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Wang J, Han X, Yang Y, Zeng Y, Qu Y, Yang H, Song J, Qiu C, Song H. The association of psychological and trauma-related factors with biological and facial aging acceleration: evidence from the UK Biobank. BMC Med 2024; 22:359. [PMID: 39227814 PMCID: PMC11373276 DOI: 10.1186/s12916-024-03578-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 08/22/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Psychological and trauma-related factors are associated with many diseases and mortality. However, a comprehensive assessment of the association between psycho-trauma exposures and aging acceleration is currently lacking. METHODS Using data from 332,359 UK Biobank participants, we calculated biological aging acceleration, indexed by the presence of leukocyte telomere length (LTL) deviation (i.e., the difference between genetically determined and observed LTL > 0). The acceleration of facial aging (i.e., looking older than the chronological age) was assessed using a self-report question. Then, we estimated the associations of each psycho-trauma factor with biological and facial aging acceleration, using logistic regression models adjusted for multiple important covariates. Furthermore, restricted to 99,180 participants with complete psychological and trauma-related data, we identified clusters of individuals with distinct psycho-trauma patterns using the latent class analysis method and assessed their associations with aging acceleration using similar models. RESULTS We observed most of the studied psycho-trauma factors were associated with biological and facial aging acceleration. Compared to the "Absence of trauma and psychopathology" cluster, the "adverse childhood experiences (ACEs) with psychopathology" cluster showed strong associations with those aging measurements (odds ratio [OR] = 1.13 [1.05 - 1.23] for biological and 1.52 [1.18 - 1.95] for facial aging acceleration), while no such association was observed for the "ACEs without psychopathology" cluster (1.04 [0.99 - 1.09] and 1.02 [0.84 - 1.24]. CONCLUSIONS Our study demonstrated significant associations of psycho-trauma factors with both biological and facial aging acceleration. The differential aging consequences observed among ACEs exposed individuals with and without psychopathology prompt interventions aimed to improve individuals' psychological resilience to prevent aging acceleration.
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Affiliation(s)
- Junren Wang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Xin Han
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Yang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yu Zeng
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jie Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Changjian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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Widom CS, Do H(H, Miller QC, Javakhishvili M, Eckstein Indik C, Belsky DW. Childhood Maltreatment and Biological Aging in Middle Adulthood: The Role of Psychiatric Symptoms. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100341. [PMID: 39040430 PMCID: PMC11260844 DOI: 10.1016/j.bpsgos.2024.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 07/24/2024] Open
Abstract
Background Childhood maltreatment and psychiatric morbidity have each been associated with accelerated biological aging primarily through cross-sectional studies. Using data from a prospective longitudinal study of individuals with histories of childhood maltreatment and control participants followed into midlife, we tested 2 hypotheses examining whether 1) psychiatric symptoms mediate the relationship between childhood maltreatment and biological aging and 2) psychiatric symptoms of anxiety, depression, or posttraumatic stress disorder (PTSD) act in conjunction with childhood maltreatment to exacerbate the association of child maltreatment to aging. Methods Children (ages 0-11 years) with documented histories of maltreatment and demographically matched control children were followed into adulthood (N = 607) and interviewed over several waves of the study. Depression, anxiety, and PTSD symptoms were assessed at mean ages of 29 (interview 1) and 40 (interview 2) years. Biological age was measured from blood chemistries collected later (mean age = 41 years) using the Klemera-Doubal method. Hypotheses were tested using linear regressions and path analyses. Results Adults with documented histories of childhood maltreatment showed more symptoms of depression, PTSD, and anxiety at both interviews and more advanced biological aging, compared with control participants. PTSD symptoms at both interviews and depression and anxiety symptoms only at interview 2 predicted accelerated biological aging. There was no evidence of mediation; however, anxiety and depression moderated the relationship between childhood maltreatment and biological aging. Conclusions These new findings reveal the shorter- and longer-term longitudinal impact of PTSD on biological aging and the amplifying effect of anxiety and depression on the relationship between child maltreatment and biological aging.
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Affiliation(s)
- Cathy Spatz Widom
- Psychology Department, John Jay College, City University of New York, New York, New York
- Graduate Center, City University of New York, New York, New York
| | - Hang (Heather) Do
- Psychology Department, John Jay College, City University of New York, New York, New York
| | - Quincy C. Miller
- Psychology Department, John Jay College, City University of New York, New York, New York
| | - Magda Javakhishvili
- Psychology Department, John Jay College, City University of New York, New York, New York
| | - Claire Eckstein Indik
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, New York
| | - Daniel W. Belsky
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, New York
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Bourassa KJ, Sbarra DA. Trauma, adversity, and biological aging: behavioral mechanisms relevant to treatment and theory. Transl Psychiatry 2024; 14:285. [PMID: 38997260 PMCID: PMC11245531 DOI: 10.1038/s41398-024-03004-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Although stress and adversity are largely universal experiences, people exposed to greater hardship are at increased risk for negative health consequences. Recent studies identify accelerated biological aging as a mechanism that could explain how trauma and adversity gives rise to poor health, and advances in this area of study coincide with technological innovations in the measurement of biological aging, particularly epigenetic profiles consistent with accelerated aging derived from DNA methylation. In this review, we provide an overview of the current literature examining how adversity might accelerate biological aging, with a specific focus on social and health behaviors. The most extensive evidence in this area suggests that health-compromising behaviors, particularly smoking, may partially explain the association between adversity and accelerated aging. Although there is relatively less published support for the role of social behaviors, emerging evidence points to the importance of social connection as a mechanism for future study. Our review highlights the need to determine the extent to which the associations from adversity to accelerated aging are consistent with causal processes. As we consider these questions, the review emphasizes methodological approaches from the causal inference literature that can help deepen our understanding of how stress and trauma might result in poor health. The use of these methodologies will help provide evidence as to which behavioral interventions might slow aging and improve health, particularly among populations that more often experience adversity and trauma.
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Affiliation(s)
- Kyle J Bourassa
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA.
- Geriatric Research, Education, and Clinical Center, Durham Veteran Affairs (VA) Health Care System, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
| | - David A Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, USA
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Moshfeghinia R, Torabi A, Mostafavi S, Rahbar S, Moradi MS, Sadeghi E, Mootz J, Vardanjani HM. Maternal psychological stress during pregnancy and newborn telomere length: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:947. [PMID: 38102621 PMCID: PMC10724935 DOI: 10.1186/s12888-023-05387-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Telomeres protect the ends of chromosomes, and shorter leukocyte telomeres are associated with major group diseases. Maternal psychological stress may be related to the shortening of telomeres in infants. This systematic review and meta-analysis set out to consolidate the varying effect sizes found in studies of maternal psychological stress and telomere length (TL) in newborns and identify moderators of the relationship between stress during pregnancy and newborn TL. METHODS Our systematic review was registered in Prospero. Six databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, and CINAHL Complete) were searched for records in English from inception to February 10, 2023. Observational studies were included that measured the relationship of psychological stress of the mother during pregnancy on the TL of the newborn. The Newcastle-Ottawa quality assessment scale was used to assess the quality of the included studies. A random-effect model was selected. Statistical analysis performed by Stata software version 17. RESULTS Eight studies were included for qualitative and four for quantitative analysis. There was an inverse statistically significant relationship between maternal stress and newborn TL; A one score increase in maternal psychological stress resulted in a 0.04 decrease in the TL of the newborn (B = -0.04, 95% CI = [-0.08, 0.00], p = 0.05). Selectivity analysis showed that the pooled effect size was sensitive to one study; After removing this study, the pooled effect size remained significant (B = -0.06, 95% CI = [-0. 10, -0.02], p < 0.001). CONCLUSION Physiological and environmental factors can significantly affect the TL of newborns. Our results support a significant impact of maternal psychological stress on the TL of a newborn. This association demonstrates the significance of stress in influencing the telomere length, which can be a contributing factor in the infant's future. Therefore, recognizing this association is crucial for understanding and addressing potential health risks and necessitates the need for additional future studies to validate our findings.
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Affiliation(s)
- Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Torabi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Mostafavi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Rahbar
- Islamic Azad University, Shiraz Branch, Shiraz, Iran
| | | | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jennifer Mootz
- Department of Psychiatry, Columbia University, New York, NYC, USA.
| | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz, Iran.
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Ravi M, Powers A, Rothbaum BO, Stevens JS, Michopoulos V. Neighborhood Poverty Prospectively Predicts PTSD Symptoms Six-Months Following Trauma Exposure. MENTAL HEALTH SCIENCE 2023; 1:213-221. [PMID: 38406565 PMCID: PMC10888169 DOI: 10.1002/mhs2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/06/2023] [Indexed: 02/27/2024]
Abstract
Introduction Individuals living in areas with high rates of poverty are disproportionately affected by posttraumatic stress disorder (PTSD). Despite this association, little is known about how neighborhood poverty rates impact risk for PTSD development. In the current prospective study, we determined the relationship between neighborhood poverty rate and PTSD symptoms six-months after experiencing a traumatic event in a sample of varied race, gender, and socioeconomic status. Methods Participants (N=252) were enrolled in a hospital emergency department after experiencing a traumatic event. Demographic information (including zip code of residence), baseline PTSD symptoms, and baseline trauma history was assessed in the emergency department. PTSD symptoms were again assessed six-months post-trauma. Neighborhood poverty rate was determined using the American Community Survey. Results Correlation analyses revealed that neighborhood poverty was significantly associated with baseline PTSD symptoms (r=.181, p=.004) and PTSD symptoms six-months post-trauma (r=.163, p=.009). A regression analysis controlling for baseline trauma exposure, clinician-rated trauma severity, and individual socioeconomic status demonstrated that neighborhood poverty predicted PTSD symptoms six-months post-trauma (R2= 0.099, B= 0.15, p=0.04), but this relationship was no longer significant when baseline PTSD symptoms was added as an additional covariate (R2=.304, B= 0.07, p>0.05). Conclusion Overall, results suggest that neighborhood poverty generally increases PTSD symptom severity, and the context in which an individual lives should be considered when conceptualizing risk for PTSD.
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Affiliation(s)
- Meghna Ravi
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Abigail Powers
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Barbara O Rothbaum
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Jennifer S Stevens
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
| | - Vasiliki Michopoulos
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia
- Emory National Primate Research Center, Atlanta, Georgia
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Ratanatharathorn A, Roberts AL, Chibnik LB, Choi KW, De Vivo I, Kim Y, Nishimi K, Rimm EB, Sumner JA, Kubzansky LD, Koenen KC. Posttraumatic Stress Disorder, Depression, and Accelerated Aging: Leukocyte Telomere Length in the Nurses' Health Study II. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:510-518. [PMID: 37519465 PMCID: PMC10382693 DOI: 10.1016/j.bpsgos.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 10/18/2022] Open
Abstract
Background Exposure to trauma, posttraumatic stress disorder (PTSD), and depression have been independently associated with leukocyte telomere length (LTL), a cellular marker of aging associated with mortality and age-related diseases. However, the joint contributions of trauma and its psychological sequelae on LTL have not been examined. Methods We conducted an analysis of LTL in a subset of women from the Nurses' Health Study II (N = 1868). Lifetime exposure to traumatic events, PTSD, and depression was assessed with validated measures. DNA was extracted from peripheral blood leukocytes and telomere repeat copy number to single gene copy number was determined by quantitative real-time polymerase chain reaction telomere assay. Linear regression models assessed the association of trauma, PTSD, and depression with LTL after adjustment for health behaviors and medical conditions. Results Trauma, PTSD, and depression were not independently associated with LTL in mutually adjusted models. However, individuals with severe psychological distress-characterized by comorbid PTSD and depression-had shorter LTL equivalent to being 7.62 years older (95% CI, 0.02 to 17.97) than participants who had never experienced a traumatic event and were not depressed. Further examination found only an association among individuals with the highest number of PTSD symptoms and comorbid depression equivalent to 9.71 additional years of aging (95% CI, 1.36 to 20.49). No effect was found among individuals meeting the minimum threshold for probable PTSD with comorbid depression. Conclusions Severe psychological distress, as indicated by the presence of comorbid PTSD and depression, may be associated with shorter LTL.
