Hostname: page-component-5d84bcc8dc-c8dhn Total loading time: 0 Render date: 2026-09-05T15:00:34.839Z Has data issue: false hasContentIssue false
  • English
  • Français

Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood

Published online by Cambridge University Press:  07 July 2015

E. D. Ballard ,
K. Van Eck ,
R. J. Musci ,
S. R. Hart ,
C. L. Storr ,
N. Breslau  and
H. C. Wilcox
E. D. Ballard*
Affiliation:
National Institute of Mental Health, Experimental and Pathophysiology Branch, Bethesda, MD, USA
K. Van Eck
Affiliation:
Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Division of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
R. J. Musci
Affiliation:
Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
S. R. Hart
Affiliation:
Child Development Department, California State University, Chico, CA, USA
C. L. Storr
Affiliation:
Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Department of Family and Community Health, School of Nursing, University of Maryland, Baltimore, Baltimore, MD, USA
N. Breslau
Affiliation:
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
H. C. Wilcox
Affiliation:
Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
*
* Address for correspondence: E. D. Ballard, Ph.D., National Institute of Mental Health, Experimental and Pathophysiology Branch, Building 10, CRC Room 7-3345, 10 Center Drive, MSC 1282, Bethesda, MD 20892, USA. (Email: Elizabeth.Ballard@nih.gov)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood.

Method

A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood.

Results

Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group.

Conclusions

Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.

