Cumulative life-course victimization and inflammation in a U.S. national sample: Comparing intersections based on sexual orientation, gender, race/ethnicity, and education.

Violence victimization has been associated with low-grade inflammation. Lesbian, Gay, and Bisexual (LGB) individuals are at greater risk for victimization in childhood and young adulthood compared to heterosexuals. Moreover, the intersection of LGB identity with gender, race/ethnicity, and educational attainment may be differentially associated with victimization rates. However, no previous study has examined the role of cumulative life-course victimization during childhood and young adulthood in the association between 1) LGB identity and low-grade inflammation during the transition to midlife, and 2) intersection of LGB identity with gender, race/ethnicity, and educational attainment and low-grade inflammation during the transition to midlife. We utilized multi-wave data from a national sample of adults entering midlife in the United States- the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 4573) - and tested four bootstrapped mediation models. Results indicate LGB identity, LGB and White, and LGB and Black identities were indirectly associated with low-grade inflammation during the transition to midlife via higher levels of cumulative life-course victimization. Moreover, among LGB adults, the association between 1) less than college education and 2) some college education, and low-grade inflammation was mediated by cumulative life-course victimization. For LGB females, there was a direct association between identity and low-grade inflammation and this association was mediated by cumulative life-course victimization . Reducing accumulation of victimization could be critical for preventing biological dysregulation and disease onset among LGB individuals, particularly for those with multiple marginalized identities.

Co-occurring childhood maltreatment exposure and depressive symptoms in adulthood: Testing differential effects of stress dysregulation and perceived stress.

Objectives: Objectives were to explore: 1) the association between sub-groups with different multi-type childhood maltreatment exposures and depressive symptoms in late adulthood, and 2) the mediating effects of dysregulated physiological stress system function and perceived stress in midlife on the aforementioned associations.Methods: Data come from the Biomarker project (n = 1,053) of the Midlife Development in the United States study. Latent profile analysis was used to identify sub-groups with differing childhood maltreatment type and chronicity. We then test our mediation hypothesis using a product of coefficients method procedure.Results: Two vulnerable sub-groups were identified (Class 2: Emotional and physical maltreatment class, n = 52, and Class 3: Sexual abuse class, n = 79) along with a normative sub-group (Class 1: Normative class, n = 922) comprising of a majority of adults. Both vulnerable sub-groups had higher levels of perceived stress in late adulthood. Perceived stress mediated the association between both vulnerable sub-groups and depressive symptoms. Physiological stress dysregulation mediated the association only between the emotional and physical maltreatment class and depressive symptoms in late adulthood.Conclusion: Therapeutic approaches targeted at prevention of perceived stress for both vulnerable sub-groups identified in this study and those targeting physiological dysregulation in addition for the emotional and physical maltreatment class could be critical for depressive symptom recovery.

The Sociodemographic and Lifestyle Correlates of Epigenetic Aging in a Nationally Representative U.S. Study of Younger Adults.

