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Ehrlich KB, Miller GE, Rogosch FA, Cicchetti D. Maltreatment exposure across childhood and low-grade inflammation: Considerations of exposure type, timing, and sex differences. Dev Psychobiol 2020; 63:529-537. [PMID: 32896910 DOI: 10.1002/dev.22031] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 07/17/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022]
Abstract
Links between child maltreatment and low-grade inflammation in adulthood are well documented, but these studies often rely on adults to report retrospectively on experiences of childhood abuse. Furthermore, these findings raise questions about whether exposure to childhood maltreatment needs time to "incubate," only giving rise to nonresolving inflammation in adulthood, or whether heightened inflammation may be observable in childhood, closer in time to the maltreatment exposure. The present study examined this question in a sample of 155 low-income children (ages 8-12), half of whom had been exposed to maltreatment. Trained coders evaluated case reports to classify maltreatment based on timing and exposure type. Blood samples from children assessed C-reactive protein and cytokines, which were used to form a composite of low-grade inflammation. Analyses revealed a marginally significant Maltreatment Exposure × Sex interaction, which suggested that maltreatment exposure was associated with higher inflammation for girls but not boys. Additionally, analyses focused on the accumulation of maltreatment experiences (through multiple forms of maltreatment or across multiple time points) revealed that girls with greater diversity in their maltreatment experiences and those who experienced maltreatment at multiple time points were at greatest risk. Finally, examination of timing of first onset of maltreatment suggested that girls whose exposures occurred before the age of 5 had the highest low-grade inflammation. These findings add new evidence linking maltreatment to inflammation in childhood, which could increase the risk for mental and physical health problems across the lifespan.
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Affiliation(s)
- Katherine B Ehrlich
- Center for Family Research, University of Georgia, Athens, GA, USA.,Department of Psychology, University of Georgia, Athens, GA, USA
| | - Gregory E Miller
- Department of Psychology, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA.,Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Nöthling J, Malan-Müller S, Abrahams N, Hemmings SMJ, Seedat S. Epigenetic alterations associated with childhood trauma and adult mental health outcomes: A systematic review. World J Biol Psychiatry 2020; 21:493-512. [PMID: 30806160 DOI: 10.1080/15622975.2019.1583369] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objectives: Multiple, chronic and repeated trauma exposure in childhood is associated with adverse mental health outcomes in adulthood. In this paper we synthesise the literature on epigenetic modifications in childhood trauma (CT) and the mediating effects of differential epigenetic mechanisms on the association between CT and the later onset of psychiatric disorders.Methods: We reviewed the literature up to March 2018 in four databases: PubMed, Web of Science, EBSCOhost and SCOPUS. Non-human studies were excluded. All studies investigating CT exposure both in healthy adults (18 years and older) and adults with psychiatric disorders were included.Results: Thirty-six publications were included. For mood disorders, methylation of the glucocorticoid receptor NR3C1 gene, specifically at the NGFI-A binding site in exon 1F, and correlation with CT was a robust finding. Several studies documented differential methylation of SLC6A4, BDNF, OXTR and FKBP5 in association with CT. Common pathways identified include neuronal functioning and maintenance, immune and inflammatory processes, chromatin and histone modification, and transcription factor binding.Conclusions: A variety of epigenetic mediators that lie on a common pathway between CT and psychiatric disorders have been identified, although longitudinal studies and consistency in methodological approach are needed to disentangle cause and effect associations.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Stefanie Malan-Müller
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Naeemah Abrahams
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
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Social bonds do not mediate the relationship between early adversity and adult glucocorticoids in wild baboons. Proc Natl Acad Sci U S A 2020; 117:20052-20062. [PMID: 32747546 PMCID: PMC7443977 DOI: 10.1073/pnas.2004524117] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In humans and other animals, harsh conditions in early life can have profound effects on adult physiology, including the stress response. This relationship may be mediated by a lack of supportive relationships in adulthood. That is, early life adversity may inhibit the formation of supportive social ties, and weak social support is itself often linked to dysregulated stress responses. Here, we use prospective, longitudinal data from wild baboons in Kenya to test the links between early adversity, adult social bonds, and adult fecal glucocorticoid hormone concentrations (a measure of hypothalamic-pituitary-adrenal [HPA] axis activation and the stress response). Using a causal inference framework, we found that experiencing one or more sources of early adversity led to a 9 to 14% increase in females' glucocorticoid concentrations across adulthood. However, these effects were not mediated by weak social bonds: The direct effects of early adversity on adult glucocorticoid concentrations were 11 times stronger than the effects mediated by social bonds. This pattern occurred, in part, because the effect of social bonds on glucocorticoids was weak compared to the powerful effects of early adversity on glucocorticoid levels in adulthood. Hence, in female baboons, weak social bonds in adulthood are not enough to explain the effects of early adversity on glucocorticoid concentrations. Together, our results support the well-established notions that early adversity and weak social bonds both predict poor adult health. However, the magnitudes of these two effects differ considerably, and they may act independently of one another.
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Crosswell AD, Lockwood KG. Best practices for stress measurement: How to measure psychological stress in health research. Health Psychol Open 2020; 7:2055102920933072. [PMID: 32704379 PMCID: PMC7359652 DOI: 10.1177/2055102920933072] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite the strong evidence linking psychological stress to disease risk, health researchers often fail to include psychological stress in models of health. One reason for this is the incorrect perception that the construct of psychological stress is too vague and broad to accurately measure. This article describes best practices in stress measurement, detailing which dimensions of stressor exposures and stress responses to capture, and how. We describe when to use psychological versus physiological indicators of stress. It is crucial that researchers across disciplines utilize the latest methods for measuring and describing psychological stress in order to build a cumulative science.
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55
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Boylan JM, Cundiff JM, Fuller-Rowell TE, Ryff CD. Childhood socioeconomic status and inflammation: Psychological moderators among Black and White Americans. Health Psychol 2020; 39:497-508. [PMID: 32212770 PMCID: PMC7437114 DOI: 10.1037/hea0000866] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The current study examined race differences in how childhood socioeconomic status (SES) predicted midlife inflammation. It also tested psychological resources (purpose in life, optimism, and conscientiousness) as moderators of the association between childhood SES and inflammation among Black and White adults. METHOD Data came from the biomarker subsamples of the Midlife in the United States Core and Refresher studies (n = 1,578 White and n = 395 Black participants). Childhood SES was operationalized as a composite of parental education, perceived financial status, and welfare status. Outcomes included circulating IL-6 and CRP. RESULTS Childhood SES did not predict IL-6 or CRP among Black or White adults in fully adjusted models. Among Black adults with low optimism, lower childhood SES predicted higher IL-6 and CRP. Among Black adults with low purpose in life, lower childhood SES predicted higher CRP (but not IL-6). Conscientiousness did not moderate childhood SES-inflammation associations among Black adults. Among White adults with low conscientiousness or low optimism, lower childhood SES predicted higher IL-6 (but not CRP). Purpose in life did not moderate associations among White adults. Effect sizes were small (≤1% variance explained) and comparable to effects of clinical risk factors in this sample (e.g., age, chronic conditions). CONCLUSIONS Race differences in the childhood SES and inflammation association were not apparent. Childhood SES was linked to inflammation more strongly among those with fewer psychological resources across both racial groups. Psychological resources may be important moderators of inflammation in the context of early life SES disadvantage. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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56
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Lewis CR, Sowards HA, Huentelman MJ, Doane LD, Lemery-Chalfant K. Epigenetic differences in inflammation genes of monozygotic twins are related to parent-child emotional availability and health. Brain Behav Immun Health 2020; 5:100084. [PMID: 34589859 PMCID: PMC8474531 DOI: 10.1016/j.bbih.2020.100084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 01/03/2023] Open
Abstract
The inflammatory response is an immune defense engaged immediately after injury or infection. Chronic inflammation can be deleterious for various health outcomes and is characterized by high levels of pro-inflammatory markers such as C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α). A large body of research demonstrates these inflammatory markers are responsive to stress and quality of social relationships throughout the lifespan. For example, the quality of the early parental bond predicts various health outcomes and may be driven by changes in immune function. Epigenetic processes, such as DNA methylation, may be one mechanism by which early social experiences shape immune functioning. The present study used a monozygotic twin difference design to assess if mother-reported emotional availability at 1 year and 2.5 years predicted immune gene methylation at 8 years of age. Further, we assessed if inflammation gene methylation was related to general health problems (e.g. infections, allergies, etc.). We found that mother-reported emotional availability at 1 year, but not 2.5 years, was related to methylation of various immune genes in monozygotic twins. Furthermore, twin pairs discordant in health problems have more difference in immune gene methylation compared to twin pairs concordant for health problems, suggesting that methylation of immune genes may have functional consequences for general health. These results suggest that the emotional component of attachment quality during infancy contributes to immune epigenetic profiles in childhood, which may influence general health.
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Affiliation(s)
- Candace R Lewis
- Translational Genomics Research Institute, Neurogenomics Division, United States.,Arizona State University, Psychology Department, United States
| | | | - Matthew J Huentelman
- Translational Genomics Research Institute, Neurogenomics Division, United States
| | - Leah D Doane
- Arizona State University, Psychology Department, United States
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Kautz MM, Coe CL, McArthur BA, Mac Giollabhui N, Ellman LM, Abramson LY, Alloy LB. Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents. Brain Behav Immun 2020; 86:43-52. [PMID: 30822466 PMCID: PMC6710165 DOI: 10.1016/j.bbi.2019.02.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 11/23/2018] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology, Temple University, United States
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, United States
| | | | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Lauren B Alloy
- Department of Psychology, Temple University, United States.
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58
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Kuhlman KR, Robles TF, Haydon MD, Dooley L, Boyle CC, Bower JE. Early life stress sensitizes individuals to the psychological correlates of mild fluctuations in inflammation. Dev Psychobiol 2020; 62:400-408. [PMID: 31489628 PMCID: PMC8211401 DOI: 10.1002/dev.21908] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/15/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early life stress (ELS) has been linked to health disparities across the human lifespan, particularly increased risk for depression and its recurrence. In this study we explore two plausible and competing pathways through which ELS may lead to depression via inflammation. METHODS Participants (ages 18-22; n = 41) completed the Early Trauma Inventory as a measure of ELS. Participants then completed consecutive daily diaries of mood and other sickness behavior for the 7 days prior to and 7 days after receiving the annual influenza vaccine. Circulating concentrations of plasma interleukin-6 (IL-6) were measured immediately before and 24 hr after vaccination. RESULTS ELS was not associated with the magnitude of change in IL-6 from pre- to post-vaccine, however, exposure to ELS moderated the association between change in IL-6 from pre- to post-vaccine and changes in both cognitive difficulty and depressed mood. Individuals exposed to greater ELS showed greater psychological sensitivity to increases in IL-6. CONCLUSIONS Exposure to ELS may increase sensitivity to peripheral inflammation in the central nervous system. Future studies elaborating on the impact of ELS on the sensitivity of specific neural circuits and cells to inflammation are needed.
