Childhood Adversity and Self-Reported Rheumatoid Arthritis: A Structural Equation Modeling Analysis of the Canadian Longitudinal Study on Aging
Authors' conclusion
ACEs were significantly associated with self-reported RA, partially through indirect pathways involving depression, obesity, and smoking, with evidence of sex-specific effects on the obesity pathway. Targeted screening and intervention for ACEs-affected individuals with psychosocial and behavioural risk factors may help reduce RA burden. Prospective mediation research examining gene-environment interactions (e.g., smoking × RA risk alleles) and sex-specific mechanisms is warranted.
Study context
- Population
- Participants of the Canadian Longitudinal Study on Agingdata from the Canadian Longitudinal Study on Aging
- Participants
- 44,142 participants
- Comparison
- Latent adverse childhood experiences (ACEs) construct and self-reported rheumatoid arthritis (RA), direct and indirect pathways through depression, anxiety, obesity, and smoking
- Outcome
- Dimensionality of ACEs
Methodological detailsexploratory and confirmatory factor analyses, multigroup structural equation modeling (SEM) for moderation by birth sex, adjusted for sociodemographic factors, asthma, and childhood passive smoking
- Exploratory and confirmatory factor analyses
- Multigroup SEM for moderation by birth sex
- Adjusted for sociodemographic factors, asthma, and childhood passive smoking
Main finding
As reported in the abstract
- EFA and CFA supported a higher-order latent childhood adversity factor with three first-order factors (physical abuse, sexual abuse, household dysfunction)
Further findings
ACEs-RA association
- Small but significant direct ACEs-RA association
- Significant associations operating through depression, obesity, and smoking
Moderation by birth sex
- Birth sex appeared to moderate the indirect pathway through obesity, with a stronger association for men
- An indirect association through smoking was observed only in men, though the between-group difference was not statistically significant
Original publication
Childhood Adversity and Self-Reported Rheumatoid Arthritis: A Structural Equation Modeling Analysis of the Canadian Longitudinal Study on Aging. J Rheumatol. Published 1 November 2026. doi:10.
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