Abstract
BackgroundAdverse childhood experiences (ACEs) have been associated with poorer health across the life course. Previous studies have used cumulative risk scores (ACE scores) or individual ACEs but these two approaches have important shortcomings. ACE scores assume that each adversity is equally important for the outcome of interest and the single adversity approach assumes that ACEs do not co-occur. Latent class analysis (LCA) is an alternative approach to operationalising ACEs data, identifying groups of people co-reporting similar ACEs. Here we apply these three approaches for ACEs operationalisation with inflammation in childhood with the aim of identifying particular ACEs or ACE combinations that are particularly associated with higher inflammation in early life. MethodsUsing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) we compare ACE scores, single adversities and LCA-derived ACE clusters in their relationships with Interleukin-6 at age 9 (n = 4935) and C-Reactive Protein (CRP) at age 9 (n = 4887). ACEs included were parental separation/divorce, parental alcohol problems, parental mental health problems, parental offending, inter-parental violence, parental drug misuse, and physical, emotional and sexual abuse. ResultsTwo thirds of the sample reported at least one ACE. Mother’s mental health problems was the most frequently reported ACE (32.3 %). LCA identified four ACE classes – ‘Low ACEs’ (81.1 %), ‘Maternal mental health problems’ (10.3 %), ‘Maternal mental health problems and physical abuse’ (6.3 %) and ‘Parental conflict, mental health problems and emotional abuse’ (2.4 %). Parental separation/divorce was associated with higher IL-6. Parental alcohol problems, paternal mental health problems, parental convictions and emotional abuse were associated with lower levels of IL-6. Associations for paternal mental health problems and emotional abuse were only observed for boys. ACE score and LCA-derived ACE classes were not associated with differences in IL-6. Girls in the ‘Maternal mental health problems’ cluster had lower CRP levels. ConclusionsSpecific adversities and adversity combinations are important for differences in childhood inflammation. Some associations were only observed for girls or boys.
Highlights
The importance of adverse childhood experiences (ACEs) for lifelong health have been well documented
The authors did not investigate associations between individual Adverse childhood experiences (ACEs) and inflammation, and our results suggest that these associations may be driven by specific ACEs; in our study parental separation/divorce was associated with higher levels of IL-6 at age 9
We showed that ACEs cluster in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort and derived four clusters using an Latent class analysis (LCA) approach
Summary
The importance of adverse childhood experiences (ACEs) for lifelong health have been well documented. Specific ACEs linked to higher levels of C-Reactive Protein (CRP) or Interleukin(IL)-6 have included child maltreatment (Danese et al, 2008), parental mental health disorders (O’Connor et al, 2019) and parental separation/divorce (Lacey et al, 2013). Methods: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) we compare ACE scores, single adversities and LCA-derived ACE clusters in their relationships with Interleukin-6 at age 9 (n = 4935) and C-Reactive Protein (CRP) at age 9 (n = 4887). ACEs included were parental separation/divorce, parental alcohol problems, parental mental health problems, parental offending, inter-parental violence, parental drug misuse, and physical, emotional and sexual abuse. Paternal mental health problems, parental convictions and emotional abuse were associated with lower levels of IL-6. Associations for paternal mental health problems and emotional abuse were only observed for boys.
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