A Systematic Review of the Biological Correlates and Consequences of Childhood Maltreatment and Adverse Childhood Experiences

Cooke, Eric M.; Connolly, Eric J.; Boisvert, Danielle; Hayes, Brittany E.

doi:10.1177/15248380211021613

Cited by 25 publications

(10 citation statements)

References 116 publications

(188 reference statements)

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“…These ndings, and the large body of evidence outlining the detrimental impact of childhood maltreatment on biological systems (e.g. HPA axis, in ammation etc) (20), highlight that the mechanisms linking childhood adversities to depression and obesity are not fully explained by socioeconomic status. Therefore, combining childhood adversities and low socioeconomic status as the antecedent exposure, allows for a more comprehensive understanding of how childhood stressors impact mental, physical, and comorbid health outcomes, and ultimately examines cumulative effects of stressors which may surpass the impact of socioeconomic status alone.…”

Section: Introductionmentioning

confidence: 99%

Examining lifestyle factors as potential moderators in the link between childhood adversity and comorbid psychological distress and obesity in early adulthood

Woofenden,

Fairchild,

Lancaster

2024

Preprint

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Background: Whilst childhood adversities are risk factors for mental, physical, and comorbid health problems in childhood and middle-to-late adulthood, there is less evidence for these associations in early adulthood. It is also unclear if lifestyle factors modify the risk of these health outcomes following childhood adversities. This study aims to examine childhood adversities as risk factors for psychological distress, obesity, and their comorbidity, and further quantify the moderating impact of lifestyle factors. This could provide insight into potential protective influences against the detrimental health consequences of childhood adversities, particularly mental-physical comorbidity. Methods: Analyses were conducted on data from the 1970 British Cohort Study (n=16,407). The cumulative impact of parent- and self-reported adversities (range 0-33) were consolidated across childhood (0-16 years) and examined as a predictor of psychological distress (Malaise Inventory ≥ 8), obesity (BMI ≥ 30 kg/m2) and their comorbidity in early adulthood (30 years) using multinomial logistic regression. Self-reported lifestyle factors in adolescence (16 years), including physical activity, diet, sleep duration, smoking, and alcohol consumption were assessed as moderators of the association between childhood adversities and the specified outcome categories. Results: A one-item increase in reported childhood adversities elevated the risk of psychological distress (OR [95% CI]; 1.11 [1.09, 1.13]), obesity (OR [95% CI]; 1.05 [1.03, 1.06]) and mental-physical comorbidity (OR [95% CI]; 1.16 [1.12, 1.20]). Compared to comorbidity, childhood adversity was a weaker risk factor for psychological distress (OR [95% CI]; 0.96 [0.92, 0.99]) or obesity alone (OR [95% CI]; 0.90 [0.87, 0.94]). None of the examined lifestyle factors were significant moderators of the association between childhood adversities and the outcome categories. Conclusions: Consistent with evidence from middle- to late-adulthood, childhood adversities showed a stronger association with comorbidity in early adulthood than mental or physical health problems alone. There was no evidence that lifestyle factors influenced the association between childhood adversities and comorbidity or individual health problems. Our findings highlight the importance of considering comorbidities when investigating the negative health consequences of childhood adversities, and therefore, the continuing need to identify factors which mitigate the increased risk of comorbidity.

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Section: Introductionmentioning

confidence: 99%

Examining lifestyle factors as potential moderators in the link between childhood adversity and comorbid psychological distress and obesity in early adulthood

Woofenden,

Fairchild,

Lancaster

2024

Preprint

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“…A relatively new approach is the use of genetic data as a surrogate for exposure, given that genetic markers are affected by types of biases (e.g., weak instrument, population stratification, pleiotropy) that are different from the sources of bias that commonly affect observational studies and produce non-causal results (e.g., residual confounding, reverse causation, information bias) [ 54 – 56 ]. To date, the use of genetic data as a proxy for childhood maltreatment has been limited [ 56 – 60 ].…”

