Unseen wounds of childhood: Emotional abuse, neglect, and later diabetes vulnerability in Saudi Arabia: A Cross-sectional study

Childhood emotional abuse and neglect (CEAN) are adverse experiences that are often underrecognized for their long-lasting impacts on health. Despite research having demonstrated a link between childhood adversity and diabetes, the association between CEAN and the timing of diabetes diagnosis, along with their sociodemographic patterns, remains poorly understood. This cross-sectional survey collected data on CEAN from 306 Saudi individuals diagnosed with diabetes. Employing a culturally modified version of the self-report Childhood Trauma Questionnaire-Short Form, the severity of CEAN was evaluated using composite scores (none, moderate, or severe) derived from the questionnaire items. Chi-square tests were used to examine associations among abuse severity, sociodemographic variables, and age at diagnosis, with Cramér's V calculated to determine the effect size. Multivariable logistic regression was performed to adjust for potential confounders. Severe emotional abuse was reported by 38.9% of the participants, and severe neglect by 22.2%. Severity levels of both emotional maltreatment and neglect were significantly correlated with sex, age group, marital status, educational attainment, occupation, and age at diagnosis (all P < .05). Greater severity of both emotional abuse and neglect was correlated with an older age at diabetes diagnosis, demonstrating linear trends. CEAN are prevalent among individuals with diabetes and are significantly associated with sociodemographic factors and age at diagnosis. In multivariable logistic regression analysis, adjusting for age and sex, emotional abuse was independently correlated with an earlier age at diabetes diagnosis (adjusted odds ratio = 2.62, 95% confidence interval: 1.25-5.49, P = .011). These findings underscore the enduring impact of early-life emotional adversity on health and highlight the need to incorporate trauma informed and socially responsive strategies in diabetes management and prevention.