title: Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders.
abstract: OBJECTIVE
  We aimed to examine the prevalence of several types of childhood adversity across adult cohorts, whether age moderates the effect of childhood adversity on mental health, the relationship between childhood adversity and psychopathology among older adults, the dose-response relationship between number of types of childhood adversities and mental disorders in later life, and whether lifetime mental health treatment reduces the odds of psychopathology among older survivors of childhood adversity.
  
  
  METHODS
  In a population-based, cross-sectional study on a nationally representative U.S. sample, we studied 34,653 community-dwelling Americans 20 years and older, including 7,080 adults 65 years and older from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Trained lay interviewers assessed past-year mood and anxiety disorders and lifetime personality disorders. Participants self-reported childhood adversity based on questions from the Adverse Childhood Experiences Study.
  
  
  RESULTS
  Childhood adversity was prevalent across five age cohorts. In our adjusted models, age did not moderate the effect of childhood adversity on mental disorders. Older adults who experienced childhood adversity had higher odds of having mood (odds ratio: 1.73; 95% confidence interval: 1.32-2.28), anxiety (odds ratio: 1.48; 95% confidence interval: 1.20-1.83), and personality disorders (odds ratio: 2.11; 95% confidence interval: 1.75-2.54) after adjusting for covariates. An increasing number of types of childhood adversities was associated with higher odds of personality disorders and somewhat higher odds of anxiety disorders. Treatment-seeking was associated with a reduced likelihood of anxiety and, especially, mood disorders in older adult childhood adversity survivors.
  
  
  CONCLUSIONS
  These results emphasize the importance of preventing childhood adversity and intervening once it occurs to avoid the negative mental health effects that can last into old age.
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Raposo
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychology, Mount Royal University, Calgary, Alberta, Canada.
authors.forename: Corey S
authors.initials: CS
authors.lastname: Mackenzie
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Henriksen
authors.affiliation: Departments of Community Health Sciences, Psychiatry, and Family Social Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: tracie.afifi@med.umanitoba.ca.
authors.forename: Tracie O
authors.initials: TO
authors.lastname: Afifi
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology*; D010554:Personality Disorders / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Childhood abuse; childhood neglect; persistence; risk; treatment