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Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder.

ABSTRACT: Gender differences in stressors that affect the development of co-occurring psychiatric and substance use disorders (COD) have been given inadequate attention, despite evidence that women and men commonly develop different types of both psychiatric disorder and substance use disorders and have different experiences of illness and treatment. This paper assesses early life antecedents of COD, specifically childhood poverty and childhood adversity, and how they vary by gender. Weighted multinomial logistic regressions were conducted with the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC-III) (n = 33,676) nationally representative data from 2014-2015 to assess whether antecedents of COD are conditional on gender. Results demonstrate that overall nearly one in five people (17.5%) have lifetime COD, and disorder prevalence differs for males and females (COD: 18.0% vs 16.4%; psychiatric disorder: 8.5% vs. 20.9%; substance use disorder: 5.6% vs. 13.0%, respectively). Males with childhood poverty are more likely than males without to have COD but poverty does not affect COD risk for females. For both males and females, increases in number of adversities are associated with increased probability of COD, however, the magnitude of this association is stronger for males. To understand COD risk, conditional relationships between early poverty, early adversity and gender must be considered. With this knowledge, prevention and treatment efforts have the potential to be targeted more effectively.

SUBMITTER: van Draanen J

PROVIDER: S-EPMC7047198 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder.

van Draanen Jenna J

SSM - population health 20200113

Gender differences in stressors that affect the development of co-occurring psychiatric and substance use disorders (COD) have been given inadequate attention, despite evidence that women and men commonly develop different types of both psychiatric disorder and substance use disorders and have different experiences of illness and treatment. This paper assesses early life antecedents of COD, specifically childhood poverty and childhood adversity, and how they vary by gender. Weighted multinomial ...[more]

PMID: 32140539

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Project description:Background: Patients with major depressive disorder (MDD) have various theory of mind (ToM) impairments which often predict a poor outcome. However, findings on ToM deficits in MDD are inconsistent and suggest the role of moderating factors. Child abuse and neglect are strong predictors of adult MDD and are often associated with a poorer clinical course trajectory. Objective: Because early-life adversities result in various forms of ToM deficits in clinical and nonclinical samples, our aim was to investigate if they are significant confounding factors of ToM impairments in MDD. Methods: We investigated 60 mildly or moderately depressed, nonpsychotic adult patients with MDD during an acute episode, and 32 matched healthy controls. The mental state decoding subdomain of ToM was examined with the Reading the Mind in the Eyes Test (RMET). Childhood adversities were assessed with the childhood trauma questionnaire (CTQ) and the early trauma inventory. Results: There was no difference between the control and MDD groups in RMET performance. However, when we divided the MDD group into two subgroups, one (N = 30) with high and the other (N = 30) with low levels of childhood adversities, a significant difference emerged between the controls and the highly maltreated MDD subgroup in RMET performance. A series of 3 (group) × 3 (valence) mixed-model analyses of covariance (ANCOVAs) revealed that childhood emotional and physical neglect had a significant negative impact on the response accuracy in RMET in general, whereas emotional abuse specifically interfered with the accuracy in the positive and negative valences if it co-occurred with early-life neglect. To test the dose-response relationship between the number of childhood adversities and RMET capacities, we subjected RMET data of the MDD group to multiple hierarchical regressions: the number of childhood adversities was a significant predictor of RMET total scores and RMET scores in the negative valence after controlling for age, sex, years of education, and the severity of current depression. Conclusion: Childhood adversities impair ToM capacities in MDD. Exposure to early-life emotional abuse and neglect have a negative impact on the performance in the emotional valences of RMET. Multiple early-life adversities have a dose-dependent association with mental state decoding deficits.

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Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder.

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Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder.

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