Adults with type 2 diabetes who reported childhood sexual abuse also reported lower adherence to their diabetes medication, according to a cross-sectional study published in BioPsychoSocial Medicine. The association persisted even after the researchers statistically adjusted for participants’ current levels of psychological distress, suggesting that the link between early adversity and medication-taking behaviour is not simply explained by present-day psychopathological symptoms.
The study, led by Gonçalo Marques Moreira, with co-authors João Sérgio Neves and Ivone Castro-Vale, set out to examine a question that has remained unclear despite growing evidence that adverse childhood experiences are associated with poorer health outcomes in general: whether such experiences also affect how consistently patients with type 2 diabetes take their prescribed medication.
Participants were 50 adults with type 2 diabetes mellitus, recruited from the outpatient endocrinology clinic of Centro Hospitalar e Universitário São João and from community-based settings. Each participant completed a set of validated self-report questionnaires. Adverse childhood experiences were measured with the Childhood Trauma Questionnaire-Short Form, psychopathological symptoms with the Brief Symptom Inventory, and medication adherence with the Medication Adherence Scale. Physical activity levels were assessed using the International Physical Activity Questionnaire-Short Form.
Because the study was cross-sectional and relied on self-report instruments, the researchers used correlation-based analyses rather than causal modelling. Spearman’s correlation was applied to examine associations between the variables, and partial correlation analysis was performed to test whether psychopathological symptoms influenced the relationship between childhood adversity and adherence.
The central finding concerned childhood sexual abuse. This specific category of adversity correlated with lower medication adherence, with a Spearman’s rank correlation coefficient of ρ = -0.382 (p = 0.006). In other words, participants who reported more severe childhood sexual abuse tended to report taking their diabetes medication less consistently.
Current psychological distress also showed a relationship with adherence, though a weaker one. The Global Severity Index of the Brief Symptom Inventory, a summary measure of overall psychopathological symptoms, was weakly associated with lower adherence (ρ = -0.297, p = 0.037). Among the individual symptom dimensions measured by the inventory, hostility stood out, showing a moderate negative correlation with adherence (ρ = -0.377, p = 0.007).
Not every tested relationship reached statistical significance. The researchers found no significant associations between adverse childhood experiences, the Global Severity Index, and physical activity levels, indicating that the observed pattern was specific to medication adherence rather than extending to physical activity behaviour in this sample.
The partial correlation analysis produced the study’s most striking technical result. When the association between childhood sexual abuse and adherence was adjusted for the Global Severity Index of overall psychological distress, the correlation did not weaken or disappear — it strengthened substantially, rising to ρ = -0.686 (p < 0.001). The authors interpret this as evidence that the association between childhood sexual abuse and lower self-reported medication adherence remained after adjustment for overall psychological distress, and that current distress did not account for the relationship.
On the basis of these findings, the authors conclude that integrating trauma-informed care into diabetes management may help address barriers to adherence. They also emphasise that larger longitudinal studies are needed to clarify the mechanisms involved and to guide the design of interventions. Such caution is warranted given the study’s scope: with 50 participants, a single clinical and community recruitment setting, a cross-sectional design that cannot establish temporal order or causation, and adherence measured by self-report rather than objective pharmacy or electronic monitoring data, the results should be regarded as hypothesis-generating rather than definitive.
Nevertheless, the study adds a specific and clinically relevant data point to a broader research conversation.
Subject of Research: The association between adverse childhood experiences and medication adherence in adults with type 2 diabetes
Article Title: Exploring the relation between childhood adversity and diabetes medication adherence: a cross-sectional study
Article References: Moreira, G. M., Neves, J. S., & Castro-Vale, I. (2026). Exploring the relation between childhood adversity and diabetes medication adherence: a cross-sectional study. BioPsychoSocial Medicine. https://doi.org/10.1186/s13030-026-00368-w
Image Credits: AI Generated
DOI: 10.1186/s13030-026-00368-w
Keywords: adverse childhood experiences, childhood sexual abuse, type 2 diabetes, medication adherence, cross-sectional study, psychopathological symptoms, Brief Symptom Inventory, Childhood Trauma Questionnaire, trauma-informed care, psychological distress, hostility, endocrinology
News Source: Glenn Wilkins. (October 29, 2026). Childhood sexual abuse linked to poorer diabetes medication adherence in small cross-sectional study. Scienmag.
