Associations of adversity in childhood and risk factors for cardiovascular disease in mid-adulthood

Abstract

Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N=3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51cm greater waist circumference (95% confidence interval [CI]: 0.02cm, 1.00cm, p=0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women.

Keywords: Adversity; Cardiovascular disease; Childhood; Psychosocial.

Fig. 1

Participant flow through the study.

Fig. 2

Structural equation model. X_1-n represent observed binary indicators that load onto each single latent psychosocial adversity construct (i.e. the first order factors). A complete list of the binary indicators for each latent construct is provided in Supplemental Table S1, along with their factor loadings and model fit statistics. Cumulative psychosocial adversity is a second order factor that captures each of the single latent psychosocial adversity constructs. Supplemental Table S1 provides factor loadings for each of the first order factors onto the second order factor. Childhood social class has been shown as a covariate for illustrative purposes; in our confounder adjusted model, ethnicity and age at outcome assessment were additionally adjusted for. CVD risk factors are multivariate outcomes with residual covariances.