Biological embedding of child maltreatment: A systematic review of biomarkers and resilience in children and youth.

Abstract

Objective: Child maltreatment (CM) is a widespread problem associated with poor mental and physical health outcomes. The underlying mechanisms of this link are not always well understood, however certain biological changes observed in maltreated individuals may play a role in connecting experience and outcome. This review specifically focuses on 2 markers of biological embedding, DNA methylation (DNAm) and telomere length (TL) in maltreated children and youth. As biomarker changes are not uniform among maltreated children, we additionally discuss biological and environmental resilience factors that may contribute to variability. Method: We conducted a systematic review of Medline, Embase and PsycINFO databases for studies examining DNAm and/or TL in maltreated children and youth. Methodological quality of the included studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) checklists for cohort studies and randomized control trials. Data extraction focused on various factors including population and CM (type, chronicity, severity, and duration) characteristics. Results: The initial search returned 1,688 nonduplicate results, with 417 full text articles reviewed. Twenty-six articles from 16 studies were ultimately included of which 8 examined telomere length and 18 examined DNA methylation. Conclusions: While some heterogeneity of findings was found, evidence supports differential changes in both biomarkers associated with CM. This review enhances understanding of the constellation of biological changes related to CM and consideration of the important role of resilience factors in mitigating risk. Elucidating these factors may highlight targets for future study and intervention development. Clinical Impact StatementChild maltreatment is a serious problem linked to poor mental and physical health outcomes. The mechanisms of these links are not always clear, however, biological changes observed in some maltreated individuals may play a role. Here, we systematically review literature related to 2 biomarkers of interest in maltreated children, telomere length and DNA methylation. Findings are varied; however, overall an association between child maltreatment and changes in both biomarkers is supported. We additionally discuss factors that may confer resilience related to these changes to highlight potential targets for future study and interventions.

The association between adverse childhood experiences and epigenetic age acceleration in the Canadian longitudinal study on aging (CLSA)

“…Studies in children and younger adults have shown associations between exposure to ACEs including childhood exposure to sexual abuse, intimate partner violence, and poor parental mental health, and epigenetic age acceleration (Brody et al, 2016 ; Davis et al, 2017 ; Lawn et al, 2018 ; Nelles‐McGee et al, 2022 ; Simons et al, 2016 ; Zannas et al, 2015 ). Further, results from a meta‐analysis showed that childhood exposure to traumatic stress, broadly defined as the number of different types of traumatic events experienced in childhood including witnessing family violence, sexual abuse, physical abuse, or neglect occurring prior to age 18, was associated with epigenetic age acceleration; with each additional exposure to a new type of trauma associated with a 6‐month age acceleration.…”

Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling

“…Furthermore, emerging intelligence suggested a range of factors that can help individuals develop resilience during childhood. Strong links with cultural traditions had better-developed self-regulation skills, and a sense of having some control over personal circumstances had wholly been associated with moderating the negative impacts of childhood adversity ( 30 , 31 ). Thus, the more ACEs the target population experienced, the more the self-perception of substance abuse they had, and those who had adverse experiences in childhood perhaps nurtured resilience so that ACEs were probably negatively associated with self-perception of substance use.…”

Introduction to the special issue: Resilience and perseverance for human flourishing.

“…Such findings have important implications for policy and legislation to help to improve at-risk youth transitions. In the second, Nelles-McGee et al (2022) review changes in biological markers (i.e., DNA methylation, telomere length) associated with childhood maltreatment, but importantly also considered environmental resilience factors that mitigated risk. Complementing these reviews, Hebert et al (2022) identify profiles of adaptation in adolescent survivors of child sexual abuse, including resilient, externalized, and internalized classes.…”