title: Childhood family psychosocial environment and carotid intima media thickness: the CARDIA study.
abstract: Little is known about whether the childhood family psychosocial environment (characterized by cold, unaffectionate interactions, conflict, aggression, neglect and/or low nurturance) affects coronary heart disease (CHD) risk. Objectives were to evaluate associations of childhood family psychosocial environment with carotid intima media thickness (IMT), a subclinical measure of atherosclerosis. The study population included 2659 CARDIA study participants, aged 37-52 years. Childhood family psychosocial environment was measured using a risky family questionnaire via self-report. Carotid IMT was calculated using the average of 20 measurements of mean common carotid, bulb and internal carotid IMT, assessed using high-resolution B-mode ultrasound images. Utilizing linear regression analyses adjusted for age, a 1-unit (range 0-21) increase in risky family score was associated with 0.0036 (95% CI: 0.0006,0.0066 mm) and 0.0020 (95% CI: 0.0002,0.0038) mm increase in mean IMT in white males and females, respectively. Formal mediation analyses and covariate adjustments suggested childhood socioeconomic position and smoking may be important mechanisms in white males and females, as well as education and depressive symptomatology in white males. No associations were found in black participants. Formal statistical tests for interaction between risky family score and sex, and between risky family score and race/ethnicity, demonstrated borderline evidence of interactions for both sex (p = 0.12) and race/ethnicity (p = 0.14) with risky family score for associations with mean IMT. In conclusion, childhood family psychosocial environment was positively associated with IMT in white participants, with little evidence of association in black participants. Mechanisms in white participants may include potential negative impacts of socioeconomic constraints on parenting quality, potentially influencing offspring's cardiovascular risk factors (e.g. smoking), socioeconomic position (e.g. education), and/or psychosocial functioning (e.g. depression), which may in turn lead to atherosclerotic processes. Borderline racial/ethnic differences in findings should be replicated, but add to literature exploring race/ethnicity-specific associations of parenting approaches with health outcomes.
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02906, USA. Electronic address: eric.loucks@brown.edu.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Loucks
authors.affiliation: Department of Psychology, University of California Los Angeles, USA.
authors.forename: Shelley E
authors.initials: SE
authors.lastname: Taylor
authors.affiliation: Department of Radiology, Tufts University School of Medicine, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02906, USA.
authors.forename: Aude
authors.initials: A
authors.lastname: Wilhelm
authors.affiliation: Division of Research, Kaiser Permanente, USA.
authors.forename: Preety
authors.initials: P
authors.lastname: Kalra
authors.affiliation: Department of Psychiatry, University of Pittsburgh, USA; Department of Psychology, University of Pittsburgh, USA; Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D000328:Adult; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000208:ethnology / Q000523:psychology; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012931:Social Environment; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: Carotid intima media thickness; Coronary heart disease; Family; Life course