Exploring the Association Between Trauma, Instability, and Youth Cardiometabolic Health Outcomes Over Three Years

Abstract

Purpose: Childhood adversity plays a fundamental role in predicting youth cardiometabolic health. Our understanding of how adverse experiences in childhood should best be conceptualized remains elusive, based on one-dimensional measures of adversity. The present study fills a major gap in existing research by examining two distinct forms of threat and instability-related exposures that may impact cardiometabolic risk (CMR) in adolescence.

Methods: We explore two specific subtypes of adversity: trauma (e.g., badly hurt, victim of crime, loss of close person) and instability (e.g., moving, change of schools, change in household structure) as differential influences that can accumulate to impact early childhood onset of CMR (body mass index, high-density lipoprotein (HDL), low-density lipoprotein, diastolic and systolic blood pressure, triglycerides, C-reactive protein, insulin sensitivity). Secondary data were drawn from a randomized control behavioral trial of youth recruited during sixth grade from urban Cleveland (Ohio) schools beginning in 2012-2014 (n = 360) and followed for 3 years. Participants reported on 12 adverse experiences, six trauma- and six instability-specific. Multiple regression assessed effects of prospective and accumulative indices of trauma and instability with 3-year trajectories of eight objective CMR markers.

Results: Instability was associated with increased body mass index, decreased high-density lipoprotein, and increased C-reactive protein slopes. Trauma was associated with trends in triglyceride levels but not with any other CMR outcomes.

Discussion: Experiences with instability distinctly impacted adolescent CMR. Future research is needed to examine factors that can enhance stability for families in marginalized communities.

Trial registration: ClinicalTrials.gov NCT01514279.

Keywords: Adolescence; Adverse childhood experiences; Cardiometabolic risk; Diabetes; Instability; Low-income; Obesity; Trauma.