Childhood Adversity and Successful Aging

Abstract

Extant literature offers consensus regarding the long-term impacts of childhood adversity (CA) but its impact on successful aging is not well understood. The Midlife in the United States (MIDUS) study – a nationally representative sample including 1,017 adults 55-76 (Ryff et al., 2016) – did not include a measure of CA exposure for use in analyses. Two papers were developed for this dissertation. The first paper, An effective measure of childhood adversity for use with older adults, explored whether a cumulative CA measure that is effective for older adults could be developed using existing MIDUS questions. It provided a rationale for operationalization of CA for researchers and for creating a cumulative score of eight CA types. Distributions of individual items and the CA score were consistent with past studies using similar CA measures. The overall factor structure of the scale was consistent with previous research: 1) household dynamics (did not live with both biological parents until age 16, substance abuse in the home, financial distress, moved three or more times) and 2) child abuse and neglect (sexual assault, emotional abuse, physical abuse, emotional neglect). Consistent with the literature, CA score showed a significant negative association with life satisfaction and positive association with number of chronic conditions, and dose-response relationships with cumulative CA. This study demonstrated that CA score, created using existing MIDUS data, was an effective measure for use with older adults. The second paper, The impact of childhood adversity on successful aging for older adults, examined the impact of CA score on successful aging for older adults, operationalized using eight dimensions of wellness. Results showed that CA affected successful aging decades later. Controlling for age and gender, hierarchical multiple regression showed a significant negative association between CA score and emotional, physical, social, financial, environmental, and spiritual wellness as well as the cumulative wellness index, and no significant association with intellectual or occupational wellness. Prevention is the best way to address public health implications of CA. However, the present study provided insight into successful aging and can inform interventions that target adults for whom prevention of CA is not possible.