Self Reported Childhood Difficulties, Adult Multimorbidity and Allostatic Load. A Cross-Sectional Analysis of the Norwegian HUNT Study

Margret Olafia Tomasdottir; Johann Agust Sigurdsson; Halfdan Petursson; Anna Luise Kirkengen; Steinar Krokstad; Bruce McEwen; Irene Hetlevik; Linn Getz

doi:10.1371/journal.pone.0130591

Self Reported Childhood Difficulties, Adult Multimorbidity and Allostatic Load. A Cross-Sectional Analysis of the Norwegian HUNT Study

PLoS One. 2015 Jun 18;10(6):e0130591. doi: 10.1371/journal.pone.0130591. eCollection 2015.

Authors

Margret Olafia Tomasdottir¹, Johann Agust Sigurdsson¹, Halfdan Petursson², Anna Luise Kirkengen³, Steinar Krokstad⁴, Bruce McEwen⁵, Irene Hetlevik², Linn Getz²

Affiliations

¹ Department of Family Medicine, University of Iceland and Primary Health Care of the Capital Area, Reykjavik, Iceland; General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
² General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
³ General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of General Practice, UiT The Arctic University, Tromsø, Norway.
⁴ HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Levanger, Norway.
⁵ Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York, United States of America.

Abstract

Background: Multimorbidity receives increasing scientific attention. So does the detrimental health impact of adverse childhood experiences (ACE). Aetiological pathways from ACE to complex disease burdens are under investigation. In this context, the concept of allostatic overload is relevant, denoting the link between chronic detrimental stress, widespread biological perturbations and disease development. This study aimed to explore associations between self-reported childhood quality, biological perturbations and multimorbidity in adulthood.

Materials and methods: We included 37 612 participants, 30-69 years, from the Nord-Trøndelag Health Study, HUNT3 (2006-8). Twenty one chronic diseases, twelve biological parameters associated with allostatic load and four behavioural factors were analysed. Participants were categorised according to the self-reported quality of their childhood, as reflected in one question, alternatives ranging from 'very good' to 'very difficult'. The association between childhood quality, behavioural patterns, allostatic load and multimorbidity was compared between groups.

Results: Overall, 85.4% of participants reported a 'good' or 'very good' childhood; 10.6% average, 3.3% 'difficult' and 0.8% 'very difficult'. Childhood difficulties were reported more often among women, smokers, individuals with sleep problems, less physical activity and lower education. In total, 44.8% of participants with a very good childhood had multimorbidity compared to 77.1% of those with a very difficult childhood (Odds ratio: 5.08; 95% CI: 3.63-7.11). Prevalences of individual diseases also differed significantly according to childhood quality; all but two (cancer and hypertension) showed a significantly higher prevalence (p<0.05) as childhood was categorised as more difficult. Eight of the 12 allostatic parameters differed significantly between childhood groups.

Conclusions: We found a general, graded association between self-reported childhood difficulties on the one hand and multimorbidity, individual disease burden and biological perturbations on the other. The finding is in accordance with previous research which conceptualises allostatic overload as an important route by which childhood adversities become biologically embodied.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Allostasis*
Child
Comorbidity
Cross-Sectional Studies
Female
Humans
Life Change Events*
Male
Middle Aged
Norway / epidemiology
Self Report
Socioeconomic Factors

Grants and funding

The HUNT3 Survey was mainly funded by the Norwegian Ministry of Health, the Norwegian University of Science and Technology, the Norwegian Research Council (the FUGE program), Central Norway Regional Health Authority, the Nord-Trøndelag County Council and the Norwegian Institute of Public Health. The present analysis received support from the Research Fund of the Icelandic College of Family Physicians. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.