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. 2023 May 23;57(6):489-498.
doi: 10.1093/abm/kaac057.

Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife

Sara R Jaffee  1 , Cathy Spatz Widom  2
Affiliations

Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife

Sara R Jaffee et al. Ann Behav Med. .

Abstract

Background: Although childhood maltreatment is associated with a host of poor health and social outcomes in adulthood, many individuals manifest resilience.

Purpose: We tested competing predictions about whether achieving positive psychosocial outcomes in young adulthood would be differentially predictive of allostatic load at midlife for those with and without a childhood history of maltreatment.

Methods: The sample included 808 individuals, 57% of whom had court-documented records of childhood abuse or neglect between 1967 and 1971, and demographically matched controls without those histories. Participants provided information on socioeconomic, mental health, and behavioral outcomes in interviews conducted between 1989 and 1995 (mean age = 29.2 years). Indicators of allostatic load were measured between 2003 and 2005 (mean age = 41.2 years).

Results: The relationship between positive life outcomes in young adulthood and allostatic load in middle adulthood varied depending on childhood maltreatment status (b = .16, 95% CI: .03; .28); for adults who did not experience childhood maltreatment, more positive life outcomes predicted lower allostatic load (b = -.12, 95% CI: -.23; -.01), whereas the relationship was not significant for adults with a childhood history of maltreatment (b = .04, 95% CI: -.06; .13). There were no differences in the results predicting allostatic load for African-American and White respondents.

Conclusions: Childhood maltreatment may have enduring effects on physiological functioning that are manifest in elevated allostatic load scores in middle age. Alternatively, resilience to maltreatment-as manifest in positive functioning in socioeconomic and behavioral domains-may not be sufficiently stable over adulthood to buffer individuals from the physiological consequences of stressful environments.

Keywords: Allostasis; Allostatic load; Child abuse; Maltreatment; Middle-aged; Resilience.

Plain language summary

We tested whether young adults who were succeeding in life according to conventional standards would have lower allostatic load at midlife, which reflects wear and tear on organs and tissues, resulting from chronic stress. We also tested whether any association between positive outcomes in young adulthood and allostatic load at midlife would differ depending on whether someone had a childhood history of maltreatment. That is, does being resilient to maltreatment in young adulthood predict good health in middle age? In a sample of 808 individuals, 57% of whom had court-documented records of childhood maltreatment, we found that success in young adulthood was associated with lower allostatic load at mid-life only for those without a history of maltreatment. Individuals with a childhood history of maltreatment had elevated allostatic load at midlife regardless of their success in young adulthood. Thus, although some individuals were resilient to maltreatment in young adulthood, this did not predict low allostatic load, at mid-life. The findings suggest that (1) childhood maltreatment may have enduring physiological effects or (2) individuals with childhood histories of maltreatment may have difficulty maintaining or building on the successes they establish early in life, such that their buffering effects on health are limited.

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Figures

Fig. 1.
Fig. 1.
The association between allostatic load and positive outcomes in economic, educational, social, and behavioral domains differs as a function of maltreatment status. Attaining more positive outcomes in economic, educational, social, and behavioral domains in young adulthood predicts lower allostatic load scores at mid-life for the control group (b = ‐.12, 95% CI: ‐.23; ‐.01), but not for the abuse/neglect group (b = .04, 95% CI: ‐.06; .13).
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