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Affiliation(s)
- Andrew Ratanatharathorn
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Andrea L. Roberts
- Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Karmel W. Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women's Hospital - Harvard Medical School, Boston, Massachusetts
| | - Yongjoo Kim
- College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Kristen Nishimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, California
- Department of Psychiatry, University of California San Francisco, San Francisco, California
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Laura D. Kubzansky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Yusupov N, Dieckmann L, Erhart M, Sauer S, Rex-Haffner M, Kopf-Beck J, Brückl TM, Czamara D, Binder EB. Transdiagnostic evaluation of epigenetic age acceleration and burden of psychiatric disorders. Neuropsychopharmacology 2023:10.1038/s41386-023-01579-3. [PMID: 37069357 PMCID: PMC10354057 DOI: 10.1038/s41386-023-01579-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Abstract
Different psychiatric disorders as well as exposure to adverse life events have individually been associated with multiple age-related diseases and mortality. Age acceleration in different epigenetic clocks can serve as biomarker for such risk and could help to disentangle the interplay of psychiatric comorbidity and early adversity on age-related diseases and mortality. We evaluated five epigenetic clocks (Horvath, Hannum, PhenoAge, GrimAge and DunedinPoAm) in a transdiagnostic psychiatric sample using epigenome-wide DNA methylation data from peripheral blood of 429 subjects from two studies at the Max Planck Institute of Psychiatry. Burden of psychiatric disease, represented by a weighted score, was significantly associated with biological age acceleration as measured by GrimAge and DunedinPoAm (R2-adj. 0.22 and 0.33 for GrimAge and DunedinPoAm, respectively), but not the other investigated clocks. The relation of burden of psychiatric disease appeared independent of differences in socioeconomic status and medication. Our findings indicate that increased burden of psychiatric disease may associate with accelerated biological aging. This highlights the importance of medical management of patients with multiple psychiatric comorbidities and the potential usefulness of specific epigenetic clocks for early detection of risk and targeted intervention to reduce mortality in psychiatric patients.
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Affiliation(s)
- Natan Yusupov
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany.
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
| | - Linda Dieckmann
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Mira Erhart
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Susann Sauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Monika Rex-Haffner
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Johannes Kopf-Beck
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Tanja M Brückl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
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Sabot D, Lovegrove R, Stapleton P. The association between sleep quality and telomere length: A systematic literature review. Brain Behav Immun Health 2023; 28:100577. [PMID: 36691437 PMCID: PMC9860369 DOI: 10.1016/j.bbih.2022.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023] Open
Abstract
Several sleep parameters present an elevated risk for processes that contribute to cellular aging. Short sleep duration, sleep apnoea, and insomnia are significantly associated with shorter telomeres, a biological marker of cellular aging. However, there has been no review or analysis of studies that have examined the association between the psychological construct of sleep quality and telomere length. The present study aimed to provide a systematic review of the association between sleep quality and telomere length. A systematic review of English articles was conducted using MEDLINE/PubMed, PsycINFO, Google Scholar, and Web of Science electronic databases, with the final search conducted on 3rd September 2021. Search terms included sleep quality, poor sleep, insomnia, sleep difficulties, sleep issue*, non-restorative sleep, telomere*, cellular aging, and immune cell telomere length. Study eligibility criteria included human participants aged 18 years or older and a reproducible methodology. Study appraisal and synthesis were completed using a systematic search in line with a PICOS approach (P = Patient, problem, or population; I = Intervention, prognostic factor, exposure; C = Comparison, control, or comparator; O = Outcomes; S = Study designs). Twenty-two studies met review inclusion criteria. Qualitative synthesis of the literature indicated insufficient evidence overall to support a significant association between sleep quality and telomere length. Limitations across studies were addressed, such as the assessment of examined constructs. Findings highlight important targets for future research, including the standardised operationalisation of the sleep quality construct and experimental study designs. Research in this area has clinical significance by identifying possible mechanisms that increase the risk for age-related disease and mortality. PROSPERO Registration No.: CRD 42021233139.
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Affiliation(s)
- Debbie Sabot
- School of Psychology, Faculty of Society and Design, Bond University, Australia
| | - Rhianna Lovegrove
- School of Psychology, Faculty of Society and Design, Bond University, Australia
| | - Peta Stapleton
- School of Psychology, Faculty of Society and Design, Bond University, Australia
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9
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Sumner JA, Cleveland S, Chen T, Gradus JL. Psychological and biological mechanisms linking trauma with cardiovascular disease risk. Transl Psychiatry 2023; 13:25. [PMID: 36707505 PMCID: PMC9883529 DOI: 10.1038/s41398-023-02330-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, and experiences of psychological trauma have been associated with subsequent CVD onset. Identifying key pathways connecting trauma with CVD has the potential to inform more targeted screening and intervention efforts to offset elevated cardiovascular risk. In this narrative review, we summarize the evidence for key psychological and biological mechanisms linking experiences of trauma with CVD risk. Additionally, we describe various methodologies for measuring these mechanisms in an effort to inform future research related to potential pathways. With regard to mechanisms involving posttraumatic psychopathology, the vast majority of research on psychological distress after trauma and CVD has focused on posttraumatic stress disorder (PTSD), even though posttraumatic psychopathology can manifest in other ways as well. Substantial evidence suggests that PTSD predicts the onset of a range of cardiovascular outcomes in trauma-exposed men and women, yet more research is needed to better understand posttraumatic psychopathology more comprehensively and how it may relate to CVD. Further, dysregulation of numerous biological systems may occur after trauma and in the presence of posttraumatic psychopathology; these processes of immune system dysregulation and elevated inflammation, oxidative stress, mitochondrial dysfunction, renin-angiotensin system dysregulation, and accelerated biological aging may all contribute to subsequent cardiovascular risk, although more research on these pathways in the context of traumatic stress is needed. Given that many of these mechanisms are closely intertwined, future research using a systems biology approach may prove fruitful for elucidating how processes unfold to contribute to CVD after trauma.
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Affiliation(s)
- Jennifer A Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Shiloh Cleveland
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tiffany Chen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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10
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Fijtman A, Clausen A, Kauer-Sant'Anna M, Morey R. Trauma history in veterans with bipolar disorder and its impact on suicidality. J Psychiatr Res 2023; 157:119-126. [PMID: 36463626 DOI: 10.1016/j.jpsychires.2022.10.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Veterans are at increased risk for exposure to trauma, developing serious mental illnesses, and death by suicide. History of trauma correlates with worsening outcomes in patients with bipolar disorder. This study investigated associations between trauma exposure (type and timing) and suicide attempt in Veterans with bipolar disorder. METHODS One hundred six Veterans with a diagnosis of bipolar disorder and 815 Veterans with no psychiatric history (age rage = 20-72 years old) completed a clinical questionnaire, the Beck Scale for Suicide Ideation, and the Traumatic Live Events Questionnaire. Multinomial logistic regressions investigated correlations between diagnosis, time of trauma (before, during, or after the military), trauma type (attack, illness, accident, child violence, child sexual abuse, and adult sexual abuse), and suicide attempt. RESULTS Seventy-five Veterans with bipolar disorder had comorbid PTSD. Controlling for PTSD, Veterans with bipolar disorder had a higher prevalence of trauma including physical assault [odds ratio (OR) = 2.85; 95% confidence interval (CI) = 1.39-5.86] and child sexual trauma (OR = 2.89; CI = 1.38-6.05). Veterans with bipolar disorder who endorsed previous suicide attempts (n = 42) had significantly higher levels of exposure to childhood trauma (OR = 5.69; CI = 1.84-17.62). CONCLUSIONS Results support incorporating history of previous trauma exposure when assessing Veterans at risk for bipolar disorder. Especially, trauma characterized as attack and childhood sexual abuse. Particular attention should be given to Veterans with bipolar disorder and exposure to trauma during childhood, which may be associated with increased risk of suicidality.
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Affiliation(s)
- Adam Fijtman
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA.
| | - Ashley Clausen
- St. Vincent Hospital, Department of Behavioral Health, 2900 12th Ave N, Billings, MT, 59101, USA.
| | - Marcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-002, Brazil.
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- Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA
| | - Rajendra Morey
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA; Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA.
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11
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Post-traumatic stress disorder and risk for hospitalization and death following COVID-19 infection. Transl Psychiatry 2022; 12:482. [PMID: 36411283 PMCID: PMC9678873 DOI: 10.1038/s41398-022-02156-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is associated with an increased risk for physical illnesses and early mortality. However, we do not know if it also increases the risk for adverse outcomes of coronavirus disease 2019 (COVID-19). In this retrospective cohort study, we examined associations of PTSD and other psychiatric disorders with risk for hospitalization and death in the 60 days following a COVID-19 infection in 228,367 U.S. Department of Veteran Affairs (VA) patients who tested positive for COVID-19 between February 2020 and August 2021 (age m = 60.6, 89.5% male). Generalized linear models estimated associations of PTSD and other psychiatric disorders with outcomes following a positive SARS-CoV-2 test, adjusting for socio-demographic, medical, and behavioral factors. Among 228,367 VA patients, 25.6% had PTSD, and 28.2% had a psychiatric disorder other than PTSD. In the 60 days following a positive COVID-19 test, 15% of patients were hospitalized, and 6% died. Patients with PTSD had an increased risk for both hospitalization (adjusted relative risk, ARR = 1.18, 95% CI 1.15-1.21) and death (ARR = 1.13, 95% CI 1.08-1.19) relative to those with no psychiatric disorders, adjusting for socio-demographics. Estimates remained significant when models were additionally adjusted for medical comorbidities and smoking. Patients with other psychiatric disorders also had an increased risk of adverse COVID-19 outcomes, with larger effect sizes than PTSD in older (≥65 years) but not younger patients. In this large-scale study of VA patients, individuals with PTSD, and other psychiatric disorders, had heightened vulnerability to severe adverse outcomes of COVID-19; thus, individuals with PTSD should also be considered at higher risk for severe COVID-19 outcomes, and potentially prioritized for vaccination, screening, and early treatment intervention for COVID-19.
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12
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Behnke A, Mack M, Fieres J, Christmann M, Bürkle A, Moreno-Villanueva M, Kolassa IT. Expression of DNA repair genes and its relevance for DNA repair in peripheral immune cells of patients with posttraumatic stress disorder. Sci Rep 2022; 12:18641. [PMID: 36333408 PMCID: PMC9636148 DOI: 10.1038/s41598-022-22001-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) involves elevated levels of cellular oxidative stress which jeopardizes the integrity of essential cell compartments. Previously, we demonstrated higher levels of DNA lesions in peripheral blood mononuclear cells (PBMCs) in PTSD. Retaining vital levels of DNA integrity requires cells to mobilize compensatory efforts in elevating their DNA-repair capacity. Accordingly, we hypothesized to find increased expression rates of the DNA-repair genes X-ray repair cross complementing 1 (XRCC1), poly (ADP-ribose) polymerase 1 (PARP1), and polymerase β (Polβ) in PBMCs of PTSD patients as compared to controls, leading to functionally relevant changes in DNA-repair kinetics. In a cohort of 14 refugees with PTSD and 15 without PTSD, we found significantly higher XRCC1 expression in PTSD patients than controls (U = 161.0, p = 0.009, Cohen's r = 0.49), and positive correlations between the severity of PTSD symptoms and the expression of XRCC1 (rS = 0.57, p = 0.002) and PARP1 (rS = 0.43, p = 0.022). Higher XRCC1 (F = 2.39, p = 0.010, η2p = 0.10) and PARP1 (F = 2.15, p = 0.022, η2p = 0.09) expression accounted for slower repair of experimentally X-ray irradiation-induced DNA damage, highlighting the possible physiological relevance of altered DNA-repair gene expression in PTSD. Our study provides first evidence for a compensatory regulation of DNA-repair mechanisms in PTSD. We discuss the implications of increased DNA damage and altered DNA-repair mechanisms in immune senescence, premature aging, and increased physical morbidity in PTSD.
