Patterns of violence exposure in a life-course perspective and associations to mental and physical health problems and health-related risk behaviors among women and men in Sweden: A latent class analysis.

Background: Individual histories of abuse characteristics and other adversities must be considered to understand poly-victimization and its impact on ill-health, which suggests the importance of understanding how experiences of violence are interconnected over a life-course. Objective: To explore gendered patterns of lifetime poly-victimization-physical, emotional, and sexual-and examine how distinct exposure profiles relate to adult health outcomes. The analysis is guided by the Trauma-Informed Theory of Individual Health Behavior (TTB) framework to deepen understanding of gendered trauma trajectories and their long-term effects. Methods: 10 337 Swedish women and men aged 18-74 participated in a combined online and postal survey. Attrition bias was controlled for based on official registry information. Latent Class Analysis (LCA) was used for identification of groups. Associations between mental and physical health indicators and health-related risk behaviors were analyzed using logistic regression, adjusting for background variables including age, self-reported parental immigrant status, and parental educational attainment. Results: Patterns of lifetime poly-victimization were more complex among women (7 classes) than men (4 classes). Among men, exposure was primarily characterized by childhood physical and emotional violence, as well as adult non-partner physical violence. In contrast, women's profiles often included childhood sexual violence and partner violence in adulthood, with stronger associations to multiple health problems and risk behaviors, and generally higher odds ratios compared to men. Among women, three unique clusters were identified, one of which may reflect more advanced resilience capacities compared to other clusters with similar trajectories of childhood violence exposure. Conclusions: Gendered patterns of poly-victimization and their health-related consequences underscore the importance of early intervention to prevent revictimization. The identification of unique and resilient clusters among women, despite similar childhood violence exposure, highlights the need for further research into protective mechanisms and trauma-to-benefit pathways, as conceptualized within the TTB framework.