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Affiliation(s)
- Kate R. Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California Irvine, Irvine, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Institute for Interdisciplinary Salivary Bioscience, University of California Irvine, Irvine, CA, USA
| | - Theodore F. Robles
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Marcie D. Haydon
- Department of Psychological Science, School of Social Ecology, University of California Irvine, Irvine, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Chloe C. Boyle
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Julienne E. Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
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59
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Pamplin JR, Susser ES, Factor-Litvak P, Link BG, Keyes KM. Racial differences in alcohol and tobacco use in adolescence and mid-adulthood in a community-based sample. Soc Psychiatry Psychiatr Epidemiol 2020; 55:457-466. [PMID: 31542795 PMCID: PMC7083697 DOI: 10.1007/s00127-019-01777-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Smoking and alcohol use have been posited as possible contributors to racial health disparities, despite higher smoking and alcohol use among non-Hispanic White youth and young adults compared to Blacks. To further investigate this claim, we aim to assess variation in alcohol and cigarette use across two distinct points of the life course. METHOD Data are from a subset of 559 (279 male, 280 female) self-identified Black and White participants of the Child Health and Development study. Self-report alcohol and cigarette use were collected between age 15-17 and at mean age 50. Logistic regressions were estimated; supplementary analyses adjusted for maternal age, prenatal smoking, household income, childhood SES, and education. RESULTS White participants were more likely to drink regularly (Odds ratio (OR) 2.2; 95%CI 1.2, 4.0) and be intoxicated (OR 2.0; 95%CI 1.2, 3.2) in adolescence compared with Blacks. In mid-adulthood, Whites remained more likely to currently drink (OR 2.3; 95%CI 1.6, 3.4) but among drinkers, less likely to binge drink (OR 0.4; 95%CI 0.2, 0.8). White participants were less likely to smoke in mid-adulthood (OR 0.4; 95%CI 0.3, 0.6), but among smokers, were more likely to smoke ≥ ½ a pack per day (OR 3.4; 95%CI 1.5, 7.8). CONCLUSIONS Blacks were less likely to engage in drinking across the life course, but, among drinkers, more likely to binge drink in mid-adulthood. Blacks were more likely to smoke in mid-adulthood, but smoked infrequently compared with Whites. These patterns suggest that a reframing of disparities mechanisms to focus on broader structural and social factors may benefit progress in understanding and ameliorating inequities.
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Affiliation(s)
- John R. Pamplin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ezra S. Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bruce G. Link
- Department of Sociology, University of California Riverside, Riverside, CA, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,Center for Research on Society and Health, Universidad Mayor, Santiago, Chile
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Ferguson SA, Varma V, Sloper D, Panos JJ, Sarkar S. Increased inflammation in BA21 brain tissue from African Americans with Alzheimer's disease. Metab Brain Dis 2020; 35:121-133. [PMID: 31823110 DOI: 10.1007/s11011-019-00512-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/25/2019] [Indexed: 12/21/2022]
Abstract
Chronic neuroinflammation is strongly associated with AD and altered peripheral and central levels of chemokines and cytokines have been frequently described in those with AD. Given the increasing evidence of ethnicity-related differences in AD, it was of interest to determine if those altered chemokine and cytokine levels are ethnicity-related. Because African Americans exhibit a higher incidence of AD and increased symptom severity, we explored chemokine and cytokine concentrations in post-mortem brain tissue from the BA21 region of African Americans and Caucasians with AD using multiplex assays. IL-1β, MIG, TRAIL, and FADD levels were significantly increased in African Americans while levels of IL-3 and IL-8 were significantly decreased. Those effects did not interact with gender; however, overall levels of CCL25, CCL26 and CX3CL1 were significantly decreased in women. The NLRP3 inflammasome is thought to be critically involved in AD. Increased activation of this inflammasome in African Americans is consistent with the current results.
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Affiliation(s)
- Sherry A Ferguson
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA.
| | - Vijayalakshmi Varma
- Division of Systems Biology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - Daniel Sloper
- Division of Systems Biology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - John J Panos
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
| | - Sumit Sarkar
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
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Evans CR, Long DL, Howard G, McClure LA, Zakai NA, Jenny NS, Kissela BM, Safford MM, Howard VJ, Cushman M. C-reactive protein and stroke risk in blacks and whites: The REasons for Geographic And Racial Differences in Stroke cohort. Am Heart J 2019; 217:94-100. [PMID: 31520899 PMCID: PMC6861684 DOI: 10.1016/j.ahj.2019.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 08/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND C-reactive protein (CRP) is an inflammatory biomarker used in vascular risk prediction, though with less data in people of color. Blacks have higher stroke incidence and also higher CRP than whites. We studied the association of CRP with ischemic stroke risk in blacks and whites. METHODS REGARDS, an observational cohort study, recruited and followed 30,239 black and white Americans 45 years and older for ischemic stroke. We calculated hazard ratios and 95% CIs of ischemic stroke by CRP category (<1, 1-3, 3-10, and ≥10 mg/L) adjusted for age, sex and stroke risk factors. RESULTS There were 292 incident ischemic strokes among blacks and 439 in whites over 6.9 years of follow-up. In whites, the risk was elevated for CRP in the range from 3 to 10 mg/L and even higher for CRP >10 mg/L, whereas in blacks, an association was only seen for CRP >10 mg/L. Considered as a continuous variable, the risk factor-adjusted hazard ratios per SD higher lnCRP were 1.18 (95% CI 1.09-1.28) overall, 1.14 (95% CI 1.00-1.29) in blacks, and 1.22 (95% CI 1.10-1.35) in whites. Spline regression analysis visually confirmed the race difference in the association. CONCLUSIONS CRP may not be equally useful in stroke risk assessment in blacks and whites. Confirmation, similar study for coronary heart disease, and identification of reasons for these racial differences require further study.
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Affiliation(s)
- Christina R Evans
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - D Leann Long
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - George Howard
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Leslie A McClure
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Neil A Zakai
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Nancy S Jenny
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Brett M Kissela
- University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | | | - Virginia J Howard
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Mary Cushman
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
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Fuller-Rowell TE, Homandberg LK, Curtis DS, Tsenkova VK, Williams DR, Ryff CD. Disparities in insulin resistance between black and white adults in the United States: The role of lifespan stress exposure. Psychoneuroendocrinology 2019; 107:1-8. [PMID: 31055182 PMCID: PMC6635018 DOI: 10.1016/j.psyneuen.2019.04.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/23/2019] [Accepted: 04/26/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Disparities in insulin resistance between Black and White adults in the United States are well documented, yet relatively little is known about the psychosocial or biological antecedents of these inequities. The current study examined childhood adversity and contemporaneous psychosocial stressors in adulthood as possible mediators of the racial disparity in insulin resistance. Inflammatory and hypothalamic-pituitary adrenal (HPA) axis mechanisms implicated in associations between lifespan stress exposure and insulin resistance were also considered. METHODS Data were derived from the biomarker component of the Midlife in the United States Study (N = 1170, 20% Black, 56% female, Mean age = 54.7 years, SD = 11.6). A homeostatic model assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin concentrations. Twelve risk factors relating to household dysfunction, socioeconomic disadvantage, and maltreatment were sum scored to index childhood adversity. Measures of adult stress included socioeconomic adversity, major stressful events, everyday discrimination, and lifetime discrimination. RESULTS Levels of insulin resistance were higher among Black than White adults. Childhood adversity was positively associated with HOMA-IR, and attenuated 18% of the race difference. Measures of adult stress mediated 33% of the association between childhood adversity and HOMA-IR, and accounted for an additional 47% of the race difference. Higher inflammation and lower nocturnal cortisol both played an important role in mediating the association between stress exposure and HOMA-IR. CONCLUSIONS Findings are consistent with prior research showing that childhood adversity and adult stress are salient predictors of glucose metabolism, and extend this work by showing that lifespan stress exposures attenuate a significant portion of the Black-White disparity in HOMA-IR. Results also suggest stress effects on insulin resistance through inflammatory and HPA-axis pathways.
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Affiliation(s)
- Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, AL, United States.
| | - Lydia K Homandberg
- Department of Human Development and Family Studies, Auburn University, AL, United States
| | - David S Curtis
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, United States
| | - Vera K Tsenkova
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard University, Cambridge, MA, United States
| | - Carol D Ryff
- Department of Psychology, University of Wisconsin, Madison, WI, United States
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Sheffler JL, Piazza JR, Quinn JM, Sachs-Ericsson NJ, Stanley IH. Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood. ANXIETY, STRESS, AND COPING 2019; 32:594-609. [PMID: 31288568 PMCID: PMC6824267 DOI: 10.1080/10615806.2019.1638699] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 06/03/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The current study examined whether coping strategies mediate the link between adverse childhood experiences (ACEs) and adult psychiatric and physical health outcomes. METHODS Data were drawn from wave I (N = 7108), wave II (N = 4963), and wave III (N = 3294) of the Midlife Development in the United States (MIDUS) Survey. An ACE count was created using seven aspects of early adversity based on prior literature. Coping variables were created using subscales of the COPE inventory. Psychiatric and health outcomes were assessed at baseline and at the 20-year follow-up. Bootstrapping mediation analyses were conducted using MPLUS to examine the link between ACEs and health outcomes and to determine if coping strategies mediate these relationships. RESULTS Results of path analyses in Mplus showed that ACEs, reported at Wave I, were associated with worse psychiatric and physical health outcomes at Wave III. ACEs at Wave I were associated with greater use of avoidant emotion-focused coping and lower use of problem-focused strategies at Wave II. Avoidant emotion-focused coping at Wave II partially mediated the relationship between ACEs, reported at Wave I, and psychiatric and physical health outcomes reported at Wave III. No significant mediation was detected for problem-focused coping. CONCLUSIONS Coping strategies may be an important point target for prevention or intervention for individuals who have experienced ACEs.
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Affiliation(s)
- Julia L Sheffler
- a Behavioral Sciences and Social Medicine, Florida State University College of Medicine , Tallahassee , FL , USA
| | - Jennifer R Piazza
- b Department of Public Health, California State University , Fullerton , CA , USA
| | - Jamie M Quinn
- c Florida Center for Reading Research, Florida State University , Tallahassee , FL , USA
| | | | - Ian H Stanley
- d Department of Psychology, Florida State University , Tallahassee , FL , USA
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64
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Chou PH, Koenen KC. Associations between childhood maltreatment and risk of myocardial infarction in adulthood: Results from the National Epidemiologic Survey on alcohol and Related Conditions. J Psychiatr Res 2019; 116:172-177. [PMID: 30553535 DOI: 10.1016/j.jpsychires.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although childhood maltreatment has been reported to be associated with the incidence of cardiovascular diseases, its association with specific major cardiovascular events remains unclear. This study aimed to examine the relationship between different types of childhood maltreatment (CM) and myocardial infarction (MI) occurrence in a nationally representative sample. METHODS We used data from the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative US sample of adults aged 20 years and older (N = 34, 653). Logistic regression models were constructed to investigate the associations between five types of CMs including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse and the risk of MI adjusting for sociodemographic variables. RESULTS After adjusting for sociodemographic variables, childhood sexual abuse was significantly associated with increased odds of MI occurrence (adjusted odds ratio [aOR] = 1.85, 95%CI = 1.24-2.76, p = 0.003). Additionally, childhood physical abuse was significantly associated with increased odds of MI occurrence in men (aOR = 2.45, 95%CI = 1.35-4.44, p = 0.004) but this association was not observed in women (aOR = 0.72, 95%CI = 0.32-1.66, p = 0.440). Compared to those who did not experience CM, those who experienced more than three types of CMs showed increased odds of MI occurrence (adjusted OR = 2.08-3.05, all p < 0.05). CONCLUSIONS Using data from a nationally representative US sample of adults, we found significant positive associations between CM and odds of MI occurrence in adulthood. Future longitudinal prospective studies are needed to confirm our findings.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, 40447, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, 40402, Taiwan.
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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65
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Beydoun MA, Weiss J, Obhi H, Beydoun HA, Dore GA, Liang H, Evans MK, Zonderman AB. Cytokines are associated with longitudinal changes in cognitive performance among urban adults. Brain Behav Immun 2019; 80:474-487. [PMID: 30981715 PMCID: PMC6698146 DOI: 10.1016/j.bbi.2019.04.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/20/2019] [Accepted: 04/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chronic systemic inflammation has been positively associated with structural and functional brain changes representing early markers of Alzheimer's Disease (AD) and cognitive decline. The current study examined associations between systemic inflammation and cognitive performance among African-Americans and Whites urban adults. METHODS Participants were selected from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (2004-2013, baseline age: 30-64 y, mean ± SD follow-up time of 4.64 ± 0.93 y, N = 189-222, k = 1.5-1.7 observations/participant). Cytokines known to be positively linked to AD incidence among others were tested against cross-sectional and longitudinal cognitive function, stratifying by age group (≤50 y vs. >50 y), sex and race. A series of mixed-effects regression models were conducted, adjusting for key confounders. RESULTS Among key findings, IL1β was positively associated with a faster rate of decline on a test of executive functioning, among older adults (age >50 y, γ11 = +2.49 ± 0.89, p = 0.005), while in the total population, IL-6 was linked to a faster decline on a test of verbal memory (γ11 = -0.011 ± 0.004, p = 0.009). Among younger participants, IL-18 was linked to a poorer performance on a test of attention at baseline (age ≤50 y, γ01 = -0.007 ± 0.0025, p = 0.004) though a slower rate of decline with higher IL-18 was detected for a test of psychomotor speed in older adults (age >50 y, γ11 = +0.0010 ± 0.0004, p = 0.008). Finally, among Whites, unlike among African-Americans, IL-6 was associated with a better baseline performance on two tests of verbal and working memory. CONCLUSIONS Cytokines were shown to be associated with age-related cognitive decline among middle-aged and older urban adults in an age group and race-specific manner. Further longitudinal studies are needed to replicate our findings and mediation through relevant biological and psychosocial factors need to be studied as well.
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Affiliation(s)
- May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD.,Corresponding author: May A. Beydoun, PhD, NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room#: 04B118, Baltimore, MD 21224, , Fax:410-558-8236
| | - Jordan Weiss
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hardeep Obhi
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hind A. Beydoun
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Gregory A. Dore
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hailun Liang
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
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van Dammen L, Bush NR, de Rooij SR, Mol BWJ, Groen H, Hoek A, Roseboom TJ. Childhood adversity and women's cardiometabolic health in adulthood: associations with health behaviors, psychological distress, mood symptoms, and personality. BMC WOMENS HEALTH 2019; 19:102. [PMID: 31337378 PMCID: PMC6652022 DOI: 10.1186/s12905-019-0797-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/02/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND We tested whether childhood adversity is associated with poor cardiometabolic health in adulthood among a sample of overweight or obese Dutch women of reproductive age. Health behaviors, psychological distress, mood symptoms, or personality traits were included as potential mediators. METHODS Data came from a follow-up visit (N = 115), carried out in 2016/2017, of a randomized controlled lifestyle intervention trial in 577 obese infertile women. The associations between total adversity exposure score and cardiometabolic health were tested with regression models. Sleep, smoking and eating behavior, symptoms of depression, anxiety and stress, and personality traits were potential mediators. RESULTS Childhood adversity scores were not associated with cardiometabolic outcomes but were associated with poorer sleep quality score (M = 7.2 (SD = 3.5) for those with ≥2 types of events versus 4.8 (2.9) for those with no events; p = 0.022), higher external eating score (26.4 (8.7) versus 21.8 (10.3); p = 0.038), higher perceived stress score (17.1 (6.8) versus 12.3 (4.5); p = 0.016), post-traumatic stress score (1.9 (1.5) versus 0.6 (1.1); p < 0.001), and lower agreeableness score (28.2 (4.2) versus 30.3 (3.1); p = 0.035). CONCLUSION Childhood adversity was associated with poorer health behaviors including sleep and eating behavior, and more stress-related symptoms, but not with women's cardiometabolic health.
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Affiliation(s)
- Lotte van Dammen
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA. .,Departments of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Nicole R Bush
- Departments of Psychiatry and Pediatrics, University of California San Francisco, San Francisco, California, USA.,Division of Developmental Medicine, Center for Health and Community, San Francisco, California, USA
| | - Susanne R de Rooij
- Departments of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annemieke Hoek
- Departments of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tessa J Roseboom
- Departments of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands.,Obstetrics and Gynaecology, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands
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67
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Nusslock R, Brody G, Armstrong C, Carroll A, Sweet LH, Yu T, Barton A, Hallowell E, Chen E, Higgins J, Parrish T, Wang L, Miller G. Higher Peripheral Inflammatory Signaling Associated With Lower Resting-State Functional Brain Connectivity in Emotion Regulation and Central Executive Networks. Biol Psychiatry 2019; 86:153-162. [PMID: 31054766 PMCID: PMC7430716 DOI: 10.1016/j.biopsych.2019.03.968] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Researchers document bidirectional pathways linking peripheral inflammation and neural circuitries subserving emotion processing and regulation. To extend this work, we present results from two independent studies examining the relationship between inflammation and resting-state functional connectivity (rsFC), as measured by functional magnetic resonance imaging. METHODS Study 1 involved 90 rural African American young adults, 25 years of age (52% female), and study 2 involved 82 urban African American youths, 13 to 14 years of age (66% female). Both studies measured circulating inflammatory biomarkers (C-reactive protein, interleukin 6, interleukin 10, tumor necrosis factor alpha), and the measures were averaged to form a composite. Study 2 also enumerated classical monocytes, a key leukocyte subpopulation involved in immune-to-brain signaling. All participants completed a resting-state functional magnetic resonance imaging scan. RESULTS Consistent with our prediction, higher scores on the inflammatory composite were associated with lower rsFC within an emotion regulation network in study 1, controlling for sex. Study 2 replicated study 1, showing that higher scores on the inflammatory composite were associated with lower rsFC within the emotion regulation network, controlling for sex, age, and pubertal status, and found a similar pattern for rsFC within a central executive network. Study 2 also found that higher numbers of classical monocytes were associated with lower rsFC within both the emotion regulation and central executive networks. There was no relationship between rsFC in the anterior salience or default mode networks with inflammation in either study. CONCLUSIONS With these findings, we document relationships between peripheral inflammation and rsFC within an emotion regulation and central executive network and replicate these associations with the emotion regulation network across two independent samples.
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Affiliation(s)
- Robin Nusslock
- Institute for Policy Research, Northwestern University, Evanston, Illinois; Department of Psychology, Northwestern University, Evanston, Illinois.
| | - Gene Brody
- Center for Family Research, University of Georgia, Athens GA
| | - Casey Armstrong
- Department of Psychology, Northwestern University, Evanston IL
| | - Ann Carroll
- Department of Psychology, Northwestern University, Evanston IL
| | | | - Tianyi Yu
- Center for Family Research, University of Georgia, Athens GA
| | - Allen Barton
- Center for Family Research, University of Georgia, Athens GA
| | | | - Edith Chen
- Institute for Policy Research, Northwestern University, Evanston IL,Department of Psychology, Northwestern University, Evanston IL
| | - James Higgins
- Department of Radiology, Northwestern Feinberg School of Medicine, Chicago IL
| | - Todd Parrish
- Department of Radiology, Northwestern Feinberg School of Medicine, Chicago IL
| | - Lei Wang
- Department of Radiology, Northwestern Feinberg School of Medicine, Chicago IL,Department of Psychiatry, Northwestern Feinberg School of Medicine, Chicago IL
| | - Gregory Miller
- Institute for Policy Research, Northwestern University, Evanston IL,Department of Psychology, Northwestern University, Evanston IL
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Vásquez E, Quiñones A, Ramirez S, Udo T. Association Between Adverse Childhood Events and Multimorbidity in a Racial and Ethnic Diverse Sample of Middle-Aged and Older Adults. Innov Aging 2019; 3:igz016. [PMID: 31276051 PMCID: PMC6599428 DOI: 10.1093/geroni/igz016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 12/27/2022] Open
Abstract
Background and Objectives Adverse childhood events (ACEs) have been associated with increased health risks later in life. However, it is unclear whether ACEs may be associated with multimorbidity among diverse racial/ethnic middle-aged and older adults. We evaluated whether there were racial and ethnic differences in the association between ACEs and the number of somatic and psychiatric multimorbidity in a sample of U.S. middle-aged and older adults. Research Design and Methods Data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 10,727; ≥55 years) were used to test whether the number of self-reported somatic conditions (i.e., heart disease, hypertension, stroke, diabetes, arthritis, cancer, osteoporosis, and chronic lung problems) as well as DSM-5 psychiatric disorders (i.e., depression) during the past 12 months differed by history of ACEs while stratifying by age (i.e., 55-64 or ≥65) and racial/ethnic group (i.e., non-Hispanic White [NHW; n = 7,457], non-Hispanic Black [NHB; n = 1,995], and Hispanic [n=1275]). Results The prevalence of reporting more than two somatic conditions and psychiatric disorders was 48.8% and 11.4% for those with a history of ACEs, and 41.1% and 3.3% for those without a history of ACEs. Adjusting for sociodemographic and other health risk factors, ACEs was significantly associated with greater numbers of somatic multimorbidity among racial and ethnic middle-aged adults but this was not the case for older adults. Discussion and Implications Our findings suggest that middle-aged adults with a history of ACEs are more likely to suffer from somatic and psychiatric multimorbidity, highlighting the importance of screening for ACEs in promoting healthy aging.
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Affiliation(s)
- Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany State University of New York, Portland
| | - Ana Quiñones
- Department of Family Medicine, Oregon Health and Science University, Portland
| | - Stephanie Ramirez
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany State University of New York, Portland
| | - Tomoko Udo
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany State University of New York, Portland
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69
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Quiñones AR, Botoseneanu A, Markwardt S, Nagel CL, Newsom JT, Dorr DA, Allore HG. Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults. PLoS One 2019; 14:e0218462. [PMID: 31206556 PMCID: PMC6576751 DOI: 10.1371/journal.pone.0218462] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/03/2019] [Indexed: 11/21/2022] Open
Abstract
Background Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years. Methods and findings We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly-available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic disease burden among 8,872 non-Hispanic black, non-Hispanic white, and Hispanic participants who were 51–55 years of age at their first interview any time during the study period (1998–2014) and all subsequent follow-up observations until 2014. Multimorbidity was defined as having two or more of seven somatic chronic diseases: arthritis, cancer, heart disease (myocardial infarction, coronary heart disease, angina, congestive heart failure, or other heart problems), diabetes, hypertension, lung disease, and stroke. We used negative binomial generalized estimating equation models to assess the trajectories of multimorbidity burden over time for non-Hispanic black, non-Hispanic white, and Hispanic participants. In covariate-adjusted models non-Hispanic black respondents had initial chronic disease counts that were 28% higher than non-Hispanic white respondents (IRR 1.279, 95% CI 1.201, 1.361), while Hispanic respondents had initial chronic disease counts that were 15% lower than non-Hispanic white respondents (IRR 0.852, 95% CI 0.775, 0.938). Non-Hispanic black respondents had rates of chronic disease accumulation that were 1.1% slower than non-Hispanic whites (IRR 0.989, 95% CI 0.981, 0.998) and Hispanic respondents had rates of chronic disease accumulation that were 1.5% faster than non-Hispanic white respondents (IRR 1.015, 95% CI 1.002, 1.028). Using marginal effects commands, this translates to predicted values of chronic disease for white respondents who begin the study period with 0.98 chronic diseases and end with 2.8 chronic diseases; black respondents who begin the study period with 1.3 chronic diseases and end with 3.3 chronic diseases; and Hispanic respondents who begin the study period with 0.84 chronic diseases and end with 2.7 chronic diseases. Conclusions Middle-aged non-Hispanic black adults start at a higher level of chronic disease burden and develop multimorbidity at an earlier age, on average, than their non-Hispanic white counterparts. Hispanics, on the other hand, accumulate chronic disease at a faster rate relative to non-Hispanic white adults. Our findings have important implications for improving primary and secondary chronic disease prevention efforts among non-Hispanic black and Hispanic Americans to stave off greater multimorbidity-related health impacts.
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Affiliation(s)
- Ana R. Quiñones
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Anda Botoseneanu
- Department of Health & Human Services, University of Michigan, Dearborn, Michigan, United States of America
- Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sheila Markwardt
- School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Corey L. Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Jason T. Newsom
- Department of Psychology, Portland State University, Portland, Oregon, United States of America
| | - David A. Dorr
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Heather G. Allore
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Biostatistics School of Public Health, Yale University, New Haven, Connecticut, United States of America
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Pinto Pereira SM, Stein Merkin S, Seeman T, Power C. Understanding associations of early-life adversities with mid-life inflammatory profiles: Evidence from the UK and USA. Brain Behav Immun 2019; 78:143-152. [PMID: 30682500 PMCID: PMC6941353 DOI: 10.1016/j.bbi.2019.01.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES In two cohorts, we aimed to establish associations between early-life adversities and adult inflammation, and whether adult (a) adiposity or (b) socioeconomic disadvantage are key intermediaries. METHODS In both cohorts (N = 7661, 1958 British birth cohort; N = 1255, MIDUS), information was used on adult inflammatory markers (C-reactive protein (CRP), fibrinogen and (MIDUS only) interleukin-6 (IL-6)), adiposity and socioeconomic disadvantage, and early-life adversities (neglect, emotional neglect, physical, psychological, sexual abuse and childhood disadvantage). RESULTS Early-life adversities varied from 1.6% (sexual abuse, 1958 cohort) to 14.3% (socioeconomic disadvantage, MIDUS). Across the two cohorts, associations were consistent for physical abuse, e.g. 16.3%(3.01,29.7) and 17.0%(-16.4,50.3) higher CRP in the 1958 cohort and MIDUS respectively. Associations attenuated after accounting for adult adiposity, e.g. physical abuse (1958 cohort) and sexual abuse (MIDUS, non-white participants) associations were abolished. Some associations attenuated after adjustment for adult socioeconomic disadvantage; e.g. 1958 cohort neglect-CRP associations reduced from 23.2%(13.7,32.6) to 17.7%(8.18,27.2). Across the cohorts, no associations were found for psychological abuse or emotional neglect; associations for childhood socioeconomic disadvantage were inconsistent. CONCLUSIONS Specific early-life adversities are associated with adult inflammation; adiposity is a likely intermediary factor. Weight reduction and obesity prevention may offset pro-inflammatory related adult disease among those who experienced early-life adversities.
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Affiliation(s)
- Snehal M Pinto Pereira
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Sharon Stein Merkin
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chris Power
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
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Chiang JJ, Park H, Almeida DM, Bower JE, Cole SW, Irwin MR, McCreath H, Seeman TE, Fuligni AJ. Psychosocial stress and C-reactive protein from mid-adolescence to young adulthood. Health Psychol 2019; 38:259-267. [PMID: 30762405 DOI: 10.1037/hea0000701] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Cardiovascular disease (CVD) is one of the most prevalent chronic conditions and leading causes of death. Although CVD clinically manifests in adulthood, underlying processes of CVD begin in the earlier decades of life. Inflammation has been shown to play a key role, but relatively little is understood about how inflammation changes over time among young individuals. Additionally, how psychosocial factors like stress may influence changes in inflammation earlier in the lifespan is not entirely clear. Thus, the current three-wave longitudinal study examined the developmental trajectory of CRP, a marker of systemic inflammation, over a 4-year period from mid-adolescence into young adulthood. Between- and within-person differences in stress in relation to changes in CRP were also examined. METHOD A sample of 350 individuals was recruited during mid-adolescence and participated in 1 to 3 assessments, 2 years apart. At each assessment, participants provided dried blood spots for the assessment of CRP and reported on recent major life events, perceived stress, and daily interpersonal stress. RESULTS Multilevel modeling indicated that CRP increased with age, and within-person increases in perceived stress, but not life events or daily stress, were associated with higher CRP. Between-person differences in average levels of stress from mid-adolescence into young adulthood were not associated with changes in CRP. CONCLUSION These findings suggest that the link between stress and systemic inflammation between mid-adolescence and young adulthood may be most affected by contemporaneous experiences of perceived stress. There was little evidence to suggest that CRP trajectories varied by between-person differences in overall average levels of perceived stress, life events, and daily stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | - David M Almeida
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Julienne E Bower
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences and Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
| | - Heather McCreath
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles
| | - Andrew J Fuligni
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
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Neergheen VL, Topel M, Van Dyke ME, Sullivan S, Pemu PE, Gibbons GH, Vaccarino V, Quyyumi AA, Lewis TT. Neighborhood social cohesion is associated with lower levels of interleukin-6 in African American women. Brain Behav Immun 2019; 76:28-36. [PMID: 30686334 PMCID: PMC6370481 DOI: 10.1016/j.bbi.2018.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Social cohesion is a positive neighborhood characteristic defined by feelings of connectedness and solidarity within a community. Studies have found significant associations between social cohesion and cardiovascular disease (CVD) risk factors and outcomes. Inflammation is one potential physiological pathway linking social cohesion to CVD development, but few studies have evaluated the relationship between social cohesion and inflammatory biomarkers. Prior research has also established that race and gender can modify the effects of neighborhood features, including social cohesion, on CVD risk factors and outcomes. This study aimed to examine the association between social cohesion and the inflammatory biomarkers interleukin-6 (IL-6) and C-reactive protein (CRP) in a cohort of African American and White women and men. MATERIALS AND METHODS Data from the Morehouse and Emory Team Up to Eliminate Health Disparities (META-Health) Study were used to assess the association between social cohesion and inflammation among African American (n = 203) and White (n = 176) adults from the Atlanta metropolitan area. Social cohesion was measured using the social cohesion subscale from the Neighborhood Health Questionnaire. Inflammatory biomarkers were measured from plasma frozen at -70 °C. Multivariable linear regression analyses were conducted, controlling for demographic, clinical, behavioral, and psychosocial factors sequentially. Interaction by race and gender was also examined. RESULTS In models adjusted for age, race, gender, and education, social cohesion was significantly associated with lower levels of IL-6 (β = -0.06, p = 0.03). There was a significant race × social cohesion interaction (p = 0.04), and a marginally significant gender × race × social cohesion interaction (p = 0.09). In race-stratified models controlling for age, gender, and education, social cohesion was associated with lower IL-6 levels in African Americans (β = -0.11, p = 0.01), but not Whites (β = 0.01, p = 0.91). In fully adjusted race- and gender-stratified models, social cohesion was associated with lower levels of IL-6 in African American women only (β = -0.15, p = 0.003). CRP was not associated with social cohesion in fully adjusted models. CONCLUSION The association between social cohesion and lower levels of IL-6 is modified by gender and race, with the strongest association emerging for African American women. Although the pathways through which social cohesion impacts inflammation remain unclear, it is possible that for African American women social cohesion manifests through neighborhood networks.
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Affiliation(s)
- Vanessa L Neergheen
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Matthew Topel
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Miriam E Van Dyke
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Samaah Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Gary H Gibbons
- National Heart, Lung, and Blood Institute, Bethesda, MD, United States
| | - Viola Vaccarino
- Rollins School of Public Health, Emory University, Atlanta, GA, United States; Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Arshed A Quyyumi
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Tené T Lewis
- Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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73
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Schwartz JA, Wright EM, Valgardson BA. Adverse childhood experiences and deleterious outcomes in adulthood: A consideration of the simultaneous role of genetic and environmental influences in two independent samples from the United States. CHILD ABUSE & NEGLECT 2019; 88:420-431. [PMID: 30605796 PMCID: PMC6943915 DOI: 10.1016/j.chiabu.2018.12.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/06/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a potent risk factor. Despite these findings, studies have also recognized the importance of considering additional sources of genetic and environmental influence that cluster within families. OBJECTIVE To properly control for latent sources of genetic and within-family environmental influences and isolate the association between ACEs and the following outcomes in adulthood: physical health, depressive symptoms, educational attainment, income attainment, alcohol problems, and antisocial behavior. PARTICIPANTS AND SETTING Two independent samples of twins and siblings from the United States: the Midlife Development in the United States (MIDUS) study (N = 862) and the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 3112). METHODS Sibling comparison models, which control for latent sources of genetic and within-family environmental influences, were estimated to examine whether differential exposure to ACEs was associated with the examined outcomes. RESULTS Families that experienced more adversity also experienced more deleterious outcomes. However, siblings that experienced more adversity were no more likely to experience deleterious outcomes than their co-siblings. However, greater exposure to ACEs was associated with increases in depressive symptoms (Add Health). Additional models revealed that the similarity between siblings from the same family stemmed from latent sources of within-family environmental influences not captured by traditional ACEs measures. CONCLUSIONS Considering genetic influences and additional latent sources of within-family influences is crucial in isolating the effects of ACEs. Currently employed ACEs measures may not adequately capture the full range of impactful sources of family-level environmental influence.
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Affiliation(s)
- Joseph A Schwartz
- School of Criminology and Criminal Justice, University of Nebraska Omaha, Omaha, NE 68182-0149, USA.
| | - Emily M Wright
- School of Criminology and Criminal Justice, University of Nebraska Omaha, Omaha, NE 68182-0149, USA
| | - Bradon A Valgardson
- School of Criminology and Criminal Justice, University of Nebraska Omaha, Omaha, NE 68182-0149, USA
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74
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Social stratification and allostatic load: shapes of health differences in the MIDUS study in the United States. J Biosoc Sci 2019; 51:627-644. [PMID: 30688190 DOI: 10.1017/s0021932018000378] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Social stratification is an important mechanism of human organization that helps to explain health differences between demographic groups commonly associated with socioeconomic gradients. Individuals, or group of individuals, with similar health profiles may have had different stratification experiences. This is particularly true as social stratification is a significant non-measurable source of systematic unobservable differences in both SES indicators and health statuses of disadvantage. The goal of the present study was to expand the bulk of research that has traditionally treated socioeconomic and demographic characteristics as independent, additive influences on health by examining data from the United States. It is hypothesized that variation in an index of multi-system physiological dysregulation - allostatic load - is associated with social differentiation factors, sorting individuals with similar demographic and socioeconomic characteristics into mutually exclusive econo-demographic classes. The data were from the Longitudinal and Biomarker samples of the national Study of Midlife Development in the US (MIDUS) conducted in 1995 and 2004/2006. Latent class analyses and regression analyses revealed that physiological dysregulation linked to socioeconomic variation among black people, females and older adults are associated with forces of stratification that confound socioeconomic and demographic indicators. In the United States, racial stratification of health is intrinsically related to the degree to which black people in general, and black females in particular, as a group, share an isolated status in society. Findings present evidence that disparities in health emerge from group-differentiation processes to the degree that individuals are distinctly exposed to the ecological, political, social, economic and historical contexts in which social stratification is ingrained. Given that health policies and programmes emanate from said legal and political environments, interventions should target the structural conditions that expose different subgroups to different stress risks in the first place.
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75
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Hantsoo L, Jašarević E, Criniti S, McGeehan B, Tanes C, Sammel MD, Elovitz MA, Compher C, Wu G, Epperson CN. Childhood adversity impact on gut microbiota and inflammatory response to stress during pregnancy. Brain Behav Immun 2019; 75:240-250. [PMID: 30399404 PMCID: PMC6349044 DOI: 10.1016/j.bbi.2018.11.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), such as abuse or chronic stress, program an exaggerated adult inflammatory response to stress. Emerging rodent research suggests that the gut microbiome may be a key mediator in the association between early life stress and dysregulated glucocorticoid-immune response. However, ACE impact on inflammatory response to stress, or on the gut microbiome, have not been studied in human pregnancy, when inflammation increases risk of poor outcomes. The aim of this study was to assess the relationships among ACE, the gut microbiome, and cytokine response to stress in pregnant women. METHODS Physically and psychiatrically healthy adult pregnant women completed the Adverse Childhood Experiences Questionnaire (ACE-Q) and gave a single stool sample between 20 and 26 weeks gestation. Stool DNA was isolated and 16S sequencing was performed. Three 24-hour food recalls were administered to assess dietary nutrient intake. A subset of women completed the Trier Social Stress Test (TSST) at 22-34 weeks gestation; plasma interleukin-6 (IL-6), interleukin-1β (IL-1β), high sensitivity C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), and cortisol were measured at four timepoints pre and post stressor, and area under the curve (AUC) was calculated. RESULTS Forty-eight women completed the ACE-Q and provided stool; 19 women completed the TSST. Women reporting 2 or more ACEs (high ACE) had greater differential abundance of gut Prevotella than low ACE participants (q = 5.7 × 10^-13). Abundance of several gut taxa were significantly associated with cortisol, IL-6, TNF-α and CRP AUCs regardless of ACE status. IL-6 response to stress was buffered among high ACE women with high intake of docosahexaenoic acid (DHA) (p = 0.03) and eicosapentaenoic acid (EPA) (p = 0.05). DISCUSSION Our findings suggest that multiple childhood adversities are associated with changes in gut microbiota composition during pregnancy, and such changes may contribute to altered inflammatory and glucocorticoid response to stress. While preliminary, this is the first study to demonstrate an association between gut microbiota and acute glucocorticoid-immune response to stress in a clinical sample. Finally, exploratory analyses suggested that high ACE women with high dietary intake of ω-3 polyunsaturated fatty acids (PUFAs) had a dampened inflammatory response to acute stress, suggesting potentially protective effects of ω-3s in this high-risk population. Given the adverse effects of inflammation on pregnancy and the developing fetus, mechanisms by which childhood adversity influence the gut-brain axis and potential protective factors such as diet should be further explored.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104, United States.
| | - Eldin Jašarević
- Department of Pharmacology, Center for Epigenetic Research in Child Health and Brain Development, University of Maryland School of Medicine, 670 W Baltimore St. HSF3, 9-173, Baltimore, MD 21201
| | - Stephanie Criniti
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
| | - Brendan McGeehan
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
| | - Ceylan Tanes
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, 19104
| | - Mary D. Sammel
- Department of Biostatistics, Epidemiology and Informatics, The University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, 605 Blockley Hall, Philadelphia, PA 19104
| | - Michal A. Elovitz
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, The University of Pennsylvania Perelman School of Medicine, 421 Curie Blvd., 1354 BRB II/III Philadelphia, PA 19104
| | - Charlene Compher
- Department of Biobehavioral Health Sciences, The University of Pennsylvania School of Nursing, 137 Claire Fagin Hall, Philadelphia, PA 19104
| | - Gary Wu
- Department of Gastroenterology, The University of Pennsylvania Perelman School of Medicine, 915 BRB II/III, 421 Curie Blvd, Philadelphia, PA 19104
| | - C. Neill Epperson
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
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76
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Vásquez E, Udo T, Corsino L, Shaw BA. Racial and Ethnic Disparities in the Association Between Adverse Childhood Experience, Perceived Discrimination and Body Mass Index in a National Sample of U.S. Older Adults. J Nutr Gerontol Geriatr 2019; 38:6-17. [PMID: 30810507 DOI: 10.1080/21551197.2019.1572569] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The current study evaluated whether there were racial/ethnic differences in the association between childhood adverse experience (ACEs), perceived racial discrimination (PRD), and body mass index (BMI) in a sample of middle age and older adults. We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 11,404; ≥55 years) that included ACE and past year experiences with PRD. Generalized linear models were stratified by race/ethnicity (non-Hispanic White (NHW; n = 7337), non-Hispanic Black (NHB; n = 1960), and Hispanic (n = 1249)). The prevalence of ACE and PRD was significantly greater in NHB (63.6 and 29.8%, respectively) and Hispanic (61.2 and 15.9%, respectively), relative to NHW (53.1 and 4.6%, respectively). Across race/ethnicity, exposure to ACE's was associated with significantly greater odds of reporting PRD. Surprisingly, among Hispanics, exposure to ACE's was generally associated with lower BMI; however, this association was moderated by PRD in that BMI was highest among those with no ACE's and PRD, and lowest among those without ACE's or PRD. Similar, but not significant, trends were found for NHW's and NHB's. Our findings highlight the importance of screening for psychosocial adversity across the life course as risks factors for high BMI among middle age and older adults, particularly among Hispanics.
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Affiliation(s)
- Elizabeth Vásquez
- a School of Public Health , University at Albany, State University of New York , New York , NY , USA
| | - Tomoko Udo
- a School of Public Health , University at Albany, State University of New York , New York , NY , USA
| | - Leonor Corsino
- b Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition , Duke School of Medicine , Durham , NC , USA
| | - Benjamín A Shaw
- a School of Public Health , University at Albany, State University of New York , New York , NY , USA
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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78
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Deighton S, Neville A, Pusch D, Dobson K. Biomarkers of adverse childhood experiences: A scoping review. Psychiatry Res 2018; 269:719-732. [PMID: 30273897 DOI: 10.1016/j.psychres.2018.08.097] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences that occur during childhood. Research has demonstrated a link between ACEs and risk of physical and mental health disorders, where early life adversity may become "biologically embedded" and have wide-ranging effects on various physiological systems. The aim of this study was to identify the extent and breadth of recent research activity relating to biological measures of ACEs in adulthood. We undertook a scoping review including published research articles. Medline and PsycINFO were searched for articles from 2007 to July 2017. Articles were eligible if they included adult participants, were written in English, and reported on a biomarker of childhood adversity in adulthood. Forty articles met our inclusion criteria. Studies investigated a range of ACEs that were often measured retrospectively. The studies identified biomarkers related to inflammation (e.g., CRP), cardio/metabolic systems (e.g., BMI), genetics (e.g., telomere length), and endocrine systems (e.g., cortisol), as well as composites of multiple physiological systems. However, not every study identified found significant associations. Health behaviours, emotional distress, social relationships, and socioeconomic factors may help explain some of these associations. Further research is needed to better understand biomarkers of ACEs in adulthood and their relationship to health conditions.
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Affiliation(s)
| | | | - Dennis Pusch
- Southport Psychological Services, Alberta, Calgary, Canada
| | - Keith Dobson
- University of Calgary, Department of Psychology, Alberta, Canada
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79
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Allen JP, Loeb EL, Tan JS, Narr RK, Uchino BN. The body remembers: Adolescent conflict struggles predict adult interleukin-6 levels. Dev Psychopathol 2018; 30:1435-1445. [PMID: 29212559 PMCID: PMC5991989 DOI: 10.1017/s0954579417001754] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Struggles managing conflict and hostility in adolescent social relationships were examined as long-term predictors of immune-mediated inflammation in adulthood that has been linked to long-term health outcomes. Circulating levels of interleukin-6 (IL-6), a marker of immune system dysfunction when chronically elevated, were assessed at age 28 in a community sample of 127 individuals followed via multiple methods and reporters from ages 13 to 28. Adult serum IL-6 levels were predicted across periods as long as 15 years by adolescents' inability to defuse peer aggression and poor peer-rated conflict resolution skills, and by independently observed romantic partner hostility in late adolescence. Adult relationship difficulties also predicted higher IL-6 levels but did not mediate predictions from adolescent-era conflict struggles. Predictions were also not mediated by adult trait hostility or aggressive behavior, suggesting the unique role of struggles with conflict and hostility from others during adolescence. The implications for understanding the import of adolescent peer relationships for life span physical health outcomes are considered.
