Sex differences in experiences of multiple traumas and mental health problems in the UK Biobank cohort

Emma Yapp,Tom Booth,Katrina Davis,Jonathan Coleman,Louise M Howard,Gerome Breen,Stephani L Hatch,Matthew Hotopf,Siân Oram

doi:10.1007/s00127-021-02092-y

Abstract

PurposeExperiences of reported trauma are common and are associated with a range of mental health problems. Sex differences in how reported traumas are experienced over the life course in relation to mental health require further exploration.Methods157,358 participants contributed data for the UK Biobank Mental Health Questionnaire (MHQ). Stratified Latent Class Analysis (LCA) was used to analyse combinations of reported traumatic experiences in males and females separately, and associations with mental health.ResultsIn females, five trauma classes were identified: a low-risk class (58.6%), a childhood trauma class (13.5%), an intimate partner violence class (12.9%), a sexual violence class (9.1%), and a high-risk class (5.9%). In males, a three-class solution was preferred: a low-risk class (72.6%), a physical and emotional trauma class (21.9%), and a sexual violence class (5.5%). In comparison to the low-risk class in each sex, all trauma classes were associated with increased odds of current depression, anxiety, and hazardous/harmful alcohol use after adjustment for covariates. The high-risk class in females and the sexual violence class in males produced significantly increased odds for recent psychotic experiences.ConclusionThere are sex differences in how reported traumatic experiences co-occur across a lifespan, with females at the greatest risk. However, reporting either sexual violence or multiple types of trauma was associated with increased odds of mental health problems for both males and females. Findings emphasise the public mental health importance of identifying and responding to both men and women’s experiences of trauma, including sexual violence.

Highlights

A traumatic event is defined as exposure to actual or threatened death, serious injury or sexual violence through direct experience or witnessing in the Diagnostic and Statistical Manual for Mental Disorders 5th edition
This cohort is not representative of the UK general population, and neither are the data produced by the subset of participants who participated in the Mental Health Questionnaire (MHQ) [18]
Higher prevalence of psychological intimate partner violence was found for the UK Biobank MHQ (30% in females, 16% in males) when compared to surveys conducted with similar questions in England and Wales [41]

Summary

Introduction

A traumatic event is defined as exposure to actual or threatened death, serious injury or sexual violence through direct experience or witnessing in the Diagnostic and Statistical Manual for Mental Disorders 5th edition. Experiences of both violence and trauma are highly prevalent in the general population. Certain traumatic experiences are likely to co-occur; for example, people who experience one form of childhood maltreatment are likely to experience another, because they are often living with their perpetrator [4]. Being a victim of violence or abuse may contribute to the onset of mental health problems, which in turn renders individuals vulnerable to further violence or abuse [6]

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