Childhood abuse/neglect and temporal patterns in late-life anxiety

Abstract

Objectives

Anxiety has been associated with childhood abuse/neglect, but this relationship and its mechanisms are poorly documented in older adults. This study examined the association between childhood abuse/neglect and late-life anxiety temporal patterns (i.e. absence, remission, incidence, persistence), testing for mediators.

Methods

Data were derived for 724 French-speaking community-living older adults participating in the Étude sur la santé des ainés – Services study with available information at baseline and 4-year follow-up. Past-month anxiety was based on a cutoff score ≥5 on a French translation of the 7-item Generalized Anxiety Disorder at interviews. Questions on childhood abuse/neglect (e.g. psycho-emotional, physical, sexual) were administered. Adjusted multinomial regression analyses and mediation bootstrapping models were used. Tested mediators included traumatic events (excluding childhood abuse/neglect), daily hassles, psychological resilience, and cortisol activity.

Results

The absence, remission, incidence and persistence of anxiety was found in 45.3%, 25.3%, 8.7% and 20.7% of the sample, respectively. Participants with incident and persistent late-life anxiety experienced more childhood abuse/neglect. Participants with persistent anxiety also reported lower psychological resilience. The association between childhood abuse/neglect with anxiety incidence was mediated by daily hassles, while its association with anxiety persistence was mediated by daily hassles and psychological resilience.

Conclusion

Past childhood abuse/neglect was associated with late-life anxiety incidence and persistence, with psychological resilience and daily hassles potentially explaining this relationship. Further research should focus on ascertaining the clinical applications of psychosocial and biological profiles in informing the prevention and personalized treatment of anxiety in older adults.

Keywords:

• Cortisol
• anxiety
• persistence
• incidence
• remission
• older adults
• childhood adversities
• resilience
• abuse/neglect

Disclosure statement

All authors declare that they have no conflicts of interest.

Author statement

HB conceptualized the analytic plan in collaboration with HMV and MCO. HB carried out all analyses and wrote the first draft of the paper. MCO, HF, SD, HMV contributed to the interpretation and discussion of results and critically revised the final manuscript. HMV, HF and SD conceptualized and obtained funding for the ESA-Services follow-up study including salivary cortisol sampling and measuring.

Additional information

Funding

The ESA-Services longitudinal study was supported in part by operating grants from the Fonds de recherche du Québec ‒ Santé (FRQS) (#1600), a Canadian Institutes of Health Research (CIHR) research grant (201403MOP), a catalyst grant by the CIHR (201703) and pilot project grant from the Quebec Network for Research on Aging, funded by the FRQS. HMV and MCO held a Senior Research scholar with the FRQS at the time of the study. HB holds a doctoral scholarship from the University of Sherbrooke.