Associations between childhood maltreatment and physiological dysregulation in adulthood: Methodological decisions and implications

Abstract

Background: Childhood maltreatment is linked with health problems in adulthood. Theoretical models suggest that maltreatment leads to dysregulation in several bodily systems, and this has been corroborated using measures of physiological function (i.e., biomarkers). Methodological decisions involving the measurement of maltreatment and dimension reduction with respect to biomarkers (i.e., combining information across multiple measures) may influence research findings.

Objective: The present study compares associations between childhood maltreatment and adult physiological dysregulation using multiple dimension reduction approaches and measures of maltreatment.

Participants and setting: Participants were recruited, as children, to a prospective study of the correlates and consequences of childhood maltreatment. 253 participants were retained and provided biomarker data at midlife. Physiological dysregulation was operationalized with a conventional allostatic load approach and a novel statistical distance approach.

Methods: Regression models were employed with allostatic load or statistical distance as the outcome and prospectively or retrospectively measured child maltreatment as the primary predictor.

Results: When using allostatic load as the outcome, prospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.70, SE = 0.31, p = 0.02). When using statistical distance as the outcome, retrospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.69, SE = 0.19 p < 0.001).

Conclusions: We report a positive association between childhood maltreatment and physiological dysregulation at midlife. However, the significance and magnitude of effects varied with different maltreatment and physiological dysregulation measures. Further review of the methods used to study adult health conditions and their relation to childhood maltreatment is needed.

Keywords: Adult health; Allostatic load; Childhood maltreatment; Mahalanobis distance.

Fig. 1.

Flow chart showing the sample size of the initial Lehigh Longitudinal Study cohort, the number of respondents retained in the midlife wave, and the number of those respondents for whom we have complete and biologically plausible biomarker measurements to be used in our analysis broken down by prospective exposure status, retrospective exposure status, and those who were exposed to childhood maltreatment according to both measures.

Fig. 2.. Distributions of allostatic load and Mahalanobis distance measures of physiological dysfunction by exposure to childhood maltreatment as defined by recruitment from the child welfare system or retrospective self-report.

Note: Observations to the right of each vertical line are high scores, i.e., above 6 for the allostatic load scores or above the 99.9th percentile of the chi-squared distribution.

Fig. 3.. Distribution of z-scores for the 11 biomarker measures by measure of maltreatment.

Note: The non-grey observations represent individuals whose allostatic load (blue) measure or Mahalanobis distance measure (green) is high. An individual's biomarker observation will appear twice in a column if that individual is identified as having a high score by both measures.