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Affiliation(s)
- Alexander Behnke
- grid.6582.90000 0004 1936 9748Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany
| | - Matthias Mack
- grid.6582.90000 0004 1936 9748Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany ,grid.9811.10000 0001 0658 7699Molecular Toxicology, Department of Biology, University of Konstanz, 78457 Constance, Germany
| | - Judy Fieres
- grid.9811.10000 0001 0658 7699Molecular Toxicology, Department of Biology, University of Konstanz, 78457 Constance, Germany ,grid.9811.10000 0001 0658 7699Department of Sport Science, Human Performance Research Centre, University of Konstanz, 78457 Constance, Germany
| | - Markus Christmann
- grid.5802.f0000 0001 1941 7111Applied Toxicology, Institute of Toxicology, University of Mainz, 55131 Mainz, Germany
| | - Alexander Bürkle
- grid.9811.10000 0001 0658 7699Molecular Toxicology, Department of Biology, University of Konstanz, 78457 Constance, Germany
| | - María Moreno-Villanueva
- grid.9811.10000 0001 0658 7699Molecular Toxicology, Department of Biology, University of Konstanz, 78457 Constance, Germany ,grid.9811.10000 0001 0658 7699Department of Sport Science, Human Performance Research Centre, University of Konstanz, 78457 Constance, Germany
| | - Iris-Tatjana Kolassa
- grid.6582.90000 0004 1936 9748Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany ,grid.9811.10000 0001 0658 7699Centre of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, 78464 Constance, Germany
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13
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Bürgin D, Clemens V, Varghese N, Eckert A, Huber M, Bruttin E, Boonmann C, Unternährer E, O'Donovan A, Schmid M. Adverse and traumatic exposures, posttraumatic stress disorder, telomere length, and hair cortisol – Exploring associations in a high-risk sample of young adult residential care leavers. Brain Behav Immun Health 2022; 26:100524. [PMID: 36213488 PMCID: PMC9535425 DOI: 10.1016/j.bbih.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/17/2022] [Accepted: 09/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Childhood adversities (CAs), potentially traumatic exposures (PTEs), and posttraumatic stress disorder (PTSD) are known to increase the risk for poor health outcomes, including diseases of aging and early mortality. Telomere length (TL) and hair cortisol concentrations (HCC) are biomarkers known to be associated with CA and PTEs, and PTSD, but there is considerable heterogeneity in findings. Objectives This study aims to investigate the association of CAs, PTEs, and PTSD with TL and HCC in a high-risk sample of young adults who were previously placed in youth residential care institutions throughout Switzerland. Method Our sample includes 130 participants (30.8% women, M Age = 26.5 ± 3.7 years) with previous youth residential care placements (MPlacements= 3.9). CAs and PTEs, as well as PTSD, were assessed with self-reported questionnaires and semi-structured clinical interviews. Immune cell TL was measured with quantitative polymerase chain reaction (qPCR) in whole blood. Hair samples were collected for HCC measurement and assayed with high-sensitivity ELISA. Multivariate regression models were fitted to describe the associations between CAs, PTEs, and PTSD with TL and HCC, adjusting for covariates. Results In our high-risk sample, a higher burden of CAs, PTEs, Criterion A trauma, and PTSD was associated with longer TL. PTEs, Criterion A trauma, and PTSD were associated with lower HCC, however no significant associations between CAs and HCC were found. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Conclusions Our findings are in contrast with many, but not all, previous studies of associations between adversity and both TL and HCC. For instance, our findings are in line with other studies that find a state of hypocortisolism in PTSD. Better measurement of adversities and trauma, multisystem biomarker approaches, and more research in larger high-risk samples at the upper end of the adversity-continuum is warranted. In this high-risk sample,childhood adversities, potential traumatic exposures, criterion A trauma, or posttraumatic stress disorder (PTSD) was associated with longer telomere length (TL). Potentially traumatic exposures, criterion A trauma, and PTSD were associated with lower hair cortisol concentrations. The magnitude of these effects varied depending on the dimensional or categorical nature of the stress-phenotype and the specific measure used. Hypocortisolism might explain findings of longer TL in participants with cumulated adverse and traumatic exposures. Research in high-risk populations is strongly needed as results across the entire spectrum of adversity exposures may not generalize to the top end of the spectrum.
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Affiliation(s)
- David Bürgin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Corresponding author. University Psychiatric Hospitals Basel Research Department for Child and Adolescent Psychiatry Wilhelm-Klein Strasse 27, 4056, Basel, Switzerland.
| | - Vera Clemens
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Nimmy Varghese
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Mara Huber
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Evelyne Bruttin
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Eva Unternährer
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Marc Schmid
- Research Department for Child and Adolescent Psychiatry, University Psychiatric Hospitals Basel, University of Basel, Basel, Switzerland
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14
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Kankam HK, Lee KC, Sardeli AV, Dretzke J, Lord JM, Moiemen N. Are acute burn injuries associated with long-term mortality? A systematic review and meta-analysis. Burns 2022; 48:1783-1793. [DOI: 10.1016/j.burns.2022.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/25/2022] [Accepted: 06/15/2022] [Indexed: 11/02/2022]
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15
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Sun S, Sheridan M, Tyrka A, Donofry SD, Erickson K, Loucks E. Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence. Neurosci Biobehav Rev 2022; 134:104526. [PMID: 34998833 PMCID: PMC8844271 DOI: 10.1016/j.neubiorev.2022.104526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Early life adversities (ELA) are prevalent and have a profound and adverse impact across the lifespan, including on age-related health outcomes, yet interventions to remediate its adverse impact are scarce. This paper presents evidence for mindfulness training to reduce the elevated mental and physical health risks linked to ELA among adults by targeting biological mechanisms of ELA leading to these adverse health outcomes. We first provide a brief overview of ELA, its adverse health impacts, and mechanisms that might be responsible. Next, we review converging evidence that demonstrates that mindfulness training influences key biological pathways involved in ELA-linked negative health consequences, including (a) brain networks involved in self-regulation, (b) immunity and inflammation, (c) telomere biology, and (d) epigenetic modifications. Further, we review preliminary evidence from mindfulness-based trials that focused on populations impacted by ELA. We discuss limitations of this review and provide recommendations for future research. If effective, a mindfulness-based approach could be an important public health strategy for remediating the adverse mental and physical health consequences of ELA.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, United States; Mindfulness Center at Brown University, United States.
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Audrey Tyrka
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Brown University Alpert Medical School
| | | | - Kirk Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA,Center for the Neural Basis of Cognition, Pittsburgh, PA
| | - Eric Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health,Mindfulness Center at Brown University
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16
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Carvalho CM, Coimbra BM, Xavier G, Bugiga AVG, Fonseca T, Olff M, Polimanti R, Mello AF, Ota VK, Mello MF, Belangero SI. Shorter Telomeres Related to Posttraumatic Stress Disorder Re-experiencing Symptoms in Sexually Assaulted Civilian Women. Front Psychiatry 2022; 13:835783. [PMID: 35664481 PMCID: PMC9161278 DOI: 10.3389/fpsyt.2022.835783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Telomeres are short tandem repeats of "TTAGGG" that protect the chromosome ends from deterioration or fusion of chromosomes. Their repeat length shortens with cell division acting as a biomarker of cellular aging. Traumatic stress events during adulthood or childhood have been associated with posttraumatic stress disorder (PTSD) and short leukocyte telomere length (LTL). This study investigated whether LTL was associated with PTSD in a Brazilian sample of sexually assaulted civilian women at two time points: baseline and 1-year follow-up. At baseline, we assessed 64 women with PTSD following sexual assault (cases) and 60 women with no previous history of sexual trauma or mental disorders (healthy controls - HC). At follow-up visit, 13 persistent PTSD cases, 11 HCs, and 11 PTSD remitters patients were evaluated. PTSD diagnosis and severity were assessed using Mini International Neuropsychiatric Interview (Diagnostic and Statistical Manual of Mental Disorders III/IV criteria) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), respectively. LTL was measured using multiplex real-time polymerase chain reaction (PCR). In the baseline analysis, we observed that LTL was associated with re-experiencing symptoms (B = -0.16; confidence interval (CI) 95% = -0.027--0.005; Bonferroni-adjusted p-value = 0.02), but no association was observed between other PTSD symptoms and LTL. In the longitudinal analysis, telomere shortening was no longer observed in patients with PTSD and PTSD remitters. In conclusion, our findings indicate that shorter baseline LTL is associated with early stage of PTSD re-experiencing symptoms in recently sexually assaulted women.
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Affiliation(s)
- Carolina Muniz Carvalho
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Bruno Messina Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Psychiatry, University of Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, Netherlands
| | - Gabriela Xavier
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Amanda V G Bugiga
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tamiris Fonseca
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Miranda Olff
- Department of Psychiatry, University of Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, Netherlands.,ARQ National Psychotrauma Centre, Diemen, Netherlands
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, VA CT Healthcare Center, West Haven, CT, United States
| | - Andrea Feijó Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Vanessa Kiyomi Ota
- LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Feijó Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sintia Iole Belangero
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,LiNC - Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil.,Genetics Division of Department of Morphology, Genetics of Universidade Federal de São Paulo, São Paulo, Brazil
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17
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Clausen AN, Fercho KA, Monsour M, Disner S, Salminen L, Haswell CC, Rubright EC, Watts AA, Buckley MN, Maron-Katz A, Sierk A, Manthey A, Suarez-Jimenez B, Olatunji BO, Averill CL, Hofmann D, Veltman DJ, Olson EA, Li G, Forster GL, Walter H, Fitzgerald J, Théberge J, Simons JS, Bomyea JA, Frijling JL, Krystal JH, Baker JT, Phan KL, Ressler K, Han LKM, Nawijn L, Lebois LAM, Schmaal L, Densmore M, Shenton ME, van Zuiden M, Stein M, Fani N, Simons RM, Neufeld RWJ, Lanius R, van Rooij S, Koch SBJ, Bonomo S, Jovanovic T, deRoon-Cassini T, Ely TD, Magnotta VA, He X, Abdallah CG, Etkin A, Schmahl C, Larson C, Rosso IM, Blackford JU, Stevens JS, Daniels JK, Herzog J, Kaufman ML, Olff M, Davidson RJ, Sponheim SR, Mueller SC, Straube T, Zhu X, Neria Y, Baugh LA, Cole JH, Thompson PM, Morey RA. Assessment of brain age in posttraumatic stress disorder: Findings from the ENIGMA PTSD and brain age working groups. Brain Behav 2022; 12:e2413. [PMID: 34907666 PMCID: PMC8785613 DOI: 10.1002/brb3.2413] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/03/2021] [Accepted: 10/15/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with markers of accelerated aging. Estimates of brain age, compared to chronological age, may clarify the effects of PTSD on the brain and may inform treatment approaches targeting the neurobiology of aging in the context of PTSD. METHOD Adult subjects (N = 2229; 56.2% male) aged 18-69 years (mean = 35.6, SD = 11.0) from 21 ENIGMA-PGC PTSD sites underwent T1-weighted brain structural magnetic resonance imaging, and PTSD assessment (PTSD+, n = 884). Previously trained voxel-wise (brainageR) and region-of-interest (BARACUS and PHOTON) machine learning pipelines were compared in a subset of control subjects (n = 386). Linear mixed effects models were conducted in the full sample (those with and without PTSD) to examine the effect of PTSD on brain predicted age difference (brain PAD; brain age - chronological age) controlling for chronological age, sex, and scan site. RESULTS BrainageR most accurately predicted brain age in a subset (n = 386) of controls (brainageR: ICC = 0.71, R = 0.72, MAE = 5.68; PHOTON: ICC = 0.61, R = 0.62, MAE = 6.37; BARACUS: ICC = 0.47, R = 0.64, MAE = 8.80). Using brainageR, a three-way interaction revealed that young males with PTSD exhibited higher brain PAD relative to male controls in young and old age groups; old males with PTSD exhibited lower brain PAD compared to male controls of all ages. DISCUSSION Differential impact of PTSD on brain PAD in younger versus older males may indicate a critical window when PTSD impacts brain aging, followed by age-related brain changes that are consonant with individuals without PTSD. Future longitudinal research is warranted to understand how PTSD impacts brain aging across the lifespan.
