The associations among childhood trauma, loneliness, mental health symptoms, and indicators of social exclusion in adulthood: A UK Biobank study

• Published in: Brain and behavior Vol. 13; no. 4; pp. e2959 - n/a
• Main Authors: Allen, Sarah F., Gilbody, Simon, Atkin, Karl, Feltz‐Cornelis, Christina M.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-04-2023; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Adults; Adverse Childhood Experiences; Anxiety - psychology; Anxiety Disorders; Biobanks; Biological Specimen Banks; childhood trauma; Depression - psychology; Female; Humans; Loneliness; Loneliness - psychology; Male; Mental Health; Middle Aged; Missing data; Neurosciences; Original; Participation; Poverty; Psychopathology; Questionnaires; Sex crimes; Sexual abuse; Social exclusion; Social isolation; Social networks; Society; UK Biobank; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK; childhood trauma; loneliness; UK Biobank; mental health; social exclusion
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.2959

Aims
Childhood trauma has been associated with adult psychosocial outcomes linked to social exclusion. However, the strength of these associations in the general population is unknown. The emergence of the UK Biobank, with rich phenotypic characterization of the adult population, affords the exploration of the childhood determinants of adult psychopathology with greater statistical power. The current study aims to explore (1) the associations between childhood trauma and social exclusion in adulthood and (2) the role that self‐reported loneliness and symptoms of distress play in the associations.
Methods
This study was an analysis of 87,545 participants (mean [± SD] age = 55.68 [7.78], 55.0% female, 97.4% White) enrolled in the UK Biobank. Childhood trauma was determined by the five‐item Childhood Trauma Screener. Current loneliness and symptoms of anxiety (Generalized Anxiety Disorder Scale‐7) and depression (Patient Health Questionnaire‐9) were also entered in analyses. Outcomes were “limited social participation,” “area deprivation,” “individual deprivation,” and “social exclusion” from a previously determined dimensional measure of social exclusion in the UK Biobank.
Results
Hierarchical multiple regression models indicated small associations between childhood trauma and social exclusion outcomes, explaining between 1.5% and 5.0% of the variance. Associations weakened but remained significant when loneliness, anxiety, and depression were entered in the models; however, anxiety symptoms demonstrated a negative association with “individual deprivation” and “social exclusion” in the final models. Depression was most strongly associated with “individual deprivation,” “area deprivation,” and “social exclusion” followed by childhood trauma. Loneliness was most strongly associated with “limited social participation.”
Conclusions
Experiences of childhood trauma can increase the propensity for adulthood social exclusion. Loneliness and symptoms of depression attenuate but do not eliminate these associations. Anxiety symptoms have a potentially protective effect on the development of “individual deprivation.” Findings add to the growing body of literature advocating for trauma‐informed approaches in a variety of settings to help ameliorate the effects of childhood trauma on adult psychosocial outcomes. Further research, however, is required.
An analysis of UK Biobank data finds associations between childhood trauma and increased indicators of social exclusion. These associations are attenuated by but not eliminated by loneliness and depression. Anxiety may play a minor protective role in the development of employment and education related aspects of social exclusion.