Measuring Childhood Trauma among Adults in the Health and Retirement Study

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Abstract Background Early life social determinants of health, such as childhood trauma, have implication on adverse health outcomes later in the life course. Our objective was to develop a childhood trauma measure within the Health and Retirement Study (HRS) – a large, diverse, U.S.-based aging cohort. Methods Data from the HRS Psychosocial and Lifestyle Questionnaire [2006-2016] and Life History Survey [2015-2017]) surveys collected thirteen binary items measuring self-reported exposure to early life adversity across the two study questionnaires. Participants who completed both questionnaires and had exposure items available were included in the analyses. Frequencies and percentages for self-reported trauma items are presented for the study sample and by gender and race/ethnicity. Using complete cases, exploratory factor analyses followed by Mokken scale analyses were performed to evaluate the scalability of the childhood trauma items. Predictive criterion validity of the final domains was evaluated with general health and socioeconomic indicators at participant baseline. Results Among the sample with complete childhood trauma data available (n=9,340), most were women (60.7%), White/Non-Hispanic (73.2%), and had a high school/general education degree (54.0%). The most reported childhood traumas were paternal separation ≥6-months (22.8%), parental death (21.4%), sibling death (18.1%), and problematic parental substance use (17.5%). Two scales were formed based on factor analysis and scalability coefficients. The domain measuring disruption of family structure had strong scalability ( H T = 0.55) and included living in an orphanage, foster care, parents divorced/separated, ≥6-month from mother and/or father, and grandparents as primary caretakers. A second domain measuring adverse experiences of parent and/or sibling death had moderate scalability ( H T = 0.41). Parental substance abuse and physical abuse clustered together in a third domain with weak scalability ( H T = 0.39). Conclusions The early adversity items available in the HRS offer meaningful domains for which researchers can evaluate childhood trauma exposure in the context of aging outcomes in older adults. In particular, the family structure domain and parental/sibling death demonstrated moderate-to-strong scalability and may have important implications for health trajectories later in life.

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