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Affiliation(s)
- Ashley N Clausen
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA.,Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Kelene A Fercho
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, South Dakota, USA.,Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, Oklahoma, USA.,Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota, USA.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota, USA
| | - Molly Monsour
- Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA
| | - Seth Disner
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, South Dakota, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Lauren Salminen
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Courtney C Haswell
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA
| | - Emily Clarke Rubright
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA
| | - Amanda A Watts
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA
| | - M Nicole Buckley
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA
| | - Adi Maron-Katz
- Department of Psychiatry and Behavioral Sciences, Stanford University of Medicine, Stanford, California, USA
| | - Anika Sierk
- University Medical Centre Charite, Berlin, Germany
| | | | - Benjamin Suarez-Jimenez
- Columbia University Medical Center, Manhattan, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Christopher L Averill
- Clinical Neuroscience Division, National Center for PTSD, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Elizabeth A Olson
- Harvard Medical School, Boston, Massachusetts, USA.,McLean Hospital, Belmont, Massachusetts, USA
| | - Gen Li
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Gina L Forster
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand.,Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota, USA
| | | | | | - Jean Théberge
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Jeffrey S Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, South Dakota, USA.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota, USA
| | - Jessica A Bomyea
- UC San Diego Department of Psychiatry, San Deigo, California, USA.,VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, San Deigo, California, USA
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - John H Krystal
- Clinical Neuroscience Division, National Center for PTSD, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Justin T Baker
- Institute for Technology in Psychiatry, McLean Hospital, Harvard University, Belmont, Massachusetts, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Kerry Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - Laura K M Han
- Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, GGZ inGeest, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - Lianne Schmaal
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Maria Densmore
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Martha E Shenton
- Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts, USA.,Departments of Psychiatry & Radiology, Harvard Medical School, Boston, Massachusetts, USA.,Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Murray Stein
- UC San Diego Department of Family Medicine and Public Health, San Deigo, California, USA.,UC San Diego Department of Psychiatry, San Deigo, California, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Raluca M Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, South Dakota, USA.,Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, University of British Columbia, Okanagan, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Ruth Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Sanne van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Serena Bonomo
- New York State Psychiatric Institute, New York, New York, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | | | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vincent A Magnotta
- Departments of Radiology, Psychiatry and Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Xiaofu He
- Columbia University Medical Center, Manhattan, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Chadi G Abdallah
- Clinical Neuroscience Division, National Center for PTSD, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Michael E, DeBakey VA Medical Center, Houston, Texas, USA.,Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University of Medicine, Stanford, California, USA.,Wu Tsai Neuroscience Institute, Stanford University, Stanford, California, USA
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Isabelle M Rosso
- Harvard Medical School, Boston, Massachusetts, USA.,McLean Hospital, Belmont, Massachusetts, USA
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Julia Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Milissa L Kaufman
- Division of Women's Mental Health, McLean Hospital, Belmont, Massachusetts, USA
| | - Miranda Olff
- ARQ National Psychotrauma Centrum, Diemen, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Richard J Davidson
- Center for Healthy Minds, Departments of Psychology and Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott R Sponheim
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Xi Zhu
- Columbia University Medical Center, Manhattan, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Yuval Neria
- Columbia University Medical Center, Manhattan, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Lee A Baugh
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, South Dakota, USA.,Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota, USA.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota, USA
| | - James H Cole
- Centre for Medical Image Computing, Computer Science, University College London, London, UK.,Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Rajendra A Morey
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA.,Duke University Brain Imaging and Analysis Center, Durham, North Carolina, USA.,Kansas City VA Medical Center, Kansas City, Missouri, USA.,ARQ National Psychotrauma Centrum, Diemen, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, GGZ inGeest, Amsterdam Neuroscience, Amsterdam, The Netherlands
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18
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Webb EK, Weis CN, Huggins AA, Fitzgerald JM, Bennett K, Bird CM, Parisi EA, Kallenbach M, Miskovich T, Krukowski J, deRoon-Cassini TA, Larson CL. Neural impact of neighborhood socioeconomic disadvantage in traumatically injured adults. Neurobiol Stress 2021; 15:100385. [PMID: 34471656 PMCID: PMC8390770 DOI: 10.1016/j.ynstr.2021.100385] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
Nearly 14 percent of Americans live in a socioeconomically disadvantaged neighborhood. Lower individual socioeconomic position (iSEP) has been linked to increased exposure to trauma and stress, as well as to alterations in brain structure and function; however, the neural effects of neighborhood SEP (nSEP) factors, such as neighborhood disadvantage, are unclear. Using a multi-modal approach with participants who recently experienced a traumatic injury (N = 185), we investigated the impact of neighborhood disadvantage, acute post-traumatic stress symptoms, and iSEP on brain structure and functional connectivity at rest. After controlling for iSEP, demographic variables, and acute PTSD symptoms, nSEP was associated with decreased volume and alterations of resting-state functional connectivity in structures implicated in affective processing, including the insula, ventromedial prefrontal cortex, amygdala, and hippocampus. Even in individuals who have recently experienced a traumatic injury, and after accounting for iSEP, the impact of living in a disadvantaged neighborhood is apparent, particularly in brain regions critical for experiencing and regulating emotion. These results should inform future research investigating how various levels of socioeconomic circumstances may impact recovery after a traumatic injury as well as policies and community-developed interventions aimed at reducing the impact of socioeconomic stressors.
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Affiliation(s)
- E. Kate Webb
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Carissa N. Weis
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Ashley A. Huggins
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | | | | | - Claire M. Bird
- Marquette University, Department of Psychology, Milwaukee, WI, USA
| | - Elizabeth A. Parisi
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Maddy Kallenbach
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Tara Miskovich
- VA Northern California Healthcare System, Martinez, CA, USA
| | | | - Terri A. deRoon-Cassini
- Medical College of Wisconsin, Department of Surgery, Division of Trauma & Acute Care Surgery, Milwaukee, WI, USA
| | - Christine L. Larson
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
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19
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Fritz MM, Walsh LC, Cole SW, Epel E, Lyubomirsky S. Kindness and cellular aging: A pre-registered experiment testing the effects of prosocial behavior on telomere length and well-being. Brain Behav Immun Health 2021; 11:100187. [PMID: 34589726 PMCID: PMC8474583 DOI: 10.1016/j.bbih.2020.100187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 01/02/2023] Open
Abstract
Objective Prosocial behavior can improve psychological well-being and physical health. However, the underlying biological mechanisms that mediate the relationship between prosociality and health remain unclear. In this pre-registered experiment, we tested whether a 4-week kindness intervention could slow leukocyte telomere shortening and increase well-being. Methods Community adults (N = 230) were randomly assigned to complete 1 of 3 activities, each week for 4 weeks: to perform 3 kind acts for other people, to perform 3 kind acts for themselves, or to list daily activities. At baseline and post-intervention, participants came to the lab to provide a small dried blood spot (DBS) sample via finger prick for analysis of telomere length. Participants completed psychological measures (e.g., loneliness, life satisfaction) at baseline, post-intervention, and at the 2-week follow up. Results Participants who performed kind acts for others did not demonstrate hypothesized changes in well-being, nor in telomere length, relative to controls. Exploratory analyses revealed that, relative to controls, participants who did kind acts for others showed reductions in loneliness through the 2-week follow up. Conclusions The salubrious effects of prosocial behavior in the short term are not likely due to the inhibition of cellular aging (at least as indexed by telomere length). However, extending kindness to others holds promise as a future research direction for interventions to alleviate loneliness. Prosocial behavior is associated with better health, but mechanisms remain unclear. We report a pre-registered investigation of prosocial behavior and telomere length. A 4-week prosocial behavior intervention did not slow rates of telomere shortening. Performing prosocial behavior for others was linked with reductions in loneliness. Prosocial behavior may reduce loneliness but does not appear to impact telomeres.
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Affiliation(s)
- Megan M Fritz
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Lisa C Walsh
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Steven W Cole
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Sonja Lyubomirsky
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
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20
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Navarro-Mateu F, Husky M, Cayuela-Fuentes P, Álvarez FJ, Roca-Vega A, Rubio-Aparicio M, Chirlaque MD, Cayuela ML, Martínez S, Sánchez-Meca J. The association of telomere length with substance use disorders: a systematic review and meta-analysis of observational studies. Addiction 2021; 116:1954-1972. [PMID: 33140537 DOI: 10.1111/add.15312] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/09/2020] [Accepted: 10/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Several recent studies have investigated the relationship between telomere length and substance use disorders with inconsistent results. We aimed to assess this association and to identify moderators of the relationship. METHODS Systematic review and meta-analysis. Selection criteria were observational studies reporting telomere length in people with a substance use disorder compared with a control group. Studies focused solely on nicotine addiction, employing other study designs, and non-human studies were excluded. Study selection and data extraction were independently conducted by two researchers following a standardized protocol and included studies until December 2019. Standardized mean differences were used as the effect size index [d; 95% confidence interval (CI)] and random-effects models were used for the meta-analysis. Cochran's Q-statistic, I2 index, visual inspection of the forest plot and a 95% prediction interval were applied to verify study heterogeneity. Subgroup analyses and meta-regressions were conducted to explore heterogeneity. Small study effects were examined using the 'funnel plot', the Egger test, Duval & Tweedie's trim-and-fill method and the precision-effect test-precision-effect estimate with standard error (PET-PEESE) method. The risk of bias and the quality of evidence were assessed. RESULTS Ten studies (12 analysis units with 2671 cases and 4532 controls) met the selection criteria. An overall effect size of moderate magnitude was found (d+ = -0.63; 95% CI = -1.00 and -0.26; P = 0.0008). A potential small study effect was detected, as well as large heterogeneity between studies (Q-statistic P < 0.001, I2 = 97.3%). Selection of controls, reporting laboratory quality control procedures and total sample size significantly affected the effect size. The quality of the evidence was very low, based on risk of bias analysis and the grading of recommendations assessment, development and evaluation (GRADE) system. CONCLUSIONS People with substance use disorders appear to have shorter telomere length than controls; however, this finding should be interpreted with caution due to the poor quality of the evidence.
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Affiliation(s)
- Fernando Navarro-Mateu
- Servicio Murciano de Salud, Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Murcia, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIB-Arrixaca, Murcia, Spain.,Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain
| | - Mathilde Husky
- Université de Bordeaux, Laboratoire de Psychologie EA4139, Bordeaux, France
| | - Pedro Cayuela-Fuentes
- Escuela Universitaria de Enfermería de Cartagena, University of Murcia, Murcia, Spain
| | - Francisco-Javier Álvarez
- Servicio Murciano de Salud, Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Murcia, Spain
| | - Agustín Roca-Vega
- Biblioteca Virtual MurciaSalud, Centro Tecnológico de Información y Documentación Sanitaria, Servicio Murciano de Salud, Murcia, Spain
| | | | - María Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIB-Arrixaca, Murcia, Spain.,Servicio de Epidemiología, Consejería de Salud, Murcia, Spain.,Departamento de Ciencias Sociosanitarias, University of Murcia, Murcia, Spain
| | - María Luisa Cayuela
- Grupo Telomerasa, Cáncer y Envejecimiento, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Salvador Martínez
- Instituto de Neurociencias, UMH-CSIC, Alicante, Spain.,and CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Julio Sánchez-Meca
- Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain
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21
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Abstract
Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact on physical function and health in the elderly and may be associated with premature aging and dementia. It is critical that clinicians screen for trauma-based symptoms and to treat as appropriate.
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Affiliation(s)
- Rebekah J Jakel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 3950, Durham, NC 27710, USA.
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22
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Pousa PA, Souza RM, Melo PHM, Correa BHM, Mendonça TSC, Simões-e-Silva AC, Miranda DM. Telomere Shortening and Psychiatric Disorders: A Systematic Review. Cells 2021; 10:1423. [PMID: 34200513 PMCID: PMC8227190 DOI: 10.3390/cells10061423] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/23/2022] Open
Abstract
Telomeres are aging biomarkers, as they shorten while cells undergo mitosis. The aim of this study was to evaluate whether psychiatric disorders marked by psychological distress lead to alterations to telomere length (TL), corroborating the hypothesis that mental disorders might have a deeper impact on our physiology and aging than it was previously thought. A systematic search of the literature using MeSH descriptors of psychological distress ("Traumatic Stress Disorder" or "Anxiety Disorder" or "depression") and telomere length ("cellular senescence", "oxidative stress" and "telomere") was conducted on PubMed, Cochrane Library and ScienceDirect databases. A total of 56 studies (113,699 patients) measured the TL from individuals diagnosed with anxiety, depression and posttraumatic disorders and compared them with those from healthy subjects. Overall, TL negatively associates with distress-related mental disorders. The possible underlying molecular mechanisms that underly psychiatric diseases to telomere shortening include oxidative stress, inflammation and mitochondrial dysfunction linking. It is still unclear whether psychological distress is either a cause or a consequence of telomere shortening.
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Affiliation(s)
- Pedro A. Pousa
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Raquel M. Souza
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Paulo Henrique M. Melo
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Bernardo H. M. Correa
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Tamires S. C. Mendonça
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Ana Cristina Simões-e-Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Débora M. Miranda
- Department of Pediatrics, Laboratory of Molecular Medicine, UFMG, Belo Horizonte, Minas Gerais 30130-100, Brazil
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23
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Oxidative Dysregulation in Early Life Stress and Posttraumatic Stress Disorder: A Comprehensive Review. Brain Sci 2021; 11:brainsci11060723. [PMID: 34072322 PMCID: PMC8228973 DOI: 10.3390/brainsci11060723] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/30/2022] Open
Abstract
Traumatic stress may chronically affect master homeostatic systems at the crossroads of peripheral and central susceptibility pathways and lead to the biological embedment of trauma-related allostatic trajectories through neurobiological alterations even decades later. Lately, there has been an exponential knowledge growth concerning the effect of traumatic stress on oxidative components and redox-state homeostasis. This extensive review encompasses a detailed description of the oxidative cascade components along with their physiological and pathophysiological functions and a systematic presentation of both preclinical and clinical, genetic and epigenetic human findings on trauma-related oxidative stress (OXS), followed by a substantial synthesis of the involved oxidative cascades into specific and functional, trauma-related pathways. The bulk of the evidence suggests an imbalance of pro-/anti-oxidative mechanisms under conditions of traumatic stress, respectively leading to a systemic oxidative dysregulation accompanied by toxic oxidation byproducts. Yet, there is substantial heterogeneity in findings probably relative to confounding, trauma-related parameters, as well as to the equivocal directionality of not only the involved oxidative mechanisms but other homeostatic ones. Accordingly, we also discuss the trauma-related OXS findings within the broader spectrum of systemic interactions with other major influencing systems, such as inflammation, the hypothalamic-pituitary-adrenal axis, and the circadian system. We intend to demonstrate the inherent complexity of all the systems involved, but also put forth associated caveats in the implementation and interpretation of OXS findings in trauma-related research and promote their comprehension within a broader context.
