6. LATENT ASPECTS OF LATE-LIFE DEPRESSION: EXPLORING THE ROLE OF CHILDHOOD TRAUMA AND PERSONALITY

Introduction

The presence of childhood trauma in the geriatric population is as high, if not higher than those in middle age or young adulthood, where many estimates range from 15-45%. This is likely especially true among those with history of depression (LLD). Still, geriatricians, psychiatrists, and psychologists often remain focused on the acute aspects of worsening mood and possible depression tied to typical aging (e.g., functional limitations, declining physical health, and interpersonal losses, etc.) neglecting two important aspects of a person’s depressive past and current presentation: childhood trauma and baseline personality characteristics. We sought to investigate if, and to what extent, neuroticism – the personality variable most implicated in psychopathology – and childhood trauma relate to a person’s history of depression.

Methods

99 adults aged 55-79 (M age = 65, SD = 6.5) were administered the Structured Clinical Interview for DSM-5 (SCID-5) and categorized as 61 never-depressed (N-DEP) and 38 with at least one depressive episode (DEP) with a first onset before the age of 35 (including active and remitted). All participants were administered the NEO Personality Inventory (NEO-PI) and the Childhood Trauma Questionnaire (CTQ). There were two primary outcomes: to describe the prevalence and make-up of childhood trauma in a sample of older adults and to investigate its relationship with personality variables to an individual’s history of depression. Exploratory analyses were conducted to see if the type of childhood trauma uniquely predicted depressive episodes. Linear mixed models, including hierarchical regression were used to for this analysis and were adjusted for age, sex, and education.

Results

In our sample with a majority of never-depressed participants, 54% scored over 35, the typical threshold for clinical significance on the CTQ, with the sexual abuse subscale receiving the lowest amount of suprathreshold scores (22%) and emotional neglect being the highest amount (55%). Further, when comparing between N-DEP and DEP groups, we found nearly three and a half times as much emotional abuse and nearly three times as much physical abuse in the DEP group. Neuroticism facet scores (entered in the second block) were predictive of depression history (p LESS THAN .001), but childhood trauma scores (entered in the third block) were not. Finally, of the five subscales, only emotional abuse was a significant contributor to the model (block three, replacing overall CTQ scores; p = 01) when entered in their own model steps.

Conclusions

The majority of the sample reporting scores considered clinically meaningful confirmed our hypothesis that these experiences are likely more common than previously suspected. Further, our results highlight the importance of giving trait-based variables – principally, the facet of personality labeled neuroticism – consideration for treating adult mood symptoms in late life. The fact that childhood trauma scores overall did not significantly contribute to the model may be related to the high baseline presence of trauma across the sample, regardless of depression history. Finally, the unique positioning of emotional abuse, both in differentiating the groups and in predicating group assignment highlights the need for further research on the impact of childhood trauma in older people.