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St-Arnaud V, Chicoine AX, Tardif JC, Busseuil D, D’Antono B. Childhood Maltreatment and Body Mass Index in Older Adults With Chronic Illness. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:87-97. [PMID: 39070955 PMCID: PMC11282884 DOI: 10.1016/j.cjcpc.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 07/30/2024]
Abstract
Background Childhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Emotional dysregulation and increased body mass index (BMI) may be involved. This study evaluated whether (1) childhood maltreatment is associated with a higher BMI at study onset and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status moderate these results; and (3) baseline symptoms of anxiety, depression, and perceived stress (emotional dysregulation) mediate the association between childhood maltreatment and BMI at follow-up. Methods A total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. The weight and height of the participant were measured, and the BMI was calculated using the weight (kg)/height (m2) ratio. Results Childhood maltreatment was not significantly associated with BMI at study onset nor at follow-up. This relation did not differ as a function of sex nor CAD status. Although childhood maltreatment was associated with significantly greater psychological distress at study onset (all P < 0.001), there latter was not found to mediate the relation between maltreatment and change in BMI at follow-up. Conclusions In contrast to previous literature, childhood maltreatment was not associated with BMI nor with the change in BMI over 5 years in men and women with chronic disease. However, as psychological distress increases risk for morbidity and mortality, it may represent an important target for prevention and intervention in survivors of childhood maltreatment.
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Affiliation(s)
- Vicki St-Arnaud
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Ann Xiuli Chicoine
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - David Busseuil
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
| | - Bianca D’Antono
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
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Espinosa Dice AL, Lawn RB, Ratanatharathorn A, Roberts AL, Denckla CA, Kim AH, de la Rosa PA, Zhu Y, VanderWeele TJ, Koenen KC. Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses. BMC Med 2024; 22:135. [PMID: 38523269 PMCID: PMC10962116 DOI: 10.1186/s12916-024-03360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/15/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Childhood maltreatment is common globally and impacts morbidity, mortality, and well-being. Our understanding of its impact is constrained by key substantive and methodological limitations of extant research, including understudied physical health outcomes and bias due to unmeasured confounding. We address these limitations through a large-scale outcome-wide triangulation study. METHODS We performed two outcome-wide analyses (OWAs) in the UK Biobank. First, we examined the relationship between self-reported maltreatment exposure (number of maltreatment types, via Childhood Trauma Screener) and 414 outcomes in a sub-sample of 157,316 individuals using generalized linear models ("observational OWA"). Outcomes covered a broad range of health themes including health behaviors, cardiovascular disease, digestive health, socioeconomic status, and pain. Second, we examined the relationship between a polygenic risk score for maltreatment and 298 outcomes in a non-overlapping sample of 243,006 individuals ("genetic OWA"). We triangulated results across OWAs based on differing sources of bias. RESULTS Overall, 23.8% of the analytic sample for the observational OWA reported at least one maltreatment type. Of 298 outcomes examined in both OWAs, 25% were significant in both OWAs and concordant in the direction of association. Most of these were considered robust in the observational OWA according to sensitivity analyses and included outcomes such as marital separation (OR from observational OWA, ORo = 1.25 (95% CI: 1.21, 1.29); OR from genetic OWA, ORg = 1.06 (1.03, 1.08)), major diet changes due to illness (ORo = 1.27 (1.24, 1.29); ORg = 1.01 (1.00, 1.03)), certain intestinal diseases (ORo = 1.14 (1.10, 1.18); ORg = 1.03 (1.01, 1.06)), hearing difficulty with background noise (ORo = 1.11 (1.11, 1.12); ORg = 1.01 (1.00, 1.01)), knee arthrosis (ORo = 1.13 (1.09, 1.18); ORg = 1.03 (1.01, 1.05)), frequent sleeplessness (ORo = 1.21 (1.20, 1.23); ORg = 1.02 (1.01, 1.03)), and low household income (ORo = 1.28 (1.26, 1.31); ORg = 1.02 (1.01, 1.03)). Approximately 62% of results were significant in the observational OWA but not the genetic OWA, including numerous cardiovascular outcomes. Only 6 outcomes were significant in the genetic OWA and null in the observational OWA; these included diastolic blood pressure and glaucoma. No outcomes were statistically significant in opposite directions in the two analyses, and 11% were not significant in either OWA. CONCLUSIONS Our findings underscore the far-reaching negative effects of childhood maltreatment in later life and the utility of an outcome-wide triangulation design with sensitivity analyses for improving causal inference.
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Affiliation(s)
- Ana Lucia Espinosa Dice
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Rebecca B Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Andrew Ratanatharathorn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, NY, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christy A Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ariel H Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Pedro A de la Rosa
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Yiwen Zhu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Klinger-König J, Erhardt A, Streit F, Völker MP, Schulze MB, Keil T, Fricke J, Castell S, Klett-Tammen CJ, Pischon T, Karch A, Teismann H, Michels KB, Greiser KH, Becher H, Karrasch S, Ahrens W, Meinke-Franze C, Schipf S, Mikolajczyk R, Führer A, Brandes B, Schmidt B, Emmel C, Leitzmann M, Konzok J, Peters A, Obi N, Brenner H, Holleczek B, Moreno Velásquez I, Deckert J, Baune BT, Rietschel M, Berger K, Grabe HJ. Childhood Trauma and Somatic and Mental Illness in Adulthood. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:1-8. [PMID: 37876295 PMCID: PMC10916765 DOI: 10.3238/arztebl.m2023.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Childhood trauma is associated with somatic and mental illness in adulthood. The strength of the association varies as a function of age, sex, and type of trauma. Pertinent studies to date have mainly focused on individual diseases. In this study, we investigate the association between childhood trauma and a multiplicity of somatic and mental illnesses in adulthood. METHODS Data from 156 807 NAKO Health Study participants were analyzed by means of logistic regressions, with adjustment for age, sex, years of education, and study site. The Childhood Trauma Screener differentiated between no/minor (n = 115 891) and moderate/severe childhood trauma (n = 40 916). The outcome variables were medical diagnoses of five somatic and two mental health conditions as stated in the clinical history. RESULTS Persons with childhood trauma were more likely to bear a diagnosis of all of the studied conditions: cancer (odds ratio [OR] = 1.10; 95% confidence interval: [1.05; 1.15]), myocardial infarction (OR = 1.13 [1.03; 1.24]), diabetes (OR = 1.16, [1.10; 1.23]), stroke (OR = 1.35 [1.23; 1.48]), chronic obstructive pulmonary disease (OR = 1.45 [1.38; 1.52]), depression (OR = 2.36 [2.29; 2.43]), and anxiety disorders (OR = 2.08 [2.00; 2.17]). All of these associations were stronger in younger persons, regardless of the nature of childhood trauma. Differences between the sexes were observed only for some of these associations. CONCLUSION Childhood trauma was associated with a higher probability of developing mental as well as somatic illness in adulthood. As childhood trauma is an element of individual history that the victim has little to no control over, and because the illnesses that can arise in adulthood in association with it are a heavy burden on the affected persons and on society, there is a need for research on these associations and for the development of preventive measures.
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Affiliation(s)
- Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Angelika Erhardt
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maja P. Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health I, Bavarian State Office for Health and Food Safety, Erlangen, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Center for Infection Research (HZI), Braunschweig, Germany
| | - Carolina J. Klett-Tammen
- Department of Epidemiology, Helmholtz Center for Infection Research (HZI), Braunschweig, Germany
| | - Tobias Pischon
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Karin B. Michels
- Institute for Prevention and Tumor Epidemiology, Medical Center—University of Freiburg, Medical Faculty, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - K. Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiko Becher
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Claudia Meinke-Franze
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sabine Schipf
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Rafael Mikolajczyk
- IInstitute of Medical Epidemiology, Biometry and Informatics, Profile Center Health Sciences, Medical School, Martin Luther University Halle-Wittenberg, Halle, Germany
- German Center for Mental Health (DZPG), Jena-Magdeburg-Halle Site, Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Halle, Germany
| | - Amand Führer
- IInstitute of Medical Epidemiology, Biometry and Informatics, Profile Center Health Sciences, Medical School, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Berit Brandes
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Börge Schmidt
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Medicine Essen, Essen, Germany
| | - Carina Emmel
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Medicine Essen, Essen, Germany
| | - Michael Leitzmann
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Anette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, LMU—Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Mental Health (DZPG), Munich site, Munich, Germany
| | - Nadia Obi
- Central Institute for Occupational Medicine and Maritime Medicine (ZfAM,) University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Saarbrücken, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Saarbrücken, Germany
| | | | - Ilais Moreno Velásquez
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Bernhard T. Baune
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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Köhler-Dauner F, Dalhof Gulde M, Hart L, Ziegenhain U, Fegert JM. The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment. BMC Psychol 2023; 11:292. [PMID: 37759267 PMCID: PMC10523770 DOI: 10.1186/s40359-023-01327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period. OBJECTIVE It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic. METHOD Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used. RESULTS The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints. CONCLUSIONS Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.
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Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany.
| | - Manuela Dalhof Gulde
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Lara Hart
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
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Jones EJ, Marsland AL, Gianaros PJ. Do trait-level emotion regulation strategies moderate associations between retrospective reports of childhood trauma and prospective changes in systemic inflammation? Stress Health 2023; 39:525-538. [PMID: 36265175 PMCID: PMC10518806 DOI: 10.1002/smi.3205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/19/2022] [Accepted: 09/01/2022] [Indexed: 11/11/2022]
Abstract
Childhood trauma may confer risk for poorer adult health through changes in systemic inflammation. Emotion regulation may plausibly moderate associations between childhood trauma and adult psychological well-being, but it remains unclear whether moderation effects extend to differences in systemic inflammation. To examine whether childhood trauma and emotion regulation separately and interactively predict prospective changes in C-reactive protein (CRP) and interleukin-6 (IL-6) and whether biopsychosocial factors account for observed associations. Healthy midlife adults (N = 331) retrospectively reported on childhood trauma, current trait-level cognitive reappraisal and expressive suppression, and had their blood drawn. At baseline and then a median of 2.85 years later, 279 of the 331 participants had their blood drawn, body mass index calculated, and reported on health behaviours (smoking, sleep), psychological distress (perceived stress, depressive symptoms), and years of education. Childhood trauma predicted prospective increases in CRP (B = 0.004, p = 0.049), which were partially accounted for by differences in adiposity, psychological distress, and health behaviours. In contrast, cognitive reappraisal predicted prospective decreases in IL-6 (B = -0.007, p = 0.006), which were independent of biopsychosocial influences. Cognitive reappraisal further moderated the association between childhood trauma and prospective changes in IL-6 (B = -0.001, p = 0.012) such that childhood trauma predicted greater IL-6 increases but only among adults lower in cognitive reappraisal (B = 0.006, p = 0.007). There were no main or moderation effects of expressive suppression (ps > 0.05). Cognitive reappraisal may attenuate IL-6 changes over time and may moderate the prospective association between childhood trauma and systemic inflammation in midlife.