Importance: Epigenetic clocks represent molecular evidence of disease risk and aging processes and have been used to identify how social and lifestyle characteristics are associated with accelerated biological aging. However, most of this research is based on older adult samples who already have measurable chronic disease. Objective: To investigate whether and how sociodemographic and lifestyle characteristics are related to biological aging in a younger adult sample across a wide array of epigenetic clock measures. Design: Nationally representative prospective cohort study. Setting: United States (U.S.). Participants: Data come from the National Longitudinal Study of Adolescent to Adult Health, a national cohort of adolescents in grades 7-12 in U.S. in 1994 followed for 25 years over five interview waves. Our analytic sample includes participants followed-up through Wave V in 2016-18 who provided blood samples for DNA methylation (DNAm) testing (n=4237) at Wave V. Exposure: Sociodemographic (sex, race/ethnicity, immigrant status, socioeconomic status, geographic location) and lifestyle (obesity status, exercise, tobacco, and alcohol use) characteristics. Main Outcome: Biological aging assessed from blood DNAm using 16 epigenetic clocks when the cohort was aged 33-44 in Wave V. Results: While there is considerable variation in the mean and distribution of epigenetic clock estimates and in the correlations among the clocks, we found sociodemographic and lifestyle factors are more often associated with biological aging in clocks trained to predict current or dynamic phenotypes (e.g., PhenoAge, GrimAge and DunedinPACE) as opposed to clocks trained to predict chronological age alone (e.g., Horvath). Consistent and strong associations of faster biological aging were found for those with lower levels of education and income, and those with severe obesity, no weekly exercise, and tobacco use. Conclusions and Relevance: Our study found important social and lifestyle factors associated with biological aging in a nationally representative cohort of younger-aged adults. These findings indicate that molecular processes underlying disease risk can be identified in adults entering midlife before disease is manifest and represent useful targets for interventions to reduce social inequalities in heathy aging and longevity. Key Points: Question: Are epigenetic clocks, measures of biological aging developed mainly on older-adult samples, meaningful for younger adults and associated with sociodemographic and lifestyle characteristics in expected patterns found in prior aging research?Findings: Sociodemographic and lifestyle factors were associated with biological aging in clocks trained to predict morbidity and mortality showing accelerated aging among those with lower levels of education and income, and those with severe obesity, no weekly exercise, and tobacco use.Meaning: Age-related molecular processes can be identified in younger-aged adults before disease manifests and represent potential interventions to reduce social inequalities in heathy aging and longevity.

Intersectionality and Adverse Childhood Experiences: Comparing Subgroups of Sex, Race/Ethnicity, and Sexual Orientation.

INTRODUCTION: This study investigated the intersectionality of adverse childhood experiences (ACEs) among subgroups of sex, race/ethnicity, and sexual orientation. METHODS: Using data from the Behavioral Risk Factor Surveillance Survey across 34 states (N=116,712) from 2009 to 2018, authors stratified subgroups of sex (male/female), race/ethnicity (White/Hispanic/Black/multiracial/other), and sexual orientation (heterosexual/bisexual/gay) to investigate the number of ACEs across groups. Analyses were conducted in 2022. RESULTS: Stratification resulted in 30 distinct subgroups (e.g., bisexual Black females, straight multiracial males) with significant post hoc differences per group. Generally, those identifying as sexual minority individuals had the highest number of ACEs (the top 14 of 30 subgroups), whereas seven of the top ten subgroups were female. Surprisingly, no clear patterns emerged by race/ethnicity, although the two largest groups (straight White females and straight White males) were 27th and 28th of 30, respectively. CONCLUSIONS: Although studies have examined ACEs by individual demographic variables, less is known about the extent to which ACEs are present in stratified subgroups. Sexual minority subgroups (particularly female bisexual subgroups) trend toward a higher number of ACEs, whereas heterosexual subgroups (regardless of sex) comprised the lowest 6 groups with respect to ACEs. Implications include further examination of bisexual and female subgroups (including specific ACE domain investigations) to identify the vulnerable population.

Multi-type childhood maltreatment exposure and substance use development from adolescence to early adulthood: A GxE study.

BACKGROUND: Childhood maltreatment types can co-occur and are associated with increased substance use during adolescence and early adulthood. There is also a strong genetic basis for substance use which interacts with environmental factors (e.g., childhood maltreatment) to influence substance use phenotype. OBJECTIVE: This research aimed to identify childhood maltreatment sub-groups based on type and chronicity, and their association with substance use change from adolescence to early adulthood, while accounting for the influence of substance use polygenic risk (i.e., genetic risk based on the combined effects of multiple genes). PARTICIPANTS: We used a sample of unrelated European-origin Americans with genetic and childhood maltreatment data (n = 2,664) from the National Longitudinal Study of Adolescent to Adult Health. METHODS: Latent profile analysis was used for sub-group identification and direct and interaction effects were tested for longitudinal trajectories of substance use utilizing generalized estimating equations. RESULTS: Three sub-groups with co-occurring childhood maltreatment exposures were identified: a high sexual abuse sub-group, a high physical abuse sub-group, and a normative sub-group (with low maltreatment exposure). At high polygenic risk, the high physical abuse sub-group had faster increases in substance use over time. In comparison, the high sexual abuse sub-group had faster progression in substance use only at low and medium polygenic risk. CONCLUSIONS: Findings provide initial evidence for biological and environmental differences among maltreatment sub-groups on trajectories of substance use.