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses

Espinosa Dice,

Lawn,

Ratanatharathorn

et al. 2024

BMC Med

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Background Childhood maltreatment is common globally and impacts morbidity, mortality, and well-being. Our understanding of its impact is constrained by key substantive and methodological limitations of extant research, including understudied physical health outcomes and bias due to unmeasured confounding. We address these limitations through a large-scale outcome-wide triangulation study. Methods We performed two outcome-wide analyses (OWAs) in the UK Biobank. First, we examined the relationship between self-reported maltreatment exposure (number of maltreatment types, via Childhood Trauma Screener) and 414 outcomes in a sub-sample of 157,316 individuals using generalized linear models (“observational OWA”). Outcomes covered a broad range of health themes including health behaviors, cardiovascular disease, digestive health, socioeconomic status, and pain. Second, we examined the relationship between a polygenic risk score for maltreatment and 298 outcomes in a non-overlapping sample of 243,006 individuals (“genetic OWA”). We triangulated results across OWAs based on differing sources of bias. Results Overall, 23.8% of the analytic sample for the observational OWA reported at least one maltreatment type. Of 298 outcomes examined in both OWAs, 25% were significant in both OWAs and concordant in the direction of association. Most of these were considered robust in the observational OWA according to sensitivity analyses and included outcomes such as marital separation (OR from observational OWA, ORo = 1.25 (95% CI: 1.21, 1.29); OR from genetic OWA, ORg = 1.06 (1.03, 1.08)), major diet changes due to illness (ORo = 1.27 (1.24, 1.29); ORg = 1.01 (1.00, 1.03)), certain intestinal diseases (ORo = 1.14 (1.10, 1.18); ORg = 1.03 (1.01, 1.06)), hearing difficulty with background noise (ORo = 1.11 (1.11, 1.12); ORg = 1.01 (1.00, 1.01)), knee arthrosis (ORo = 1.13 (1.09, 1.18); ORg = 1.03 (1.01, 1.05)), frequent sleeplessness (ORo = 1.21 (1.20, 1.23); ORg = 1.02 (1.01, 1.03)), and low household income (ORo = 1.28 (1.26, 1.31); ORg = 1.02 (1.01, 1.03)). Approximately 62% of results were significant in the observational OWA but not the genetic OWA, including numerous cardiovascular outcomes. Only 6 outcomes were significant in the genetic OWA and null in the observational OWA; these included diastolic blood pressure and glaucoma. No outcomes were statistically significant in opposite directions in the two analyses, and 11% were not significant in either OWA. Conclusions Our findings underscore the far-reaching negative effects of childhood maltreatment in later life and the utility of an outcome-wide triangulation design with sensitivity analyses for improving causal inference.

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“…Previous research has generally shown that ACEs are associated with higher risk levels for a variety of biological measures, although findings across studies are not always consistent. Two recent reviews of studies of negative childhood experiences and biomarkers of health, one summarizing findings from 40 studies between 2007 and 2017 [ 9 ] and the other summarizing findings from 199 studies conducted between 2010 and 2020 [ 10 ], report that some studies of childhood adversity and endocrine biomarkers, often cortisol or dehydroepiandrosterone (DHEAS), find a positive relationship while others find a negative relationship. One of the reviews notes that results sometimes depend on whether cortisol levels are based on saliva, urine, or blood [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…One of the reviews notes that results sometimes depend on whether cortisol levels are based on saliva, urine, or blood [ 9 ]. Most of the reviewed studies find that childhood adversity is associated with elevated levels of individual biomarkers that reflect inflammation, such as interleukin 6 and C-reactive protein, but the results are not always significant and can differ depending on the measure of childhood adversity [ 9 , 10 ]. Similarly, findings are also mixed for biomarkers related to cardiovascular and metabolic function and measures of overall physiological dysregulation [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Exposure to childhood maltreatment predicts adult physiological dysregulation, particularly inflammation

Cornman,

Witt,

Glei

et al. 2023

PLoS ONE

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Although a growing literature describes the effects of negative childhood experiences on biological outcomes, it is difficult to compare results across studies because of differences in measures of childhood experiences, biological markers, sample characteristics, and included covariates. To ensure comparability across its analyses, this study used a single national survey of adults in the United States—the Midlife in the United States (MIDUS) study—to examine comprehensively the association between adverse childhood experiences, operationalized as childhood maltreatment (CM), and biological markers of risk for poor health and to assess whether these associations differ by type of maltreatment, sex, or race. The sample included 1254, mostly White (78%), adults aged 34–86 years (mean age 57 years), 57% of whom were female. We present incidence rate ratios (IRR) from negative binomial and Poisson regressions to examine the relationships between exposure to CM (emotional, physical, and sexual abuse; emotional and physical neglect; and a CM-index reflecting frequency across all five types of maltreatment) and four biological risk summary scores (overall physiological dysregulation, cardiometabolic risk, inflammation, and hypothalamic pituitary axis/sympathetic nervous system (HPA/SNS) function). We also tested whether the effect of each type of CM varied by sex and by race. The CM-index was associated with higher overall physiological dysregulation and inflammation, but the associations were weaker and not statistically significant for cardiometabolic risk and HPA/SNS function. With the exception of a possible sex difference in the association between sexual abuse and overall physiological dysregulation, there was little evidence that the associations varied systematically by type of CM or by sex or race. We conclude that exposure to CM predicts adult biological risk, particularly inflammation. Inconsistency with previous research suggests that additional research is needed to confirm findings regarding sex and race differences.

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A Systematic Review of the Biological Correlates and Consequences of Childhood Maltreatment and Adverse Childhood Experiences

Cited by 25 publications

References 116 publications

Examining lifestyle factors as potential moderators in the link between childhood adversity and comorbid psychological distress and obesity in early adulthood

Examining lifestyle factors as potential moderators in the link between childhood adversity and comorbid psychological distress and obesity in early adulthood

Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses

Exposure to childhood maltreatment predicts adult physiological dysregulation, particularly inflammation

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