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Affiliation(s)
- Emily J. Jones
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anna L. Marsland
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Peter J. Gianaros
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Elsenburg LK, Bengtsson J, Rieckmann A, Rod NH. Childhood adversity and risk of type 2 diabetes in early adulthood: results from a population-wide cohort study of 1.2 million individuals. Diabetologia 2023; 66:1218-1222. [PMID: 37076640 DOI: 10.1007/s00125-023-05911-w] [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: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 04/21/2023]
Abstract
AIMS/HYPOTHESIS To examine whether childhood adversity is related to development of type 2 diabetes in early adulthood (16 to 38 years) among men and women. METHODS We used nationwide register data of 1,277,429 individuals born in Denmark between 1 January 1980 and 31 December 2001, who were still resident in Denmark and without diabetes at age 16 years. Individuals were divided into five childhood adversity groups based on their yearly exposure to childhood adversities (from age 0-15 years) across three dimensions: material deprivation, loss or threat of loss, and family dynamics. We estimated HR and hazard differences (HD) for type 2 diabetes according to the childhood adversity groups using Cox proportional hazards and Aalen additive hazards models. RESULTS During follow-up from age 16 to 31 December 2018, 4860 individuals developed type 2 diabetes. Compared with the low adversity group, the risk of type 2 diabetes was higher in all other childhood adversity groups among both men and women. For example, the risk was higher in the high adversity group characterised by high rates of adversity across all three dimensions among men (HR 2.41; 95% CI 2.04, 2.85) and women (1.58; 1.31, 1.91), translating into 36.2 (25.9, 46.5) additional cases of type 2 diabetes per 100,000 person-years among men and 18.6 (8.2, 29.0) among women. CONCLUSIONS/INTERPRETATION Individuals who experienced childhood adversity are at higher risk of developing type 2 diabetes in early adulthood. Intervening upon proximal determinants of adversity may help reduce the number of type 2 diabetes cases among young adults.
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Affiliation(s)
- Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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7
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Kim K, Yaffe K, Rehkopf DH, Zheng Y, Nannini DR, Perak AM, Nagata JM, Miller GE, Zhang K, Lloyd-Jones DM, Joyce BT, Hou L. Association of Adverse Childhood Experiences With Accelerated Epigenetic Aging in Midlife. JAMA Netw Open 2023; 6:e2317987. [PMID: 37306997 PMCID: PMC10261996 DOI: 10.1001/jamanetworkopen.2023.17987] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/05/2023] [Indexed: 06/13/2023] Open
Abstract
Importance Adverse childhood experiences (ACEs) are associated with the risk of poorer health, and identifying molecular mechanisms may lay the foundation for health promotion in people with ACEs. Objective To investigate the associations of ACEs with changes in epigenetic age acceleration (EAA), a biomarker associated with various health outcomes in middle-aged adults, in a population with balanced race and sex demographics. Design, Setting, and Participants Data for this cohort study were from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants in CARDIA underwent 8 follow-up exams from baseline (year 0 [Y0]; 1985-1986) to Y30 (2015-2016), and participant blood DNA methylation information was obtained at Y15 (2000-2001) and Y20 (2005-2006). Individuals from Y15 and Y20 with available DNA methylation data and complete variables for ACEs and covariates were included. Data were analyzed from September 2021 to August 2022. Exposures Participant ACEs (general negligence, emotional negligence, physical violence, physical negligence, household substance abuse, verbal and emotional abuse, and household dysfunction) were obtained at Y15. Main Outcomes and Measures The primary outcome consisted of results from 5 DNA methylation-based EAA measurements known to be associated with biological aging and long-term health: intrinsic EAA (IEAA), extrinsic EAA (EEAA), PhenoAge acceleration (PhenoAA), GrimAge acceleration (GrimAA), and Dunedin Pace of Aging Calculated From the Epigenome (DunedinPACE), measured at Y15 and Y20. Linear regression and generalized estimating equations were used to assess associations of the burden of ACEs (≥4 vs <4 ACEs) with EAA adjusting for demographics, health-related behaviors, and early life and adult socioeconomic status. Results A total of 895 participants for Y15 (mean [SD] age, 40.4 [3.5] years; 450 males [50.3%] and 445 females [49.7%]; 319 Black [35.6%] and 576 White [64.4%]) and 867 participants for Y20 (mean [SD] age, 45.4 [3.5] years; 432 males [49.8%] and 435 females [50.2%]; 306 Black [35.3%] and 561 White [64.7%]) were included after excluding participants with missing data. There were 185 participants with (20.7%) vs 710 participants without (79.3%) 4 or more ACEs at Y15 and 179 participants with (20.6%) vs 688 participants without (79.4%) 4 or more ACEs at Y20. Having 4 or more ACEs was positively associated with EAA in years at Y15 (EEAA: β = 0.60 years; 95% CI, 0.18-1.02 years; PhenoAA: β = 0.62 years; 95% CI = 0.13-1.11 years; GrimAA: β = 0.71 years; 95% CI, 0.42-1.00 years; DunedinPACE: β = 0.01; 95% CI, 0.01-0.02) and Y20 (IEAA: β = 0.41 years; 95% CI, 0.05-0.77 years; EEAA: β = 1.05 years; 95% CI, 0.66-1.44 years; PhenoAA: β = 0.57 years; 95% CI, 0.08-1.05 years; GrimAA: β = 0.57 years; 95% CI, 0.28-0.87 years; DunedinPACE: β = 0.01; 95% CI, 0.01-0.02) after adjusting for demographics, health-related behaviors, and socioeconomic status. Conclusions and Relevance In this cohort study, ACEs were associated with EAA among middle-aged adults after controlling for demographics, behavior, and socioeconomic status. These findings of the associations between early life experience and the biological aging process in midlife may contribute to health promotion in a life course perspective.
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Affiliation(s)
- Kyeezu Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - David H. Rehkopf
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Drew R. Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amanda M. Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco
| | - Greg E. Miller
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer
| | - Donald M. Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Potocsnak Longevity Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brian T. Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Potocsnak Longevity Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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8
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Jaffee SR, Widom CS. Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife. Ann Behav Med 2023; 57:489-498. [PMID: 37040622 PMCID: PMC10413319 DOI: 10.1093/abm/kaac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Although childhood maltreatment is associated with a host of poor health and social outcomes in adulthood, many individuals manifest resilience. PURPOSE We tested competing predictions about whether achieving positive psychosocial outcomes in young adulthood would be differentially predictive of allostatic load at midlife for those with and without a childhood history of maltreatment. METHODS The sample included 808 individuals, 57% of whom had court-documented records of childhood abuse or neglect between 1967 and 1971, and demographically matched controls without those histories. Participants provided information on socioeconomic, mental health, and behavioral outcomes in interviews conducted between 1989 and 1995 (mean age = 29.2 years). Indicators of allostatic load were measured between 2003 and 2005 (mean age = 41.2 years). RESULTS The relationship between positive life outcomes in young adulthood and allostatic load in middle adulthood varied depending on childhood maltreatment status (b = .16, 95% CI: .03; .28); for adults who did not experience childhood maltreatment, more positive life outcomes predicted lower allostatic load (b = -.12, 95% CI: -.23; -.01), whereas the relationship was not significant for adults with a childhood history of maltreatment (b = .04, 95% CI: -.06; .13). There were no differences in the results predicting allostatic load for African-American and White respondents. CONCLUSIONS Childhood maltreatment may have enduring effects on physiological functioning that are manifest in elevated allostatic load scores in middle age. Alternatively, resilience to maltreatment-as manifest in positive functioning in socioeconomic and behavioral domains-may not be sufficiently stable over adulthood to buffer individuals from the physiological consequences of stressful environments.
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Affiliation(s)
- Sara R Jaffee
- Department of Psychology, University of Pennsylvania, 425 South University Ave., Philadelphia, PA 19104, USA
| | - Cathy Spatz Widom
- Department of Psychology, John Jay College of Criminal Justice, New York, New York, USA
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Elsenburg LK, Liefbroer AC, van Eeden AE, Hoek HW, Oldehinkel AJ, Smidt N. Relationship Between Childhood Abuse and Body Mass Index in Young Adulthood: Mediated by Depression and Anxiety? CHILD MALTREATMENT 2023; 28:286-296. [PMID: 35655122 PMCID: PMC10028135 DOI: 10.1177/10775595221092946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We examined whether childhood abuse is related to body mass index (BMI) in young adults and whether this relationship is mediated by depression and anxiety. Data are from the Dutch longitudinal cohort study TRAILS (nfemales = 836, nmales = 719). At wave 4, childhood sexual, physical and verbal abuse, and lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD) were assessed. BMI was measured at wave 4 and 5 (mean age = 19.2/22.4 years). Sex-stratified structural equation models were estimated. Females who had experienced sexual abuse had a higher BMI at wave 4 (B = 0.97, 95%CI = [-0.01,1.96]) and a higher increase in BMI between wave 4 and 5 (B = 0.52, 95%CI = [0.04,1.01]) than females who had not experienced sexual abuse. Additionally, MDD and BMI at wave 4 were related in females (B = 1.35, 95%CI = [0.52,2.18]). MDD mediated the relationship between sexual abuse and BMI at wave 4 in females. In addition, sexual abuse moderated the relationship between MDD and BMI at wave 4. The relationship was stronger among females who had experienced sexual abuse than among females who had not. Prevention of BMI changes among females who experienced sexual abuse may thus be warranted, particularly when they developed MDD. MDD treatment, such as abuse-focused psychotherapy, may aid this prevention.
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Affiliation(s)
- Leonie K. Elsenburg
- Department of Epidemiology, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic
Institute, The Hague, The Netherlands
| | - Aart C. Liefbroer
- Department of Epidemiology, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic
Institute, The Hague, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annelies E. van Eeden
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Epidemiology, Mailman School
of Public Health, Columbia University, New York, NY, USA
| | - Albertine J. Oldehinkel
- Department of Psychiatry, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of
Groningen, University Medical Center Groningen, Groningen, The Netherlands
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10
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Moore SM, Welsh MC, Peterson E. Childhood maltreatment predicts physical health in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:942-951. [PMID: 34152945 DOI: 10.1080/07448481.2021.1909047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: Childhood maltreatment (CM) is associated with physical health problems throughout the lifespan, yet more research is needed regarding the trajectory of health problems (e.g., onset of health risk indicators) in young adults. The current study examined whether college students self-reporting higher levels of CM exhibited poorer physical health outcomes. Method: Young adults in college (N = 100) completed a physical health assessment (heart rate, body mass index (BMI), blood pressure, blood sugar, waist circumference), self-reported measures of health (symptoms of illness), and CM during spring semester 2018. Results: CM scores predicted higher heart rate and increased symptoms of illness. Females with maltreatment history presented higher levels of obesity and more metabolic syndrome conditions than their peers. Conclusions: Findings support the importance of examining the trajectory of CM to chronic disease, as health risk indicators are present in young adults.
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Affiliation(s)
- Susannah M Moore
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Marilyn C Welsh
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Eric Peterson
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
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11
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Emotional and experiential factors that determine civilizational diseases. HEALTH PSYCHOLOGY REPORT 2023. [DOI: 10.5114/hpr/159283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BackgroundThe effects of adverse childhood experiences may persist in adult life and manifest themselves in various areas of function-ing. The aim of the study was to identify the emotional and experiential factors that determine civilizational diseases and the methods of regulating emotions and functioning in society.Participants and procedureThe surveyed group was composed of 141 adults. The respondents defined the existence of adverse experiences and their attachment styles in retrospective. The methods of regulating emotions were also measured, as well as the presence of civilizational diseases.ResultsThe authors found a correlation between the style of attachment and the traumatic events experienced during the first 18 years of life and the existence of civilizational diseases. Adverse experiences in childhood and attachment styles proved to be predictors of specific social behaviour aimed at regulating emotions.ConclusionsThe results emphasised the importance of the bond with a parent and of traumatic childhood experiences for the future health condition and for the social and emotional functioning. The study demonstrated that persons who experienced traumatic events in their families or in the peer environment in the first 18 years of their lives reported the presence of civilizational diseases. A correlation was found between peer violence, the threat of being abandoned by a caregiver, and diagnosed civilizational diseases in respondents. The fearful-ambivalent style in the relationship with the father proved to be a predictor of reported civilizational diseases. Adverse childhood experiences are linked to regulating emotions by tak-ing perspective. The attachment style developed in the relationship with parents determined the ways of regulating nega-tive and positive emotions in contact with other people. Persons who developed an avoidant attachment style in the rela-tionships with the mother or the father less frequently seek social support when they experience negative emotions.
