1. Arch Pediatr Adolesc Med. 2009 Dec;163(12):1135-43.

Adverse childhood experiences and adult risk factors for age-related disease:
depression, inflammation, and clustering of metabolic risk markers.

Danese A, Moffitt TE, Harrington H, Milne BJ, Polanczyk G, Pariante CM, Poulton
R, Caspi A.

Social, Genetic, and Developmental Psychiatry Centre, Department of Psychology
and Neuroscience, Duke University, Durham, NC 27708, USA.

OBJECTIVE: To understand why children exposed to adverse psychosocial experiences
are at elevated risk for age-related disease, such as cardiovascular disease, by
testing whether adverse childhood experiences predict enduring abnormalities in
stress-sensitive biological systems, namely, the nervous, immune, and
endocrine/metabolic systems.
DESIGN: A 32-year prospective longitudinal study of a representative birth
cohort.
SETTING: New Zealand.
PARTICIPANTS: A total of 1037 members of the Dunedin Multidisciplinary Health and
Development Study. Main Exposures During their first decade of life, study
members were assessed for exposure to 3 adverse psychosocial experiences:
socioeconomic disadvantage, maltreatment, and social isolation.
MAIN OUTCOME MEASURES: At age 32 years, study members were assessed for the
presence of 3 age-related-disease risks: major depression, high inflammation
levels (high-sensitivity C-reactive protein level >3 mg/L), and the clustering of
metabolic risk biomarkers (overweight, high blood pressure, high total
cholesterol, low high-density lipoprotein cholesterol, high glycated hemoglobin,
and low maximum oxygen consumption levels.
RESULTS: Children exposed to adverse psychosocial experiences were at elevated
risk of depression, high inflammation levels, and clustering of metabolic risk
markers. Children who had experienced socioeconomic disadvantage (incidence rate
ratio, 1.89; 95% confidence interval, 1.36-2.62), maltreatment (1.81; 1.38-2.38),
or social isolation (1.87; 1.38-2.51) had elevated age-related-disease risks in
adulthood. The effects of adverse childhood experiences on age-related-disease
risks in adulthood were nonredundant, cumulative, and independent of the
influence of established developmental and concurrent risk factors.
CONCLUSIONS: Children exposed to adverse psychosocial experiences have enduring
emotional, immune, and metabolic abnormalities that contribute to explaining
their elevated risk for age-related disease. The promotion of healthy
psychosocial experiences for children is a necessary and potentially
cost-effective target for the prevention of age-related disease.


PMID: 19996051 [PubMed - indexed for MEDLINE]