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24
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Coimbra BM, Yeh M, D'Elia AT, Maciel MR, Carvalho CM, Milani AC, Mozzambani A, Juruena M, Belangero SI, Jackowski AP, Poyares D, Mello AF, Mello MF. Posttraumatic Stress Disorder and Neuroprogression in Women Following Sexual Assault: Protocol for a Randomized Clinical Trial Evaluating Allostatic Load and Aging Process Acceleration. JMIR Res Protoc 2020; 9:e19162. [PMID: 33206061 PMCID: PMC7710442 DOI: 10.2196/19162] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/20/2020] [Accepted: 10/20/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and severe disorder related to traumatic events. Women are disproportionately affected by PTSD than men and are more at risk in the occurrence of sexual assault victimization. Estimates suggest that 50% of women develop PTSD following sexual assault and successful clinical management can be challenging. Growing evidence has implicated neural, immune, and endocrine alterations underpinning PTSD, but only few studies have assessed the evolution of acute PTSD in women. OBJECTIVE This study aims to measure whether the onset of PTSD is associated with accelerated aging in women following sexual assault. We hypothesize that the increase of allostatic load caused by PTSD leads to neuroprogression. We will implement a randomized clinical trial to compare responses to treatment with either interpersonal psychotherapy adapted for PTSD (IPT-PTSD) or the selective serotonin reuptake inhibitor sertraline. METHODS We will include women between 18 and 45 years of age, who experienced sexual assault from 1 to 6 months before the initial evaluation, and present with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnosis of PTSD. Baseline evaluation will comprise clinical and psychometric assessments, structural and functional magnetic resonance imaging, neuropsychological testing, polysomnography, evaluation of immune and endocrine parameters, and genetic analyses. Age-matched female healthy controls will be included and subjected to the same evaluation. Patients will be randomized for treatment in 1 of the 2 arms of the study for 14 weeks; follow-up will continue until 1 year after inclusion via treatment as usual. The researchers will collect clinical and laboratory data during periodic clinical assessments up to 1-year follow-up. RESULTS Data collection started in early 2016 and will be completed by the end of the first semester of 2020. Analyses will be performed soon afterward, followed by the elaboration of several articles. Articles will be submitted in early 2021. This research project has obtained a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 2014/12559-5). CONCLUSIONS We expect to provide insight into the consequences of recent sexual assault exposure in women by investigating the degree of neuroprogression developing from an early stage of PTSD. We also expect to provide important evidence on the efficacy of a non-exposure psychotherapy (IPT-PTSD) to mitigate PTSD symptoms in recently sexually assaulted women. Further, we aim to obtain evidence on how treatment outcomes are associated with neuroprogression measures. TRIAL REGISTRATION Brazilian Clinical Trials Registry RBR-3z474z; http://www.ensaiosclinicos.gov.br/rg/RBR-3z474z/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19162.
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Affiliation(s)
- Bruno Messina Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mary Yeh
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Teresa D'Elia
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mariana Rangel Maciel
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Carolina Muniz Carvalho
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Carolina Milani
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Adriana Mozzambani
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mario Juruena
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College, London, United Kingdom
| | - Sintia Iole Belangero
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Andrea Parolin Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Andrea Feijo Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Feijo Mello
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD, Universidade Federal de São Paulo, São Paulo, Brazil
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25
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Colich NL, Rosen ML, Williams ES, McLaughlin KA. Biological aging in childhood and adolescence following experiences of threat and deprivation: A systematic review and meta-analysis. Psychol Bull 2020; 146:721-764. [PMID: 32744840 DOI: 10.1037/bul0000270] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Life history theory argues that exposure to early life adversity (ELA) accelerates development, although existing evidence for this varies. We present a meta-analysis and systematic review testing the hypothesis that ELA involving threat (e.g., violence exposure) will be associated with accelerated biological aging across multiple metrics, whereas exposure to deprivation (e.g., neglect, institutional rearing) and low-socioeconomic status (SES) will not. We meta-analyze 54 studies (n = 116,010) examining associations of ELA with pubertal timing and cellular aging (telomere length and DNA methylation age), systematically review 25 studies (n = 3,253) examining ELA and neural markers of accelerated development (cortical thickness and amygdala-prefrontal cortex functional connectivity) and evaluate whether associations of ELA with biological aging vary according to the nature of adversity experienced. ELA overall was associated with accelerated pubertal timing (d = -0.10) and cellular aging (d = -0.21), but these associations varied by adversity type. Moderator analysis revealed that ELA characterized by threat was associated with accelerated pubertal development (d = -0.26) and accelerated cellular aging (d = -0.43), but deprivation and SES were unrelated to accelerated development. Systematic review revealed associations between ELA and accelerated cortical thinning, with threat-related ELA consistently associated with thinning in ventromedial prefrontal cortex, and deprivation and SES associated with thinning in frontoparietal, default, and visual networks. There was no consistent association of ELA with amygdala-PFC connectivity. These findings suggest specificity in the types of early environmental experiences associated with accelerated biological aging and highlight the importance of evaluating how accelerated aging contributes to health disparities and whether this process can be mitigated through early intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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26
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Zannas AS. Epigenetics as a key link between psychosocial stress and aging: concepts, evidence, mechanisms
. DIALOGUES IN CLINICAL NEUROSCIENCE 2020; 21:389-396. [PMID: 31949406 PMCID: PMC6952744 DOI: 10.31887/dcns.2019.21.4/azannas] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Psychosocial stress—especially when chronic, excessive, or occurring early in
life—has been associated with accelerated aging and increased disease risk. With rapid
aging of the world population, the need to elucidate the underlying mechanisms is
pressing, now more so than ever. Among molecular mechanisms linking stress and aging,
the present article reviews evidence on the role of epigenetics, biochemical processes
that can be set into motion by stressors and in turn influence genomic function and
complex phenotypes, including aging-related outcomes. The article further provides a
conceptual mechanistic framework on how stress may drive epigenetic changes at
susceptible genomic sites, thereby exerting systems-level effects on the aging epigenome
while also regulating the expression of molecules implicated in aging-related processes.
This emerging evidence, together with work examining related biological processes,
begins to shed light on the epigenetic and, more broadly, molecular underpinnings of the
long-hypothesized connection between stress and aging.
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Affiliation(s)
- Anthony S Zannas
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, US; Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, US; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, US; Institute for Trauma Recovery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, US; Neuroscience Curriculum, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, US
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McLaughlin KA, Colich NL, Rodman AM, Weissman DG. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med 2020; 18:96. [PMID: 32238167 PMCID: PMC7110745 DOI: 10.1186/s12916-020-01561-6] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transdiagnostic processes confer risk for multiple types of psychopathology and explain the co-occurrence of different disorders. For this reason, transdiagnostic processes provide ideal targets for early intervention and treatment. Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology. We articulate a transdiagnostic model of the developmental mechanisms that explain the strong links between childhood trauma and psychopathology as well as protective factors that promote resilience against multiple forms of psychopathology. MAIN BODY We present a model of transdiagnostic mechanisms spanning three broad domains: social information processing, emotional processing, and accelerated biological aging. Changes in social information processing that prioritize threat-related information-such as heightened perceptual sensitivity to threat, misclassification of negative and neutral emotions as anger, and attention biases towards threat-related cues-have been consistently observed in children who have experienced trauma. Patterns of emotional processing common in children exposed to trauma include elevated emotional reactivity to threat-related stimuli, low emotional awareness, and difficulties with emotional learning and emotion regulation. More recently, a pattern of accelerated aging across multiple biological metrics, including pubertal development and cellular aging, has been found in trauma-exposed children. Although these changes in social information processing, emotional responding, and the pace of biological aging reflect developmental adaptations that may promote safety and provide other benefits for children raised in dangerous environments, they have been consistently associated with the emergence of multiple forms of internalizing and externalizing psychopathology and explain the link between childhood trauma exposure and transdiagnostic psychopathology. Children with higher levels of social support, particularly from caregivers, are less likely to develop psychopathology following trauma exposure. Caregiver buffering of threat-related processing may be one mechanism explaining this protective effect. CONCLUSION Childhood trauma exposure is a powerful transdiagnostic risk factor associated with elevated risk for multiple forms of psychopathology across development. Changes in threat-related social and emotional processing and accelerated biological aging serve as transdiagnostic mechanisms linking childhood trauma with psychopathology. These transdiagnostic mechanisms represent critical targets for early interventions aimed at preventing the emergence of psychopathology in children who have experienced trauma.
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Affiliation(s)
- Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA.
| | - Natalie L Colich
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA
| | - Alexandra M Rodman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - David G Weissman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
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Qiao S, Jiang Y, Li X. The Impact of Health Promotion Interventions on Telomere Length: A Systematic Review. Am J Health Promot 2020; 34:633-647. [DOI: 10.1177/0890117120906958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives:The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging).Data Source:PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases.Study Inclusion and Exclusion Criteria:Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects.Data Extraction:Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines.Data Synthesis:Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead.Results:Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length.Conclusions:Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education, & Behavior, University of South Carolina, Columbia, SC, USA
| | - Yanping Jiang
- Department of Health Promotion, Education, & Behavior, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, & Behavior, University of South Carolina, Columbia, SC, USA
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29
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Association between leucocyte telomere length and cardiovascular disease in a large general population in the United States. Sci Rep 2020; 10:80. [PMID: 31919463 PMCID: PMC6952450 DOI: 10.1038/s41598-019-57050-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/21/2019] [Indexed: 12/12/2022] Open
Abstract
Leucocyte telomere length (LTL) has been reported to be linked to ageing, cancer and cardiovascular disease (CVD). This study aimed to explore the association between LTL and CVD risk in a nationally representative sample of U.S. adults. Complex associations, including nonlinearity and interaction, were also examined. A total of 7,378 subjects from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 were collected. Telomere length was detected from DNA samples and expressed as the mean T/S ratio (telomere repeats per single-copy gene). We performed multiple logistic regression models and interactive analysis to explore the associations between LTL and CVD risk by adjusting for potential confounders. We also performed a sensitivity analysis to investigate the robustness of our results. Among all participants, LTL was associated with the risk of CVD (OR = 0.79, 95% CI: 0.63~0.98, P = 0.033) in a linear manner rather than in a nonlinear manner (P = 0.874). Interaction effects of LTL with both education (P = 0.017) and hypertension (P = 0.007) were observed. Furthermore, using subgroup analyses, protective effects of LTL on CVD risk were found in females and in individuals who were college graduates or above, had serum cotinine >10 ng/ml, did not have hypertension, or had normal white blood cell levels. LTL is linearly inversely associated with CVD risk in the general population of the United States.
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Ridout KK, Ridout SJ, Guille C, Mata DA, Akil H, Sen S. Physician-Training Stress and Accelerated Cellular Aging. Biol Psychiatry 2019; 86:725-730. [PMID: 31230727 PMCID: PMC6788968 DOI: 10.1016/j.biopsych.2019.04.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stress is a key precipitant for many common diseases, but established biological markers to track stress and guide investigations into mechanisms linking stress and disease are lacking. Cross-sectional studies have identified correlations between stress and telomere attrition, but no large, longitudinal studies examining the impacts of chronic stress on telomere length exist. Residency training for physicians is a well-established stressful experience and can be used as a prospective stress model. METHODS In a longitudinal cohort study of 250 interns (first-year residents) at 55 United States hospital systems serving during the 2015-2016 academic year, we examined associations between measures of the residency experience and saliva-measured telomere attrition. RESULTS Telomere length shortened significantly over the course of internship year, from mean ± SD of 6465.1 ± 876.8 base pairs before internship to 6321.5 ± 630.6 base pairs at the end of internship (t246 = 2.69; p = .008). Stressful early family environments and neuroticism were significantly associated with shorter preinternship telomere length. Longer work hours were associated with greater telomere intern telomere loss over the year (p = .002). Of note, the mean telomere attrition during internship year was six times greater than the typical annual attrition rate identified in a recent meta-analysis. CONCLUSIONS This work implicates telomere attrition as a biologically measurable consequence of physician training, with the magnitude of attrition associated with workload. Identification of an objective, biological sequela of residency stress may help to facilitate the development of effective interventions. Further, the findings implicate telomere attrition as an objective biomarker to follow the pathologic effects of stress, in general.