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12
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Dempster KS, Wade TJ, MacNeil AJ, O'Leary DD. Adverse childhood experiences are associated with altered cardiovascular reactivity to head-up tilt in young adults. Am J Physiol Regul Integr Comp Physiol 2023; 324:R425-R434. [PMID: 36693169 DOI: 10.1152/ajpregu.00148.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with greater prevalence of cardiovascular disease and altered acute stress reactivity. The current study investigated the effect of ACEs on hemodynamic and autonomic responses to orthostatic stress imposed by 60° head-up tilt (HUT) in young adults. Two-hundred twenty-six healthy young adults (age = 22.6 ± 1.5 yr; n = 116 females) without cardiovascular disease participated and had complete data. Participants underwent supine blood pressure (BP), R-R interval (RRI), cardiac output (CO), total peripheral resistance (TPR), and cardiovagal baroreflex sensitivity (cvBRS) testing followed by a transition to 60° HUT where measures were reassessed. Childhood adversity exposures were assessed based on categorical exposure and nonexposure to childhood household dysfunction and maltreatment, and <4 and ≥4 types of ACEs. Significantly greater increases in SBP (P < 0.05), DBP, MAP, and TPR (P < 0.01; all) following 60° HUT were observed in individuals with ≥4 compared with those with <4 types of ACEs. Attenuated decreases in RRI and cvBRS were observed in those with ≥4 types of ACEs (P < 0.05). Experiencing ≥4 types of ACEs was associated with augmented BP and TPR reactivity and a blunted decrease in cvBRS in response to 60° HUT in young adults. Results suggest that a reduced vagal response to orthostatic stress is present in those who have experienced ≥4 types of ACEs that may promote autonomic dysfunction. Future research examining the sympathetic and vagal baroreflex branches is warranted.
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Affiliation(s)
- Kylie S Dempster
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Terrane J Wade
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
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Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Thomas EBK, Taylor A, Teague TK, Jenkins NDM. Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences. J Appl Physiol (1985) 2023; 134:742-752. [PMID: 36727632 PMCID: PMC10027078 DOI: 10.1152/japplphysiol.00524.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Adverse childhood experiences (ACEs) are early-life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-wk combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21 ± 3 yr) with ≥4 (ACE+; n = 28) or 0 ACEs (ACE-; n = 14) participated in this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n = 14) or nonexercise control (ACE+CON; n = 14) group, whereas all ACE- participants were assigned to a nonexercise control (n = 14) group. Hope agency and DBP did not change in any group (P ≥ 0.43), but hope pathways improved only in ACE+EXT (means ± SE change; +1.6 ± 0.74 au, P = 0.032, Hedges' g = 0.53). ET-1 decreased in ACE+EXT only (-0.31 ± 0.15 pg/mL, P = 0.043, g = 0.46). Although the interactions for resilience and SBP did not reach significance (P = 0.05-0.06), forced post hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, P = 0.012, g = 0.64) and SBP tended to improve (-4.0 ± 2.0 mmHg, P = 0.053, g = 0.51) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ = -0.43, P = 0.023) and ET-1 (ρ = -0.53, P = 0.005), and between changes in SBP and ET-1 (ρ = 0.49; P = 0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.NEW & NOTEWORTHY This randomized controlled pilot trial shows, for the first time, that 8 wk of structured, progressive exercise training lowers serum endothelin-1 (ET-1) and improves positive psychological coping in young women with significant early-life psychosocial stress. Furthermore, the observed associations among changes in psychological attributes, ET-1, and systolic blood pressure signify a potential interplay between positive psychology and cardiovascular disease risk among women with adverse childhood experiences.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio, United States
| | | | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, Oklahoma, United States
| | - Emily B K Thomas
- Department of Psychology and Brain Sciences, University of Iowa, Iowa City, Iowa, United States
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Science, Tulsa, Oklahoma, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
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14
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Klinger-König J, Hannemann A, Friedrich N, Nauck M, Völzke H, Grabe HJ. Association between childhood maltreatment and adult cortisol concentrations mediated through subjective health complaints. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1098822. [PMID: 38455886 PMCID: PMC10911021 DOI: 10.3389/fepid.2023.1098822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 03/09/2024]
Abstract
Background Lower cortisol concentrations in adulthood were repeatedly associated with more severe childhood maltreatment. Additionally, childhood maltreatment was reported to promote health risk behavior, such as smoking or alcohol consumption, and to increase the risk of mental and somatic diseases during adulthood, such as major depressive disorders or obesity. The present study investigated if health risk behavior and disease symptoms in adults mediate the associations between past childhood maltreatment and present basal serum cortisol concentrations. Methods Data from two independent adult cohorts of the general population-based Study of Health in Pomerania (SHIP-TREND-0: N = 3,517; SHIP-START-2: N = 1,640) was used. Childhood maltreatment was assessed via the Childhood Trauma Questionnaire (CTQ). Cortisol concentrations were measured in single-point serum samples. Health risk behavior and mental and physical symptoms were used as mediators. Mediation analyses were calculated separately for both cohorts; results were integrated via meta-analyses. Results In mediator-separated analyses, associations between childhood maltreatment and basal serum cortisol concentrations were partly mediated by depressive symptoms (BDI-II: βindirect effect = -.011, pFDR = .017, 21.0% mediated) and subjective somatic health complaints (somatic complaints: βindirect effect = -.010, pFDR = .005, 19.4% mediated). In the second step, both mediators were simultaneously integrated into one mediation model. The model replicated the mediation effects of the subjective somatic health complaints (whole model: βindirect effect = -.014, p = .001, 27.6% mediated; BDI-II: βindirect effect = -.006, p = .163, 11.4% mediated, somatic complaints: βindirect effect = -.020, p = .020, 15.5% mediated). Conclusion The results support the hypothesis that the long-lasting effects of childhood maltreatment on the stress response system are partly mediated through self-perceived disease symptoms. However, no mediation was found for health risk behavior or physically measured mediators. Mediation models with multiple simultaneous mediators pointed to a relevant overlap between the potential mediators. This overlap should be focused on in future studies.
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Affiliation(s)
- Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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15
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Boyas JF, Moore D, Duran MY, Fuentes J, Woodiwiss J, McCoy L, Cirino A. Exploring the health of child protection workers: A call to action. Health Promot Perspect 2022; 12:381-390. [PMID: 36852203 PMCID: PMC9958233 DOI: 10.34172/hpp.2022.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/20/2022] [Indexed: 02/22/2023] Open
Abstract
Background: This exploratory study determined if a relationship exists between secondary traumatic stress (STS) related to health status, health outcomes, and health practices among child protection workers in a Southern state. Methods: This study used a cross-sectional survey research design that included a non-probability sample of child protection workers (N=196). Data were collected face-to-face and online between April 2018 and November 2019 from multiple county agencies. A self-administered questionnaire was completed focused on various health behaviors, outcomes, and workplace perceptions. Results: Results of the zero-order correlations suggest that higher levels of STS were significantly associated with not having visited a doctor for a routine checkup (r=-0.17, P=0.04), more trips to see a doctor (r=0.16, P=0.01), and increased number of visits to emergency room (ER) (r=0.20, P=0.01). Lower levels of STS were associated with better self-rated health (SRH) (r=-0.32, P≤0.001), higher perceptions of health promotion at work (r=-0.29, P≤0.001), frequent exercise (r=-0.21, P=0.01), and by avoiding salt (r=-0.20, P≤0.031). T-test results suggest that workers who did not have children (µ=45.85, SD=14.02, P=0.01) and non-Hispanic white workers (µ=51.79, SD=11.62, P≤0.001) reported significantly higher STS levels than workers who had children (µ=39.73, SD=14.58) and self-identified as Black (µ=39.01, SD=14.38). Conclusion: Findings show that increased interpersonal trauma was linked to unhealthy eating, general physical health problems, and health care utilization. If not addressed, both STS and poor health and health outcomes can have unfavorable employee outcomes, such as poor service delivery.
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Affiliation(s)
- Javier F. Boyas
- Troy University, School of Social Work and Human Services, 112A Wright Hall, Troy, AL, 36082, USA,Corresponding Author: Javier F. Boyas,
| | - Debra Moore
- Troy University, School of Social Work and Human Services, 112A Wright Hall, Troy, AL, 36082, USA
| | - Maritza Y. Duran
- University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA
| | - Jacqueline Fuentes
- University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA
| | - Jana Woodiwiss
- University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA
| | - Leah McCoy
- University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA
| | - Antonella Cirino
- University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA
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16
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Johnson-Motoyama M, Moon D, Rolock N, Crampton D, Nichols CB, Haran H, Zhang Y, Motoyama Y, Gonzalez E, Sillaman N. Social Determinants of Health and Child Maltreatment Prevention: The Family Success Network Pilot. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15386. [PMID: 36430105 PMCID: PMC9692748 DOI: 10.3390/ijerph192215386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/05/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Child maltreatment is a highly prevalent public health concern that contributes to morbidity and mortality in childhood and short- and long-term health consequences that persist into adulthood. Past research suggests that social determinants of health such as socioeconomic status and intergenerational trauma are highly correlated with child maltreatment. With support from the U.S. Children's Bureau, the Ohio Children's Trust Fund is currently piloting the Family Success Network, a primary child maltreatment prevention strategy in Northeast Ohio that seeks to address these social determinants through pillars of service that include family coaching, financial assistance, financial education, parenting education, and basic life skills training. This study highlights the initial development phase of a pilot study. Plans for in-depth process and outcome evaluations are discussed. The project seeks to improve family functioning and reduce child protective services involvement and foster care entry in an economically disadvantaged region.
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Affiliation(s)
| | - Deborah Moon
- School of Social Work, The University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Nancy Rolock
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - David Crampton
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - C. Bailey Nichols
- School of Social Work, The University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Hanna Haran
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Yiran Zhang
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Yasuyuki Motoyama
- City and Regional Planning of the Knowlton School, The Ohio State University, Columbus, OH 43210, USA
| | - Eric Gonzalez
- The Ohio Children’s Trust Fund, Columbus, OH 43215, USA
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17
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Zoladz P, Reneau K, Weiser J, Cordes C, Virden E, Helwig S, Thebeault C, Pfister C, Getnet B, Boaz K, Niese T, Stanek M, Long K, Parker S, Rorabaugh B, Norrholm S. Childhood Maltreatment in Females Is Associated with Enhanced Fear Acquisition and an Overgeneralization of Fear. Brain Sci 2022; 12:1536. [PMID: 36421860 PMCID: PMC9688290 DOI: 10.3390/brainsci12111536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 06/27/2024] Open
Abstract
Childhood maltreatment may alter fear neurocircuitry, which results in pathological anxiety and depression. One alteration of fear-related behaviors that has been observed in several psychiatric populations is an overgeneralization of fear. Thus, we examined the association between childhood maltreatment and fear generalization in a non-clinical sample of young adults. Two hundred and ninety-one participants underwent differential fear conditioning in a fear-potentiated startle paradigm. One visual stimulus (CS+), but not another (CS-), was associated with an aversive airblast to the throat (US) during acquisition. The next day, participants were tested for their fear responses to the CS+, CS-, and several generalization stimuli (GS) without the presence of the US. Participants also completed questionnaires that assessed symptoms of childhood maltreatment, anxiety, depression, and post-traumatic stress disorder (PTSD). Participants reporting high childhood maltreatment (n = 71; 23 males, 48 females) exhibited significantly greater anxiety, depression, and symptoms of PTSD than participants reporting low childhood maltreatment (n = 220; 133 males, 87 females). Females reporting high childhood maltreatment demonstrated significantly enhanced fear learning and greater fear generalization, based on their fear-potentiated startle responses. Our findings suggest that childhood maltreatment may sex-dependently influence the development of fear neurocircuitry and result in greater fear generalization in maltreated females.
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Affiliation(s)
- Phillip Zoladz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kassidy Reneau
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Jordan Weiser
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Chloe Cordes
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Emma Virden
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sara Helwig
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Caitlin Thebeault
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Cassidy Pfister
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Bruktawit Getnet
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kayla Boaz
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Taylor Niese
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Mercedes Stanek
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Kristen Long
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Sydney Parker
- Psychology Program, The School of Health and Behavioral Sciences, Ohio Northern University, Ada, OH 45810, USA
| | - Boyd Rorabaugh
- Department of Pharmaceutical Sciences, Marshall University School of Pharmacy, Huntington, WV 25755, USA
| | - Seth Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
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18
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Upenieks L, Thomas PA. Matters of the Heart: Childhood Maltreatment, Religious Transitions, and Cardiovascular-Related Problems over the Life Course. J Aging Health 2022; 35:405-418. [PMID: 36321397 DOI: 10.1177/08982643221135689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: Childhood maltreatment is associated with a higher risk of cardiovascular-related problems, the leading cause of death in the United States. Drawing from cumulative inequality theory, this study considers whether transitions in religious attendance moderate the deleterious impact of childhood maltreatment on long-term cardiovascular risk. Methods: We utilize over 35 years of prospective panel data from the National Longitudinal Study of Youth from the United States (1979–2015). Results: Our findings suggest that decreases in religious attendance between adolescence and adulthood (from high to low, and high to moderate attendance) were associated with elevated cardiovascular-related risk for those abused as children. Neither stable high attendance nor increases in attendance buffered against the impact of childhood abuse on cardiovascular-related problems. Discussion: We illustrate the importance of incorporating the role of stability and change in religious attendance across the life course and suggest directions for future research.
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19
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Carson MY, Barinas‐Mitchell E, Maki PM, Thurston RC. Childhood Maltreatment and Arterial Stiffness Among Midlife Women. J Am Heart Assoc 2022; 11:e026081. [PMID: 36314495 PMCID: PMC9673641 DOI: 10.1161/jaha.122.026081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Childhood maltreatment has been associated with arterial stiffness. This relationship has not been examined specifically among women at midlife, a time of increased arterial stiffness in women. This study tested whether childhood maltreatment is associated with arterial stiffness among a cohort of midlife women. Methods and Results A total of 162 nonsmoking perimenopausal and postmenopausal women free of clinical cardiovascular disease (mean age, 54 years; 72% White race, 23% Black race, and 5% Asian/Pacific Islander or Mixed race) completed the Child Trauma Questionnaire at baseline. At a follow-up visit 5 years later, blood pressure and carotid-femoral pulse wave velocity (a measure of arterial stiffness) were assessed. Relationships between childhood maltreatment and carotid-femoral pulse wave velocity were tested in linear regression models, adjusting for time between visits, age, race and ethnicity, education, body mass index, heart rate, hypertension medication, and diastolic blood pressure. Seventy-one women (44% of the sample) met criteria for a history of childhood maltreatment. Women with a history of childhood maltreatment had higher carotid-femoral pulse wave velocity (B [SE]=0.47 [0.21]; P=0.03) than women without this history, controlling for time between visits, age, race and ethnicity, education, body mass index, heart rate, hypertension medication, and diastolic blood pressure. Conclusions Among these midlife women, childhood maltreatment was associated with arterial stiffness, highlighting the potential long-term cardiovascular implications of childhood maltreatment.
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Affiliation(s)
| | - Emma Barinas‐Mitchell
- Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA
| | - Pauline M. Maki
- Department of Psychiatry, Psychology, and Obstetrics & GynecologyUniversity of Illinois at ChicagoChicagoIL
| | - Rebecca C. Thurston
- Department of PsychologyUniversity of PittsburghPA,Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA,Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
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20
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Iannarelli NJ, Wade TJ, Dempster KS, Moore J, MacNeil AJ, O'Leary DD. No Mediation Effect of Telomere Length or Mitochondrial DNA Copy Number on the Association Between Adverse Childhood Experiences (ACEs) and Central Arterial Stiffness. J Am Heart Assoc 2022; 11:e026619. [DOI: 10.1161/jaha.122.026619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Adverse childhood experiences (ACEs) have been linked to increased cardiovascular disease (CVD) risk. Previous reports have suggested that accelerated biological aging—indexed by telomere length (TL) and mitochondrial DNA copy number (mtDNAcn)—may contribute to associations between ACEs and cardiovascular health outcomes. Here, we examine the potential mediating effects of TL and mtDNAcn on the association between ACEs and central arterial stiffness—an intermediate cardiovascular health outcome—as a novel pathway linking ACEs to CVD risk among young adults.
Methods and Results
One hundred and eighty‐five (n=102 women; mean age, 22.5±1.5 years) individuals provided information on ACEs. TL (kb per diploid cell) and mtDNAcn (copies per diploid cell) were quantified using quantitative polymerase chain reaction techniques. Central arterial stiffness was measured as carotid‐femoral pulse wave velocity (cfPWV; m/s). Multiple linear regression analyses were used to examine the associations between ACEs, TL, mtDNAcn, and cfPWV. ACEs were positively associated with cfPWV (
β
=0.147,
P
=0.035). TL (
β
=−0.170,
P
=0.011) and mtDNAcn (
β
=−0.159,
P
=0.019) were inversely associated with cfPWV. Neither TL (
β
=−0.027,
P
=0.726) nor mtDNAcn (
β
=0.038,
P
=0.620) was associated with ACEs. Neither marker mediated the association between ACEs and cfPWV.
Conclusions
An increasing number of ACEs were associated with a faster cfPWV and thus, a greater degree of central arterial stiffness. ACEs were not associated with either TL or mtDNAcn, suggesting that these markers do not represent a mediating pathway linking ACEs to central arterial stiffness.
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Affiliation(s)
- Nathaniel J. Iannarelli
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Terrance J. Wade
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Kylie S. Dempster
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Jessy Moore
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
| | - Adam J. MacNeil
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
| | - Deborah D. O'Leary
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
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21
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Liang YY, Ai S, Weng F, Feng H, Yang L, He Z, Xue H, Zhou M, Shu X, Chen Y, Ma H, Guo L, Geng Q, Zhang J. Associations of Childhood Maltreatment and Genetic Risks With Incident Heart Failure in Later Life. J Am Heart Assoc 2022; 11:e026536. [PMID: 36196897 PMCID: PMC9673679 DOI: 10.1161/jaha.122.026536] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background We aimed to determine the associations of childhood maltreatment with incident heart failure in later life and explore the potentially modifying effects of genetic risk for heart failure on the associations. Methods and Results This cohort study included adults free of heart failure at baseline enrolled between 2006 and 2010 in the UK Biobank. Childhood maltreatment was retrospectively assessed with the online Childhood Trauma Screener in 2016. Five types of childhood maltreatment (range, 0-5), including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse, were combined into a total score. A weighted polygenic risk score for heart failure was constructed. Incident all-cause heart failure was prospectively ascertained via hospital inpatient and death records, followed up to May 31, 2021. A total of 153 287 adults (mean [SD] age, 55.9 [7.7] years; 43.6% male) were included. Over a median of 12.2 years (interquartile range, 11.5-12.9 years) of follow-up, 2352 participants had incident heart failure. Childhood maltreatment was associated with a greater risk of incident heart failure in a dose-response manner. One additional type of childhood maltreatment was associated with a 15% increase in the risk of developing heart failure (hazard ratio [HR], 1.15 [95% CI, 1.07-1.23]). There was no statistically significant interaction between genetic risk and childhood maltreatment (Pinteraction=0.218). Among participants with high genetic risk, those with 3 to 5 types of childhood maltreatment had a double hazard (HR, 2.00 [95% CI, 1.43-2.80]) of developing heart failure when taking those without any childhood maltreatment as the reference. Conclusions Irrespective of genetic risk for heart failure, childhood maltreatment was associated with an increased risk of incident heart failure in a dose-dependent manner.
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Affiliation(s)
- Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China.,Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China.,Department of Neurology, The First Affiliated Hospital Jinan University Guangzhou Guangdong China
| | - Sizhi Ai
- Department of Cardiology, Heart Center The First Affiliated Hospital of Xinxiang Medical University Weihui Henan China
| | - Foqian Weng
- School of Medicine Jinan University Guangzhou Guangdong China
| | - Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Zhixuan He
- School of Medicine Jinan University Guangzhou Guangdong China
| | - Huachen Xue
- Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China
| | - Mingqing Zhou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Xinyue Shu
- School of Medicine Jinan University Guangzhou Guangdong China
| | - Yilin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China.,Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Huan Ma
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Lan Guo
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Qingshan Geng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China.,Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou Guangdong China.,Department of Sleep Medicine, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
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22
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Miller NE, Lacey RE. Childhood adversity and cardiometabolic biomarkers in mid-adulthood in the 1958 British birth cohort. SSM Popul Health 2022; 19:101260. [PMID: 36238817 PMCID: PMC9550530 DOI: 10.1016/j.ssmph.2022.101260] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Studies that have examined associations between adverse childhood experiences (ACEs) and cardiometabolic biomarkers in adulthood are limited as they mainly focus on childhood maltreatment. This study aimed to examine the association between a range of prospectively and retrospectively reported ACEs and cardiometabolic biomarkers in mid-adulthood. Multiply-imputed data on 8511 participants from the National Child Development Study (1958 British birth cohort) were used. ACEs were prospectively reported at ages 7, 11 and 16, and retrospectively reported at age 33/44/45. Cardiometabolic outcomes assessed at age 44/45 included glycated haemoglobin (HbA1c), cholesterol (total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), triglycerides, blood pressure (systolic and diastolic), body mass index, waist circumference and metabolic syndrome. Parental separation/divorce, physical neglect, emotional neglect and psychological abuse were associated with lower HDL cholesterol. Parental offending and physical neglect were associated with higher triglyceride concentrations. Parental offending was also associated with increased HbA1c. Exposure to 2+ (vs. 0) prospective ACEs was associated with lower HDL cholesterol. All these associations were after adjustment for sex and multiple early life factors. To conclude, several individual ACEs are associated with poorer cardiometabolic risk factor profiles in mid-adulthood. Furthermore, exposure to two or more prospective ACEs is associated with lower HDL cholesterol concentrations in mid-adulthood. Parental separation/divorce in childhood is associated with lower high-density lipoprotein cholesterol in mid-adulthood. Physical neglect in childhood is associated with poorer lipid profiles in mid-adulthood. Psychological abuse in childhood is associated with lower high-density lipoprotein cholesterol in mid-adulthood. Parental offending in childhood is associated with higher triglycerides and glycated haemoglobin in mid-adulthood.
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23
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Nguyen KA, Kengne AP, Abrahams N, Jewkes R, Mhlongo S, Peer N. Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study. BMJ Open 2022; 12:e057436. [PMID: 36123062 PMCID: PMC9486236 DOI: 10.1136/bmjopen-2021-057436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To examine the associations of childhood maltreatment (CM) with hypertension, and the mediating effects of hypertension risk factors on the associations in South African women, using baseline data of the Rape Impact Cohort Evaluation longitudinal study. DESIGN Cross-sectional SETTING AND PARTICIPANTS: Self-reported data on CM exposure and its severity in 18-40-year-old women living in KwaZulu-Natal province were assessed. Logistic regression models, adjusted for traditional hypertension risk factors, rape exposure, HIV-infection, other traumatic exposures, depression scores and acute stress reactions (ASR) scores were used to examine the CM-hypertension associations. RESULTS Among 1797 women, 220 (12.2%) had hypertension; CM prevalence was higher in women with hypertension than without hypertension overall (70.9% vs 57.2%) and for each abuse type: sexual abuse (20.9% vs 12.4%), physical abuse (51.8% vs 41.5%), emotional abuse (40% vs 27.6%) and parental neglect (35% vs 25.7%). Exposures to 1-2 types and 3-4 types of CM were 46.4% and 24.5%, respectively, in women with hypertension, and lower in women without (42.9% and 14.3%, respectively). Exposures to any CM (adjusted OR: 1.62; 95% CI: 1.19 to 2.25), sexual abuse (1.64; 95% CI: 1.12 to 2.37), emotional abuse (1.57; 95% CI: 1.16 to 2.13), physical abuse (1.43; 95% CI: 1.07 to 1.92) and parental neglect (1.37; 95% CI: 1.00 to 1.86) were associated with hypertension. Exposures to an increasing number of abuse types and cumulative severity of CM overall (1.13; 95% CI: 1.05 to 1.21) and for each CM type were associated with increased odds of hypertension. Alcohol use, other trauma experienced, depression and ASR partially mediated these associations. CONCLUSION CM was associated with hypertension; the effects were greater with multiple abuse types and severe abuse, and were partially mediated by alcohol use, depression, ASR and other traumatic exposures. While CM must be prevented, effective mental health interventions to curb the uptake of unhealthy behaviours and the development of hypertension in women exposed to CM are key.
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Affiliation(s)
- Kim Anh Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
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24
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Cao X, Zhang J, Ma C, Li X, Chia-Ling K, Levine ME, Hu G, Allore H, Chen X, Wu X, Liu Z. Life course traumas and cardiovascular disease-the mediating role of accelerated aging. Ann N Y Acad Sci 2022; 1515:208-218. [PMID: 35725988 PMCID: PMC10145586 DOI: 10.1111/nyas.14843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The complex relationship between life course traumas and cardiovascular disease (CVD) and the underpinning pathways are poorly understood. We aimed to (1) examine the associations of three separate assessments including childhood, adulthood (after 16 years of age), and lifetime traumas (childhood or adulthood) with CVD; (2) examine the associations between diverse life course traumatic profiles and CVD; and (3) examine the extent to which PhenoAge, a well-developed phenotypic aging measure, mediated these associations. Using data from 104,939 participants from the UK Biobank, we demonstrate that subgroups of childhood, adulthood, and lifetime traumas were associated with CVD. Furthermore, life course traumatic profiles were significantly associated with CVD. For instance, compared with the subgroup experiencing nonsevere traumas across life course, those who experienced nonsevere childhood and severe adulthood traumas, severe childhood and nonsevere adulthood traumas, or severe traumas across life course had significantly higher odds of CVD (odds ratios: 1.07-1.33). Formal mediation analyses suggested that phenotypic aging partially mediated the above associations. These findings suggest a potential pathway from life course traumas to CVD through phenotypic aging, and underscore the importance of policy programs targeting traumas over the life course in ameliorating inequalities in cardiovascular health.
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Affiliation(s)
- Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Chao Ma
- School of Economics and Management, Southeast University, Nanjing, China
| | - Xueqin Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Kuo Chia-Ling
- Department of Public Health Sciences, Connecticut Convergence Institute for Translation in Regenerative Engineering, Institute for Systems Genomics, University of Connecticut Health, Farmington, Connecticut, USA
| | - Morgan E. Levine
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Economics, Yale University, New Haven, Connecticut, USA
| | - Xifeng Wu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
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25
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Jenkins NDM, Robinson AT. How do Adverse Childhood Experiences get Under the Skin to Promote Cardiovascular Disease? A Focus on Vascular Health. FUNCTION 2022; 3:zqac032. [PMID: 35859580 PMCID: PMC9279110 DOI: 10.1093/function/zqac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 01/07/2023] Open
Affiliation(s)
- Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA
- Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA
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26
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Caceres BA, Sharma Y, Doan D. Hypertension risk in sexual and gender minority individuals. Expert Rev Cardiovasc Ther 2022; 20:339-341. [PMID: 35532894 PMCID: PMC9233064 DOI: 10.1080/14779072.2022.2075345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Billy A Caceres
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
| | - Yashika Sharma
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
| | - Danny Doan
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
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27
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Thurston RC, Chang Y, Matthews KA, Harlow S, El Khoudary SR, Janssen I, Derby C. Interpersonal Trauma and Risk of Incident Cardiovascular Disease Events Among Women. J Am Heart Assoc 2022; 11:e024724. [PMID: 35322675 PMCID: PMC9075461 DOI: 10.1161/jaha.121.024724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Traumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of subsequent clinical CVD events. Methods and Results A total of 2201 women, aged 42 to 52 years at baseline, underwent up to 16 in-person visits over 22 years. Measures included questionnaires (including of childhood physical/sexual abuse, adult physical/sexual abuse, and IPV), physical measures, phlebotomy, and reported CVD events (myocardial infarction, stroke, heart failure, and revascularization). Death certificates were collected. Relationships between childhood abuse, adult abuse, and IPV with incident fatal/nonfatal CVD were tested in Cox proportional hazards models. Women with a childhood abuse history had increased risk for incident CVD (versus no abuse; hazard ratio [HR] [95% CI], 1.65 [1.12-2.44]; P=0.01; adjusted for demographics and CVD risk factors); associations were strongest for childhood sexual abuse. Adult abuse was not significantly associated with CVD. Women with IPV had a doubling of risk for incident CVD in demographic-adjusted models (versus no IPV; IPV: HR [95% CI], 2.06 [1.01-4.23]; P=0.04; no partner: HR [95% CI], 1.79 [0.91-3.53]; P=0.09); systolic blood pressure partially mediated relationships between IPV and CVD. Conclusions Childhood abuse, particularly sexual abuse, was associated with increased risk of CVD in women. IPV was associated with risk for CVD, with the higher systolic blood pressure among IPV-exposed women important in these associations. Interpersonal violence prevention may contribute to CVD risk reduction in women.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA.,Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Yuefang Chang
- Department of Neurosurgery University of Pittsburgh School of Medicine Pittsburgh PA
| | - Karen A Matthews
- Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA.,Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Sioban Harlow
- Department of Epidemiology University of MichiganHenry F. Vaughn School of Public Health Ann Arbor MI
| | - Samar R El Khoudary
- Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Imke Janssen
- Department of Preventive Medicine Rush University Medical Center Chicago IL
| | - Carol Derby
- Department of Epidemiology Albert Einstein College of Medicine Bronx NY
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28
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Caceres BA, Britton LE, Cortes YI, Makarem N, Suglia SF. Investigating the associations between childhood trauma and cardiovascular health in midlife. J Trauma Stress 2022; 35:409-423. [PMID: 34800058 PMCID: PMC9035028 DOI: 10.1002/jts.22752] [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: 12/18/2020] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross-sectional data from 1,251 participants in the National Survey of Midlife Development in the United States' II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association's Life's Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p < .001 to p = .018, and higher LS7 scores, p = .027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs = -0.306- -0.076, p < .001-p = .048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%-57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex-specific, trauma-informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.
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Affiliation(s)
- Billy A Caceres
- Columbia University School of Nursing, New York, New York, USA
| | - Laura E Britton
- Columbia University School of Nursing, New York, New York, USA
| | - Yamnia I Cortes
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Shakira F Suglia
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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29
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Nguyen KA, Abrahams N, Jewkes R, Mhlongo S, Seedat S, Myers B, Lombard C, Garcia-Moreno C, Chirwa E, Kengne AP, Peer N. The Associations of Intimate Partner Violence and Non-Partner Sexual Violence with Hypertension in South African Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074026. [PMID: 35409715 PMCID: PMC8998257 DOI: 10.3390/ijerph19074026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023]
Abstract
This study describes associations of intimate partner violence (IPV), non-partner sexual violence (NPSV) and sexual harassment (SH) exposures with hypertension in South African women aged 18–40 years. Baseline data (n = 1742) from the Rape Impact Cohort Evaluation study, including a history of sexual, physical, emotional and economic IPV, NPSV and SH were examined. Hypertension was based on blood pressure ≥140/90 mmHg or a previous diagnosis. Logistic regressions were adjusted for traditional hypertension risk factors and previous trauma (e.g., recent rape). Hypertension was more prevalent in women with a history of all forms of IPV, NPSV, and SH, all p ≤ 0.001, compared to women without. Frequent NPSV (adjusted odds ratio: 1.63; 95% CI: 1.27–2.67) any SH (2.56; 1.60–4.03), frequent physical (1.44; 1.06–1.95) and emotional IPV (1.45; 1.06–1.98), and greater severity of emotional IPV (1.05; 1.02–1.08) were associated with hypertension. Current depression, post-traumatic stress symptoms and/or alcohol binge-drinking completely or partially mediated these associations. This study shows that exposure to gender-based violence is associated with hypertension in young women. Understanding the role of psychological stress arising from abuse may enable the development of prevention and management strategies for hypertension among women with histories of abuse.
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Affiliation(s)
- Kim Anh Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (A.P.K.); (N.P.)
- Correspondence:
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (N.A.); (R.J.); (S.M.); (E.C.)
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (N.A.); (R.J.); (S.M.); (E.C.)
- Office of the Executive Scientist, South African Medical Research Council, Cape Town 7505, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (N.A.); (R.J.); (S.M.); (E.C.)
| | - Soraya Seedat
- SAMRC Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7600, South Africa;
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7505, South Africa;
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town 7505, South Africa;
| | - Claudia Garcia-Moreno
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 1211 Geneva, Switzerland;
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; (N.A.); (R.J.); (S.M.); (E.C.)
- School of Public Health, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (A.P.K.); (N.P.)
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (A.P.K.); (N.P.)
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
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Hyde NK, Dowty JG, Scovelle A, Armstrong G, Sutherland G, Olive L, Lycett K, O'Neil A. Association between maternal adversity, DNA methylation, and cardiovascular health of offspring: a longitudinal analysis of the ALSPAC cohort study. BMJ Open 2022; 12:e053652. [PMID: 35332037 PMCID: PMC8948393 DOI: 10.1136/bmjopen-2021-053652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Maternal adversity during pregnancy has been shown to be associated with some health outcomes in the offspring. This study investigated the association of maternal adversity during pregnancy and DNA methylation with offspring cardiovascular (CV) health. DESIGN Longitudinal observational cohort study SETTING: All pregnant residents in county Avon (∼0.9 million), UK, were eligible to participate if their estimated delivery date was between 1 April 1991 and 31 December 1992. PARTICIPANTS Mother-offspring pairs enrolled in the Avon Longitudinal Study of Parents and Children cohort at seven (n=7431) and 17 years of age (n=3143). PRIMARY AND SECONDARY OUTCOME MEASURES Offspring CV health primary measures were heart rate (HR), blood pressure (BP) and secondary measures were pulse-wave velocity and carotid intima-media thickness. RESULTS Overall, there was no association between maternal adversity scores (number or perceived impact) and primary CV measures (Perceived impact; HR: 0.999-fold change 95% CI 0.998 to 1.001; systolic BP (SBP): 1.000-fold change 95% CI 0.999 to 1.001; diastolic BP: 1.000-fold change 95% CI 0.999 to 1.002). Some small offspring sex effects were observed and there was also a small association between methylation of some CpG sites and offspring BP measures. CONCLUSIONS We found little evidence to support the overall association of maternal adversity during pregnancy and DNA methylation with offspring CV measures. Offspring sex-specific and age-specific associations require further investigation.
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Affiliation(s)
- Natalie K Hyde
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation,School of Medicine, Barwon Health, Geelong, VIC, Australia
| | - James G Dowty
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Anna Scovelle
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Gregory Armstrong
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina Sutherland
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Olive
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation,School of Medicine, Barwon Health, Geelong, VIC, Australia
- School of Psychology, Deakin, Geelong, Victoria, Australia
| | - Kate Lycett
- School of Psychology, Deakin, Geelong, Victoria, Australia
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Adrienne O'Neil
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation,School of Medicine, Barwon Health, Geelong, VIC, Australia
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See Mey L, Khairudin R, Tengku Muda TEA, Abdullah @ Mohd Nor H, Kamaluddin MR. The Mediating Role of Forgiveness and Self-Efficacy in the Relationship Between Childhood Maltreatment and Treatment Motivation Among Malaysian Male Drug Addicts. Front Psychol 2022; 13:816373. [PMID: 35360613 PMCID: PMC8963337 DOI: 10.3389/fpsyg.2022.816373] [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: 11/16/2021] [Accepted: 02/14/2022] [Indexed: 11/15/2022] Open
Abstract
Studies have reported high rates of childhood maltreatment among individuals with drug addiction problems; however, investigation about the potentially protective factors to mitigate the effects of maltreatment experiences on motivation to engage in addiction treatment has received less attention. This study aims at exploring the mediating effects of forgiveness and self-efficacy on the association between childhood maltreatment and treatment motivation among drug addicts. A total of 360 male drug addicts (mean age = 33.34, SD = 7.25) were recruited from three mandatory inpatient rehabilitation centers in Malaysia. Participants completed a package of self-report questionnaires including measures of childhood maltreatment experiences, forgiveness, self-efficacy, and motivation for treatment. The analysis conducted using the structural equation model (SEM) revealed that childhood maltreatment significantly predicted lower treatment motivation, while forgiveness and self-efficacy played a fully mediating role regarding the effect of childhood maltreatment on treatment motivation. In conclusion, these findings suggest that combining the element of forgiveness and self-efficacy in treatment programs appears to benefit the drug addicts with childhood maltreatment history.
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Affiliation(s)
- Loy See Mey
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Rozainee Khairudin
- Faculty of Social Sciences and Humanities, Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Hilwa Abdullah @ Mohd Nor
- Faculty of Social Sciences and Humanities, Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Mohammad Rahim Kamaluddin
- Faculty of Social Sciences and Humanities, Centre for Research in Psychology and Human Well-Being, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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Finegood ED, Miller GE. Childhood Violence Exposure, Inflammation, and Cardiometabolic Health. Curr Top Behav Neurosci 2022; 54:439-459. [PMID: 34935115 DOI: 10.1007/7854_2021_283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Exposure to interpersonal violence during childhood, a severe and often traumatic form of social stress, is an enduring problem that an emerging body of work suggests may be relevant to cardiometabolic health and the progression of cardiovascular disease (CVD) across the life course. Less is known about this association causally, and consequently, the biological mechanisms that may confer risk for, and resilience to, poor health outcomes in the aftermath of violence are not well understood. Drawing on recent theoretical insights and empirical research in both humans and non-human animal models, the current paper articulates a hypothesis for one way that childhood violence could get "under the skin" to influence CVD. Based on this emerging literature, one plausible way that childhood violence exposure could increase susceptibility to CVD in later life is by sensitizing stress-response neurobiology and immune processes that regulate and promote inflammation, which is a key pathogenic mechanism in CVD. This is inherently a developmental process that begins in early life and that unfolds across the life course, although less is known about the specific mechanisms through which this occurs. The goal of this paper is to articulate some of these plausible mechanisms and to suggest areas for future research that aims to reduce the burden of disease among individuals who are exposed to violence.
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Affiliation(s)
- Eric D Finegood
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA.
| | - Gregory E Miller
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA
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Park DH, Meltendorf T, Kahl KG, Kamp JC, Richter MJ, Gall H, Ghofrani HA, Hoeper MM, Olsson KM, Fuge J. Childhood Trauma in Patients With PAH-Prevalence, Impact on QoL, and Mental Health-A Preliminary Report. Front Psychiatry 2022; 13:812862. [PMID: 35222119 PMCID: PMC8866231 DOI: 10.3389/fpsyt.2022.812862] [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: 11/10/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVE Child maltreatment is associated with increased risk of psychological consequences, contributes to morbidity and has long lasting effects on mental health and quality of life. Child maltreatment has not been assessed in patients with pulmonary arterial hypertension (PAH). We examined the prevalence of child maltreatment and determined their impact on disease severity in patients with PAH. METHODS A cross-sectional observational multicenter study at two PH centers in Germany was conducted. Patients with a confirmed diagnosis of PAH were given a self-administered questionnaire. Child maltreatment using the Childhood Trauma Questionnaire (CTQ), quality of life (QoL), anxiety, depression, and lifestyle factors were assessed and enhanced by clinical parameters 6-min walk distance (6MWD), WHO functional class (WHO FC), and serum levels of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP). Prevalence rates of child maltreatment were compared to the general population and impact of child maltreatment on disease severity was calculated by logistic regression analysis. RESULTS Two-hundred and seventeen patients, 71% female and a median age of 56 years were enrolled in this study. Patients with PAH had higher rates of emotional abuse and lower rates of physical neglect compared to the German population while rates of emotional neglect, physical abuse, and sexual abuse did not differ between patients and German population. Patients with any form of child maltreatment were more likely to be active smokers, had a worse QoL and more anxiety or depression. Moderate associations between child maltreatment, mental health, QoL, lifestyle factors and clinical parameters could be observed. Logistic regression analysis showed a significant impact of CTQ-total score on disease severity with an OR of 1.022 (95%-CI: 1.001-1.042, p = 0.035). CONCLUSION We found a higher rate of child maltreatment in patients with PAH in comparison to the German population. Correlations suggest moderate associations between CTQ-scores and mental health as well as QoL. Child maltreatment had significant impact on disease severity. However, effects were moderate. We conclude that child maltreatment has effects on mental health and quality of life in patients with PAH and may have limited effect on disease severity.
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Affiliation(s)
- Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Tanja Meltendorf
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan C Kamp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Manuel J Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany.,German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany.,German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany.,German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Marius M Hoeper
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Karen M Olsson
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
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34
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Bertele N, Karabatsiakis A, Buss C, Talmon A. How biomarker patterns can be utilized to identify individuals with a high disease burden: a bioinformatics approach towards predictive, preventive, and personalized (3P) medicine. EPMA J 2021; 12:507-516. [PMID: 34950251 PMCID: PMC8648886 DOI: 10.1007/s13167-021-00255-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/08/2021] [Indexed: 12/21/2022]
Abstract
Prevalences of non-communicable diseases such as depression and a range of somatic diseases are continuously increasing requiring simple and inexpensive ways to identify high-risk individuals to target with predictive and preventive approaches. Using k-mean cluster analytics, in study 1, we identified biochemical clusters (based on C-reactive protein, interleukin-6, fibrinogen, cortisol, and creatinine) and examined their link to diseases. Analyses were conducted in a US American sample (from the Midlife in the US study, N = 1234) and validated in a Japanese sample (from the Midlife in Japan study, N = 378). In study 2, we investigated the link of the biochemical clusters from study 1 to childhood maltreatment (CM). The three identified biochemical clusters included one cluster (with high inflammatory signaling and low cortisol and creatinine concentrations) indicating the highest disease burden. This high-risk cluster also reported the highest CM exposure. The current study demonstrates how biomarkers can be utilized to identify individuals with a high disease burden and thus, may help to target these high-risk individuals with tailored prevention/intervention, towards personalized medicine. Furthermore, our findings raise the question whether the found biochemical clusters have predictive character, as a tool to identify high-risk individuals enabling targeted prevention. The finding that CM was mostly prevalent in the high-risk cluster provides first hints that the clusters could indeed have predictive character and highlight CM as a central disease susceptibility factor and possibly as a leverage point for disease prevention/intervention.
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Affiliation(s)
- Nina Bertele
- Psychology Department, Stanford University, Stanford, CA USA.,Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexander Karabatsiakis
- Institute of Psychology, Department of Clinical Psychology-II, University of Innsbruck, Innsbruck, Austria
| | - Claudia Buss
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Development, Health and Disease Research Program, Department of Pediatrics, University of California Irvine, Irvine, CA USA
| | - Anat Talmon
- Psychology Department, Stanford University, Stanford, CA USA
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Goncalves Soares A, Zimmerman A, Zammit S, Karl A, Halligan SL, Fraser A. Abuse in Childhood and Cardiometabolic Health in Early Adulthood: Evidence From the Avon Longitudinal Study of Parents and Children. J Am Heart Assoc 2021; 10:e021701. [PMID: 34873916 PMCID: PMC9075220 DOI: 10.1161/jaha.121.021701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Although childhood abuse has been consistently associated with cardiovascular disease in later adulthood, its associations with cardiometabolic health in younger adults are poorly understood. We assessed associations between childhood physical, sexual, and psychological abuse and cardiometabolic outcomes at 18 and 25 years. Methods and Results We used data on 3223 participants of the ALSPAC (Avon Longitudinal Study of Parents and Children). Exposure to childhood abuse was self-reported retrospectively at 22 years. We used linear regression to assess the associations between childhood abuse and cardiometabolic outcomes at 18 and 25 years. At 18 years, physical (β 1.35 kg/m2; 95% CI, 0.66-2.05), sexual (β 0.57 kg/m2; 95% CI 0.04-1.11), and psychological (β 0.47 kg/m2; 95% CI 0.01-0.92) abuse were associated with higher body mass index. Physical abuse was also associated with lower high-density lipoprotein cholesterol (β -0.07 mmol/L; 95% CI, -0.13 to -0.01) and higher C-reactive protein (31%; 95% CI, 1%-69%), and sexual abuse was associated with higher heart rate (β 1.92 bpm; 95% CI 0.26-3.58). At age 25, all 3 types of abuse were additionally associated with higher insulin, and sexual abuse was associated with lower cholesterol (-0.14 mmol/L; 95% CI, -0.26 to -0.01). The age at which abuse occurred (<11or 11-17 years) had little influence on the associations, and when sex differences were evident, associations were stronger in men. Conclusions Childhood abuse is associated with negative cardiometabolic outcomes even by young adulthood. Further follow-up will determine whether associations strengthen across the life course and whether sex differences persist, which is essential for targeting effective screening programs and early interventions in those who suffered abuse in childhood.
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Affiliation(s)
- Ana Goncalves Soares
- Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom.,MRC Integrative Epidemiology Unit at the University of Bristol Bristol United Kingdom
| | - Annie Zimmerman
- Health Service & Population Research King's College London London United Kingdom
| | - Stan Zammit
- Division of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff United Kingdom.,Centre for Academic Mental Health Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom
| | - Anke Karl
- Mood Disorders Centre University of Exeter Exeter United Kingdom
| | - Sarah L Halligan
- Department of Psychology University of Bath Bath United Kingdom.,Department of Psychiatry and Mental Health University of Cape Town Cape Town South Africa
| | - Abigail Fraser
- Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom.,MRC Integrative Epidemiology Unit at the University of Bristol Bristol United Kingdom
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The Gasotransmitter Hydrogen Sulfide and the Neuropeptide Oxytocin as Potential Mediators of Beneficial Cardiovascular Effects through Meditation after Traumatic Events. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1030016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Trauma and its related psychological and somatic consequences are associated with higher cardiovascular morbidity. The regulation of both the gasotransmitter hydrogen sulfide (H2S) and the neuropeptide oxytocin (OT) have been reported to be affected during physical and psychological trauma. Both mediators are likely molecular correlates of trauma-induced cardiovascular complications, because they share parallel roles and signaling pathways in the cardiovascular system, both locally as well as on the level of central regulation and the vagus nerve. Meditation can alter the structure of specific brain regions and can have beneficial effects on cardiovascular health. This perspective article summarizes the evidence pointing toward the significance of H2S and OT signaling in meditation-mediated cardio-protection.
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Dalvie S, Chatzinakos C, Al Zoubi O, Georgiadis F, Lancashire L, Daskalakis NP. From genetics to systems biology of stress-related mental disorders. Neurobiol Stress 2021; 15:100393. [PMID: 34584908 PMCID: PMC8456113 DOI: 10.1016/j.ynstr.2021.100393] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/22/2021] [Accepted: 09/08/2021] [Indexed: 01/20/2023] Open
Abstract
Many individuals will be exposed to some form of traumatic stress in their lifetime which, in turn, increases the likelihood of developing stress-related disorders such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and anxiety disorders (ANX). The development of these disorders is also influenced by genetics and have heritability estimates ranging between ∼30 and 70%. In this review, we provide an overview of the findings of genome-wide association studies for PTSD, depression and ANX, and we observe a clear genetic overlap between these three diagnostic categories. We go on to highlight the results from transcriptomic and epigenomic studies, and, given the multifactorial nature of stress-related disorders, we provide an overview of the gene-environment studies that have been conducted to date. Finally, we discuss systems biology approaches that are now seeing wider utility in determining a more holistic view of these complex disorders.
