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We evaluated whether the association of ACE with disease differs between IMID and other chronic diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nested retrospective case-control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We used data from the Canadian Longitudinal Study on Aging (CLSA), which recruited participants aged 45\u201385 years between 2010 and 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We included 12 627 CLSA participants: 2 102 who reported diagnoses of IMID (258 multiple sclerosis (MS), 1 692 rheumatoid arthritis (RA) and 160 inflammatory bowel disease (IBD)), 5 519 with diabetes, 170 with epilepsy, 3 889 with asthma and 1 125 with no chronic diseases. ACE, including childhood maltreatment (physical, emotional and sexual abuse, neglect) and household dysfunction, were queried using questions from the Childhood Experiences of Violence Questionnaire-Short Form and the National Longitudinal Study of Adolescent to Adult Health Wave III questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We first evaluated whether the association of maltreatment differed across diagnoses (IMID, diabetes, asthma, epilepsy, no chronic diseases). Second, we evaluated whether the association between maltreatment differed across IMID. We repeated our analyses for different types of ACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maltreatment or household dysfunction was experienced by 64% of participants and 30% experienced both. On multivariable analysis, history of any maltreatment, sexual abuse, any household dysfunction and having \u22653 types of ACE were all associated with increased risk of IMID compared with no chronic disease. The association between ACE and IMID did not differ across MS, RA and IBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACE are common among Canadians with and without chronic diseases. History of any maltreatment or household dysfunction is associated with increased risk of chronic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087133","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T21:36:19Z","timestamp":1737408979000},"page":"e087133","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["A nested case-control study evaluating the relationship between adverse childhood experiences and immune-mediated inflammatory disease in the Canadian Longitudinal Study on Aging"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8338-1133","authenticated-orcid":false,"given":"Julia","family":"O'Mahony","sequence":"first","affiliation":[{"name":"Mellen Center, Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Department of Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8041-3574","authenticated-orcid":false,"given":"Charles N","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Ann","family":"Marrie","sequence":"additional","affiliation":[{"name":"Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"},{"name":"Departments of Internal Medicine and Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"2025121603221483000_15.1.e087133.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1568-9972(03)00006-5"},{"key":"2025121603221483000_15.1.e087133.2","first-page":"102193","article-title":"Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019","volume":"64","author":"Wu","year":"2023","journal-title":"eClinMed"},{"key":"2025121603221483000_15.1.e087133.3","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.091462"},{"key":"2025121603221483000_15.1.e087133.4","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1111\/jan.12329","article-title":"Adverse childhood experiences: towards a clear conceptual meaning","volume":"70","author":"Kalmakis","year":"2014","journal-title":"J Adv Nurs"},{"key":"2025121603221483000_15.1.e087133.5","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e31824c2013"},{"key":"2025121603221483000_15.1.e087133.6","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.jpsychores.2012.10.007","article-title":"Gender-specific association between childhood trauma and rheumatoid arthritis: a case-control study","volume":"74","author":"Spitzer","year":"2013","journal-title":"J Psychosom Res"},{"key":"2025121603221483000_15.1.e087133.7","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1037\/pro0000430","article-title":"Adverse childhood experiences, risk factors in the onset of autoimmune diseases in adults: A meta-analysis","volume":"53","author":"Macarenco","year":"2022","journal-title":"Professional Psychology: Research and Practice"},{"key":"2025121603221483000_15.1.e087133.8","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.3024","article-title":"Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies","volume":"13","author":"Rehan","year":"2023","journal-title":"Brain Behav"},{"key":"2025121603221483000_15.1.e087133.9","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000001025"},{"key":"2025121603221483000_15.1.e087133.10","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.3875"},{"key":"2025121603221483000_15.1.e087133.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.12.055"},{"key":"2025121603221483000_15.1.e087133.12","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz173"},{"key":"2025121603221483000_15.1.e087133.13","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1017\/S0714980809990055","article-title":"The Canadian longitudinal study on aging (CLSA)","volume":"28","author":"Raina","year":"2009","journal-title":"Can J Aging"},{"key":"2025121603221483000_15.1.e087133.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2008.05.003"},{"key":"2025121603221483000_15.1.e087133.15","doi-asserted-by":"publisher","DOI":"10.1177\/0886260511416462"},{"key":"2025121603221483000_15.1.e087133.16","unstructured":"Harris KM , Udry JR . 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