Adverse Childhood Experiences Associated with Children's Patterns of Out of Home Placement Over Time and Subsequent Negative Outcomes During Adolescence.

BACKGROUND: Out of home placement (OOHP) of welfare involved children is a critical problem associated with child abuse and neglect and household dysfunction. Few studies have also implicated greater instability in OOHP with more negative outcomes. However, several gaps remain. OBJECTIVES: Objectives were twofold. To identify combinations of adverse childhood experiences that are associated with OOHP - based on both duration of OOHP and change in actual placement during each time point, among welfare involved youth. The second objective was to understand long-term negative outcomes during adolescence that are associated with greater placement instability. METHODS: Data come from the National Survey of Child and Adolescent Wellbeing (n = 1,657). Multinomial logistic regression was used to evaluate adverse childhood experiences that were associated with specific patterns of OOHP. Multivariate regression models were estimated to evaluate delinquency, aggression as well as depressive and trauma symptoms during adolescence that were associated with specific patterns of OOHP. RESULTS: There were six categories of OOHP found in the sample: 1) no OOHP, 2) OOHP one time, 3) OOHP two times, 4) OOHP two times with change in placements, 5) OOHP three times, and 6) OOHP three times with change in placement. Longer duration of OOHP was associated with more adversity exposure. Longer duration and more change in placement were associated with the most negative outcomes. CONCLUSIONS: Findings demonstrate the need for future testing of these findings in prevention trials.

Childhood maltreatment exposure and physical functional limitations in late adulthood: examining subjective sleep quality in midlife as a mediator.

Objective: The present study had three major aims: 1) To identify sub-groups of adults with differing combinations of childhood maltreatment exposures, 2) to understand the association of childhood maltreatment sub-group membership with subjective sleep quality in midlife, and 3) to assess poor sleep quality in midlife as a mechanism between childhood maltreatment sub-group membership and physical functional limitations in late adulthood. Design: Data come from the Biomarker project of the Midlife Development in the United States study (n = 1251). Outcome measures: The Pittsburgh Sleep Quality Index (Buysse et al., 1989) was used to assess sleep quality in midlife. Functional limitations in late adulthood were measured using a version of the SF-36 (Brazier et al., 1992). Results: Two vulnerable childhood maltreatment sub-groups emerged (Physical and Emotional Maltreatment Sub-group, n = 49, and Sexual Abuse Sub-group, n = 105) and a normative sub-group (n = 1087; low exposure to childhood maltreatment). Poor sleep quality in midlife mediated the association between both maltreatment sub-groups and functional limitations in late adulthood. Conclusion: Results highlight the role of sleep in linking childhood maltreatment with functional impairments in adulthood and offer a potential target for interventions to improve quality of life in older adults.

The Association of Psychological Well-Being with Disablement Processes in a National Sample.

OBJECTIVE: Objectives were to explore subgroups of individuals with differential disability trajectories and evaluate the protective effects of psychological well-being (i.e. hedonic and eudaimonic) in the presence of multiple disease conditions (or multimorbidity) and sociodemographic disadvantages. METHODS: Data come from the prospective longitudinal cohort study the Midlife Development in the United States (n = 3,904). Three waves of data spanning a 20-year period were used to identify subgroups with different disability trajectories. Subgroup membership was then modelled as a function of psychological well-being assessed at wave 1 of the study using multinomial logistic regression. RESULTS: Three unique groups were identified: a normative group with initially low and slowly increasing levels of disability; a group with high levels of disability that was stable over time; and a group with moderate initial levels of disability that increased over time. Hedonic well-being at wave 1 was associated with membership in the risk groups relative to the normative group. CONCLUSION: Individuals may follow one of three disability pathways mostly as a function of multimorbidity. However, hedonic well-being was associated with having an advantageous disability trajectory regardless of multimorbidity status. Cultivating psychological well-being may improve disability outcomes in aging individuals.