Mediating role of personality traits in the association between multi-dimensional adverse childhood experiences and depressive symptoms among older adults: A 9-year prospective cohort study

Associations between childhood maltreatment and personality traits in individuals with and without depression: a CTQ-based assessment

BACKGROUND

Prior research has established a correlation between childhood maltreatment (CM) and personality traits. The current understanding regarding the potential variability in the relationship between CM and its impact on personality dimensions among those with major depressive disorder (MDD) and healthy controls (HCs) remains elusive.

AIMS

This study analyzes the association between CM and personality traits in the MDD and HC groups.

METHODS

The study recruited 188 individuals with MDD and 132 HC. The Childhood Trauma Questionnaire (CTQ) was used to assess CM, and the Sixteen Personality Factor Questionnaire (16PF) was used to assess personality traits. We used a 2*2 analysis of covariance (ANCOVA) of the diagnosis and CM on 16PF, and hierarchical regression explored the association between specific types of CM and 16PF in both groups.

RESULTS

The 2*2 ANCOVA results indicated significant interaction effects between CM and diagnosis on personality traits, with CM's impact notably different between groups. In the MDD group, sexual abuse (SA) independently predicted the subscale Q1 (Openness to Change), related to the Big Five's openness. In the HC group, emotional abuse (EA) predicted the subscales C (emotional stability), O (apprehension), and Q4(tension), linked to Big Five's neuroticism.

CONCLUSION

The findings highlight the impact of early adversity on personality development, informing psychology and guiding tailored therapy development.

Associations of childhood trauma with remission and treatment response after 12 weeks of selective serotonin reuptake inhibitor treatment in patients with major depressive disorder

OBJECTIVE

To explore the associations of childhood trauma and its subtypes with remission and treatment response after 12 weeks of selective serotonin reuptake inhibitor (SSRI) treatment among patients with major depressive disorder (MDD).

METHODS

Data were from patients with MDD in the Depression Cohort in China. At baseline, the Childhood Trauma Questionnaire-Short Form was used to assess childhood trauma, including physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. After 12 weeks of SSRI treatment, depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). Remission was defined as a PHQ-9 score < 5, and response was defined as a ≥ 50 % decline in the PHQ-9 score from baseline.

RESULTS

The sample included 572 patients with MDD (mean [SD] age, 27.4 [7.2] years; 30.6 % male). After receiving 12 weeks of SSRI treatment, 32.2 % of patients achieved remission and 49.1 % of patients responded to treatment. After fully adjusting for confounders, patients with childhood trauma (OR, 0.55; 95 % CI, 0.36 to 0.84), physical abuse (OR, 0.43; 95 % CI, 0.23 to 0.79), emotional abuse (OR, 0.40; 95 % CI, 0.24 to 0.67), or sexual abuse (OR, 0.49; 95 % CI, 0.24 to 0.99) had a lower likelihood of remission, but those with physical neglect or emotional neglect did not. The response showed similar results.

CONCLUSIONS

Among patients with MDD, childhood abuse (i.e., physical abuse, emotional abuse, and sexual abuse), but not childhood neglect (i.e., physical neglect and emotional neglect), was associated with a lower likelihood of remission and response after 12 weeks of SSRI treatment.

The impact of adverse childhood experiences on cognitive function among middle-aged and older Chinese adults: Multiple mediators of cognitive reserve and depressive symptoms

BACKGROUND

Adverse childhood experiences (ACEs) are associated with later cognitive decline. However, the mechanisms underlying the effects of different types of ACEs are unclear. This study examined how ACEs impact cognitive function, specifically deprivation-related ACEs (DrACEs) and threat-related ACEs (TrACEs). Additionally, we explored the potential role of cognitive reserve (CR) and depression in these relationships.

METHODS

Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2020. CR, depressive symptoms and cognitive function measures were collected from 2020. ACEs were assessed at the 2014 Life Course Survey. The main analyses included 7113 participants aged 45 years or older. To explore potential associations, linear regression and SPSS Macro PROCESS were employed.

RESULTS

Among middle-aged and older adults, only exposure to DrACEs was associated with cognitive function ((β = -0.101 [95%CI: -0.150, -0.052]) for DrACEs = 1; (β = -0.250 [95%CI: -0.333, -0.167]) for DrACEs ≥ 2). The indirect effects mediated by CR and depressive symptoms were statistically significant.

LIMITATIONS

The use of retrospective self-reported data for ACEs may introduce recall bias.

