Gender Differences in Response to Childhood Adversities

Bruno Mendonça Coêlho, MD, a researcher at the Faculty of Medicine Foundation, Federal University of São Paulo, Brazil, delivered a talk at the Annual Meeting of the American Psychiatric Association in San Diego on a study conducted to examine the adult impact of incidents of adversity that were experienced during childhood.

Coêlho explained that childhood adversities (CA) comprise the group of negative experiences that individuals suffer up until age 18, and that CA have been implicated in various psychiatric outcomes. Coêlho said that the aim of the study was to examine the clustering of CA in a representative sample of the general population in Brazil and to investigate the influence of gender on outcomes.

Information was collected from just over 5000 subjects in the general population from the São Paulo metropolitan area that comprised the occurrence of parental mental illness, substance abuse, criminality, divorce, and death or other loss of either parent during the subject’s childhood, as well as any history of family violence, physical abuse, sexual abuse, neglect, physical illness, or economic adversity that was experienced by the subject during childhood.

Coêlho applied various statistical algorithms to the data. “After determining the best number of dimensions to use for CA with confirmatory factory analysis following principal components analysis (PCA), a Rasch model from item response theory models (IRT) was used to isolate the contribution of each adversity on the results, and analyses were broken down by gender,” he told the audience, explaining the ITR/Rasch analysis can measure underlying traits of different variables and the independent chance of each individual CA being reported.

Regarding the approach taken for the statistical analysis, Coêlho said, “In order to address the entire spectrum of CA and because some adversities are more difficult to disclose than others, the CA should be considered as clusters of risk factors rather than as a single group with common characteristics.”

CA were seen in just over half of the subjects, and the majority of these presented with 2 or more CA. In the overall sample and in the male cohort, a 3-factor model fit best, while a 2-factor model fit best for women.

Coêlho added, “There was a group of 4 adversities consisting of physical abuse, neglect, parental mental disorders, and family violence that co-occurred independent of other factors in either gender and in the overall group, implying that these are common components of dysfunctional families and violent environments.”

Coêlho characterized this observation as important, because of the suggestion by other researchers in the field that general characteristics of the home environment are more important than the presence of any specific adversity in the development of psychopathology. Coêlho noted that sexual abuse, although reported only infrequently in males, appeared to be important for this group. “The relationship to sexual abuse was more related to the parental substance abuse disorder risk factor in the male subgroup, making it possible to infer that there is a clinical distinction between those individuals exposed to sexual abuse and those who were not so exposed.”

Concluding his remarks, Coêlho said, “CA constitute a multidimensional group of events that are frequently experienced by individuals during childhood and adolescence. The key finding from this study is that CA occurrence profiles differ in males and females such that they cannot be seen as a homogeneous group.”