Emotional neglect in childhood and cerebral infarction in older age

Objective: The purpose of the study was to test the hypothesis that a higher level of childhood adversity is associated with increased risk of cerebral infarction in old age. Methods: Older participants in a longitudinal clinical–pathologic study rated adverse childhood experiences (e.g., emotional neglect, parental intimidation and violence) on a previously established 16-item scale. During a mean of 3.5 years of follow-up, there were 257 deaths, with 206 brain autopsies (80.2). Number of chronic cerebral infarcts (gross plus microscopic; expressed as 0, 1, or >1) was determined in a uniform neuropathologic examination, which had been completed in 192 individuals at the time of these analyses. Results: Childhood adversity scores ranged from 0 to 31 (mean = 8.3, SD = 6.4). In an ordinal logistic regression model adjusted for age, sex, and education, higher adversity was associated with higher likelihood of chronic cerebral infarction. In analyses of childhood adversity subscales, only emotional neglect was associated with infarction (odds ratio [OR] = 1.097; 95% confidence interval [CI] 1.048–1.148). The likelihood of infarction was 2.8 times higher (95% CI 2.0–4.1) in those reporting a moderately high level of childhood emotional neglect (score = 6, 75th percentile) vs a moderately low level of neglect (score = 1, 25th percentile). Results were comparable in subsequent analyses that controlled for lifetime socioeconomic status, cardiovascular risk factors, and an anxiety-related trait. Conclusion: Emotional neglect in childhood may be a risk factor for cerebral infarction in old age.

[1]  S. Leurgans,et al.  Microinfarct Pathology, Dementia, and Cognitive Systems , 2011, Stroke.

[2]  Martin H. Teicher,et al.  Hurtful words: association of exposure to peer verbal abuse with elevated psychiatric symptom scores and corpus callosum abnormalities. , 2010, The American journal of psychiatry.

[3]  Rosalind J Wright,et al.  Abuse in childhood and adolescence as a predictor of type 2 diabetes in adult women. , 2010, American journal of preventive medicine.

[4]  F. Stanley,et al.  Monitoring child abuse and neglect at a population level: patterns of hospital admissions for maltreatment and assault. , 2010, Child abuse & neglect.

[5]  A. Roy,et al.  Childhood Trauma and Prevalence of Cardiovascular Disease in Patients With Type 1 Diabetes , 2010, Psychosomatic medicine.

[6]  R. J. Wright,et al.  Hypertension in adult survivors of child abuse: observations from the Nurses' Health Study II , 2010, Journal of Epidemiology & Community Health.

[7]  M. Hall,et al.  Psychological and Somatic Symptoms of Anxiety and Risk of Coronary Heart Disease: The Health and Social Support Prospective Cohort Study , 2010, Biological Psychiatry.

[8]  Dan J Stein,et al.  Early childhood adversity and later hypertension: data from the World Mental Health Survey. , 2010, Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists.

[9]  K. Matthews,et al.  Childhood Abuse Is Associated With Adiposity in Midlife Women: Possible Pathways Through Trait Anger and Reproductive Hormones , 2010, Psychosomatic medicine.

[10]  C. Widom,et al.  A 30‐year Follow‐up of the Effects of Child Abuse and Neglect on Obesity in Adulthood , 2009, Obesity.

[11]  Bumseok Jeong,et al.  Preliminary Evidence for White Matter Tract Abnormalities in Young Adults Exposed to Parental Verbal Abuse , 2009, Biological Psychiatry.

[12]  E. Hyppönen,et al.  Obesity and Type 2 Diabetes Risk in Midadult Life: The Role of Childhood Adversity , 2008, Pediatrics.

[13]  D A Bennett,et al.  Relation of cognitive activity to risk of developing Alzheimer disease , 2007, Neurology.

[14]  J. Schneider,et al.  Loneliness and risk of Alzheimer disease. , 2007, Archives of general psychiatry.

[15]  J. Schneider,et al.  Neuropathology of older persons without cognitive impairment from two community-based studies , 2006, Neurology.

[16]  D. Bennett,et al.  Childhood adversity and psychosocial adjustment in old age. , 2006, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[17]  David A. Bennett,et al.  The Rush Memory and Aging Project: Study Design and Baseline Characteristics of the Study Cohort , 2005, Neuroepidemiology.

[18]  Debbie A Lawlor,et al.  Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study. , 2005, American journal of public health.

[19]  D. Williamson,et al.  The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. , 2004, Child abuse & neglect.

[20]  M. Stein,et al.  Association between childhood trauma and physical disorders among adults in the United States , 2004, Psychological Medicine.

[21]  R. Yehuda,et al.  Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. , 2003, Child abuse & neglect.

[22]  J. Briere,et al.  Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women. , 2003, Child abuse & neglect.

[23]  S. Dube,et al.  The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. , 2003, Preventive medicine.

[24]  J. Schneider,et al.  Relation of cerebral infarctions to dementia and cognitive function in older persons , 2003, Neurology.

[25]  D. Wolfe,et al.  Child neglect: developmental issues and outcomes. , 2002, Child abuse & neglect.

[26]  M Y Wong,et al.  Childhood abuse and lifetime psychopathology in a community sample. , 2001, The American journal of psychiatry.

[27]  Gary G. Koch,et al.  Categorical data analysis using the sas® system, 2nd edition , 2000 .

[28]  G. Giovino,et al.  Adverse childhood experiences and smoking during adolescence and adulthood. , 1999, JAMA.

[29]  D. Williamson,et al.  Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. , 1998, American journal of preventive medicine.

[30]  Christopher G. Davis,et al.  Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey , 1997, Psychological Medicine.

[31]  D. Offord,et al.  Prevalence of child physical and sexual abuse in the community. Results from the Ontario Health Supplement. , 1997, JAMA.

[32]  Gary G. Koch,et al.  Categorical Data Analysis Using The SAS1 System , 1995 .

[33]  J Foote,et al.  Initial reliability and validity of a new retrospective measure of child abuse and neglect. , 1994, The American journal of psychiatry.

[34]  E. Barrett-Connor,et al.  Exercise patterns in a population of older adults. , 1989, American journal of preventive medicine.

[35]  J. Dale.  Global cross-ratio models for bivariate, discrete, ordered responses. , 1986, Biometrics.

[36]  E. Bedrick,et al.  Using the Bivariate Dale Model to jointly estimate predictors of frequency and quantity of alcohol use. , 2005, Journal of studies on alcohol.

[37]  P. Vokonas,et al.  Age-Adjusted and Multivariate Odds Ratios of Sudden Cardiac Death and Nonsudden Cardiac Death According to Anxiety Symptoms Score Anxiety Symptom Score , 2005 .

[38]  P. Costa,et al.  Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor Inventory (NEO-FFI) , 1992 .

[39]  Race, education and prevalence of hypertension. , 1977, American journal of epidemiology.