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80
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Horn SR, Long MM, Nelson BW, Allen NB, Fisher PA, Byrne ML. Replication and reproducibility issues in the relationship between C-reactive protein and depression: A systematic review and focused meta-analysis. Brain Behav Immun 2018; 73:85-114. [PMID: 29928963 PMCID: PMC6800199 DOI: 10.1016/j.bbi.2018.06.016] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022] Open
Abstract
One of the most common inflammatory markers examined in depression is C-reactive protein (CRP). However, the magnitude of the association between CRP and depression when controlling for potentially confounding factors such as age, sex, socio-economic status, body mass index, medication and other substance use, and medical illness, is unclear. Inconsistencies in other methodological practices, such as sample collection, assaying, and data cleaning and transformation, may contribute to variations in results. We aggregate studies that examined the association between CRP and depression in two ways. First, a systematic review summarizes how studies of CRP and depression have reported on methodological issues. Second, a tiered meta-analysis aggregates studies that have adhered to various levels of methodological rigor. Findings from the systematic review indicate a lack of protocol detail provided. The effect between depression and CRP was small, but highly significant across all stages of the meta-analysis (p < 0.01). The effect size in the most methodologically rigorous stage of the meta-analysis, which included studies controlling for age, sex, obesity, medical conditions and substance, medication, or psychosocial factors, was small (r = 0.05). There were also only 26 articles in this stage (13% of studies from the systematic review), suggesting that more studies that consistently account for these confounding factors are needed. Additionally, an a priori quality score of methodological rigor was a significant moderator in this stage of the meta-analysis. The effect size was strikingly attenuated (r = 0.005) and non-significant in studies with higher quality scores. We describe a set of recommended guidelines for future research to consider, including sample collection and assaying procedures, data cleaning and statistical methods, and control variables to assess.
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Affiliation(s)
- Sarah R Horn
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States.
| | - Madison M Long
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States; Leiden University, Faculty of Social and Behavioral Sciences, Pieter de la Court Building, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - Benjamin W Nelson
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Nicholas B Allen
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Philip A Fisher
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Michelle L Byrne
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
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Park J, Flores AJ, Aschbacher K, Mendes WB. When anger expression might be beneficial for African Americans: The moderating role of chronic discrimination. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2018; 24:303-318. [PMID: 29792483 PMCID: PMC6023724 DOI: 10.1037/cdp0000185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Anger expression is assumed to have mostly negative health effects. Yet, evidence is mixed on how anger expression influences African Americans' cardiovascular health. The present research aimed to clarify this link by examining moderating effects of chronic discrimination on the relationship between anger expression and cardiovascular risk among African Americans in experimental (Study 1) and epidemiological (Study 2) studies. METHOD Study 1 examined how African Americans' trait anger expression was linked to (a) physiologic reactivity to acute social rejection during an interracial encounter (Session 1); and (b) total/HDL cholesterol assessed two months later (Session 2). Study 2 examined the relationship between anger expression and total/HDL cholesterol with a larger sample of African Americans from the Midlife in the United States (MIDUS) survey. Both studies examined perceptions of chronic discrimination as a moderator of the relationships between anger expression and biological responses. RESULTS In Study 1 higher anger expression was associated with quicker cortisol recovery and greater testosterone reactivity following outgroup social rejection in Session 1 and lower total/HDL cholesterol in Session 2. Study 2 replicated the relationship between anger expression and lower total/HDL cholesterol and further showed that this relationship was unique to the expressive aspect of anger. Importantly, in both studies, these potentially beneficial effects of anger expression were only evident among individuals with lower perceptions of chronic discrimination. CONCLUSIONS These findings suggest that anger expression, when coupled with low levels of chronic discrimination, is associated with adaptive patterns of physiologic responses among African Americans. (PsycINFO Database Record
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Affiliation(s)
- Jiyoung Park
- School of Behavioral and Brain Sciences, University of Texas at Dallas
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82
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Chu SH, Loucks EB, Kelsey KT, Gilman SE, Agha G, Eaton CB, Buka SL, Huang YT. Sex-specific epigenetic mediators between early life social disadvantage and adulthood BMI. Epigenomics 2018; 10:707-722. [PMID: 29888956 DOI: 10.2217/epi-2017-0146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM The objective of this study was to identify potential epigenetic mediating pathways linking early life social disadvantage (ELSD) to adulthood BMI. METHODS Sex-specific epigenome-wide two-stage mediation analyses were conducted in blood and adipose tissue, and mediation estimates were obtained using cross-product mediation analysis. Pathway analyses were conducted using GREAT software (Bejerano Lab, CA, USA). RESULTS Candidate mediation CpG sites were identified in adipose tissue, but not blood, and were sex-specific. Significant mediation sites in females included CpG loci in genes: PKHG1, BCAR3, ADAM5P, PIEZO1, FGFRL1, FASN and DPP9, among others. Pathway analyses revealed evidence of enrichment for processes associated with TFG-β signaling and immunologic signatures. In males, significant mediation loci included sites in MAP3K5 and RPTOR, which have previously been associated with adipogenesis, inflammation and insulin resistance. CONCLUSION Our findings provide supportive evidence for the mediating role of epigenetic mechanisms in the effect of early life social disadvantage on adulthood BMI.
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Affiliation(s)
- Su H Chu
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA.,Channing Division of Network Medicine, Brigham & Women's Hospital & Harvard Medical School, Boston, MA, 02115, USA
| | - Eric B Loucks
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA
| | - Karl T Kelsey
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA.,Department of Pathology & Laboratory Medicine, Brown University Warren Alpert Medical School, Providence, RI, 02912, USA
| | - Stephen E Gilman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, 20892, USA.,Department of Social & Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Golareh Agha
- Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Charles B Eaton
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA.,Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, RI, 02912, USA
| | - Stephen L Buka
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA
| | - Yen-Tsung Huang
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA.,Department of Biostatistics, Brown School of Public Health, Providence, RI, 02912, USA.,Institute of Statistical Science, Academia Sinica, Taipei, 11529, Taiwan
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83
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When inflammation and depression go together: The longitudinal effects of parent-child relationships. Dev Psychopathol 2018; 29:1969-1986. [PMID: 29162196 DOI: 10.1017/s0954579417001523] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Parent-child relationships have long-term effects on health, particularly later inflammation and depression. We hypothesized that these effects would be mediated by later romantic partner relationships and elevated stressors in young adulthood, helping promote chronic, low grade, inflammation as well as depressive symptoms, and driving their covariation. It has been proposed recently that youth experiencing harsher parenting may also develop a stronger association between inflammation and depressive symptoms in adulthood and altered effects of stressors on outcomes. In the current investigation, we test these ideas using an 18-year longitudinal study of N = 413 African American youth that provides assessment of the parent-child relationship (at age 10), pro-inflammatory cytokine profile and depressive symptoms (at age 28), and potential mediators in early young adulthood (assessed at ages 21 and 24). As predicted, the effect of harsher parent-child relationships (age 10) on pro-inflammatory state and increased depressive symptoms at age 28 were fully mediated through young adult stress and romantic partner relationships. In addition, beyond these mediated effects, parent-child relationships at age 10 moderated the concurrent association between inflammation and depressive symptoms, as well as the prospective association between romantic partner relationships and inflammation, and resulted in substantially different patterns of indirect effects from young adult mediators to outcomes. The results support theorizing that the association of depression and inflammation in young adulthood is conditional on earlier parenting, and suggest incorporating this perspective into models predicting long-term health outcomes.
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84
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More than a feeling: A unified view of stress measurement for population science. Front Neuroendocrinol 2018; 49:146-169. [PMID: 29551356 PMCID: PMC6345505 DOI: 10.1016/j.yfrne.2018.03.001] [Citation(s) in RCA: 524] [Impact Index Per Article: 74.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/01/2018] [Accepted: 03/14/2018] [Indexed: 12/16/2022]
Abstract
Stress can influence health throughout the lifespan, yet there is little agreement about what types and aspects of stress matter most for human health and disease. This is in part because "stress" is not a monolithic concept but rather, an emergent process that involves interactions between individual and environmental factors, historical and current events, allostatic states, and psychological and physiological reactivity. Many of these processes alone have been labeled as "stress." Stress science would be further advanced if researchers adopted a common conceptual model that incorporates epidemiological, affective, and psychophysiological perspectives, with more precise language for describing stress measures. We articulate an integrative working model, highlighting how stressor exposures across the life course influence habitual responding and stress reactivity, and how health behaviors interact with stress. We offer a Stress Typology articulating timescales for stress measurement - acute, event-based, daily, and chronic - and more precise language for dimensions of stress measurement.
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85
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Hazlehurst MF, Nurius PS, Hajat A. Individual and Neighborhood Stressors, Air Pollution and Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E472. [PMID: 29518012 PMCID: PMC5877017 DOI: 10.3390/ijerph15030472] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
Psychosocial and environmental stress exposures across the life course have been shown to be relevant in the development of cardiovascular disease (CVD). Assessing more than one stressor from different domains (e.g., individual and neighborhood) and across the life course moves us towards a more integrated picture of how stress affects health and well-being. Furthermore, these individual and neighborhood psychosocial stressors act on biologic pathways, including immune function and inflammatory response, which are also impacted by ubiquitous environmental exposures such as air pollution. The objective of this study is to evaluate the interaction between psychosocial stressors, at both the individual and neighborhood level, and air pollution on CVD. This study used data from the 2009-2011 Behavioral Risk Factor Surveillance System (BRFSS) from Washington State. Adverse childhood experiences (ACEs) measured at the individual level, and neighborhood deprivation index (NDI) measured at the zip code level, were the psychosocial stressors of interest. Exposures to three air pollutants-particulate matter (both PM2.5 and PM10) and nitrogen dioxide (NO₂)-were also calculated at the zip code level. Outcome measures included several self-reported CVD-related health conditions. Both multiplicative and additive interaction quantified using the relative excess risk due to interaction (RERI), were evaluated. This study included 32,151 participants in 502 unique zip codes. Multiplicative and positive additive interactions were observed between ACEs and PM10 for diabetes, in models adjusted for NDI. The prevalence of diabetes was 1.58 (95% CI: 1.40, 1.79) times higher among those with both high ACEs and high PM10 compared to those with low ACEs and low PM10 (p-value = 0.04 for interaction on the multiplicative scale). Interaction was also observed between neighborhood-level stressors (NDI) and air pollution (NO₂) for the stroke and diabetes outcomes on both multiplicative and additive scales. Modest interaction was observed between NDI and air pollution, supporting prior literature on the importance of neighborhood-level stressors in cardiovascular health and reinforcing the importance of NDI on air pollution health effects. ACEs may exert health effects through selection into disadvantaged neighborhoods and more work is needed to understand the accumulation of risk in multiple domains across the life course.
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Affiliation(s)
- Marnie F Hazlehurst
- Department of Environmental & Occupational Health Sciences and Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Paula S Nurius
- School of Social Work, University of Washington, Seattle, WA 98195, USA.
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
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86
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Chen M, Lacey RE. Adverse childhood experiences and adult inflammation: Findings from the 1958 British birth cohort. Brain Behav Immun 2018; 69:582-590. [PMID: 29458198 DOI: 10.1016/j.bbi.2018.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The relationship between adverse childhood experiences (ACE) and poorer health across the life course is well established. Increased chronic inflammation might be one mechanism through which these associations operate. The aim of this study was to explore the relationship between ACE and adult inflammation using a prospective longitudinal study. We also investigated whether associations were explained by life course socioeconomic, psychological and health behavioural factors, and whether associations differed by gender. METHODS Multiply imputed data on 7464 participants of the National Child Development Study (1958 British birth cohort) were used. Prospectively collected data on ACE included care placement, physical neglect, parental separation, family history of offences, mental illness, domestic conflict and alcohol misuse across childhood (0-16 years). Adult inflammation was indicated by C-reactive protein (CRP), fibrinogen and Von Willebrand factor (vWF) at age 44/45. Multivariable linear regression models were used to estimate associations between ACE and adult inflammation. RESULTS Graded associations for ACE with CRP and fibrinogen were observed (e.g. CRP: 1 ACE: 4.61% higher, 95% CI: -3.13, 12.97; 2+ ACE: 16.35% higher, 95% CI: 6.87, 26.66). Socioeconomic and health behavioral factors were found to particularly explain these associations. After inclusion of all covariates associations between ACE and mid-life inflammation were no longer significant. Associations did not differ for men and women. CONCLUSIONS ACE were associated in a graded manner with adult inflammation in a British birth cohort. The association was explained by life course socioeconomic and health behavioral factors, in particular. This study highlights the importance of protecting children from ACE and its negative health effects, and in supporting children through education and into skilled, secure work.
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Affiliation(s)
- Mingyi Chen
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Rebecca E Lacey
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
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Recalled early life adversity and pain: the role of mood, sleep, optimism, and control. J Behav Med 2018; 41:504-515. [PMID: 29468533 DOI: 10.1007/s10865-018-9917-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 02/14/2018] [Indexed: 01/22/2023]
Abstract
Early life adversity (ELA) has been associated with pain symptomatology in adulthood, but mechanisms and moderators of these associations are unclear. Using recall based and concurrently assessed self-report data, we examined associations between ELA, mood, sleep, and recent pain intensity and interference, and whether optimism and perceived control weakened these associations in a midlife community sample of diverse adults reporting some ELA. Controlling for demographic variables and BMI, higher levels of ELA were associated with more pain intensity and interference; greater sleep disturbance and negative mood accounted for these associations. When moderation was examined, only the path from sleep disturbance to pain interference was significantly attenuated for those with higher optimism and higher perceived control. These findings suggest that higher levels of ELA may link with pain in adulthood through poorer mood and sleep, and that resilience resources such as optimism and control may buffer some of these pathways.
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88
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Roberts AL, Lyall K, Weisskopf MG. Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring. J Autism Dev Disord 2018; 47:1998-2009. [PMID: 28393290 DOI: 10.1007/s10803-017-3115-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.
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Affiliation(s)
- Andrea L Roberts
- Department of Society, Human Development and Health, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Suglia SF, Koenen KC, Boynton-Jarrett R, Chan PS, Clark CJ, Danese A, Faith MS, Goldstein BI, Hayman LL, Isasi CR, Pratt CA, Slopen N, Sumner JA, Turer A, Turer CB, Zachariah JP. Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association. Circulation 2017; 137:e15-e28. [PMID: 29254928 DOI: 10.1161/cir.0000000000000536] [Citation(s) in RCA: 322] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.
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90
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Jones JD, Ehrlich KB, Brett BE, Gross JT, Mohr JJ, Hopper EA, Dinh JV, Malanchuk O, Peck SC, Brodish AB, Adam EK, Eccles JS, Kemeny ME, Cassidy J. Perceptions of parental secure base support in African American adolescents and young adults: A preliminary study of predictive links to adult C-reactive protein. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2017; 34:1168-1185. [PMID: 36714796 PMCID: PMC9881587 DOI: 10.1177/0265407516670532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Within the field of relationship science there is increasing interest in the connections between close relationships and physical health. In the present study, we examined whether adolescents' (~12 years old) and young adults' (~20 years old) perceptions of their parents as a secure base prospectively predict C-reactive protein (CRP), a commonly used marker of inflammatory activity, at age 32 in a well-characterized sample of African Americans. We utilized existing data collected as part of the Maryland Adolescent Development in Context Study (MADICS) to construct measures of perceptions of parental secure base support (SBS), general parental support, and peer support in early adolescence and early adulthood. In the present study, SBS was operationalized as the perceived ability to depend on parents in times of need. Fifty-nine African American MADICS participants who reported on perceived support in early adolescence and early adulthood participated in a follow-up home visit at age 32 during which serum CRP was measured via a blood draw. After controlling for inflammation-related confounds (e.g., tobacco use, body mass index), adolescents' perceptions of parental SBS, but not peer support or general parental support, predicted lower CRP values at age 32 (b = -.92, SE = .34, p < .05). None of the support variables in early adulthood predicted CRP at 32 years. This study adds to a growing literature on relationships and health-related outcomes and provides the first evidence for a link between parental SBS in adolescence and a marker of inflammatory activity in adulthood.
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91
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Mitchell AM, Porter K, Christian LM. Examination of the role of obesity in the association between childhood trauma and inflammation during pregnancy. Health Psychol 2017; 37:114-124. [PMID: 28967771 DOI: 10.1037/hea0000559] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Childhood trauma is associated with negative perinatal health outcomes including mood disorders and shorter gestation. However, effects of early life exposures on maternal biology are poorly delineated. This study examined associations between childhood trauma and inflammation, as well as the mediating role of obesity in this relationship. METHOD This study examined a racially diverse sample of 77 pregnant women assessed in early, mid, and late pregnancy. Assessments included the Childhood Trauma Questionnaire, Center for Epidemiologic Studies-Depression Scale, serum CRP, IL-6, and TNF-α, and prepregnancy BMI. RESULTS Per linear mixed models, while no direct relationships were observed between childhood trauma with IL-6 or TNF-α, physical (95% CI: 0.007, 0.080) and emotional (95% CI: 0.005, 0.046) abuse as well as emotional neglect (95% CI: 0.010, 0.051) predicted elevated CRP. Effects remained after adjustment for race, income, education, smoking status, medical conditions, and depressive symptoms. PROCESS analyses showed BMI mediated the relationship between physical abuse and both serum CRP (95% CI: 0.014, 0.062) and IL-6 (95% CI: 0.009, 0.034). CONCLUSIONS Exposure to childhood trauma, particularly emotional abuse, physical abuse, and emotional neglect, is associated with inflammation in pregnant women. Obesity served as 1 pathway by which physical abuse contributed to elevations in serum CRP and IL-6. Interventions targeting maternal obesity prior to pregnancy may help mitigate the effects of childhood trauma on perinatal health. These findings have relevance for understanding biological and behavioral pathways by which early life exposures contribute to maternal health. (PsycINFO Database Record
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Affiliation(s)
- Amanda M Mitchell
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University
| | - Lisa M Christian
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center
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92
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Bleil ME, Booth-LaForce C, Benner AD. Race disparities in pubertal timing: Implications for cardiovascular disease risk among African American women. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:717-738. [PMID: 30127541 PMCID: PMC6097246 DOI: 10.1007/s11113-017-9441-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Compared to white girls, sexual maturation is accelerated in African American girls as measured by indicators of pubertal development, including age at first menses. Increasing epidemiological evidence suggests that the timing of pubertal development may have strong implications for cardio-metabolic health in adolescence and adulthood. In fact, younger menarcheal age has been related prospectively to poorer cardiovascular risk factor profiles, a worsening of these profiles over time, and an increase in risk for cardiovascular events, including non-fatal incident cardiovascular disease and cardiovascular-specific and all-cause mortality. Yet, because this literature has been limited almost exclusively to white girls/women, whether this same association is present among African American girls/women has not been clarified. In the current narrative review, the well-established vulnerability of African American girls to experience earlier pubertal onset is discussed as are findings from literatures examining the health outcomes of earlier pubertal timing and its antecedents, including early life adversity exposures often experienced disproportionately in African American girls. Gaps in these literatures are highlighted especially with respect to the paucity of research among minority girls/women, and a conceptual framework is posited suggesting disparities in pubertal timing between African American and white girls may partially contribute to well-established disparities in adulthood risk for cardio-metabolic disease between African American and white women. Future research in these areas may point to novel areas for intervention in preventing or lessening the heightened cardio-metabolic risk among African American women, an important public health objective.
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Affiliation(s)
- Maria E. Bleil
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Cathryn Booth-LaForce
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Aprile D. Benner
- Human Development and Family Sciences, University of Texas at Austin, Box G1800, Austin, TX 78712, USA
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93
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Lee C, Coe CL, Ryff CD. Social Disadvantage, Severe Child Abuse, and Biological Profiles in Adulthood. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2017; 58:371-386. [PMID: 29353512 PMCID: PMC5783196 DOI: 10.1177/0022146516685370] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Guided by the stress process model and the life course perspective, we hypothesize: (1) that childhood abuse is concentrated, in terms of type and intensity, among socially disadvantaged individuals, and (2) that experiencing serious abuse contributes to poor biological profiles in multiple body systems in adulthood. Data came from the Biomarker subsample of Midlife in the United States (2004-2006). We used latent class analysis to identify distinct profiles of childhood abuse, each reflecting a combination of type and severity. Results indicate that disadvantaged groups, women, and those from disadvantaged families are at greater risk of experiencing more severe and multiple types of abuse. Those with more severe and multifaceted childhood abuse show greater physiological dysregulation. Childhood abuse experiences partially accounted for the social status differences in physiological profiles. Our findings underscore that differential exposure to serious childhood stressors plays a significant role in gender and class inequalities in adult health.
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Affiliation(s)
- Chioun Lee
- 1 University of Wisconsin-Madison, Madison, WI, USA
| | | | - Carol D Ryff
- 1 University of Wisconsin-Madison, Madison, WI, USA
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94
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Childhood adversities and chronic conditions: examination of mediators, recall bias and age at diagnosis. Int J Public Health 2017; 63:181-192. [PMID: 28736801 DOI: 10.1007/s00038-017-1021-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The aim of this study was to (1) identify the influence of childhood socioeconomic status (CSES) on five chronic conditions: asthma, bronchitis, hypothyroid, migraine, and psychiatric disorders in later life; (2) determine the mediating role of childhood abuse (CA) in these associations, and (3) quantify recall bias due to respondent's mental health in these associations. METHODS 10,325 men and women from the Tromsø Study were followed for 13 years, and Poisson regression models were used. RESULTS Low CSES was associated with a 16-23% higher risk of chronic conditions, and CA was associated with a 16-58% higher risk of chronic conditions (p < 0.05). A minor proportion of the association between CSES and CA (3.98%, p < 0.05); CSES and chronic conditions (5.54-8.71%, p < 0.05); and CA and chronic conditions (9.51-19.52%, p < 0.05), were driven by recall bias due to the respondent's mental health. CA mediated the association between CSES and chronic conditions (9.58-25.06%, p < 0.05). CONCLUSIONS Low CSES and CA are associated with higher risk of chronic conditions in later life. A minor proportion of these associations are driven by recall bias.
