Associations of different types of child maltreatment and diabetes in adulthood – the mediating effect of personality functioning: Findings from a population-based representative German sample

• Published in: Annals of epidemiology 2023-02, Vol.78, p.47-53
• Main Authors: Zara, Sandra, Brähler, Elmar, Sachser, Cedric, Fegert, Jörg M, Häuser, Winfried, Krakau, Lina, Kampling, Hanna, Kruse, Johannes
• Format: Article
• Language: English
• Subjects: Child; Child abuse; Child Abuse - psychology; Diabetes Mellitus; Humans; Mediation analysis; Noncommunicable diseases; Personality; Personality functioning; Self Report; Surveys and Questionnaires
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2022.12.004

•All CM types are associated with an increased risk of diabetes in adulthood.•Patients with diabetes more frequently report CM than patients without diabetes.•This is the first study examining personality functioning as an underlying pathway.•Personality functioning mediates the association between abuse and diabetes.•This was most prominent for emotional abuse followed by sexual and physical abuse.•Results are based on a representative sample of the German population. This study aimed to examine the role of personality functioning in the association between various types of child maltreatment (CM) (sexual, physical, and emotional abuse as well as physical and emotional neglect) and diabetes in adulthood. Analyses are based on representative data of the German population (N = 5,041) from 2016 to 2019. Self-report questionnaires assessed diagnosis of diabetes, child maltreatment (CTQ), personality functioning (OPD-SQS), and symptoms of depression/anxiety (PHQ-4). Odd ratios were calculated to examine the association between CM and diabetes, and mediation analyses including PHQ-4 as covariate were conducted to examine the role of personality functioning. All CM types significantly elevated the odds of having diabetes in adulthood. Personality functioning mediated the association between abuse and diabetes (sexual: b = 0.012, 95% CI [.002, 0.022], PM = 25.0%, physical: b = 0.009, 95% CI [.001, 0.017], PM = 12.0%, and emotional: b = 0.013, 95% CI [.002, 0.024], PM = 59.8%), but not between neglect and diabetes. CM is associated with an increased risk of diabetes, with personality functioning being a relevant mediator for CM abuse types. Hence, by focusing on CM prevention and considering impaired personality functioning in diabetes treatment, diabetes self-management and health behavior could be improved.