Childhood Maltreatment and Dementia Risk Factors in Midlife: A Prospective Investigation.

BACKGROUND: Previous studies have linked childhood adversities to dementia risk, yet most studies are cross-sectional in design and utilize retrospective self-reports to assess childhood experiences. These design characteristics make it difficult to establish temporal order and draw firm conclusions. OBJECTIVES: Using a longitudinal design, we sought to determine whether childhood maltreatment predicts dementia risk factors in middle adulthood. METHODS: Data have been obtained from a prospective cohort design study of children with documented cases of childhood maltreatment (ages 0-11 years at case identification) and demographically matched controls who were followed up and interviewed in middle adulthood. Outcomes were assessed through a medical examination and interview, and 807 of the cases that included blood collection at mean age 41. Dementia risk were investigated using 11 potentially modifiable risk factors. RESULTS: Compared to controls, individuals with histories of childhood maltreatment had a higher risk of low educational attainment, low social contact, smoking, and clinical depression, and a higher total number of dementia risk factors. In general, childhood maltreatment predicted a higher risk of dementia for females, males, and Black and White participants. Black maltreated participants had a greater risk for traumatic brain injury compared to Black controls. Physical abuse, sexual abuse, and neglect, each predicted a higher number of dementia risk factors in mid-life. CONCLUSION: These findings provide evidence that childhood maltreatment increases the risk for dementia in mid-life and has a demonstrable impact lasting over 30 years. Reducing the prevalence of mid-life dementia risk factors could reduce the risk of later-life dementia.

Breaking the Cycle of Intergenerational Childhood Maltreatment: Effects on Offspring Mental Health.

This study evaluated how continuities and discontinuities in the intergenerational transmission of maltreatment affect offspring psychopathology. Data from a multigenerational prospective, longitudinal study were used to compare the severity of offspring psychopathology in families with no history of maltreatment (controls) and those in which parents, offspring, or both experienced childhood maltreatment (cycle breakers, initiators, and maintainers, respectively). Participants included 454 parents (Mage = 47.1, SDage = 3.4) and their 697 offspring (Mage = 22.3, SDage = 6.3). Offspring of cycle breakers reported less psychopathology than offspring of cycle maintainers and did not report more psychopathology than offspring of controls. Offspring of cycle initiators and maintainers reported comparable levels of psychopathology. Results suggest that breaking the cycle of maltreatment buffers offspring from risk for psychopathology associated with parental maltreatment, with no enduring or additive effects of maltreatment across generations. Our findings highlight the need for maltreatment prevention programs and further research to identify conditions and characteristics that reduce the probability of intergenerational transmission.

Commentary: A challenge for a higher bar in research on childhood trauma - reflections on Danese (2020).

While there have been major advances in documenting the consequences of childhood adversities for psychopathology, Professor Danese's excellent paper challenges existing theory and research methods, urging the field to move ahead with future research that overcomes existing limitations. Importantly, he reminds us of the methodological caveats necessary to consider when assessing the body of evidence for causal effects of childhood trauma and urges caution in interpreting the ACEs literature. This editorial calls attention to and elaborates on a number of issues, including (a) why prospective and retrospective data cannot be used interchangeably; (b) the need for researchers to distinguish among childhood adversities, childhood traumas, and childhood maltreatment; (c) the sparse attention at present to the role of pre-existing vulnerabilities in influencing assessments of the risk of psychopathology; and (d) the critical importance of contextual factors (e.g., age, sex, race, ethnicity, and social class) that are likely to influence the risk of psychopathology. Professor Danese argues for the use of new analytic strategies to advance the field. This editorial elaborates on this recommendation and calls attention to the use of machine learning techniques that may be particularly worthwhile for the child maltreatment field, where there is little psychometric research on measures.

From Childhood Maltreatment to Allostatic Load in Adulthood: The Role of Social Support.

Although previous research has documented that social support acts as a protective factor for individuals exposed to trauma, most research relies on assessments of social support at one point in time. The present study used data from a prospective cohort design study to examine the stability of social support from childhood through middle adulthood in individuals with documented histories of childhood abuse and neglect and matched controls (aged 0-11) and assessed the impact of social support on allostatic load, a composite measure of physiological stress response assessed through blood tests and physical measurements, in middle adulthood. Maltreated children are more likely to have unstable social support across the life span, compared to matched controls. Social support across the life span partially mediated the relationship between child maltreatment and allostatic load in adulthood, although there were differences by race and sex. These findings have implications for interventions to prevent the negative consequences of child maltreatment.

A 30-year follow-up of the effects of child abuse and neglect on obesity in adulthood.

Childhood maltreatment has been implicated as a risk factor for adult obesity. We describe the first prospective assessment of adult obesity in individuals with documented histories of childhood physical and sexual abuse and neglect and a matched comparison group in a 30-year follow-up. Using a prospective cohort design, children with court substantiated cases of physical and sexual abuse and neglect (ages 0-11 years) from a Midwest county during 1967-1971 (n=410) were matched with children without histories of abuse or neglect on age, sex, race/ethnicity and approximate family social class (n=303) and followed up and assessed at mean age 41. Outcome measures include BMI and obesity assessed in 2003-2004 as part of a medical status examination and interview. Childhood physical abuse predicted significantly higher BMI scores in adulthood (beta=0.14, P<0.05), even controlling for demographic characteristics, cigarette smoking, and alcohol consumption (beta=0.16, P<0.01). Childhood sexual abuse (beta=0.07, not significant) and neglect (beta=0.02, not significant) were not significant predictors of adult BMI scores. These results demonstrate the long-term impact of childhood physical abuse on weight into adulthood and suggest that physically abused children may be at risk for other adverse health outcomes associated with increased weight. Health professionals need to understand this risk for physically abused children and researchers should identify and evaluate strategies for effective interventions.

Sexually transmitted diseases among adults who had been abused and neglected as children: a 30-year prospective study.

OBJECTIVES: We examined associations between childhood abuse and neglect and the risk in adulthood for sexually transmitted diseases. METHODS: In a prospective cohort design, we matched children aged 0 to 11 years with documented cases of abuse or neglect during 1967 to 1971 with a control group of children who had not been maltreated (754 participants in all) and followed them into adulthood. Information about lifetime history of sexually transmitted diseases was collected as part of a medical status examination when participants were approximately 41 years old. RESULTS: Childhood sexual abuse increased risk for any sexually transmitted disease (odds ratio [OR] = 1.94; 95% confidence interval [CI] = 1.00, 3.77; P = .05) and more than 1 type of sexually transmitted disease (OR = 3.33; 95% CI = 1.33, 8.22; P = .01). Physical abuse increased risk for more than 1 type of sexually transmitted disease (OR = 3.61; 95% CI = 1.39, 9.38; P = .009). CONCLUSIONS: Our results provided the first prospective evidence that child physical and sexual abuse increases risk for sexually transmitted diseases. Early screening and interventions are needed to identify and prevent sexually transmitted diseases among child abuse victims.