Childhood maltreatment and late-life generalized anxiety disorder: Are personality and attachment characteristics mediators?

Abstract

Childhood maltreatment and generalized anxiety disorder (GAD) are related in adulthood. This association is not clear in the elderly. This work aims to investigate the role of adult attachment style and personality traits in the association between childhood maltreatment and late-life GAD. Our study sample consisted of 260 patients recruited into the Cerebral Aging Program of the city of Porto Alegre (Brazil) assessed between July 2015 and July 2016. A clinical interview using the Mini International Neuropsychiatry Interview 5.0 (DSM-5 criteria) yielded psychiatric diagnoses. Patients completed the childhood trauma questionnaire (CTQ) for maltreatment, the relationship scales questionnaire (RSQ) for adult attachment style and the Brazilian 60-item version of the NEO-Five Factor Inventory (NEO-FFI) for personality characteristics. We aimed to examine, using sequential multimediation analysis, if attachment and personality traits style could be mediators between childhood maltreatment and GAD. 20% presented late-life GAD (n=52), 29% of whom had been maltreated. Neuroticism positively mediated and extraversion negatively mediated the relation between childhood maltreatment and late-life GAD. Attachment anxiety mediated this relation in a sequential way suggesting a path from childhood trauma through attachment and personality traits towards late-life GAD. The small sample and the retrospective and cross-sectional study design mean that causal conclusions must be interpreted with caution. Our results suggest a chronological path from childhood maltreatment to late-life GAD, passing through attachment anxiety predicting higher levels of neuroticism and lower levels of extraversion predicting late-life GAD.