Typologies of childhood experiences and systemic lupus erythematosus disease activity, depression, and anxiety in the Black Women’s Experiences Living with Lupus (BeWELL) Study
Type of DegreeMaster's Thesis
Human Development and Family Studies
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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is sensitive to stress. However, there is a paucity of research on the impact of childhood stress on adult health among this population. This study uses latent class analysis (LCA) to determine patterns of childhood experiences and explores the association between classes and health outcomes in adulthood. Participants were from the Black Women’s Experiences Living with Lupus (BeWELL) Study. Childhood experiences included as latent class indicators were: Adverse Childhood Experiences (ACES), family structure, emotional support, and family connectedness. An LCA was used to determine typologies of childhood experience and multivariable regression models were used to investigate the relationship between class membership and SLE disease activity, depression, and anxiety. A total of 438 participants were included in these analyses. The 4-class solution demonstrated best fit and classes were as follows: Class 1 – Low risk; Class 2 – High risk; Class 3 – Risk and protective factors; Class 4 – Single-parent. Classes 2 and 3 had greater disease activity, depression, and anxiety compared to Class 1. There were no differences between Class 4 and Class 1 across outcomes. Class 3 had marginally lower depression and anxiety scores compared to Class 2. There are distinct typologies of childhood experiences among this sample of Black women with SLE. Further, these typologies were predictive of SLAQ, depression, and anxiety. These findings suggest that early life experiences can impact health. Further investigation of pathways to prevent and remediate the negative impacts of childhood adversity are needed.