perpetrating parent.Method: Using a sample of family caregivers from the Wisconsin Longitudinal Study, this study investigated (a) whether contact frequency and emotional closeness with an abusive parent mediated the longitudinal effects of parental childhood abuse on adult-child caregivers' depressive symptoms and (b) the moderating effects of self-acceptance and mastery on this mediational association.Results: Key findings indicated that in the caregivers of mothers, maternal childhood abuse was negatively associated with emotional closeness between an adult child caregiver and perpetrating mother care recipient. In turn, low emotional closeness was associated with higher depressive symptoms in the adult child caregiver. A lack of psychological resources such as self-acceptance and mastery strengthened the effect of maternal childhood abuse on depressive symptoms. In the caregivers of fathers, we did not find any significant indirect effect of parental childhood abuse on adult-child caregivers' depressive symptoms.Conclusion: Further research is needed to explore this phenomenon in light of the heterogeneity of contemporary families. Practitioners are encouraged to employ a trauma-informed approach when working with adults with a history of parental childhood abuse who are caregiving for their perpetrator to maximize the caregivers' health and well-being.

Adverse childhood experiences amplify the longitudinal associations of adult daily stress and health.

BACKGROUND AND OBJECTIVE: The long-term negative impact of Adverse Childhood Experiences (ACEs) is now well-recognized; however, little research has explored the link between ACEs and daily stress processes in adulthood. The current study aimed to examine the effect of ACEs in the association between daily stressor exposure and daily negative affect, and whether such associations would predict long-term health and well-being. METHODS: Using data from the National Study of Daily Experiences 2 (NSDE 2) and the Midlife in the United States (MIDUS) studies, multilevel moderated mediation analyses were conducted to account for daily measurements nested within individuals. We tested whether the indirect effect of daily stressor exposure on prospective chronic health conditions and prospective depressive symptoms through daily negative affect would differ by adults' levels of ACEs. RESULTS: We found significant positive associations between daily stressor exposure and daily negative affect at both the within- and between-person levels. Between-person daily negative affect was, in turn, associated with more chronic health conditions and higher depressive symptoms ten years later. This indirect effect was stronger for adults with high ACEs compared to those with low ACEs. CONCLUSIONS: The current study demonstrated that a history of ACEs may exacerbate the negative health effects of daily stress processes over time. Programs focusing on coping with daily stressors and resilience may benefit adults with ACEs and promote their health and well-being.

The moderating role of three-generation households in the intergenerational transmission of violence.

BACKGROUND & OBJECTIVE: Considering the increasing trends in multi-generational living arrangements, the current study aimed to test the intergenerational transmission of violence hypothesis in three-generational households. We also examined whether and how living in a three-generation household would moderate the negative effect of childhood maltreatment on adults' abusive and neglectful parenting behaviors. METHOD: We conducted secondary data analysis using data from the Wisconsin Families Study. The study sample included 727 low-income parents of young children, most of whom were African American women with, on average, a high school diploma. We estimated a series of ordinary least squares regression models. RESULTS: Our findings indicated that parents who reported a history of childhood abuse, neglect, and witnessing domestic violence showed more frequent use of psychological aggression, physical aggression, and neglectful behavior against their children. Living in a three-generation household played a protective role: The negative effects of a) a history of childhood abuse on the use of neglectful parenting and b) witnessing domestic violence on the use of psychological aggression were reduced for respondents living in a three-generation household (b = -0.11; b = -0.33, ps < 0.05, respectively). CONCLUSION: The risk of the intergenerational transmission of violence may decrease in three-generation households where parents of young children can meet their needs by sharing family resources or easing the burden of childcare. Further research is needed to identify and specify factors and contexts associated with the beneficial effects of multi-generational living arrangements.

Caregiving for Parents Who Harmed You: A Conceptual Review.

