Objective
To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization.
Design
History of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization.
Setting
General community.
Participants
The study enrolled 350 homeless adults, aged 50 and older, in Oakland, CA using population-based sampling methods.
Measurements
Moderate to severe depressive symptoms measured on a Center for Epidemiologic Studies–Depression Scale (CES-D ≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization.
Results
Participants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR] 2.0; 95% confidence interval [CI] 1.1–3.7) and lifetime history of suicide attempt (AOR 4.6; 95% CI 1.0–21.6) when compared to those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR 7.1; 95% CI 2.8–18.0); there was no increase with fewer adversities.
Conclusion
Childhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations.