Females have more complex patterns of childhood adversity: implications for mental, social, and emotional outcomes in adulthood

Eur J Psychotraumatol. 2020 Jan 10;11(1):1708618. doi: 10.1080/20008198.2019.1708618. eCollection 2020.

Abstract
in English, Spanish, Chinese

Background: Adverse childhood experiences (ACEs) have been identified as an important public health problem with serious implications. Less well understood is how distinct configurations of childhood adversities carry differential risks for mental health, emotional, and social outcomes later in life. Objective: To determine if distinct profiles of childhood adversities exist for males and females and to examine if unique associations exist between the resultant latent profiles of childhood adversities and multiple indicators of mental health and social and emotional wellbeing in adulthood. Method: Participants (N = 1,839) were a nationally representative household sample of adults currently residing in the USA and the data were collected via online self-report questionnaires. Latent class analysis was used to identify the optimal number of classes to explain ACE co-occurrence among males and females, separately. ANOVAs, chi-square tests, and t-tests were used to compare male and female classes across multiple mental health, emotional, and social wellbeing variables in adulthood. Results: Females were significantly more likely than males to report a range of ACEs and mental health, social, and emotional difficulties in adulthood. Two- and four-class models were identified as the best fit for males and females, respectively, indicating more complexity and variation in ACE exposures among females. For males and female, ACEs were strongly associated with poorer mental health, emotional, and social outcomes in adulthood. Among females, growing up in a dysfunctional home environment was a significant risk factor for adverse social outcomes in adulthood. Conclusions: Males and females have distinct patterns of childhood adversities, with females experiencing more complex and varied patterns of childhood adversity. These patterns of ACEs were associated with numerous negative mental, emotional, and social outcomes among both sexes.

Antecedentes: Las experiencias adversas infantiles (ACEs en su sigla en inglés) se han identificado como un problema de salud pública importante, con serias implicaciones. Menos comprendido es el cómo distintas configuraciones de adversidades infantiles acarrean riesgos diferenciales para los resultados de salud mental, emocional y social.Objetivo: Determinar si existen distintos perfiles de adversidades infantiles para hombres y para mujeres y examinar si existen asociaciones únicas entre los perfiles latentes resultantes de adversidad infantil y múltiples indicadores de salud mental y bienestar social y emocional en la adultez.Método: Los participantes (N = 1,839) fueron una muestra representativa de hogares de adultos actualmente residiendo en los Estados Unidos y los datos se recolectaron en cuestionarios de auto-reporte vía online. El análisis de clases latentes se utilizó para identificar el número óptimo de clases que explican la co-ocurrencia de ACEs entre hombres y mujeres, separadamente. Se empleó pruebas de ANOVA, chi-cuadrado y t para comparar clases de hombres y mujeres a través de múltiples variables de salud mental y bienestar social y emocional en la adultez.Resultados: Las mujeres fueron significativamente más propensas que los hombres a reportar un rango de ACEs y dificultades de salud mental y dificultades sociales y emocionales en la adultez. Modelos de dos y cuatro clases se identificaron como los de mejor ajuste para hombres y mujeres, respectivamente, indicando mayor complejidad y variación de exposición a ACEs en las mujeres. Para hombres y mujeres, las ACEs se asociaron fuertemente a resultados más pobres en salud mental, emocionales y sociales en la adultez. En las mujeres, crecer en un ambiente de hogar disfuncional fue un factor de riesgo significativo para resultados sociales adversos en la adultez.Conclusiones: Los hombres y mujeres tienen distintos patrones de adversidad infantil, en tanto las mujeres experimentan más complejos y variados patrones de adversidad infantil. Estos patrones de ACEs se asociaron con numerosos resultados negativos mentales, emocionales y sociales entre ambos sexos.

背景:童年期逆境经历 (ACEs) 已被确定为一个重要, 有严重影响的公共卫生问题。人们对童年期逆境的独特结构如何对以后生活中心理健康, 情绪和社会结果带来不同风险的了解还很少。目标:确定男性和女性是否存在不同的童年期逆境剖面, 并考查由此产生的童年期逆境潜在剖面与成年后心理健康及社会和情绪健康的多个指标是否存在独特关联。方法:1839名参与者是目前居住在美国的全国性家庭成人代表样本, 数据通过线上自评量表收集。潜在类别分析用于确定男性和女性各自最佳类别数目, 以解释其ACE并发。方差分析, 卡方检验和t检验用于比较男性和女性各类别中在多种成年后心理健康, 情绪和社会健康变量间的差异。结果:女性比男性更有可能报告一系列ACEs, 以及成年后的心理健康, 社会和情绪障碍。男性和女性的最佳模型分别为两类和四类, 这表明女性中ACE暴露的复杂性和差异性更大。对于男性和女性, ACEs与成年期更差的心理健康, 情绪和社会结果密切相关。在女性中, 在功能失调的家庭环境中成长是成年后不良社会结果的重要风险因素。结论:男性和女性的童年期逆境模式截然不同, 女性的童年期逆境模式更为复杂和多样。 ACEs的这些模式与男女之间许多负面的心理, 情绪和社会结果均有相关.

Keywords: ACE; Childhood trauma; PTSD; childhood adversity; latent class analysis; mental health; • 21% of males and 39% of females in the US population have been exposed to multiple ACEs in their first 18 years of life.• Females reported a more complex history of childhood adversities than males.• Exposure to ACEs is strongly associated with poorer mental health, social, and emotional outcomes in adulthood.• Exposure to particular ACEs such as growing up in a dysfunctional home was a significant risk factor for negative social outcomes among adult females..

Grant support

This work was supported by the COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT) programme from the European Union's Horizon 2020, under the Marie Sklodowska-Curie [722523]; the National Institutes of Mental Health [R01 MH08661]; the Irish Research Council [GOIPG/2018/319].