Rebecca M Sacks1, Erin Takemoto1, Sarah Andrea1, Nathan F Dieckmann2, Katherine W Bauer3, Janne Boone-Heinonen4. 1. Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon. 2. Oregon Health & Science University School of Nursing, Portland, Oregon; Oregon Health & Science University School of Medicine, Portland, Oregon. 3. Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan. 4. Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon. Electronic address: boonej@ohsu.edu.
Abstract
INTRODUCTION: Childhood maltreatment is associated with later obesity, but the underlying mechanisms are unknown. The objective of this study was to estimate the extent to which depression mediates the associations between childhood maltreatment and BMI in adolescence through adulthood. METHODS: Data on a cohort of 13,362 adolescents in the National Longitudinal Study of Adolescent to Adult Health (Wave I [1994-1995] to Wave IV [2008-2009]) were analyzed in 2015-2016. Classes of maltreatment experienced prior to age 12 years were statistically identified using latent class analysis. Gender-stratified latent growth curve analysis was used to estimate total effects of maltreatment classes on latent BMI trajectory (aged 13-31 years) and indirect effects of maltreatment classes that occurred through latent depression trajectory (aged 12-31 years). RESULTS: Four latent maltreatment classes were identified: high abuse and neglect; physical abuse dominant; supervisory neglect dominant; and no/low maltreatment. In girls, compared with no/low maltreatment, supervisory neglect dominant (coefficient=0.3, 95% CI=0.0, 0.7) and physical abuse dominant (coefficient=0.6, 95% CI=0.1, 1.2) maltreatment were associated with faster gain in BMI. Change in depression over time fully mediated the association of BMI slope with physical abuse dominant maltreatment, but not with supervisory neglect dominant maltreatment. In boys, high abuse and neglect maltreatment was associated with marginally greater BMI at baseline (coefficient=0.7, 95% CI= -0.1, 1.5); this association was not mediated by depression. CONCLUSIONS: Although maltreatment was associated with depression and BMI trajectories from adolescence to adulthood, depression only mediated associations with physical abuse dominant maltreatment in girls.
INTRODUCTION: Childhood maltreatment is associated with later obesity, but the underlying mechanisms are unknown. The objective of this study was to estimate the extent to which depression mediates the associations between childhood maltreatment and BMI in adolescence through adulthood. METHODS: Data on a cohort of 13,362 adolescents in the National Longitudinal Study of Adolescent to Adult Health (Wave I [1994-1995] to Wave IV [2008-2009]) were analyzed in 2015-2016. Classes of maltreatment experienced prior to age 12 years were statistically identified using latent class analysis. Gender-stratified latent growth curve analysis was used to estimate total effects of maltreatment classes on latent BMI trajectory (aged 13-31 years) and indirect effects of maltreatment classes that occurred through latent depression trajectory (aged 12-31 years). RESULTS: Four latent maltreatment classes were identified: high abuse and neglect; physical abuse dominant; supervisory neglect dominant; and no/low maltreatment. In girls, compared with no/low maltreatment, supervisory neglect dominant (coefficient=0.3, 95% CI=0.0, 0.7) and physical abuse dominant (coefficient=0.6, 95% CI=0.1, 1.2) maltreatment were associated with faster gain in BMI. Change in depression over time fully mediated the association of BMI slope with physical abuse dominant maltreatment, but not with supervisory neglect dominant maltreatment. In boys, high abuse and neglect maltreatment was associated with marginally greater BMI at baseline (coefficient=0.7, 95% CI= -0.1, 1.5); this association was not mediated by depression. CONCLUSIONS: Although maltreatment was associated with depression and BMI trajectories from adolescence to adulthood, depression only mediated associations with physical abuse dominant maltreatment in girls.
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