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Affiliation(s)
- Kathryn K. Ridout
- Department of Psychiatry, Kaiser Permanente, San Jose, CA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | | | - Constance Guille
- Brain Research and Integrative Neuropsychopharmacology Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Douglas A. Mata
- Department of Pathology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA,Brigham Education Institute, Boston, MA
| | - Huda Akil
- Molecular and Behavioral Neuroscience Institute and Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
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Rivara F, Adhia A, Lyons V, Massey A, Mills B, Morgan E, Simckes M, Rowhani-Rahbar A. The Effects Of Violence On Health. Health Aff (Millwood) 2019; 38:1622-1629. [DOI: 10.1377/hlthaff.2019.00480] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Frederick Rivara
- Frederick Rivara is the Seattle Children's Guild Endowed Chair in Pediatric Research and a professor in the Department of Pediatrics at the University of Washington, in Seattle
| | - Avanti Adhia
- Avanti Adhia is a senior fellow in the Department of Pediatrics, University of Washington
| | - Vivian Lyons
- Vivian Lyons is a doctoral candidate in the Department of Epidemiology, University of Washington
| | - Anne Massey
- Anne Massey is a doctoral candidate in the Department of Epidemiology, University of Washington
| | - Brianna Mills
- Brianna Mills is a research scientist in the Harborview Injury Prevention and Research Center, University of Washington
| | - Erin Morgan
- Erin Morgan is a doctoral candidate in the Department of Epidemiology, University of Washington
| | - Maayan Simckes
- Maayan Simckes is a doctoral candidate in the Department of Epidemiology, University of Washington
| | - Ali Rowhani-Rahbar
- Ali Rowhani-Rahbar is the Bartley Dobb Professor for the Study of Violence and an associate professor in the Department of Epidemiology, University of Washington
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Bateson M, Eisenberg DTA, Nettle D. Controlling for baseline telomere length biases estimates of the rate of telomere attrition. ROYAL SOCIETY OPEN SCIENCE 2019; 6:190937. [PMID: 31824705 PMCID: PMC6837209 DOI: 10.1098/rsos.190937] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/28/2019] [Indexed: 06/10/2023]
Abstract
Longitudinal studies have sought to establish whether environmental exposures such as smoking accelerate the attrition of individuals' telomeres over time. These studies typically control for baseline telomere length (TL) by including it as a covariate in statistical models. However, baseline TL also differs between smokers and non-smokers, and telomere attrition is spuriously linked to baseline TL via measurement error and regression to the mean. Using simulated datasets, we show that controlling for baseline TL overestimates the true effect of smoking on telomere attrition. This bias increases with increasing telomere measurement error and increasing difference in baseline TL between smokers and non-smokers. Using a meta-analysis of longitudinal datasets, we show that as predicted, the estimated difference in telomere attrition between smokers and non-smokers is greater when statistical models control for baseline TL than when they do not, and the size of the discrepancy is positively correlated with measurement error. The bias we describe is not specific to smoking and also applies to other exposures. We conclude that to avoid invalid inference, models of telomere attrition should not control for baseline TL by including it as a covariate. Many claims of accelerated telomere attrition in individuals exposed to adversity need to be re-assessed.
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Affiliation(s)
- Melissa Bateson
- Centre for Behaviour and Evolution and Institute of Neuroscience, Newcastle University, Henry Wellcome Building, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | | | - Daniel Nettle
- Centre for Behaviour and Evolution and Institute of Neuroscience, Newcastle University, Henry Wellcome Building, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
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Ridout KK, Parade SH, Kao HT, Magnan S, Seifer R, Porton B, Price LH, Tyrka AR. Childhood maltreatment, behavioral adjustment, and molecular markers of cellular aging in preschool-aged children: A cohort study. Psychoneuroendocrinology 2019; 107:261-269. [PMID: 31174164 PMCID: PMC7839663 DOI: 10.1016/j.psyneuen.2019.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/04/2019] [Accepted: 05/14/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Childhood maltreatment is a major risk factor for the development of behavioral problems and poor physical and mental health. Accelerated cellular aging, through reduced telomere length and mitochondrial dysfunction, may be a mechanism underlying these associations. METHODS Families with (n = 133) and without (n = 123) child welfare documentation of moderate-severe maltreatment in the past six months participated in this study. Children ranged in age from 3 to 5 years, were racially and ethnically diverse, and 91% qualified for public assistance. Structured record review and interviews were used to assess a history of maltreatment and other adversities. Telomere length and mitochondrial DNA copy number (mtDNAcn) were measured from saliva DNA using real-time PCR. Measures were repeated at a six-month follow-up assessment. Repeated measures general linear models were used to examine the effects of maltreatment and other adversities on telomere length and mtDNAcn over time. RESULTS Maltreatment and other adverse experiences were significant positive predictors of both telomere length and mtDNAcn over time. Internalizing and externalizing behavior problems were also both significantly associated with telomere length, but only internalizing symptoms were associated with mtDNAcn. CONCLUSIONS This is the first study to show that mtDNAcn is altered in children with stress and trauma, and the findings are consistent with recent studies of adults. Surprisingly, children who experienced moderate-severe levels of maltreatment in the prior six months had longer telomeres, possibly reflecting compensatory changes in response to recent trauma. Telomere length and mtDNAcn were also associated with behavioral problems, suggesting that these measures of cellular aging may be causally implicated in the pathophysiology of stress-related conditions.
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Affiliation(s)
- Kathryn K. Ridout
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI, USA
| | - Hung-Teh Kao
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Stevie Magnan
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI, USA
| | - Barbara Porton
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA,Address Correspondence to: Audrey R. Tyrka, M.D., Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. TEL: (401) 455-6520. FAX: (401) 455-6534.
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Meier HCS, Hussein M, Needham B, Barber S, Lin J, Seeman T, Diez Roux A. Cellular response to chronic psychosocial stress: Ten-year longitudinal changes in telomere length in the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 2019; 107:70-81. [PMID: 31112903 PMCID: PMC6635040 DOI: 10.1016/j.psyneuen.2019.04.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/14/2019] [Accepted: 04/26/2019] [Indexed: 01/01/2023]
Abstract
Previous studies have demonstrated an inverse association between chronic psychosocial stress and leukocyte telomere length (LTL), a potential marker of cellular aging. However, due to paucity of longitudinal data, responses of LTL and the LTL aging trajectory to changes in chronic stress exposure remain less well understood. Using data from the Stress I and II ancillary studies of the Multi-Ethnic Study of Atherosclerosis, we estimated the 10-year longitudinal (n = 1,158) associations of within-person changes in chronic stress with changes in LTL, as well as the pooled, cross-sectional associations of chronic stress and LTL (total n = 2,231). We measured chronic stress from both individual and neighborhood-environment sources. At the individual level, we calculated a summary score of each participant's rating of their ongoing (>6 months) material/social problems as moderately/very stressful on the Chronic Burden Scale. Neighborhood-level stress was measured using a summary score of reverse-coded MESA Neighborhood safety, aesthetic quality, and social cohesion scales. Quantiles of these scores were empirically categorized as high, moderate, or low stress. We then summed these individual- and neighborhood-level categorical variables for a total stress measure. Longitudinal within-person associations were estimated with fixed-effects models, which control for all time-invariant confounding, with additional control for time-varying demographics, lagged behaviors and chronic conditions, and specimen storage duration, as well as correction for regression to the mean. Change from low to high total chronic stress was associated with telomere shortening by 0.054 units [95% confidence interval: -0.095, -0.013] over 10 years. This was consistent with, though stronger in magnitude than, cross-sectional estimates. Change in individual-level stress was the primary driver of this effect. We also found suggestive evidence that 1) individuals with persistently high stress experienced the least shortening of telomeres, and 2) changes in individual-level stress were associated with stronger telomere shortening among women, whereas changes in neighborhood stress were associated with stronger shortening among men. Our findings provide longitudinal support to existing evidence, and point to interesting dynamics in telomere attrition across stress levels and genders.
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Affiliation(s)
- Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St., Milwaukee, WI, 53205, USA.
| | - Mustafa Hussein
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St., Milwaukee, WI, 53205, USA.
| | - Belinda Needham
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Sharrelle Barber
- Department of Epidemiology and Biostatistics, and the Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA, 19104, USA.
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, 600 16th Street, Room S312F Genentech Hall, San Francisco, CA, 94158, USA.
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA, 90095, USA.
| | - Ana Diez Roux
- Department of Epidemiology and Biostatistics, and the Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA, 19104, USA.
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Han LKM, Verhoeven JE, Tyrka AR, Penninx BWJH, Wolkowitz OM, Månsson KNT, Lindqvist D, Boks MP, Révész D, Mellon SH, Picard M. Accelerating research on biological aging and mental health: Current challenges and future directions. Psychoneuroendocrinology 2019; 106:293-311. [PMID: 31154264 PMCID: PMC6589133 DOI: 10.1016/j.psyneuen.2019.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/22/2019] [Accepted: 04/02/2019] [Indexed: 12/13/2022]
Abstract
Aging is associated with complex biological changes that can be accelerated, slowed, or even temporarily reversed by biological and non-biological factors. This article focuses on the link between biological aging, psychological stressors, and mental illness. Rather than comprehensively reviewing this rapidly expanding field, we highlight challenges in this area of research and propose potential strategies to accelerate progress in this field. This effort requires the interaction of scientists across disciplines - including biology, psychiatry, psychology, and epidemiology; and across levels of analysis that emphasize different outcome measures - functional capacity, physiological, cellular, and molecular. Dialogues across disciplines and levels of analysis naturally lead to new opportunities for discovery but also to stimulating challenges. Some important challenges consist of 1) establishing the best objective and predictive biological age indicators or combinations of indicators, 2) identifying the basis for inter-individual differences in the rate of biological aging, and 3) examining to what extent interventions can delay, halt or temporarily reverse aging trajectories. Discovering how psychological states influence biological aging, and vice versa, has the potential to create novel and exciting opportunities for healthcare and possibly yield insights into the fundamental mechanisms that drive human aging.
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Affiliation(s)
- Laura K M Han
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Josine E Verhoeven
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands
| | - Audrey R Tyrka
- Butler Hospital and the Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Owen M Wolkowitz
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Kristoffer N T Månsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Daniel Lindqvist
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden; Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA; Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden
| | - Marco P Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, the Netherlands
| | - Dóra Révész
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Synthia H Mellon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, USA; Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Medical Center, New York, NY, USA; Columbia Aging Center, Columbia University, New York, NY, USA.
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Forehand JA, Peltzman T, Westgate CL, Riblet NB, Watts BV, Shiner B. Causes of Excess Mortality in Veterans Treated for Posttraumatic Stress Disorder. Am J Prev Med 2019; 57:145-152. [PMID: 31248740 PMCID: PMC6642830 DOI: 10.1016/j.amepre.2019.03.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Published research indicates that posttraumatic stress disorder (PTSD) is associated with increased mortality. However, causes of death among treatment-seeking patients with PTSD remain poorly characterized. The study objective was to describe causes of death among Veterans with PTSD to inform preventive interventions for this treatment population. METHODS A retrospective cohort study was conducted for all Veterans who initiated PTSD treatment at any Department of Veterans Affairs Medical Center from fiscal year 2008 to 2013. The primary outcome was mortality within the first year after treatment initiation. In 2018, collected data were analyzed to determine leading causes of death. For the top ten causes, standardized mortality ratios (SMRs) were calculated from age- and sex-matched mortality tables of the U.S. general population. RESULTS A total of 491,040 Veterans were identified who initiated PTSD treatment. Mean age was 48.5 (±16.0) years, 90.7% were male, and 63.5% were of white race. In the year following treatment initiation, 1.1% (5,215/491,040) died. All-cause mortality was significantly higher for Veterans with PTSD compared with the U.S. population (SMR=1.05, 95% CI=1.02, 1.08, p<0.001). Veterans with PTSD had a significant increase in mortality from suicide (SMR=2.52, 95% CI=2.24, 2.82, p<0.001), accidental injury (SMR=1.99, 95% CI=1.83, 2.16, p<0.001), and viral hepatitis (SMR=2.26, 95% CI=1.68, 2.93, p<0.001) versus the U.S. POPULATION Of those dying from accidental injury, more than half died of poisoning (52.3%, 325/622). CONCLUSIONS Veterans with PTSD have an elevated risk of death from suicide, accidental injury, and viral hepatitis. Preventive interventions should target these important causes of death.