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Affiliation(s)
- Shareefa Dalvie
- South African Medical Research Council (SAMRC), Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Chris Chatzinakos
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA
| | - Obada Al Zoubi
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA
| | - Foivos Georgiadis
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA
| | | | - Lee Lancashire
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA
- Department of Data Science, Cohen Veterans Bioscience, New York, USA
| | - Nikolaos P. Daskalakis
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, USA
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Clemens V, Bürgin D, Huber-Lang M, Plener PL, Brähler E, Fegert JM. The Interplay between Child Maltreatment and Stressful Life Events during Adulthood and Cardiovascular Problems-A Representative Study. J Clin Med 2021; 10:jcm10173937. [PMID: 34501385 PMCID: PMC8432252 DOI: 10.3390/jcm10173937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 01/01/2023] Open
Abstract
Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.
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Affiliation(s)
- Vera Clemens
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Correspondence: ; Tel.: +49-731-500-61611
| | - David Bürgin
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland;
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, Ulm University Medical Centre, Helmholtzstraße 8/1, 89081 Ulm, Germany;
| | - Paul L. Plener
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany;
- Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Jörg M. Fegert
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Head of the Competence Area Mental Health Prevention Network Baden-Württemberg, Steinhövelstraße 5, 89075 Ulm, Germany
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Merz T, McCook O, Denoix N, Radermacher P, Waller C, Kapapa T. Biological Connection of Psychological Stress and Polytrauma under Intensive Care: The Role of Oxytocin and Hydrogen Sulfide. Int J Mol Sci 2021; 22:9192. [PMID: 34502097 PMCID: PMC8430789 DOI: 10.3390/ijms22179192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022] Open
Abstract
This paper explored the potential mediating role of hydrogen sulfide (H2S) and the oxytocin (OT) systems in hemorrhagic shock (HS) and/or traumatic brain injury (TBI). Morbidity and mortality after trauma mainly depend on the presence of HS and/or TBI. Rapid "repayment of the O2 debt" and prevention of brain tissue hypoxia are cornerstones of the management of both HS and TBI. Restoring tissue perfusion, however, generates an ischemia/reperfusion (I/R) injury due to the formation of reactive oxygen (ROS) and nitrogen (RNS) species. Moreover, pre-existing-medical-conditions (PEMC's) can aggravate the occurrence and severity of complications after trauma. In addition to the "classic" chronic diseases (of cardiovascular or metabolic origin), there is growing awareness of psychological PEMC's, e.g., early life stress (ELS) increases the predisposition to develop post-traumatic-stress-disorder (PTSD) and trauma patients with TBI show a significantly higher incidence of PTSD than patients without TBI. In fact, ELS is known to contribute to the developmental origins of cardiovascular disease. The neurotransmitter H2S is not only essential for the neuroendocrine stress response, but is also a promising therapeutic target in the prevention of chronic diseases induced by ELS. The neuroendocrine hormone OT has fundamental importance for brain development and social behavior, and, thus, is implicated in resilience or vulnerability to traumatic events. OT and H2S have been shown to interact in physical and psychological trauma and could, thus, be therapeutic targets to mitigate the acute post-traumatic effects of chronic PEMC's. OT and H2S both share anti-inflammatory, anti-oxidant, and vasoactive properties; through the reperfusion injury salvage kinase (RISK) pathway, where their signaling mechanisms converge, they act via the regulation of nitric oxide (NO).
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Affiliation(s)
- Tamara Merz
- Institute for Anesthesiological Pathophysiology and Process Engineering, Medical Center, Ulm University, Helmholtzstraße 8/1, 89081 Ulm, Germany; (T.M.); (N.D.); (P.R.)
| | - Oscar McCook
- Institute for Anesthesiological Pathophysiology and Process Engineering, Medical Center, Ulm University, Helmholtzstraße 8/1, 89081 Ulm, Germany; (T.M.); (N.D.); (P.R.)
| | - Nicole Denoix
- Institute for Anesthesiological Pathophysiology and Process Engineering, Medical Center, Ulm University, Helmholtzstraße 8/1, 89081 Ulm, Germany; (T.M.); (N.D.); (P.R.)
- Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center, Ulm University, 89081 Ulm, Germany
| | - Peter Radermacher
- Institute for Anesthesiological Pathophysiology and Process Engineering, Medical Center, Ulm University, Helmholtzstraße 8/1, 89081 Ulm, Germany; (T.M.); (N.D.); (P.R.)
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, 90471 Nuremberg, Germany;
| | - Thomas Kapapa
- Clinic for Neurosurgery, Medical Center, Ulm University, 89081 Ulm, Germany;
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Islam SJ, Hwan Kim J, Joseph E, Topel M, Baltrus P, Liu C, Ko YA, Almuwaqqat Z, Mujahid MS, Sims M, Mubasher M, Ejaz K, Searles C, Dunbar SB, Pemu P, Taylor H, Bremner JD, Vaccarino V, Quyyumi AA, Lewis TT. Association Between Early Trauma and Ideal Cardiovascular Health Among Black Americans: Results From the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity. Circ Cardiovasc Qual Outcomes 2021; 14:e007904. [PMID: 34380328 PMCID: PMC8455434 DOI: 10.1161/circoutcomes.121.007904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has been associated with both cardiovascular disease risk and lifestyle-related risk factors for cardiovascular disease, including smoking, obesity, and physical inactivity. Despite higher prevalence, the association between early trauma and cardiovascular health (CVH) has been understudied in Black Americans, especially those from low-income backgrounds, who may be doubly vulnerable. Therefore, we investigated the association between early trauma and CVH, particularly among low-income Black Americans. METHODS We recruited 457 Black adults (age 53±10, 38% male) without known cardiovascular disease from the Atlanta, GA, metropolitan area using personalized, community-based recruitment methods. The Early Trauma Inventory was administered to assess overall early traumatic life experiences which include physical, sexual, emotional abuse, and general trauma. Our primary outcome was the American Heart Association Life's Simple 7, which is a set of 7 CVH metrics, including 4 lifestyle-related factors (smoking, body mass index, physical activity, and diet) and three physiologically measured health factors (blood pressure, total blood cholesterol, and blood glucose). We used linear regression models adjusting for age, sex, socioeconomic status, and depression to test the association between early trauma and CVH and tested the early trauma by household income (<$50 000) interaction. RESULTS Higher levels of early trauma were associated with lower Life's Simple 7 scores (β, -0.05 [95% CI, -0.09 to -0.01], P=0.02, per 1 unit increase in the Early Trauma Inventory score) among lower, but not higher, income Black participants (P value for interaction=0.04). Subtypes of early trauma linked to Life's Simple 7 were general trauma, emotional abuse, and sexual abuse. Exploratory analyses demonstrated that early trauma was only associated with the body mass index and smoking components of Life's Simple 7. CONCLUSIONS Early trauma, including general trauma, emotional abuse, and sexual abuse, may be associated with worse CVH among low-, but not higher-income Black adults.
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Affiliation(s)
- Shabatun J Islam
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Jeong Hwan Kim
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Emma Joseph
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Matthew Topel
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Peter Baltrus
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA. (P.B., M.M.).,National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA. (P.B.)
| | - Chang Liu
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.).,Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA. (C.L., Y.-A.K.)
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA. (C.L., Y.-A.K.)
| | - Zakaria Almuwaqqat
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley (M.S.M.)
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson (M.S.)
| | - Mohamed Mubasher
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA. (P.B., M.M.)
| | - Kiran Ejaz
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Charles Searles
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Sandra B Dunbar
- Rollins School of Public Health, and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. (S.B.D.)
| | - Priscilla Pemu
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA. (P.P., H.T.)
| | - Herman Taylor
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA. (P.P., H.T.)
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. (J.D.B.).,Department of Radiology, Emory University School of Medicine, Atlanta, GA.(J.D.B.)
| | - Viola Vaccarino
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.).,Department of Epidemiology, Emory University, Atlanta, GA. (V.V., T.T.L.)
| | - Arshed A Quyyumi
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA. (S.J.I., J.H.K., E.J., M.T., C.L., Z.A., K.E., C.S., V.V., A.A.Q.)
| | - Tené T Lewis
- Department of Epidemiology, Emory University, Atlanta, GA. (V.V., T.T.L.)
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McCook O, Denoix N, Radermacher P, Waller C, Merz T. H 2S and Oxytocin Systems in Early Life Stress and Cardiovascular Disease. J Clin Med 2021; 10:jcm10163484. [PMID: 34441780 PMCID: PMC8397059 DOI: 10.3390/jcm10163484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
Today it is well established that early life stress leads to cardiovascular programming that manifests in cardiovascular disease, but the mechanisms by which this occurs, are not fully understood. This perspective review examines the relevant literature that implicates the dysregulation of the gasomediator hydrogen sulfide and the neuroendocrine oxytocin systems in heart disease and their putative mechanistic role in the early life stress developmental origins of cardiovascular disease. Furthermore, interesting hints towards the mutual interaction of the hydrogen sulfide and OT systems are identified, especially with regards to the connection between the central nervous and the cardiovascular system, which support the role of the vagus nerve as a communication link between the brain and the heart in stress-mediated cardiovascular disease.
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Affiliation(s)
- Oscar McCook
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany; (N.D.); (P.R.); (T.M.)
- Correspondence: ; Tel.: +49-731-500-60185; Fax: +49-731-500-60162
| | - Nicole Denoix
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany; (N.D.); (P.R.); (T.M.)
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany
| | - Peter Radermacher
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany; (N.D.); (P.R.); (T.M.)
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, 90471 Nuremberg, Germany;
| | - Tamara Merz
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Ulm, Germany; (N.D.); (P.R.); (T.M.)
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42
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Beach SRH, Ong ML, Lei MK, Klopack E, Carter SE, Simons RL, Gibbons FX, Lavner JA, Philibert RA, Ye K. Childhood adversity is linked to adult health among African Americans via adolescent weight gain and effects are genetically moderated. Dev Psychopathol 2021; 33:803-820. [PMID: 32372728 PMCID: PMC7644595 DOI: 10.1017/s0954579420000061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Identifying the mechanisms linking early experiences, genetic risk factors, and their interaction with later health consequences is central to the development of preventive interventions and identifying potential boundary conditions for their efficacy. In the current investigation of 412 African American adolescents followed across a 20-year period, we examined change in body mass index (BMI) across adolescence as one possible mechanism linking childhood adversity and adult health. We found associations of childhood adversity with objective indicators of young adult health, including a cardiometabolic risk index, a methylomic aging index, and a count of chronic health conditions. Childhood adversities were associated with objective indicators indirectly through their association with gains in BMI across adolescence and early adulthood. We also found evidence of an association of genetic risk with weight gain across adolescence and young adult health, as well as genetic moderation of childhood adversity's effect on gains in BMI, resulting in moderated mediation. These patterns indicated that genetic risk moderated the indirect pathways from childhood adversity to young adult health outcomes and childhood adversity moderated the indirect pathways from genetic risk to young adult health outcomes through effects on weight gain during adolescence and early adulthood.