Objectives: This paper aims to provide a conceptual review of prior research on the effect of a history of parental childhood maltreatment on the experiences and outcomes of adult-child caregivers who provide care to their perpetrating parents.Methods: We performed a search using several databases including PsycINFO, ScienceDirect, and Academic Search Premier (EBSCO) for relevant papers and reviewed reference sections of selected papers.Results: Histories of childhood maltreatment are associated with adverse psychological health in adult-child caregivers and reduced frequencies of providing support to their parents. The potential factors affecting the experiences and outcomes of such caregivers include contemporaneous relationships with perpetrating parents; caregivers' sense of choice about providing care; opportunities for posttraumatic growth; and participating in care through the end of life.Conclusions: Caregiving for perpetrating parents can be particularly challenging due to complex, intersecting factors; thus, healthcare practitioners' increased awareness of and knowledge about such caregivers are crucial to provide effective support.Clinical Implications: We highlighted the importance of ensuring caregivers' sense of choice and assessing their posttraumatic growth. In caregiving at the end of life, we noted the importance of using a trauma-informed approach when interacting with caregivers and their family members during illness and bereavement.

Effects of Parental Childhood Abuse on Daily Stress Processes in Adulthood.

Extensive evidence suggests that exposure to childhood abuse can lead to harmful health effects across a lifetime. To contribute to the literature, the current study examined whether and how a history of parental childhood abuse affects exposure to and severity appraisal of daily stressors in adulthood, as well as emotional reactivity to these stressors. We analyzed 14,912 daily interviews of 2,022 respondents from the second wave of the National Study of Daily Experiences. Multilevel modeling was utilized to analyze nested data, in that each person provided repeated measures of daily experience for eight consecutive study days. Results showed that more frequent experience of maternal childhood abuse was associated with more severe appraisal of daily stressors. In addition, adults with more frequent maternal childhood abuse exhibited greater emotional reactivity to daily stressors. The current study provides evidence that a history of parental childhood abuse may serve as a vulnerability factor in the process of experiencing and responding to stressful events encountered in daily life. Future research should further explore the long-term health effects of daily stress and emotional experience among adults with a history of parental childhood abuse. Interventions for these adults should focus on promoting emotional resilience in the face of daily stress.

Childhood Adversities, Midlife Health, and Elder Abuse Victimization: A Longitudinal Analysis Based on Cumulative Disadvantage Theory.

OBJECTIVES: Elder abuse victimization is increasingly recognized as a pressing public health concern. However, few empirical studies have investigated whether early life course adversities and midlife sequelae heighten risks for abuse in late life. Guided by cumulative disadvantage theory, the current study examined whether compromised health in middle adulthood (physical, psychological, cognitive) mediates the association between child abuse and elder abuse. METHOD: This secondary analysis was based on data from the Wisconsin Longitudinal Study, a population-based, multi-wave dataset. We analyzed responses from 5,968 participants (mean age = 71 years; 54% female) on adapted versions of standardized measures: elder abuse victimization (outcome variable), childhood adversities (independent variable), and midlife health (physical health, depressive symptoms, cognitive functioning; mediator variables). Serial multiple mediation models were conducted, controlling for background characteristics. RESULTS: Rates for any elder abuse and child adversities were, respectively, 16.34% and 47.98%. Multivariate analyses supported the cumulative disadvantage hypothesis. Childhood adversities (0.11, p < .001) and midlife health (physical, -0.10, p < .05; depressive symptoms, 0.09, p < .001; cognitive functioning, 0.02, p < .05) had significant direct effects on elder abuse victimization. Childhood adversities also had an indirect effect on elder abuse through physical health (0.002, p < .05) and depressive symptoms (0.01, p < .001), both in serial. DISCUSSION: This innovative study advances our understanding mechanisms through which childhood trauma influences abuse in late life. Boosting health in middle adulthood could help prevent elder abuse. Other implications for clinical practice, treatment, and future research on elder abuse are discussed.

Longitudinal Health Consequences of Childhood Adversity: The Mediating Role of Purpose in Life.

Early life adversity has long-term detrimental effects on physical health. Although biological, behavioral, and social factors have been explored as intermediate mechanisms, little research has explored psychosocial factors as potential mediators. This study examined whether purpose in life longitudinally mediates the relationship between childhood adversity and two measures of adult health. Data were obtained from 3,871 participants in the Midlife in the United States (MIDUS) study. We tested a longitudinal mediation model from childhood adversity to adult health via purpose in life, controlling for baseline measures of health. Results indicated that childhood adversity is associated with poorer adult health through direct and mediated paths. Childhood adversity may restrict individuals' sense of purpose in life, and reduced purpose in life is subsequently associated with poorer subjective health and increased likelihood of functional limitations. The findings of this study can be used to inform the development of psychosocial and therapeutic intervention programs and services for adults with a history of childhood adversity.