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Affiliation(s)
| | - Talya Peltzman
- Veterans Affairs Medical Center, White River Junction, Vermont
| | | | - Natalie B Riblet
- Veterans Affairs Medical Center, White River Junction, Vermont; Department of Psychiatry, Geisel School of Medicine, Hanover, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
| | - Bradley V Watts
- Veterans Affairs Medical Center, White River Junction, Vermont; Department of Psychiatry, Geisel School of Medicine, Hanover, New Hampshire; Fellowships in Quality and Safety, National Center for Patient Safety, Ann Arbor, Michigan
| | - Brian Shiner
- Veterans Affairs Medical Center, White River Junction, Vermont; Department of Psychiatry, Geisel School of Medicine, Hanover, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire; National Center for Posttraumatic Stress Disorder, White River Junction, Vermont
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Bürgin D, O'Donovan A, d'Huart D, di Gallo A, Eckert A, Fegert J, Schmeck K, Schmid M, Boonmann C. Adverse Childhood Experiences and Telomere Length a Look Into the Heterogeneity of Findings-A Narrative Review. Front Neurosci 2019; 13:490. [PMID: 31191214 PMCID: PMC6541108 DOI: 10.3389/fnins.2019.00490] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been associated with poor mental and somatic health. Accumulating evidence indicates that accelerated biological aging-indexed by altered telomere-related markers-may contribute to associations between ACEs and negative long-term health outcomes. Telomeres are repeated, non-coding deoxyribonucleic acid (DNA) sequences at the end of chromosomes. Telomeres shorten during repeated cell divisions over time and are being used as a marker of biological aging. Objectives: The aim of the current paper is to review the literature on the relationship between ACEs and telomere length (TL), with a specific focus on how the heterogeneity of sample and ACEs characteristics lead to varying associations between ACEs and TL. Methods: Multiple databases were searched for relevant English peer-reviewed articles. Thirty-eight papers were found to be eligible for inclusion in the current review. Results: Overall, the studies indicated a negative association between ACEs and TL, although many papers presented mixed findings and about a quarter of eligible studies found no association. Studies with smaller sample sizes more often reported significant associations than studies with larger samples. Also, studies reporting on non-clinical and younger samples more often found associations between ACEs and TL compared to studies with clinical and older samples. Reviewing the included studies based on the "Stressor Exposure Characteristics" recently proposed by Epel et al. (2018) revealed a lack of detailed information regarding ACEs characteristics in many studies. Conclusion: Overall, it is difficult to achieve firm conclusions about associations of ACEs with TL due to the heterogeneity of study and ACE characteristics and the heterogeneity in reported findings. The field would benefit from more detailed descriptions of study samples and measurement of ACEs.
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Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Delfine d'Huart
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Alain di Gallo
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Jörg Fegert
- Child and Adolescent Psychiatry/Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Clinic, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
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38
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Telomere shortening in blood leukocytes of patients with posttraumatic stress disorder. J Psychiatr Res 2019; 111:83-88. [PMID: 30685566 DOI: 10.1016/j.jpsychires.2019.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 01/09/2023]
Abstract
Telomeres are protective fragments on chromosome ends involved in maintaining genome stability, preventing chromosomal fusions, regulation of cell division. It was shown that telomere attrition rate is accelerated in age-related diseases, as well as in response to physiological and psychosocial stress. The aim of this study was to evaluate relative leukocyte telomere length (LTL) in patients with post traumatic stress disorder (PTSD), as well as to investigate association of functional SNPs of telomerase TERC and TERT genes with LTL and PTSD. The relative LTL was measured by multiplex quantitative PCR method; genotyping of TERC rs12696304, TERT rs7726159 and rs2736100 was performed by PCR with sequence specific primers. Comparison of LTL in diseased and healthy subjects showed that PTSD patients had shorter average LTL than controls. Also, the frequency and the carriage rate of the TERT rs2736100*T allele was higher in PTSD patients compared to controls. Overall our results are in line with previous research in different populations. Furthermore, we have demonstrated that rs2736100 of TERT gene was significantly associated with PTSD and the minor allele of this polymorphism may be considered as a risk factor for PTSD in the Armenian population.
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Dai W, Liu A, Kaminga AC, Deng J, Lai Z, Wen SW. Prevalence of Posttraumatic Stress Disorder among Children and Adolescents following Road Traffic Accidents: A Meta-Analysis. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:798-808. [PMID: 30081648 PMCID: PMC6309043 DOI: 10.1177/0706743718792194] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Children and adolescents are among the most vulnerable road users, and road traffic accidents (RTAs) can lead to not only physical injuries but also adverse psychological outcomes, particularly posttraumatic stress disorder (PTSD). However, estimates of the prevalence of PTSD among children and adolescents following RTAs varied considerably across studies. Therefore, this study aimed to estimate the pooled prevalence of PTSD among this population. METHODS A systematic search for literature was performed in the electronic databases of PubMed, Web of Science, PsycINFO, and Embase. Heterogeneity was assessed using the Cochran's chi-square test and quantified by the I2 value. Meta-regression analyses were carried out to identify the effects of some potential moderators on the overall heterogeneity. Subgroup analyses were performed to estimate the pooled prevalence of PTSD according to some sample characteristics. RESULTS Eleven eligible studies with a total of 1532 children and adolescents who were involved in RTAs were included. The overall heterogeneity (I2 = 89.7, P < 0.001) was high across the eligible studies, and the pooled prevalence of PTSD was 19.95% (95% confidence interval, 13.63% to 27.09%) by a random-effects model. No significant moderators of the overall heterogeneity were identified using meta-regression analyses. Subgroup analyses showed that the pooled prevalence of PTSD differed significantly according to the study location and gender (P < 0.05). CONCLUSIONS One-fifth of children and adolescents developed PTSD in the aftermath of RTAs, indicating the need for regular assessment of PTSD and timely and effective psychological interventions among this population. Furthermore, more population-based studies with a large sample size are warranted. The protocol was registered in the PROSPERO database (No. CRD42018087941).
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Obstetrics and Gynecology, Faculty of Medicine, OMNI Research Group, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Atipatsa C Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zhiwei Lai
- Immunization Programme Department, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Obstetrics and Gynecology, Faculty of Medicine, OMNI Research Group, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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40
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Major trauma and acceleration of the ageing process. Ageing Res Rev 2018; 48:32-39. [PMID: 30316759 DOI: 10.1016/j.arr.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/07/2018] [Accepted: 10/08/2018] [Indexed: 12/30/2022]
Abstract
It is well established that numerous factors can affect the rate at which we age biologically. Diet, physical activity, lifestyle and our genes all play a major role in influencing the ageing trajectory and longevity. Major trauma affects millions globally, is the major cause of death in young adults and could influence ageing processes but has largely been ignored by biogenterologists. The long-term health consequences of physical trauma are well known in the medical community, how trauma effects the ageing process at a molecular level is not. It has long been difficult to assess ageing trajectories due to the absence of a biomarker of biological rather than chronological age. Recent advances in epigenetics have helped by identifying specific DNA methylation sites as good indicators of biological age. Recent investigations into the impact of psychological trauma and the associated physical stress on accelerating ageing as measured by epigenetic drift are promising. The physical and metabolic stress which is synonymous with physical trauma may also accelerate the ageing process. We suggest that long term epigenetic profiling is required to understand to what degree the ageing trajectory is altered by trauma, which will in turn add support for the development of novel therapies to improve health outcomes for survivors of traumatic injury.
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41
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Willis M, Reid SN, Calvo E, Staudinger UM, Factor-Litvak P. A scoping systematic review of social stressors and various measures of telomere length across the life course. Ageing Res Rev 2018; 47:89-104. [PMID: 30048807 PMCID: PMC6195444 DOI: 10.1016/j.arr.2018.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/10/2018] [Accepted: 07/18/2018] [Indexed: 12/20/2022]
Abstract
Numerous studies examine the relationship between social stressors and telomere length (TL). Beyond considering methods and major findings, this scoping systematic review takes a novel approach as it groups studies according to the types of social stressor considered and by age groups. Following PRISMA guidelines, we searched PubMed, Web of Science, Embase, and Scopus. We included all English-language human subject research articles that modeled any measure of TL as a dependent variable and exposure to a social stressor as an independent variable. For the sample of 105 articles, we summarized methods and findings by type of social stressor (socioeconomic stressors, stressful life events, work-related stressors, and neighborhood stressors) and by age of the study population (infants/children, middle-aged adults, older adults, and mixed samples of middle-aged and older adults). We found more variation in TL measurement methodology in studies of infants/children and older adults than in studies focusing on middle-aged adults. The most consistent finding was a relationship between early-life stressors and shorter TL. Work and neighborhood stressors, and older populations, are currently understudied. Across all stressors, limited evidence suggests that the stress-TL relationship may be moderated by characteristics such as age, sex, and race/ethnicity. We conclude with specific suggestions for future research.
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Affiliation(s)
- Margaret Willis
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States.
| | - Shaina N Reid
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States
| | - Esteban Calvo
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Robert N. Butler Columbia Aging Center, Columbia University, United States; Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Chile; Laboratory on Aging and Social Epidemiology, Universidad Mayor, Chile
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center, Columbia University, United States; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States
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42
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Verhoeven JE, Yang R, Wolkowitz OM, Bersani FS, Lindqvist D, Mellon SH, Yehuda R, Flory JD, Lin J, Abu-Amara D, Makotkine I, Marmar C, Jett M, Hammamieh R. Epigenetic Age in Male Combat-Exposed War Veterans: Associations with Posttraumatic Stress Disorder Status. MOLECULAR NEUROPSYCHIATRY 2018; 4:90-99. [PMID: 30397597 PMCID: PMC6206951 DOI: 10.1159/000491431] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/30/2018] [Indexed: 12/27/2022]
Abstract
DNA methylation patterns change with age and can be used to derive an estimate of "epigenetic age," an indicator of biological age. Several studies have shown associations of posttraumatic stress disorder (PTSD) with worse somatic health and early mortality, raising the possibility of accelerated biological aging. This study examined associations between estimated epigenetic age and various variables in 160 male combat-exposed war veterans with (n = 79) and without PTSD (n = 81). DNA methylation was assessed in leukocyte genomic DNA using the Illumina 450K DNA methylation arrays. Epigenetic age was estimated using Horvath's epigenetic clock algorithm and Δage (epigenetic age-chronological age) was calculated. In veterans with PTSD (Δage = 3.2), Δage was on average lower compared to those without PTSD (Δage = 5.0; p = 0.02; Cohen's d = 0.42). This between-group difference was not explained by race/ethnicity, lifestyle factors or childhood trauma. Antidepressant use, however, explained part of the association. In the PTSD positive group, telomerase activity was negatively related to Δage (β = -0.35; p = 0.007). In conclusion, veterans with PTSD had significantly lower epigenetic age profiles than those without PTSD. Further, current antidepressant use and higher telomerase activity were related to relatively less epigenetic aging in veterans with PTSD, speculative of a mechanistic pathway that might attenuate biological aging-related processes in the context of PTSD.
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Affiliation(s)
- Josine E. Verhoeven
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ruoting Yang
- D, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
| | - Owen M. Wolkowitz
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Francesco S. Bersani
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniel Lindqvist
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Synthia H. Mellon
- Department of OB/GYN and Reproductive Sciences, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Rachel Yehuda
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janine D. Flory
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York, USA
- Department of Psychiatry, New York University, New York, New York, USA
| | - Iouri Makotkine
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Charles Marmar
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York, USA
- Department of Psychiatry, New York University, New York, New York, USA
| | - Marti Jett
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
| | - Rasha Hammamieh
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
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Connolly SL, Stoop TB, Logue MW, Orr EH, De Vivo I, Miller MW, Wolf EJ. Posttraumatic Stress Disorder Symptoms, Temperament, and the Pathway to Cellular Senescence. J Trauma Stress 2018; 31:676-686. [PMID: 30338579 PMCID: PMC6197884 DOI: 10.1002/jts.22325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 11/07/2022]
Abstract
Traumatic stress is thought to be associated with shortened telomere length (TL) in leukocytes, an age-related marker of increased risk for cellular senescence, although findings thus far have been mixed. We assessed associations between posttraumatic stress disorder (PTSD) symptom severity, temperament, and TL in a sample of 453 White, non-Hispanic, middle-aged, trauma-exposed male and female veterans and civilians. Given that prior research has suggested an association between PTSD and accelerated cellular age, we also examined associations between TL and an index of accelerated cellular age derived from DNA methylation data (DNAm age). Analyses revealed that, controlling for chronological age, PTSD was not directly associated with TL but rather this association was moderated by age, β = -.14, p = .003, ΔR2 = .02. Specifically, PTSD severity evidenced a stronger negative association with TL among relatively older participants (≥ 55 years of age). In a subset of veterans with data pertaining to temperament (n = 150), positive emotionality, and, specifically, a drive toward achievement, β = .26, p = .002, ΔR2 = .06, were positively associated with TL. There was no evidence of an association between age-adjusted TL and accelerated DNAm age. Collectively, these results indicate that older adults may be more vulnerable to the negative health effects of PTSD but that traits such as achievement, resilience, and psychological hardiness may be protective. These findings underscore the importance of identifying reliable biomarkers of cellular aging and senescence and of determining the biological mechanisms that contribute to stress-related disease and decline.