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95
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Cahill CR, Webb Girard A, Giddens J. Attitudes and behaviors of food pantry directors and perceived needs and wants of food pantry clients. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017. [DOI: 10.1080/19320248.2017.1315327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Caroline R. Cahill
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Amy Webb Girard
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Jonker I, Rosmalen JGM, Schoevers RA. Childhood life events, immune activation and the development of mood and anxiety disorders: the TRAILS study. Transl Psychiatry 2017; 7:e1112. [PMID: 28463238 PMCID: PMC5534944 DOI: 10.1038/tp.2017.62] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/09/2016] [Accepted: 02/10/2017] [Indexed: 12/11/2022] Open
Abstract
The experience of childhood life events is associated with higher vulnerability to develop psychiatric disorders. One of the pathways suggested to lead to this vulnerability is activation of the immune system. The aim of this study is to find out whether the association between childhood life events and the development of mood and anxiety disorders is predicted by the activation of the immune system. This study was performed in TRAILS, a large prospective population cohort, from which a subgroup was selected (N=1084, 54.3% female, mean age 19.0 (s.d., 0.6)). Childhood life events before age 16 were assessed using questionnaires at age 12, 14, 16 and 19. Immune activation was assessed at age 16 by elevated high-sensitive C-reactive protein (hsCRP) and by levels of immunoglobulin G antibodies against the herpes viruses herpes simplex virus 1, cytomegalovirus and Epstein-Barr virus. At age 19, the presence of mood and anxiety disorders was determined using the World Health Organization Composite International Diagnostic Interview Version 3.0. Regression analyses were used to study the association between life events, the inflammatory markers and mental health. We found that childhood life events score was associated with risk of mood disorders (B=0.269, P<0.001) and anxiety disorders (B=0.129, P<0.001). Childhood life events score was marginally associated with elevated hsCRP (B=0.076, P=0.006), but not with the antibody levels. This was especially due to separation trauma (P=0.015) and sexual abuse (P=0.019). Associations lost significance after correcting for lifestyle factors such as body mass index and substance abuse (P=0.042). None of the inflammatory markers were associated with development of anxiety disorders or mood disorders. In conclusion, the life event scores predicted the development of anxiety disorders and mood disorders at age 19. Life event scores were associated with elevated hsCRP, which was partly explained by lifestyle factors. Elevated hsCRP was not associated with the development of psychiatric disorders at age 19.
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Affiliation(s)
- I Jonker
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), Hanzeplein 1, Postbus 30.001, Groningen 9700 RB, The Netherlands. E-mail:
| | - J G M Rosmalen
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R A Schoevers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Abstract
OBJECTIVE Identifying the life course health effects of childhood adversity is a burgeoning area of research, particularly in relation to cardiovascular disease (CVD). However, adversity measurement varies widely across studies, which may hamper our ability to make comparisons across studies and identify mechanisms linking adversity to CVD. The purposes of this review are to summarize adversity measurement approaches in the context of CVD, identify gaps, and make recommendations for future research. METHODS PubMed and PsycINFO searches were conducted through June 2016. Studies were selected if CVD end point or predisease risk markers were investigated in association with a measure of childhood adversity. Forty-three studies were reviewed. A meta-analysis was not conducted because of the variation in exposures and outcomes assessed. RESULTS Adversity measurement was heterogeneous across studies. Metrics included different sets of adverse events, relational factors, and socioeconomic indicators. Thirty-seven percent measured childhood adversity prospectively, 23% examined a CVD end point, and 77% treated adversity as an unweighted summary score. Despite the heterogeneity in measurement, most studies found a positive association between childhood adversity and CVD risk, and the association seems to be dose-response. CONCLUSIONS The literature on childhood adversity and CVD would benefit from improving consistency of measurement, using weighted adversity composites, modeling adversity trajectories over time, and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score. We suggest conceptual and analytic strategies to enhance, refine, and replicate the observed association between childhood adversity and CVD risk.
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98
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Parker W, Hornik CD, Bilbo S, Holzknecht ZE, Gentry L, Rao R, Lin SS, Herbert MR, Nevison CD. The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism. J Int Med Res 2017; 45:407-438. [PMID: 28415925 PMCID: PMC5536672 DOI: 10.1177/0300060517693423] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The wide range of factors associated with the induction of autism is invariably linked with either inflammation or oxidative stress, and sometimes both. The use of acetaminophen in babies and young children may be much more strongly associated with autism than its use during pregnancy, perhaps because of well-known deficiencies in the metabolic breakdown of pharmaceuticals during early development. Thus, one explanation for the increased prevalence of autism is that increased exposure to acetaminophen, exacerbated by inflammation and oxidative stress, is neurotoxic in babies and small children. This view mandates extreme urgency in probing the long-term effects of acetaminophen use in babies and the possibility that many cases of infantile autism may actually be induced by acetaminophen exposure shortly after birth.
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Affiliation(s)
- William Parker
- 1 Departments of Surgery, Duke University Medical Center, Durham, NC USA
| | - Chi Dang Hornik
- 2 Departments of Pediatrics, Duke University Medical Center, Durham, NC USA
| | - Staci Bilbo
- 3 Departments of Pediatrics, Harvard Medical School, Charlestown, MA, USA
| | - Zoie E Holzknecht
- 1 Departments of Surgery, Duke University Medical Center, Durham, NC USA
| | - Lauren Gentry
- 1 Departments of Surgery, Duke University Medical Center, Durham, NC USA
| | - Rasika Rao
- 1 Departments of Surgery, Duke University Medical Center, Durham, NC USA
| | - Shu S Lin
- 1 Departments of Surgery, Duke University Medical Center, Durham, NC USA
| | - Martha R Herbert
- 4 Departments of Neurology, Harvard Medical School, Charlestown, MA, USA
| | - Cynthia D Nevison
- 5 Institute for Arctic and Alpine Research, University of Colorado, Boulder, Boulder, CO, USA
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Janusek LW, Tell D, Gaylord-Harden N, Mathews HL. Relationship of childhood adversity and neighborhood violence to a proinflammatory phenotype in emerging adult African American men: An epigenetic link. Brain Behav Immun 2017; 60:126-135. [PMID: 27765646 DOI: 10.1016/j.bbi.2016.10.006] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/09/2016] [Accepted: 10/09/2016] [Indexed: 12/25/2022] Open
Abstract
African American men (AAM) who are exposed to trauma and adversity during their early life are at greater risk for poor health over their lifespan. Exposure to adversity during critical developmental windows may embed an epigenetic signature that alters expression of genes that regulate stress response systems, including those genes that regulate the inflammatory response to stress. Such an epigenetic signature may increase risk for diseases exacerbated by inflammation, and may contribute to health disparity. The purpose of this study was to evaluate the extent to which exposure to early life adversity influences the psychological, cortisol, and proinflammatory response to acute stress (Trier Social Stress Test - TSST) in emerging adult AAM, ages 18-25years (N=34). Hierarchical linear modeling was used to examine the cortisol and IL-6 pattern of response to the TSST with respect to childhood adversity factors and DNA methylation of the IL-6 promoter. Findings revealed that in response to the TSST, greater levels of childhood trauma and indirect exposure to neighborhood violence were associated with a greater TSST-induced IL-6 response, and a blunted cortisol response. Reduced methylation of the IL6 promoter was related to increased exposure to childhood trauma and greater TSST-induced IL-6 levels. These results support the concept that exposure to childhood adversity amplifies the adult proinflammatory response to stress, which is related to epigenetic signature.
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Affiliation(s)
- Linda Witek Janusek
- Marcella Niehoff School of Nursing, Department of Health Promotion, Loyola University Chicago, Health Science Division, 2160 South First Ave., Maywood, IL 60153, United States.
| | - Dina Tell
- Marcella Niehoff School of Nursing, Department of Health Promotion, Loyola University Chicago, Health Science Division, 2160 South First Ave., Maywood, IL 60153, United States
| | - Noni Gaylord-Harden
- Department of Psychology, Loyola University Chicago, College of Arts and Sciences, 1032 West Sheridan Road, Chicago, IL 60660, United States
| | - Herbert L Mathews
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Health Science Division, 2160 South First Ave., Maywood, IL 60153, United States
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Maharaj NR, Phulukdaree A, Nagiah S, Ramkaran P, Tiloke C, Chuturgoon AA. Pro-Inflammatory Cytokine Levels in HIV Infected and Uninfected Pregnant Women with and without Preeclampsia. PLoS One 2017; 12:e0170063. [PMID: 28095491 PMCID: PMC5240954 DOI: 10.1371/journal.pone.0170063] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 12/28/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Preeclampsia and HIV/AIDS are inflammatory conditions that contribute significantly to adverse maternal and foetal outcomes. The immune reconstitution effects of HAART on inflammatory mediators has not been adequately studied in pregnancy and may impact on the inflammatory cytokine network in women with co-morbid preeclampsia. Our study evaluated changes in pro-inflammatory cytokines IL-2, TNF-α, IFN-γ and IL-6 in HIV infected preeclamptic women on HAART. METHODS A prospective experimental study was conducted at Prince Mshiyeni Memorial Hospital between July 2013 and September 2014. One hundred and ninety three pregnant women were recruited into 4 groups: uninfected normotensive (50; 26%), infected normotensive (45; 23%), uninfected preeclamptic (53; 28%) and infected preeclamptic women (45; 23%). Serum levels of cytokines TNF-α, IFN- γ, IL-2 and IL-6 were determined using commercially available kits and a Cytometric Bead Array (CBA). Comparative data was recorded and analysed descriptively. RESULTS In the control groups (normotensive), significantly lower values were found in IL-2 (p = 0.010), TNF-α (p = 0.045), and IL-6 (p = 0.005); and a non-significant decrease was observed in IFN-γ (p = 0.345) in HIV infected women on HAART compared to uninfected controls. In the experimental group (preeclamptic) women, significantly reduced levels were observed in IL-2 and TNF-α (p = 0.001; p = 0.000) and non-significant decreases were observed in IFN-γ and IL-6 (p = 0.023; p = 0.086) in HIV infected women on HAART compared with uninfected preeclamptic women. Non-significant differences were observed between uninfected preeclamptic and normotensive women. CONCLUSION In uncomplicated/normotensive pregnancies, HIV/HAART is associated with significant decreases in IL-2, TNF-α and IL-6, and in preeclamptic women significant decreases in IL-2 and TNF-α were observed. These findings suggest that HIV/HAART impacts on pro-inflammatory cytokines in women with co-morbid preeclampsia. This provides a platform for further research on immune reconstitution effects of HAART during pregnancy, and the development of potential immune modulation therapies for the management of preeclampsia.
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Affiliation(s)
- Niren Ray Maharaj
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
- Discipline of Medical Biochemistry, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Alisa Phulukdaree
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
| | - Savania Nagiah
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
| | - Prithiksha Ramkaran
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
| | - Charlette Tiloke
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
| | - Anil Amichund Chuturgoon
- Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa
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