Health Disparities
The role of personality in the association between adverse childhood experiences with chronic conditions Luke Barry* Luke Barry Mina Habib Roch Nianogo
Background
Adverse childhood experiences (ACEs) may contribute to physiological dysregulation and increased morbidity. Modifiable personality traits can influence this relationship. This study examines the association between ACEs and number of chronic conditions over the lifecourse, and the mediating role of personality.
Methods
Data from the 2006 and 2008 US Health and Retirement Study were analyzed. Exposures included any ACEs (before age 18) and specific ACEs (repeating a school year; parental substance use; physical abuse). Mediators were the top quartile (Y/N) of Big Five personality traits (conscientiousness, agreeableness, neuroticism, openness, extraversion). The outcome was the number of chronic conditions. Exclusions included childhood chronic conditions, missing baseline or exposure data (n=9,458). Missing mediator and outcome values were imputed using multiple imputation. Causal mediation analysis with generalized linear regression and 200 bootstrap iterations estimated associations and quantified mediators’ roles, adjusting for baseline confounders (age, age-squared, gender, race/ethnicity, childhood health and socioeconomic status, and parental smoking).
Results
Individuals with any ACEs reported 6% more chronic conditions compared to those with no ACEs (IRR = 1.06 [95% CI = 1.03, 1.10]). Physical abuse by a parent was linked to 18% more chronic conditions (IRR = 1.18 [1.11, 1.25]). High neuroticism amplified the ACE-morbidity association (Excess Ratio due to reference interaction [ER-Ref] = 0.02 [0.01, 0.04]), overall explaining 42% of this link. High openness and conscientiousness (ER-Ref for both = -0.01 (-0.03, 0.01) modestly buffered the ACE effect on morbidity but precision was lower.
Conclusion
ACEs were associated with higher morbidity, particularly parental physical abuse. High neuroticism exacerbated this link, while openness and conscientiousness offered some protective effects. Interventions targeting neuroticism could mitigate 42% of the ACE-morbidity association.