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Affiliation(s)
| | - Tawni B Stoop
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Mark W Logue
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Esther Hana Orr
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mark W Miller
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Erika J Wolf
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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Traumatic stress and cellular senescence: The role of war-captivity and homecoming stressors in later life telomere length. J Affect Disord 2018; 238:129-135. [PMID: 29879607 DOI: 10.1016/j.jad.2018.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/11/2018] [Accepted: 05/27/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Telomere length (TL) serves as a biomarker of cellular senescence and is a robust predictor of mortality. The association between traumatic stress and TL erosion is rapidly realized, as are the complexities of this relation that include links to posttraumatic stress disorder (PTSD), depression, and psychosocial factors. Nevertheless, the relation between specific stressors in early adulthood and TL in later life, specifically among populations that have undergone extreme stress in early adulthood are largely uninvestigated. METHOD Examining 99 Israeli former prisoners of war (ex-POWs) 18 and 42 years after repatriation, the current study investigated the role that specific stressors during captivity (i.e., physical abuse, nourishment deprivation and solitary confinement) and homecoming (i.e., received social-support, loss of place in the family, loneliness and sense of being accused) play in predicting TL 42 years post-repatriation. Intercorrelations analysis and a hierarchical linear regression were utilized. Variables that have been empirically associated with TL: age, BMI, physical activity, smoking, substance abuse, negative life events since repatriation, depression and PTSD symptoms were controlled for in the regression. RESULTS Solitary confinement during captivity, and loss of place in the family, loneliness and being accused at homecoming predicted shorter telomeres in later life. The remaining stressors did not significantly predict TL. CONCLUSION These findings suggest that an adequate understanding of TL after trauma must consider the unique contributions of specific types of stressors across the lifespan, and particularly account for interpersonal deficits. The findings may inform preventive interventions aimed at improving ex-POWs' longevity and well-being.
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45
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Dai W, Liu A, Kaminga AC, Deng J, Lai Z, Yang J, Wen SW. Prevalence of acute stress disorder among road traffic accident survivors: a meta-analysis. BMC Psychiatry 2018; 18:188. [PMID: 29895273 PMCID: PMC5998549 DOI: 10.1186/s12888-018-1769-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/29/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Road traffic accident (RTA), an unexpected traumatic event, may not only lead to death and serious physical injuries, but also could put survivors at an increased risk for a wide range of psychiatric disorders, particularly acute stress disorder (ASD). Early assessment of trauma-related psychological responses is important because acute trauma responses in the early post-traumatic period are among the robust predictors of long-term mental health problems. However, estimates of the prevalence of ASD among RTA survivors varied considerably across studies. Therefore, this meta-analysis aimed to identify the pooled prevalence of ASD among RTA survivors. METHODS A systematic literature search in the databases of PubMed, PsycINFO, PsycARTICLES, Embase and Web of Science was performed from their inception dates to December 2017. Subject headings were used to identify relevant articles, and the search strategy was adjusted across databases. Heterogeneity across studies was evaluated by Cochran's χ2 test and quantified by the I2 statistic. Subgroup analyses were performed to identify the pooled prevalence in relation to the country of study, instrument used to identify ASD, age, gender and traumatic brain injury. When significant heterogeneity was observed, the influence of some potential moderators was explored using meta-regression analyses. RESULTS Thirteen eligible studies conducted in 8 countries were included. A total of 2989 RTA survivors were assessed, of which 287 were identified with ASD. The overall heterogeneity was high across studies (I2=96.8%, P < 0.001), and the pooled prevalence of ASD among RTA survivors was 15.81% (95% confidence interval: 8.27-25.14%). Subgroup analyses indicated that the prevalence of ASD among RTA survivors differed significantly with regard to the country of study, instrument used to identify ASD, age and gender (P < 0.05). Meta-regression analyses showed that mean age of participants and quality assessment score were significant moderators for heterogeneity (P < 0.05). CONCLUSIONS Nearly one-sixth of RTA survivors suffer from ASD, indicating the need for regular assessment of early trauma responses among RTA survivors, as well as the importance of implementing early psychological interventions.
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Affiliation(s)
- Wenjie Dai
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China ,0000 0001 2182 2255grid.28046.38OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada ,0000 0000 9606 5108grid.412687.eOttawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON Canada ,0000 0001 2182 2255grid.28046.38School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Atipatsa C. Kaminga
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China ,grid.442592.cDepartment of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Jing Deng
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Zhiwei Lai
- Immunization Programme Department, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan China
| | - Jianzhou Yang
- grid.254020.1Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi China
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China. .,OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. .,Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada. .,School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
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46
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Wolf EJ, Maniates H, Nugent N, Maihofer AX, Armstrong D, Ratanatharathorn A, Ashley-Koch AE, Garrett M, Kimbrel NA, Lori A, Aiello AE, Baker DG, Beckham JC, Boks MP, Galea S, Geuze E, Hauser MA, Kessler RC, Koenen KC, Miller MW, Ressler KJ, Risbrough V, Rutten BP, Stein MB, Ursano RJ, Vermetten E, Vinkers CH, Uddin M, Smith AK, Nievergelt CM, Logue MW. Traumatic stress and accelerated DNA methylation age: A meta-analysis. Psychoneuroendocrinology 2018; 92:123-134. [PMID: 29452766 PMCID: PMC5924645 DOI: 10.1016/j.psyneuen.2017.12.007] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/07/2017] [Accepted: 12/12/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recent studies examining the association between posttraumatic stress disorder (PTSD) and accelerated aging, as defined by DNA methylation-based estimates of cellular age that exceed chronological age, have yielded mixed results. METHODS We conducted a meta-analysis of trauma exposure and PTSD diagnosis and symptom severity in association with accelerated DNA methylation age using data from 9 cohorts contributing to the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (combined N = 2186). Associations between demographic and cellular variables and accelerated DNA methylation age were also examined, as was the moderating influence of demographic variables. RESULTS Meta-analysis of regression coefficients from contributing cohorts revealed that childhood trauma exposure (when measured with the Childhood Trauma Questionnaire) and lifetime PTSD severity evidenced significant, albeit small, meta-analytic associations with accelerated DNA methylation age (ps = 0.028 and 0.016, respectively). Sex, CD4T cell proportions, and natural killer cell proportions were also significantly associated with accelerated DNA methylation age (all ps < 0.02). PTSD diagnosis and lifetime trauma exposure were not associated with advanced DNA methylation age. There was no evidence of moderation of the trauma or PTSD variables by demographic factors. CONCLUSIONS Results suggest that traumatic stress is associated with advanced epigenetic age and raise the possibility that cells integral to immune system maintenance and responsivity play a role in this. This study highlights the need for additional research into the biological mechanisms linking traumatic stress to accelerated DNA methylation age and the importance of furthering our understanding of the neurobiological and health consequences of PTSD.
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Affiliation(s)
- Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare System,Department of Psychiatry, Boston University School of Medicine
| | | | - Nicole Nugent
- Bradley Hasbro Children’s Research Center, Rhode Island Hospital,Departments of Psychiatry and Human Behavior and Pediatrics, Brown Medical School
| | | | - Don Armstrong
- University of Illinois Urbana-Champaign, Carl R. Woese Institute for Genomic Biology
| | | | | | - Melanie Garrett
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center
| | - Nathan A. Kimbrel
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center,VA Mid-Atlantic, Mental Illness Research, Education, and Clinical Center,Durham VA Medical Center
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University
| | | | - Allison E. Aiello
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health
| | - Dewleen G. Baker
- University of California San Diego, Department of Psychiatry,Veterans Affairs San Diego Healthcare System,Veterans Affairs Center of Excellence for Stress and Mental Health
| | - Jean C. Beckham
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center,VA Mid-Atlantic, Mental Illness Research, Education, and Clinical Center,Durham VA Medical Center
| | - Marco P. Boks
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht the Netherlands
| | | | - Elbert Geuze
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht the Netherlands,Ministry of Defence, Military Mental Healthcare, Utrecht the Netherlands
| | - Michael A. Hauser
- Duke Molecular Physiology Institute, Duke University School of Medicine
| | | | - Karestan C. Koenen
- Harvard T.H. Chan School of Public Health, Department of Epidemiology,Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, and Department of Psychiatry
| | - Mark W. Miller
- National Center for PTSD at VA Boston Healthcare System,Department of Psychiatry, Boston University School of Medicine
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Victoria Risbrough
- University of California San Diego, Department of Psychiatry,Veterans Affairs San Diego Healthcare System,Veterans Affairs Center of Excellence for Stress and Mental Health
| | - Bart P.F. Rutten
- School for Mental Health and Neuroscience and the European Graduate School of Neuroscience (EURON), Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Murray B. Stein
- University of California San Diego, Department of Psychiatry,Veterans Affairs San Diego Healthcare System,University of California San Diego, Department of Family Medicine and Public Health
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences
| | - Eric Vermetten
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht the Netherlands,Ministry of Defence, Military Mental Healthcare, Utrecht the Netherlands,Arq Psychotrauma Expert Group
| | - Christiaan H. Vinkers
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht the Netherlands
| | - Monica Uddin
- University of Illinois Urbana-Champaign, Carl R. Woese Institute for Genomic Biology,University of Illinois Urbana-Champaign, Department of Psychology
| | - Alicia K. Smith
- Department of Psychiatry and Behavioral Sciences, Emory University,Department of Gynecology and Obstetrics, Emory University
| | - Caroline M. Nievergelt
- University of California San Diego, Department of Psychiatry,Veterans Affairs San Diego Healthcare System,Veterans Affairs Center of Excellence for Stress and Mental Health
| | - Mark W. Logue
- National Center for PTSD at VA Boston Healthcare System,Department of Psychiatry, Boston University School of Medicine,Biomedical Genetics, Boston University School of Medicine
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Epel ES, Prather AA. Stress, Telomeres, and Psychopathology: Toward a Deeper Understanding of a Triad of Early Aging. Annu Rev Clin Psychol 2018; 14:371-397. [PMID: 29494257 DOI: 10.1146/annurev-clinpsy-032816-045054] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Telomeres play an important part in aging and show relationships to lifetime adversity, particularly childhood adversity. Meta-analyses demonstrate reliable associations between psychopathology (primarily depression) and shorter telomere length, but the nature of this relationship has not been fully understood. Here, we review and evaluate the evidence for impaired telomere biology as a consequence of psychopathology or as a contributing factor, and the important mediating roles of chronic psychological stress and impaired allostasis. There is evidence for a triadic relationship among stress, telomere shortening, and psychiatric disorders that is positively reinforcing and unfolds across the life course and, possibly, across generations. We review the role of genetics and biobehavioral responses that may contribute to shorter telomere length, as well as the neurobiological impact of impaired levels of telomerase. These complex interrelationships are important to elucidate because they have implications for mental and physical comorbidity and, potentially, for the prevention and treatment of depression.
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Affiliation(s)
| | - Aric A Prather
- Department of Psychiatry; Center for Health and Community; Aging, Metabolism, and Emotions Center; University of California, San Francisco, California 94118, USA; ,
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Abstract
Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact on physical function and health in the elderly and may be associated with premature aging and dementia. It is critical that clinicians screen for trauma-based symptoms and to treat as appropriate.
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Affiliation(s)
- Rebekah J Jakel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 3950, Durham, NC 27710, USA.
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49
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Lin W, Gong L, Xia M, Dai W. Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e9693. [PMID: 29505023 PMCID: PMC5779792 DOI: 10.1097/md.0000000000009693] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Involvement in road traffic accidents (RTAs) may put individuals at increased risk for a wide range of psychiatric disorders, among which posttraumatic stress disorder (PTSD) presents a public health issue. However, a great disparity was observed among studies exploring the prevalence of PTSD among RTA survivors. This meta-analysis aimed to explore the pooled prevalence of PTSD among RTA survivors. METHODS Electronic databases of PubMed, Embase, Web of Science, PsycARTICLES, PsycINFO, and CINAHL were searched to identify relevant studies. Study selection and data extraction were conducted independently by 2 investigators, and a meta-analysis was performed to synthesize the data. Heterogeneity among studies was evaluated using the Cochran Q test and quantified using the I statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger linear test. RESULTS Fifteen eligible studies containing 6804 RTA survivors were identified in this meta-analysis, of which 1489 were identified with PTSD. The pooled prevalence of PTSD among RTA survivors was 22.25% (95% confidence interval: 16.71%-28.33%). A high degree of heterogeneity was observed across studies (I = 97.1%, P < .001), with reported PTSD prevalence ranging from 6.3% to 58.3%. Subgroup analyses found that the prevalence of PTSD among RTA survivors varied significantly across studies in relation to the instrument used to assess PTSD, country, race, gender, and education level (P < .05). CONCLUSION The high pooled prevalence of PTSD among RTA survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.
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Affiliation(s)
| | | | | | - Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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