Keywords

Childhood adverse experienceslatent class analysistraumayoung adulthood

Information

Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 15 , November 2015 , pp. 3305 - 3316
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Acierno, R, Resnick, H, Kilpatrick, DG, Saunders, B, Best, CL (1999). Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships. Journal of Anxiety Disorders 13, 541–563.CrossRefGoogle ScholarPubMed
Anacker, C, O'Donnell, KJ, Meaney, MJ (2014). Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function. Dialogues in Clinical Neuroscience 16, 321–333.Google Scholar
Anda, RF, Felitti, VJ, Bremner, JD, Walker, JD, Whitfield, C, Perry, BD, Dube, SR, Giles, WH (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience 256, 174–186.Google Scholar
Andrews, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 80–88.Google Scholar
Anthony, J (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmacology 2, 244–268.CrossRefGoogle Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association: Washington, DC.Google Scholar
Barrish, HH, Saunders, M, Wolf, MW (1969). Good Behavior Game: effects of individual contingencies for group consequences on disruptive behavior in a classroom. Journal of Applied Behavior Analysis 2, 119–124.CrossRefGoogle Scholar
Block, J, Burns, R (1976). Mastery learning. In Review of Research in Education (ed. Shulman, L.). Peacock: Itasca, IL, pp. 3–49.Google Scholar
Breslau, N, Kessler, RC, Chilcoat, HD, Schultz, LR, Davis, GC, Andreski, P (1998 a). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry 55, 626–632.CrossRefGoogle ScholarPubMed
Breslau, N, Kessler, RC, Peterson, EL (1998 b). PTSD assessment with a structured interview: reliability and concordance with a standardized clinical interview. International Journal of Methods in Psychiatric Research 7, 121–127.Google Scholar
CDC (2015). High school youth risk behavior survey data, 1991–2013. Centers for Disease Control and Prevention ( http://nccd.cdc.gov/youthonline). Accessed 1 April 2015.Google Scholar
CDC (2014). Prevalence of individual adverse childhood experiences. Centers for Disease Control and Prevention (http://www.cdc.gov/violenceprevention/acestudy/prevalence.html). Accessed 1 April 2015.Google Scholar
Chaffin, M, Kelleher, K, Hollenberg, J (1996). Onset of physical abuse and neglect: psychiatric, substance abuse, and social risk factors from prospective community data. Child Abuse and Neglect 20, 191–203.Google Scholar
Chung, H, Breslau, N (2008). The latent structure of post-traumatic stress disorder: tests of invariance by gender and trauma type. Psychological Medicine 38, 563–73.Google Scholar
Cloitre, M, Stolbach, BC, Herman, JL, van der Kolk, B, Pynoos, R, Wang, J, Petkova, E (2009). A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress 22, 399–408.Google Scholar
Collins, LM, Lanza, ST (2009). Latent Class and Latent Transition Analysis: With Applications in the Social, Behavioral, and Health Sciences. Wiley: NY.Google Scholar
Dong, M, Anda, RF, Felitti, VJ, Dube, SR, Williamson, DF, Thompson, TJ, Loo, CM, Giles, WH (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 28, 771–784.Google Scholar
Dube, SR, Fairweather, D, Pearson, WS, Felitti, VJ, Anda, RF, Croft, JB (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine 71, 243–250.Google Scholar
Felitti, VJ, Anda, RF, Nordenberg, D, Williamson, DF, Spitz, AM, Edwards, V, Koss, MP, Marks, JS (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14, 245–258.Google Scholar
Garner, AS, Shonkoff, JP (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 129, e224–e231.Google Scholar
Graham, JW (2009). Missing data analysis: making it work in the real world. Annual Review of Psychology 60, 549–576.CrossRefGoogle ScholarPubMed
Grant, BF, Dawson, DA, Stinson, FS, Chou, PS, Kay, W, Pickering, R (2003). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 7–16.Google Scholar
Hardt, J, Franke, P (2007). Validity, relianbility and objectivity of the family history method in psychiatry: a meta-analysis. European Psychiatry 22, 49–58.Google Scholar
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry 45, 260–273.Google Scholar
Kellam, SG, Brown, CH, Poduska, JM, Ialongo, NS, Wang, W, Toyinbo, P, Petras, H, Ford, C, Windham, A, Wilcox, HC (2008). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes. Drug and Alcohol Dependence 95 (Suppl. 1), S5–S28.CrossRefGoogle Scholar
Kellam, SG, Werthamer-Larsson, L, Dolan, LJ, Brown, CH, Mayer, LS, Rebok, GW, Anthony, JC, Laudolff, J, Edelsohn, G (1991). Developmental epidemiologically based preventive trials: baseline modeling of early target behaviors and depressive symptoms. American Journal of Community Psychology 19, 563–584.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.Google Scholar
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.CrossRefGoogle ScholarPubMed
Liberzon, I, King, AP, Ressler, KJ, Almli, LM, Zhang, P, Ma, ST, Cohen, GH, Tamburrino, MB, Calabrese, JR, Galea, S (2014). Interaction of the ADRB2 gene polymorphism with childhood trauma in predicting adult symptoms of posttraumatic stress disorder. JAMA Psychiatry 71, 1174–1182.CrossRefGoogle ScholarPubMed
Lo, Y, Mendell, N, Rubin, D (2001). Testing the number of components in a normal mixture. Biometricka 88, 767–778.Google Scholar
McLachlan, G, Peel, D (2000). Finite Mixture Models. Wiley: New York, NY.Google Scholar
Means-Christensen, AJ, Roy-Byrne, PP, Sherbourne, CD, Craske, MG, Stein, MB (2008). Relationships among pain, anxiety, and depression in primary care. Depression and Anxiety 25, 593–600.Google Scholar
Mehta, D, Klengel, T, Conneely, KN, Smith, AK, Altmann, A, Pace, TW, Rex-Haffner, M, Loeschner, A, Gonik, M, Mercer, KB, Bradley, B, Muller-Myhsok, B, Ressler, KJ, Binder, EB (2013). Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder. Proceedings of the National Academy of Sciences USA 110, 8302–8307.Google Scholar
Muthén, LK, Muthén, BO (2013). Mplus User's Guide, 7th edition. Muthén & Muthén: CA.Google Scholar
National Center for Health Statistics (1994). Plan and Operation of the Third National Health and Nutrition Examination Survey, 1988–94. Vital Health Statistics System, Center for Disease Control and Prevention: Alexandria, VA.Google Scholar
Odgers, CL, Jaffee, SR (2013). Routine versus catastrophic influences on the developing child. Annual Review of Public Health 34, 29–48.Google Scholar
Shonkoff, JP, Garner, AS (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics 129, e232–e246.Google Scholar
Storr, CL, Or, F, Eaton, WW, Ialongo, N (2014). Genetic research participation in a young adult community sample. Journal of Community Genetics 5, 363–375.CrossRefGoogle Scholar
Storr, CL, Reboussin, BA, Anthony, JC (2004). Early childhood misbehavior and the estimated risk of becoming tobacco-dependent. American Journal of Epidemiology 160, 126–130.Google Scholar
Szyf, M (2011). The early life social environment and DNA methylation: DNA methylation mediating the long-term impact of social environments early in life. Epigenetics 6, 971–978.Google Scholar
Teicher, MH, Samson, JA (2013). Childhood maltreatment and psychopathology: a case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. American Journal of Psychiatry 170, 1114–11133.Google Scholar
Verona, E, Sachs-Ericsson, N (2005). The intergenerational transmission of externalizing behaviors in adult participants: the mediating role of childhood abuse. Journal of Consulting and Clinical Psychology 73, 1135–1145.CrossRefGoogle Scholar
Walsh, C, MacMillan, H, Jamieson, E (2002). The relationship between parental psychiatric disorder and child physical and sexual abuse: findings from the Ontario Health Supplement. Child Abuse and Neglect 26, 11–22.CrossRefGoogle ScholarPubMed
Walsh, C, MacMillan, HL, Jamieson, E (2003). The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement. Child Abuse and Neglect 27, 1409–1425.Google Scholar
Wilcox, HC, Anthony, JC (2004). The development of suicide ideation and attempts: an epidemiologic study of first graders followed into young adulthood. Drug and Alcohol Dependence 76 (Suppl.), S53–S67.CrossRefGoogle ScholarPubMed
Wilcox, HC, Kuramoto, SJ, Brent, D, Runeson, B (2012). The interaction of parental history of suicidal behavior and exposure to adoptive parents’ psychiatric disorders on adoptee suicide attempt hospitalizations. American Journal of Psychiatry 169, 309–315.Google Scholar
Wilcox, HC, Kellam, SG, Brown, CH, Poduska, JM, Ialongo, NS, Wang, W, Anthony, JC (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug and Alcohol Dependence 95 (Suppl. 1), S60–S73.Google Scholar
Wilcox, HC, Storr, CL, Breslau, N (2009). Posttraumatic stress disorder and suicide attempts in a community sample of urban American young adults. Archives of General Psychiatry 66, 305–311.Google Scholar
Wittchen, HU (1994). Reliability and validity studies of the WHO – Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 57–84.Google Scholar
World Health Organization (1995). Physical Status: The use and Interpretation of Anthropometry. World Health Organization: Geneva, Switzerland.Google Scholar
World Health Organization (1997). World Health Organization Composite International Diagnostic Interview (CIDI) Core Version 2.1, Interviewer's Manual. World Health Organization: Geneva, Switzerland.Google Scholar
Supplementary material: File

Ballard supplementary material

Ballard supplementary material 1

Download Ballard supplementary material(File)
File 14 KB