Double disadvantage: Health impacts of parenting a child with a disability for parents with prior exposure to childhood maltreatment.

BACKGROUND: Parenting a child with a disability has been shown to take a toll on physical health in mid to late life. However, the additional impact of a history of childhood maltreatment has not been explored. OBJECTIVE: This study examined the moderating effect of exposure to childhood maltreatment on the longitudinal associations between parenting a child with a disability and physical health. We also examined whether this interaction was conditional on parent gender. METHODS: Data were obtained from 3178 participants in the Midlife in the United States (MIDUS) study. We used linear mixed modeling to estimate the independent and interactive effects of a history of childhood maltreatment, parenting a child with a disability, and parent gender on physical health over three waves of assessment spanning nearly two decades. We used three distinct measures of health including a composite based on two self-rated health items, chronic conditions, and functional limitations. RESULTS: Key results showed that a history of childhood maltreatment exacerbated the adverse health effect of parenting a child with a disability for mothers, but not fathers. CONCLUSIONS: Findings suggest that a history of early maltreatment may create a context that makes it more difficult to cope with the demands of caring for a child with a disability, and the accompanying stress has a detrimental effect on health.

Different Types of Childhood Experience with Mothers and Caregiving Outcomes in Adulthood.

OBJECTIVE AND BACKGROUND: The current study examines the types of childhood experiences with mothers (i.e., maternal abuse, affection, discipline) among caregivers of aging mothers, and investigates whether membership in specific latent classes, particularly maternal maltreatment, is associated with psychological functioning among caregivers. METHOD: Using data from the Midlife in the United States (MIDUS), we used the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA) to predict distal outcomes. RESULTS: We identified four latent classes (prevalence rate noted): "Affectionate and authoritative" (65%), "affectionate and permissive" (11%), "emotionally abusive and neglectful" (8%), and "emotionally/physically abusive and authoritative" (16%). Caregivers in the "emotionally/physically abusive and authoritative" class endorsed high probabilities of both maternal affection and abuse and were most negatively affected across the three psychological functioning outcomes (i.e., self-rated mental health, psychological distress, and psychological well-being). CONCLUSION AND IMPLICATIONS: In support of the life course perspective, our findings emphasized the importance of examining adult children caregivers' early life experiences with aging mothers and how those experiences can impact the psychological effects of caregiving. This study suggests specific practice implications; for example, assessment tools for evaluating caregiver burden should consider life course factors such as caregivers' childhood experiences with aging parents.

Parental childhood maltreatment and the later-life relationship with parents.

The aims of the current study were to examine the long-term effects of childhood maltreatment on current relationships with parents and whether the quality of current relationships with parents mediates the associations between childhood maltreatment and psychological health in late adulthood. Using 2 decades of longitudinal data from the Wisconsin Longitudinal Study, multilevel structural equation modeling was employed to examine the associations between reports of childhood maltreatment, aspects of current relationships with parents (i.e., perceived closeness, contact frequency, and exchange of social support), and psychological well-being/distress of adult children. Key results indicated that reports of maternal childhood abuse and neglect predicted lower levels of perceived closeness with aging mothers, which were subsequently associated with reduced psychological well-being of adult children. We did not find evidence of mediation between reports of paternal childhood abuse/neglect, current relationships with fathers, and psychological outcomes. Our findings suggest a significant linkage between childhood and later-life intergenerational relationships. Adults who were maltreated by their mother as children may continue to experience challenges in this relationship. Further research is needed to examine how these past and current relational dynamics affect caregiving experiences and outcomes. In addition, when intervening with adults with a history of childhood maltreatment, practitioners should evaluate contemporary relationship quality with the abusive mother and help address any unresolved emotional issues with the parent. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood Sexual Abuse and Depression among American Indians in Adulthood.

