Written by Alexis Mitchell UNCC’18
Exposure to childhood trauma is associated with a host of negative outcomes, including, but not limited to, posttraumatic stress disorder (Ballard et al., 2015). For example, childhood adversity has been associated with adult outcomes like suicide, depression, alcohol and drug use, and physical consequences, like autoimmune disorders. Toxic stress that can occur during childhood, due to events such as abuse, neglect, parental substance use, and parental depression can lead to changes in learning, behavior, and physiology that have an impact throughout adulthood.
Ballard and colleagues conducted a longitudinal study using a sample initially consisting of 2,311 first graders from nineteen different schools in five different urban areas (2015). These first graders were chosen as part of an intervention called the Good-Behavior Game in order to help reduce aggressive and disruptive behavior. As the first graders progressed through school, 1,815 of the initial sample agreed to complete at least one of four young adult assessments at approximately 19, 21, 22, and 29 years old. The participants were interviewed and asked if they had ever experienced any of 18 different traumatic events based on criteria A of the DSM-IV before age 13. If they reported an event they were then further questioned to recall about suicidal ideation and attempt, health outcomes, parental substance abuse, parental psychopathology, psychiatric and substance use disorders (e.g. major depressive disorder, PTSD).
This team of researchers used an analysis which separated the participants into subtypes of trauma. This permitted the examination of how different types of traumatic exposures typically cluster across childhood, in order to identify specific demographic and clinical profiles of childhood traumatic experiences. These subtypes, referred to as classes, can identify those individuals with childhood trauma who go on to develop negative outcomes in young adulthood.
Three separate classes of childhood traumatic experiences emerged. 84% of the sample reported low levels of all traumatic experiences (the Low-Trauma class). The second class (the Violence Exposure class) comprised 8% of the sample, was predominately male, and reported highest levels of witnessing violence, physical assault, and physical injury. The third class (the Sexual Assault class), 8% of the sample, predominately female, reported highest levels of sexual assault and having known someone who was sexually assaulted.
The Sexual Assault class also reported a wide range of psychiatric outcomes, while men in the violence exposure class reported a pattern of outcomes limited to posttraumatic stress and antisocial personality disorder. Specifically, the sexual assault class had higher rates of major depressive disorder and demonstrated significantly higher likelihood of posttraumatic stress symptoms than the Low-Trauma class. These childhood trauma classes were strong predictors of young adult trauma experiences. The Sexual Assault class had significantly higher odds of experiencing sexual assault during young adulthood (after age 13) and the Violence Exposure class had significantly higher odds of being physically assaulted during young adulthood than the other two classes. Regarding health outcomes, the Sexual Assault class reported more hypertension, severe headaches, sexually-transmitted diseases, and stomach problems than the other two classes.
To conclude, these classes of childhood traumatic experiences were created and studied using an urban sample of participants followed from childhood to age 29 years. Traumatic experiences, specifically assaultive (sexual and physical) were found to predict negative psychiatric outcomes by young adulthood.
Ballard, E. D. (2015). Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychological Medicine, 45(15), 3305-3316.
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