CONCLUSIONS

Chinese middle-aged and older adults who have experienced DrACEs exhibit poorer cognitive function, while the association between TrACEs and cognitive function was not significant. And the impact of DrACEs on cognitive function was mediated by CR and depressive symptoms. Further research is necessary to validate our findings, establish causal links, and uncover the underlying mechanisms involved.

Deprivation-related adverse childhood experiences and cognitive function among older adults: Mediating role of depression symptoms

BACKGROUND

Cognitive dysfunction imposes a heavy economic burden on families and society. Depression and deprivation-related adverse childhood experiences (ACEs) are important factors that contribute to cognitive dysfunction. However, few studies have explored these complex interactions.

OBJECTIVE

This study aimed to elucidate the mediating effect of depression on the relationship between deprivation-related ACEs and cognitive function in older adults.

METHODS

This national, cross-sectional study used data from the 2020 Chinese Longitudinal Aging Social Survey. Information regarding depression, ACEs, and cognitive function was collected from individuals aged 60 years and older. A structural equation model was used to examine the mediating effect of depression on the relationship between deprivation-related ACEs and cognitive function.

RESULTS

A total of 9828 participants were included in this study. Their mean total cognitive function score was 13.488 ± 3.006. The results showed that sex, age, educational level, marital status, body mass index, registered residence, chronic disease situation, health, smoking, living alone, life satisfaction, social security, and internet use were all related to cognitive function (P < 0.05). Deprivation-related ACEs were negatively correlated with cognitive function (r = -0.132, P < 0.01). And depression symptoms were negatively correlated with cognitive function (r = -0.158, P < 0.01). The mediating effect analysis indicated that depression symptoms had a significant mediating effect between the 3 dimensions of deprivation-related ACEs and cognitive function.

CONCLUSIONS

This study highlighted that improvement of deprivation-related ACEs was indirectly related to a reduced likelihood of cognitive dysfunction through depression in older adults. With the limitations of cross-sectional studies, validation through longitudinal design studies is deemed necessary. Future interventions should focus on alleviating depression symptoms to prevent cognitive decline and impairment in this population.

Early Childhood Adversity Predicts Risk of Family Caregiver Suicidal Ideation:Roles of Neuroticism and Self-Compassion

Background

Despite high rates of family caregiver suicidal ideation (SI), little is known about its relationship with childhood adversity. Those with a history of adverse childhood experiences (ACEs) have been shown to have higher neuroticism, lower self-compassion, and higher rates of late life mental health disorders. Caregiving for a family member with dementia may pose a particular challenge for those with ACEs.

Methods

In a secondary analysis of 81 family caregivers of people living with dementia enrolled in clinical trials, we undertook a cross-sectional baseline analysis of the association between childhood adversity, measured with the ACE questionnaire, and self-reported suicidal ideation (SI). We further assessed whether the relationship between ACE and SI was mediated by neuroticism and self-compassion.

Results

18 caregivers self-reported SI (22%). 89% of caregivers with SI reported childhood adversity (ACE > 0), versus 63% of those without SI (p=.04). The relative risk of SI was 3.6x higher in those with childhood adversity than in those without (p=.04), and for those with a specific history childhood abuse, the relative risk of SI was 3.4x higher (p=.005). Neuroticism and self-compassion mediated the relationship between ACE and SI (p<.05), with neuroticism strengthening the association and self-compassion weakening it.

Conclusions

The association of SI with history of childhood adversity is high in family caregivers. Whereas elevated neuroticism might be one mechanism linking ACEs and SI, training self-compassion is a promising target for reducing SI. The phenotypic relationship between childhood adversity and SI in family caregivers should be further explored in larger samples, and could represent a new treatment target to improve the efficacy of therapies on caregiver emotional symptoms.

The Grip Strength Loss Rate and the Subsequent Cognitive Decline Rate in Older Adults: The Moderating Role of Social Isolation

Background and Objectives

Accumulating evidence suggests that low grip strength (GS) is associated with a faster cognitive decline, but most previous studies have measured GS at a single time point, ignoring changes in GS. We aimed to explore the association of the GS loss rate with the sequent cognitive decline, as well as the moderating role of social isolation in older adults.

Research Design and Methods

Data were from the English Longitudinal Study of Ageing. Absolute and relative GS loss rates were calculated as the annual losses from Wave 2 (2004-05) to Wave 4 (2008-09). Participants were divided into 3 groups according to the tertiles of GS loss rates. Linear mixed models were used to assess the association of the GS loss rate during Waves 2-4 with the cognitive decline rate during Waves 4-9 (Wave 9, 2018-19).