The present study investigated distal and proximal factors associated with depression among a sample of 479 American Indian (AI) adults in the Midwest. Distal factors included histories of childhood sexual abuse (CSA) and other childhood adversities. Proximal factors included levels of health self-efficacy and treatment for alcohol problems. The study also examined the moderating effect of treatment for alcohol problems on the relationship between CSA and depression. In model 1, results indicate that CSA was positively related to depression after controlling for demographic and background variables. In model 2, childhood adversities and treatment for alcohol problems were associated with increased depression in AI adults; CSA became nonsignificant. As a protective factor, level of health self-efficacy was negatively associated with depression. In model 3, treatment for alcohol problems magnified the effect of CSA on depression. These findings suggest that early traumatic experiences may have persistent, harmful effects on depression among AIs; one mechanism exacerbating the impact of CSA on depression is treatment for alcohol problems. Targeted interventions are needed to mitigate the long-term negative health effects of childhood trauma in this population and to strengthen proximal protective factors, such as health self-efficacy.

Child Sexual Abuse and Depression in Late Life for Men: A Population-Based, Longitudinal Analysis.

OBJECTIVE: Research investigating long-term effects of childhood sexual abuse (CSA) on mental health for men is vastly underdeveloped. This study strengthened the knowledge base by examining: (a) long-term trajectories of depressive symptoms for men with and without a history of CSA, and (b) moderating effects of social support over time. METHOD: We analyzed multiple waves of data from the Wisconsin Longitudinal Study. The sample (N = 2,451) consisted of men with histories of CSA and a stratified, randomly sampled comparison group. Growth curve modeling was employed for analyses. RESULTS: After controlling for demographic, parental, and health factors, men with CSA histories had greater depressive symptoms than those with no history of CSA. For both groups, depressive symptoms decreased over time; slope patterns did not differ. We found a significant moderating effect of social support on the relationship between CSA and depressive symptoms. DISCUSSION: This innovative, population-based, longitudinal study demonstrated that CSA can undermine mental health for men across the life span and into old age. Social support appears to mitigate these deleterious effects. In early, middle, and late adulthood, practitioners should assess for CSA and strengthen support resources for male survivors.

Re-experiencing Violence Across the Life Course: Histories of Childhood Maltreatment and Elder Abuse Victimization.

OBJECTIVES: This study primarily examines the associations between histories of childhood maltreatment (i.e., neglect, emotional, physical, and sexual abuse) and elder abuse victimization and explores whether gender moderates the associations. METHODS: We conducted a secondary data analysis of 5,968 older adults (mean age = 71 years) based on data from the Wisconsin Longitudinal Study (2010-2011). Using retrospective self-reports of childhood and current (past 12 months) victimization experiences, logistic regression analyses were conducted to estimate the effects of early-life adversities on the likelihood of elder abuse victimization. RESULTS: Results indicate that childhood emotional abuse and childhood sexual abuse (CSA) were associated with greater risk of being abused as older adults, after controlling for childhood and adult background factors. We also found that the effect of CSA on elder abuse victimization was weaker for women than men. DISCUSSION: Findings suggest that the phenomenon of revictimization may occur not only in early and middle adulthood, but also in late life. To advance our understanding of victimization across the life course, future research on root causes of elder abuse should include histories of child abuse.

The Role of Current Family Relationships in Associations Between Childhood Abuse and Adult Psychological Functioning.

OBJECTIVES: Childhood abuse has long-term negative effects on adult psychological well-being. This study examined whether and how adults with a history of childhood abuse may experience poor psychological functioning partly due to aspects of current family relationships. METHOD: We estimated multilevel mediation models using 3 waves of longitudinal data from 3,487 participants in the study of Midlife Development in the United States. Outcomes measured included negative affect, life satisfaction, and psychological well-being. We included aspects of family relationships as mediators: perceived support, perceived strain, frequency of contact, and hours of providing instrumental and emotional support. RESULTS: Multilevel mediation models showed that childhood verbal and physical abuse negatively affected diverse aspects of family relationships in later adulthood (i.e., less perceived support, more perceived strain, less frequent contact, and fewer hours of providing instrumental support). We also found that less perceived support and more family strain significantly mediated the associations between childhood abuse and all 3 psychological functioning outcomes. DISCUSSION: Childhood abuse appears to hinder perceived availability of family support in adulthood, which may undermine the psychological functioning of adults with a history of childhood abuse. To improve their psychological health, interventions should focus on facilitating supportive and functional family relationships.