Using path analysis to examine the relationship between sexual abuse in childhood and diabetes in adulthood in a sample of US adults. Prev Med 2018 Mar;108:1-7
Date
12/27/2017Pubmed ID
29277408Pubmed Central ID
PMC5828999DOI
10.1016/j.ypmed.2017.12.013Scopus ID
2-s2.0-85039727600 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
To understand mechanisms underlying the relationship between adverse childhood experiences (ACE) and diabetes the study evaluated mediators of the relationship between childhood sexual abuse and diabetes in adulthood. This study used cross-sectional data from the 2011 Behavioral Risk Factor Surveillance Survey (BRFSS). Participants totaled 48, 526 who completed the ACE module. Based on theoretical relationships, path analysis was used to investigate depression and obesity as pathways between childhood sexual abuse, and diabetes in adulthood. Among adults with diabetes, 11.6% experienced sexual abuse. In the unadjusted model without mediation, sexual abuse was significantly associated with depression (OR=4.48, CI 4.18-4.81), obesity (OR=1.28, CI 1.19-1.38), and diabetes (OR=1.39, CI 1.25-1.53). In the unadjusted model with mediation, depression and obesity were significantly associated with diabetes (OR=1.59, CI 1.48-1.72, and OR=3.77, CI 3.45-4.11, respectively), and sexual abuse and diabetes was no longer significant (OR=1.10, CI 0.98-1.23), suggesting full mediation. After adjusting for covariates in the mediation model, significance remained between sexual abuse and depression (OR=3.04, CI 2.80-3.29); sexual abuse and obesity (OR=1.41, CI 1.29-1.53), depression and diabetes (OR=1.35, CI 1.23-1.47); and obesity and diabetes (OR=3.53, CI 3.20-3.90). The relationship between sexual abuse and diabetes remained insignificant (OR=1.09, CI 0.96-1.24). This study demonstrates that depression and obesity are significant pathways through which childhood sexual abuse may be linked to diabetes in adulthood. These results can guide intervention development, including multifaceted approaches to treat depression and increase physical activity in patients with a history of sexual abuse to prevent diabetes.
Author List
Campbell JA, Farmer GC, Nguyen-Rodriguez S, Walker RJ, Egede LEAuthors
Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of WisconsinLeonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultBehavioral Risk Factor Surveillance System
Child
Child Abuse, Sexual
Cross-Sectional Studies
Depression
Diabetes Mellitus
Female
Humans
Male
Middle Aged
Obesity
Risk Factors
Surveys and Questionnaires
United States