Table 11.
Effect of exposure to childhood traumatic experiences on mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS).
| Crude effects | Total effects | Direct effects | Proportion mediated (Indirect effects) | ||
|---|---|---|---|---|---|
| Unadjusted | Adjusted for confounding variablesc | Adjusted for confounding variablescand mediatorsa, b | |||
| Childhood traumatic experiences (CTEs) | RR (95% CI) | RR (95% CI) | RR (95% CI) | %attentuationd (95% CI) | |
| MENTAL HEALTH (SCL-10) n = 8547 | |||||
| No trauma (Ps0Ph0D0) | 1.00 | 1.00 | 1.00 | Ref | |
| Psychological abuse only (Ps1Ph0D0) | 2.29(1.84–2.87) | 2.19(1.67–2.87) | 1.92(1.49–2.47) | 22.88(2.96–40.26) | |
| Physical abuse only (Ps0Ph1D0) | 1.11(0.69–1.80) | 1.10(0.61–1.97) | 1.08(0.61–1.92) | 17.82(–42.84–4455.85) | |
| Substance abuse distress only (Ps0Ph0D1) | 1.39(1.07–1–82) | 1.02(0.73–1.43) | 0.93(0.68–1.29) | – | |
| Psychological and physical abuse (Ps1Ph1D0) | 2.58(2.03–3.28) | 2.69(2.03–3.58) | 1.99(1.52–2.60) | 41.60(24.67–56.27) | |
| Psychological abuse and substance abuse distress (Ps1Ph0D1) | 3.27(2.23–4.80) | 2.14(1.23–3.73) | 1.51(0.89–2.56) | 54.97(1.38–153.99) | |
| Physical abuse and substance abuse distress (Ps0Ph1D1) | 1.91(0.84–4.33) | 2.22(0.88–5.57) | 2.37(0.95–5.95) | – | |
| Psychological abuse, physical abuse and substance abuse distress (Ps1Ph1D1) | 3.85(2.81–5.27) | 3.72(2.67–5.20) | 3.10(2.20–4.35) | 23.01(–1.08–42.94) | |
| HEALTH (EQ-5D) n = 9312 | |||||
| No trauma (Ps0Ph0D0) | 1.00 | 1.00 | 1.00 | Ref | |
| Psychological abuse only (Ps1Ph0D0) | 1.47(1.30–1.66) | 1.57(1.37–1.82) | 1.51(1.21–1.73) | 8.50(0.40–18.11) | |
| Physical abuse only (Ps0Ph1D0) | 1.32(1.08–1.60) | 1.45(1.14–1.76) | 1.38(1.10–1.68) | 12.49(–1.32–34.75) | |
| Substance abuse distress only (Ps0Ph0D1) | 1.11(0.97–1.27) | 1.11(0.93–1.27) | 1.07(0.93–1.21) | 36.11(–47.57–293.16) | |
| Psychological and physical abuse (Ps1Ph1D0) | 1.58(1.38–1.80) | 1.78(1.50–2.03) | 1.54(1.32–1.77) | 24.41(15.90–36.83) | |
| Psychological abuse and substance abuse distress (Ps1Ph0D1) | 1.82(1.46–2.26) | 1.61(1.14–2.12) | 1.44(0.98–1.89) | 24.14(2.88–91.34) | |
| Physical abuse and substance abuse distress (Ps0Ph1D1) | 1.33(0.86–2.04) | 1.69(0.91–2.61) | 1.63(0.88–2.50) | 7.13(–24.50–74.68) | |
| Psychological abuse, physical abuse and substance abuse distress (Ps1Ph1D1) | 1.85(1.53–2.24) | 2.12(1.66–2.55) | 1.96(1.54–2.37) | 10.56(1.61–20.92) | |
| WELL-BEING (SWLS) n = 8965 | |||||
| No trauma (Ps0Ph0D0) | 1.00 | 1.00 | 1.00 | Ref | |
| Psychological abuse only (Ps1Ph0D0) | 1.33(1.21–1.47) | 1.29(1.15–1.43) | 1.25(1.13–1.39) | 13.55 (2.32–30.25) | |
| Physical abuse only (Ps0Ph1D0) | 1.24(1.06–1.45) | 1.16(0.97–1.37) | 1.12(0.93–1.32) | 25.02(–13.72–217.20) | |
| Substance abuse distress only (Ps0Ph0D1) | 1.28(1.17–1.41) | 1.24(1.11–1.37) | 1.19(1.07–1.31) | 17.60(6.33–34.57) | |
| Psychological and physical abuse (Ps1Ph1D0) | 1.57(1.43–1.73) | 1.48(1.32–1.65) | 1.31(1.19–1.46) | 31.24(20.08–45.73) | |
| Psychological abuse and substance abuse distress (Ps1Ph0D1) | 1.79(1.54–2.08) | 1.62(1.31–1.92) | 1.46(1.17–1.73) | 22.36(5.64–43.85) | |
| Physical abuse and substance abuse distress (Ps0Ph1D1) | 0.93(0.60–1.43) | 0.87(0.47–1.34) | 0.84(0.47–1.24) | – | |
| Psychological abuse, physical abuse and substance abuse distress (Ps1Ph1D1) | 1.60(1.37–1.87) | 1.46(1.21–1.75) | 1.37(1.15–1.61) | 16.59(1.41–39.56) | |
The binary outcomes of mental health, health, and well-being were used for mediation analysis.
Ps0Ph0D0: Not exposed to psychological abuse, physical abuse and substance abuse distress in childhood. Ps1Ph0D0: Exposed to psychological abuse but not physical abuse and substance abuse distress. Ps0Ph1D0: Exposed to physical abuse but not psychological abuse and substance abuse distress. Ps0Ph0D1: Exposed to substance abuse distress, but not psychological abuse and physical abuse. Ps1Ph1D0: Exposed to both psychological and physical abuse but not substance abuse distress. Ps1Ph0D1: Exposed to both psychological abuse and substance abuse distress but not physical abuse. Ps0Ph1D1: Exposed to both physical abuse and substance abuse distress but not psychological abuse. Ps1Ph1D1: Exposed to psychological abuse, physical abuse, and substance abuse distress.
Social support factors were measured by instrumental and emotional support. Instrumental support: Do you have enough friends who can give you help and support when you need it? (yes, no); Emotional support: Do you have enough friends you can talk confidentially with? (yes, no).
Behavioral factors were measured by two questions: Do you/did you smoke daily? (yes, now; yes, previously; never); How many units of alcohol (a beer, a glass of wine or a drink) do you usually drink when you drink alcohol? (1–4, 5–6, 7–9, 10 or more).
Confounding variables were age, gender, father's education, mother's education and childhood financial conditions.
The percentages show the reduction in relative risk (RR) in model adjusted for mediators, compared to model adjusted only for confounding variables. For instance, the reduction in the RR for mental health for the Ps1Ph0D0group when including mediators to the first model, is [(2.19 – 1.92) / (2.19 – 1.00)] * 100 = 22.88%.
All significant associations (p < 0.05) are in bold.
SCL-10: Mental health status was measured by the Hopkins Symptoms Check List-10 (SCL-10).
EQ-5D: Health was assessed by the EQ-5D generic measure of health-related quality of life.
SWLS: Well-being was measured by the satisfaction with life scale (SWLS).