Coloring of the past via respondent's current psychological state, mediation, and the association between childhood disadvantage and morbidity in adulthood

Objective: Many researchers view retrospective reports with skepticism. Indeed, the observed association between retrospectively-reported childhood disadvantage (CD) and morbidity in adulthood has been criticized as an artefactual correlation driven by the psychological state of the respondent at the time of reporting (current psychological state). The aim of this study was to assess the role of current psychological state in the association between childhood disadvantage and morbidity in adulthood. Methods: The present analysis used cross-sectional data collected in 2007-2008 within the framework of the Tromso Study (N = 10,765), a representative study of adult men and women in Norway. The association between CD and the physical health outcomes heart attack, angina pectoris, chronic bronchitis/emphysema/COPD, diabetes mellitus, hypothyroid/low metabolism, migraine, hypertension, and comorbidity (i.e., the sum of these physical health outcomes) was assessed with Poisson regression models. Relative risks (RR) and 95% confidence intervals (CI) were estimated. A wide range of indicators of respondents' current psychological state were included in the models to assess the % attenuation in estimates. Results: CD was associated with an increased risk of heart attack, angina pectoris, chronic bronchitis/emphysema/COPD, diabetes mellitus, hypothyroid/low metabolism, migraine, hypertension, and comorbidity (p < 0.05), independent of respondents' current psychological state. A sizeable proportion (23-42%) of the association between CD and physical health outcomes was driven by recall bias or mediation via respondents' current psychological state. Controlling for indicators of current psychological state reduced the strength of associations between CD and physical health outcomes; however, the independent associations remained in the same direction. Conclusion: The association between retrospectively-reported CD and physical health outcomes in adulthood is not driven entirely by respondent's current psychological state.