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Affiliation(s)
- Steven R. H. Beach
- Department of Psychology, University of Georgia
- Center for Family Research, University of Georgia
| | - Mei Ling Ong
- Center for Family Research, University of Georgia
| | - Man-Kit Lei
- Department of Sociology, University of Georgia
| | | | | | | | | | - Justin A. Lavner
- Department of Psychology, University of Georgia
- Center for Family Research, University of Georgia
| | - Robert A. Philibert
- Department of Psychiatry, University of Iowa
- Behavioral Diagnostics, Coralville, Iowa
| | - Kaixiong Ye
- Department of Genetics and Institute of Bioinformatics, University of Georgia
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43
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Dalvie S, Daskalakis NP. The Biological Effects of Trauma. Complex Psychiatry 2021; 7:16-18. [PMID: 35592091 PMCID: PMC8443929 DOI: 10.1159/000517236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/15/2021] [Indexed: 04/04/2024] Open
Affiliation(s)
- Shareefa Dalvie
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Nikolaos P. Daskalakis
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, California, USA
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44
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Schneiderman JU, Davis JP, Negriff S. Associations Between Psychosocial Functioning and Physical Health in Youth with Maltreatment Experiences. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106080. [PMID: 34211239 PMCID: PMC8240661 DOI: 10.1016/j.childyouth.2021.106080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Childhood maltreatment often results in long-term untoward outcomes, although some individuals demonstrate better psychosocial functioning. Maltreatment is linked with poor physical health outcomes but little is known about how psychosocial functioning is related to physical health. The aims of this study were to: 1) Identify heterogeneity of psychosocial functioning using a latent profile analysis. Positive functioning was measured by both fewer problematic symptoms (depressive, PTSD, anxiety, externalizing behavior, and substance abuse disorder) and the presence of the protective factor of social support; and 2) Explore the relationship between emergent classes of psychosocial functioning and physical health (self-reported illnesses, symptoms, and health status as well as measured overweight/obesity). Participants included a sample of youth with child welfare-documented maltreatment (n=219; mean age 18.3 years; range 15-23 years) at Time 4 (T4) of a longitudinal study. Mean differences or odds ratios were assessed across the health variables between classes. The three resulting classes were labeled: 1) higher support/lower symptoms (60.7%); 2) lower support/higher internalizing symptoms (29.2%); and 3) lower support/higher externalizing/substance abuse symptoms (10%). Youth in the lower/support/higher externalizing/substance abuse symptoms class had a similar high level of internalizing symptoms as the lower support/higher internalizing symptoms class. Youth in the lower support/high externalizing/substance abuse symptoms class had more colds and pain symptoms in the past month and gastrointestinal illnesses in the past year than the higher support/lower symptoms class, and more illnesses, respiratory problems, and gastrointestinal illnesses the last year than the lower support/higher internalizing symptoms class. Overall, functioning class was related to certain health problems which often have a stress component and were more prevalent for youth with more externalizing and substance abuse symptoms.
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Affiliation(s)
- Janet U. Schneiderman
- Corresponding Author: Nursing Department, Suzanne Dworak-Peck School of Social Work; University of Southern California; 669 West 34 Street, Los Angeles, CA, USA 90089-0411; ; 213-821-1338
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work; USC Center for Artificial Intelligence in Society; USC Center for Mindfulness Science; University of Southern California; 669 West 34 Street, Los Angeles, CA, USA 90089-0411
| | - Sonya Negriff
- Department of Research & Evaluation, Kaiser Permanente Southern California; 100 South Los Robles Avenue, Pasadena, CA USA, 91101-2453
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45
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Jenkins NDM, Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Taylor A, Teague TK. Childhood psychosocial stress is linked with impaired vascular endothelial function, lower SIRT1, and oxidative stress in young adulthood. Am J Physiol Heart Circ Physiol 2021; 321:H532-H541. [PMID: 34328346 DOI: 10.1152/ajpheart.00123.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adverse childhood experiences (ACEs) are psychosocial stressors that occur during sensitive developmental windows and are associated with increased lifetime cardiovascular disease (CVD) risk in a dose-dependent manner. Vascular endothelial dysfunction is a pathophysiological mechanism that promotes hypertension and CVD and may be a mechanism by which ACEs contribute to lifetime CVD risk. We examined whether exposure to ACEs is associated with reduced vascular endothelial function (VEF) in otherwise healthy, young adult women (20.7 ± 3 yr) with (ACE+) versus without (ACE-) ACEs, explored whether differences in circulating sirtuin 1 (SIRT1) or systemic oxidative stress could explain ACEs-related differences in VEF, and examined the ability of a pilot, 8-wk exercise intervention to augment VEF and SIRT1 or reduce oxidized LDL cholesterol (oxLDL) in ACE+ young adult women. Forty-two otherwise healthy young adults completed this study. Prior to the intervention, VEF (P = 0.002) and SIRT1 (P = 0.004) were lower in the ACE+ than ACE- group, but oxLDL concentrations were not different (P = 0.77). There were also significant relationships (P ≤ 0.04) among flow-mediated dilation (FMD), SIRT1, and oxLDL in the ACE+, but not ACE- group. Adjusting for circulating SIRT1 and oxLDL reduced the differences in FMD observed between groups (P = 0.10), but only SIRT1 was a significant adjuster of the means (P < 0.05). Finally, the exercise intervention employed was unable to enhance VEF or SIRT1 in the ACE+ exercise group. Our data suggest that ACEs likely increase susceptibility to hypertension and CVD by causing endothelial dysfunction, perhaps through a SIRT1 pathway-related mechanism.NEW & NOTEWORTHY Our study provides novel evidence that young adult women with moderate-to-severe adverse childhood experience (ACE) exposure present impaired endothelial function and lower circulating sirtuin 1 (SIRT1) concentrations than age-matched controls. However, an 8-wk exercise intervention was unable to augment endothelial function or SIRT1 concentrations in a subset of those with ACEs. Our data suggest that ACEs-related impairments in endothelial function may be secondary to decreased NO bioavailability via SIRT1 and/or oxidative stress-related mechanisms.
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Affiliation(s)
- Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
| | - Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio
| | - Christina M Sciarrillo
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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Kim AW, Kakuhikire B, Baguma C, North CM, Satinsky EN, Perkins JM, Ayebare P, Kiconco A, Namara EB, Bangsberg DR, Siedner MJ, Tsai AC. Adverse childhood experiences and adult cardiometabolic risk factors and disease outcomes: Cross-sectional, population-based study of adults in rural Uganda. J Glob Health 2021; 11:04035. [PMID: 34386213 PMCID: PMC8325920 DOI: 10.7189/jogh.11.04035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Cardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda. Methods Data come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-International Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and cardiometabolic risk factors and health outcomes. Results Data were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD. Conclusions Adverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes.
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Affiliation(s)
- Andrew Wooyoung Kim
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Crystal M North
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA.,Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | | | - Allen Kiconco
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - David R Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda.,Oregon Health and Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Mark J Siedner
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Medical Practice Evaluation Center and Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Alexander C Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Mbarara University of Science and Technology, Mbarara, Uganda.,Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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47
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Ruigrok SR, Stöberl N, Yam KY, de Lucia C, Lucassen PJ, Thuret S, Korosi A. Modulation of the Hypothalamic Nutrient Sensing Pathways by Sex and Early-Life Stress. Front Neurosci 2021; 15:695367. [PMID: 34366778 PMCID: PMC8342927 DOI: 10.3389/fnins.2021.695367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022] Open
Abstract
There are sex differences in metabolic disease risk, and early-life stress (ES) increases the risk to develop such diseases, potentially in a sex-specific manner. It remains to be understood, however, how sex and ES affect such metabolic vulnerability. The hypothalamus regulates food intake and energy expenditure by sensing the organism's energy state via metabolic hormones (leptin, insulin, ghrelin) and nutrients (glucose, fatty acids). Here, we investigated if and how sex and ES alter hypothalamic nutrient sensing short and long-term. ES was induced in mice by limiting the bedding and nesting material from postnatal day (P)2-P9, and the expression of genes critical for hypothalamic nutrient sensing were studied in male and female offspring, both at P9 and in adulthood (P180). At P9, we observed a sex difference in both Ppargc1a and Lepr expression, while the latter was also increased in ES-exposed animals relative to controls. In adulthood, we found sex differences in Acacb, Agrp, and Npy expression, whereas ES did not affect the expression of genes involved in hypothalamic nutrient sensing. Thus, we observe a pervasive sex difference in nutrient sensing pathways and a targeted modulation of this pathway by ES early in life. Future research is needed to address if the modulation of these pathways by sex and ES is involved in the differential vulnerability to metabolic diseases.
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Affiliation(s)
- Silvie R. Ruigrok
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Nina Stöberl
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Kit-Yi Yam
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Chiara de Lucia
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Paul J. Lucassen
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Aniko Korosi
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
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Womersley JS, Nothling J, Toikumo S, Malan-Müller S, van den Heuvel LL, McGregor NW, Seedat S, Hemmings SMJ. Childhood trauma, the stress response and metabolic syndrome: A focus on DNA methylation. Eur J Neurosci 2021; 55:2253-2296. [PMID: 34169602 DOI: 10.1111/ejn.15370] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/13/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022]
Abstract
Childhood trauma (CT) is well established as a potent risk factor for the development of mental disorders. However, the potential of adverse early experiences to exert chronic and profound effects on physical health, including aberrant metabolic phenotypes, has only been more recently explored. Among these consequences is metabolic syndrome (MetS), which is characterised by at least three of five related cardiometabolic traits: hypertension, insulin resistance/hyperglycaemia, raised triglycerides, low high-density lipoprotein and central obesity. The deleterious effects of CT on health outcomes may be partially attributable to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which coordinates the response to stress, and the consequent fostering of a pro-inflammatory environment. Epigenetic tags, such as DNA methylation, which are sensitive to environmental influences provide a means whereby the effects of CT can be biologically embedded and persist into adulthood to affect health and well-being. The methylome regulates the transcription of genes involved in the stress response, metabolism and inflammation. This narrative review examines the evidence for DNA methylation in CT and MetS in order to identify shared neuroendocrine and immune correlates that may mediate the increased risk of MetS following CT exposure. Our review specifically highlights differential methylation of FKBP5, the gene that encodes FK506-binding protein 51 and has pleiotropic effects on stress responding, inflammation and energy metabolism, as a central candidate to understand the molecular aetiology underlying CT-associated MetS risk.
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Affiliation(s)
- Jacqueline S Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jani Nothling
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Sylvanus Toikumo
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stefanie Malan-Müller
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nathaniel W McGregor
- Systems Genetics Working Group, Department of Genetics, Faculty of Agriculture, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sîan M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [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: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
| | - Susan J Spieker
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
| | - Cathryn Booth-LaForce
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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Maier T, Kugelmann M, Rhee DS, Brill S, Gündel H, Friemert B, Becker HP, Waller C, Rappel M. Structural Equation Modeling of a Global Stress Index in Healthy Soldiers. J Clin Med 2021; 10:jcm10081799. [PMID: 33924268 PMCID: PMC8074902 DOI: 10.3390/jcm10081799] [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: 02/04/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022] Open
Abstract
Accumulation of stress is a prognostic trigger for cardiovascular disease. Classical scores for cardiovascular risk estimation typically do not consider psychosocial stress. The aim of this study was to develop a global stress index (GSI) from healthy participants by combining individual measures of acute and chronic stress from childhood to adult life. One-hundred and ninety-two female and male soldiers completed the Perceived Stress Scale (PSS4), Trier Inventory for Chronic Stress (TICS), Hospital Anxiety and Depression Scale (HADS), Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale Checklist (PDS), and the Deployment Risk and Resilience Inventory (DRRI-2). The underlying structure for the GSI was examined through structural equation modeling. The final hierarchical multilevel model revealed fair fit by taking modification indices into account. The highest order had a g-factor called the GSI. On a second level the latent variables stress, HADS and CTQ were directly loading on the GSI. A third level with the six CTQ subscales was implemented. On the lowest hierarchical level all manifest variables and the DRRI-2/PDS sum scores were located. The presented GSI serves as a valuable and individual stress profile for soldiers and could potentially complement classical cardiovascular risk factors.
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Affiliation(s)
- Tanja Maier
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
- Correspondence:
| | - Melanie Kugelmann
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
| | - Dae-Sup Rhee
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
| | | | - Harald Gündel
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
| | | | | | - Christiane Waller
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
- Department of Psychosomatics and Psychotherapeutic Medicine, Paracelsus Medical University of Nueremberg, 90419 Nueremberg, Germany
| | - Manuela Rappel
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, 89081 Ulm, Germany; (M.K.); (D.-S.R.); (H.G.); (C.W.); (M.R.)
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