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

Allen, Sarah, Gilbody, S., Atkin, K. and van der Feltz-Cornelis, C. M. (2023) The associations among childhood trauma, loneliness, mental health symptoms, and indicators of social exclusion in adulthood: A UK Biobank study. Brain and Behavior. e2959. ISSN 2157-9032 (In Press)

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Abstract

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 characterisation 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: An analysis of 87,545 participants (mean age=55.68[7.78], 55.0% female, 97.4%white) enrolled in the UK Biobank. Childhood trauma as determined by CTS-5. Current loneliness and symptoms of anxiety (GAD-7) and depression (PHQ-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 UKBiobank.

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.

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