Results

Of the 4 356 participants included in analyses, 1 938 (44.5%) were men, with a mean age of 68.4 (SD: 8.4) years. Compared with Tertile 1 of the absolute GS loss rate, Tertile 2 (β = -0.009 [95% CI: -0.018 to -0.001] SD/year) and Tertile 3 (β = -0.018 [95% CI: -0.027 to -0.010] SD/year) were associated with a faster cognitive decline rate. The results of relative GS were similar to those of absolute GS. Social isolation was a significant modifier in the associations of the absolute GS loss rate with decline rates in global cognition and episodic memory, but not in temporal orientation. We did not observe that social isolation moderated the association of the relative GS loss rate with the cognitive decline rate.

Discussion and Implications

Both absolute and relative GS loss rates were positively associated with the cognitive decline rate in older adults. Low social isolation scores attenuated the association of the absolute GS loss rate with the cognitive decline rate.

Adverse childhood experiences, sarcopenia, and social participation in older adults: a cohort study

OBJECTIVES

To examine the relationships between adverse childhood experiences (ACEs) and developing sarcopenia in older adults and the modifying effects of active social participation.

METHODS

This prospective cohort study used survey data from the China Health and Retirement Longitudinal Study, including baseline surveys from 2011, follow-up data from 2013, follow-up data from 2015, and information on ACEs from the 2014 Life History Survey. Information concerning 10 ACEs, including five threat-related ACEs and five deprivation-related ACEs before 17 years of age was obtained by questionnaires through face-to-face interviews. Sarcopenia status was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm, consisted of low muscle mass, and low muscle strength, or poor physical performance. The relationship between ACEs, social participation, and sarcopenia was evaluated using Cox proportional hazard regression models.

RESULTS

The study population comprised 6859 older adults in main analyses. Having experienced ≥ 3 ACEs led to an increased 31% risk of developing sarcopenia (hazard ratio [HR]:1.31, 95% confidence interval [CI]:1.10-1.56). Participants having experienced ≥ 2 threat-related ACEs (HR:1.22, 95%CI:1.04-1.43) or deprivation-related ACEs (HR:1.22, 95%CI:1.02-1.46) had a 22% higher risk of developing sarcopenia. Active social participation significantly modified the association between ACEs (p < 0.05), especially threat-related ACEs (p < 0.05), and sarcopenia.

CONCLUSIONS

ACEs were associated with the development of sarcopenia; however, social participation had a modifying effect. These findings provide insights for early identification of vulnerable groups, advance intervention timing, and highlight the benefits of promoting active social participation among individuals with sarcopenia who have experienced ACEs.

Mediating pathways that link adverse childhood experiences with cardiovascular disease

OBJECTIVES

There is uncertainty about which factors mediate the association between adverse childhood experiences (ACEs) and cardiovascular disease (CVD). This could inform secondary prevention targets.

STUDY DESIGN

Mediation analysis of a prospective cohort study.

METHODS

English Longitudinal Study of Ageing (ELSA) wave 3 data (2006/7) were used to measure retrospective exposure to 12 individual ACEs and waves 2 to 4 (2004/5 to 2008/9) data to measure current exposure to potential mediators [smoking, physical activity, alcohol consumption, body mass index, depression, and C-reactive protein (CRP)]. Waves 4 to 9 ELSA data (2008/9 to 2018/19) were used to measure incident CVD. Cumulative ACE exposure was categorised into experiencing 0, 1 to 3, or ≥4 individual ACEs. Associations were tested between ACE categories, potential mediators, and incident CVD, to inform which variables were analysed in causal mediation models.

RESULTS

The analytical cohort consisted of 4547 participants (56% women), with a mean age of 64 years (standard deviation = 9 years). At least one ACE had been experienced by 45% of the cohort, and 24% developed incident CVD over a median follow-up period of 9.7 years (interquartile range: 5.3-11.4 years). After adjusting for potential confounders, experiencing ≥4 ACEs compared with none was associated with incident CVD [odds ratio (OR): 1.55; 95% confidence interval (CI): 1.10, 2.17], and the association of one to three ACEs compared with none was non-significant (OR: 1.08; 95% CI: 0.93, 1.24). There were two statistically significant mediators of the association between ≥4 ACEs and incident CVD: CRP and depression, which accounted for 10.7% and 10.8% of the association, respectively.

CONCLUSIONS

Inflammation and depression partially mediated the association between ACEs and CVD. Targeting these factors may reduce the future incidence of CVD.