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Erschienen in: Current Psychiatry Reports 11/2015

01.11.2015 | Women's Mental Health (CN Epperson, Section Editor)

The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women

verfasst von: Nils C. Westfall, Charles. B. Nemeroff

Erschienen in: Current Psychiatry Reports | Ausgabe 11/2015

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Abstract

Early life trauma (ELT) comprises an array of disturbingly common distressing experiences between conception and the beginning of adulthood with numerous and significant potential long-term, even transgenerational, health consequences of great public health concern, including depression, cardiovascular disease, and other psychiatric and medical disorders, and neurobiological, psychological, and behavioral effects which are sufficiently robust to confound many types of biomedical research. The impact of ELT on a woman’s health trajectory appears to vary with the specific characteristics of the ELT (e.g., type, number of different types, severity, and timing), the individual (e.g., age, genetics, epigenetics, personality, and cognitive factors), and the individual’s environment (e.g., level of social support and ongoing stressors) and to be mediated to a significant extent by persistent changes in a number of biological systems, dysregulation of those governing the stress response chief among them. Growing knowledge of the risk factors and pathophysiological mechanisms by which ELT confers diathesis to various poor health outcomes and the unique treatment–response profiles of women with ELT will lead to much needed improvements in prevention, diagnostic, and therapeutic efforts, including more effective psychotherapy and pharmacotherapy approaches, hopefully making strides toward improvements in the lives of women everywhere and ending countless cycles of intergenerational trauma-associated pathology. This article attempts to broadly summarize the current state of knowledge about the long-term sequelae of ELT for women’s health.
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Zurück zum Zitat Khan A, McCormack HC, Bolger EA, McGreenery CE, Vitaliano G, Polcari A, et al. Childhood maltreatment, depression, and suicidal ideation: critical importance of parental and peer emotional abuse during developmental sensitive periods in males and females. Front Psychiatry. 2015;6:42. The authors conducted a cross-sectional study of 18–25 year olds to determine the effects of 10 different types of ELT occurring at different ages, providing robust evidence for modality-specific sensitive exposure periods when maltreatment maximally impacts risk for MDD, current symptoms of depression, and degree of suicidal ideation. The results highlighted the relative importance of peer and parental emotional maltreatment – insults often assumed to be significantly less noxious than physical and sexual abuse – among the various types of ELTs in terms of conferring risk of psychopathology. They also supported the hypothesis that there are early and late sensitive periods and that experiencing specific types of ELT during particular sensitive periods may be as or more important than cumulative stress exposure. The generalizability of the results to victims of ELT older than 25 years old was limited by the narrow age range of the subjects, a problem that should be addressed in future studies. PubMedCentralPubMed Khan A, McCormack HC, Bolger EA, McGreenery CE, Vitaliano G, Polcari A, et al. Childhood maltreatment, depression, and suicidal ideation: critical importance of parental and peer emotional abuse during developmental sensitive periods in males and females. Front Psychiatry. 2015;6:42. The authors conducted a cross-sectional study of 18–25 year olds to determine the effects of 10 different types of ELT occurring at different ages, providing robust evidence for modality-specific sensitive exposure periods when maltreatment maximally impacts risk for MDD, current symptoms of depression, and degree of suicidal ideation. The results highlighted the relative importance of peer and parental emotional maltreatment – insults often assumed to be significantly less noxious than physical and sexual abuse – among the various types of ELTs in terms of conferring risk of psychopathology. They also supported the hypothesis that there are early and late sensitive periods and that experiencing specific types of ELT during particular sensitive periods may be as or more important than cumulative stress exposure. The generalizability of the results to victims of ELT older than 25 years old was limited by the narrow age range of the subjects, a problem that should be addressed in future studies. PubMedCentralPubMed
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Zurück zum Zitat Lehrner A, Bierer LM, Passarelli V, Pratchett LC, Flory JD, Bader HN, et al. Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors. Psychoneuroendocrinology. 2014;40:213–20.PubMedCentralPubMedCrossRef Lehrner A, Bierer LM, Passarelli V, Pratchett LC, Flory JD, Bader HN, et al. Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors. Psychoneuroendocrinology. 2014;40:213–20.PubMedCentralPubMedCrossRef
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Zurück zum Zitat Juul SH, Hendrix C, Robinson B, Stowe ZN, Newport DJ, Brennan PA, et al. Maternal early-life trauma and affective parenting style: the mediating role of HPA-axis function. Arch Womens Ment Health. 2015. doi:10.1007/s00737-015-0528-x. The authors found that a mother’s history of ELT was significantly associated with a greater tendency toward exhibiting a neutral affect and a decreased cortisol response during interactions with her 6-month-old infant. The tendency toward exhibiting neutral affect during mother-infant interactions was partially mediated by the mother’s mean cortisol level, which was inversely related to her history of ELT. Past or present symptoms of depression did not mediate these associations. The results add to the growing literature demonstrating the deleterious effects of ELT on mothering behaviors, demonstrate that some of these effects may be mediated by persistent changes in the HPA axis, and suggest that some of these effects on the outcomes of her offspring act independently of any diagnosable psychopathology (e.g. depression, PTSD) that she may have and so require separate targeted interventions. PubMed Juul SH, Hendrix C, Robinson B, Stowe ZN, Newport DJ, Brennan PA, et al. Maternal early-life trauma and affective parenting style: the mediating role of HPA-axis function. Arch Womens Ment Health. 2015. doi:10.​1007/​s00737-015-0528-x. The authors found that a mother’s history of ELT was significantly associated with a greater tendency toward exhibiting a neutral affect and a decreased cortisol response during interactions with her 6-month-old infant. The tendency toward exhibiting neutral affect during mother-infant interactions was partially mediated by the mother’s mean cortisol level, which was inversely related to her history of ELT. Past or present symptoms of depression did not mediate these associations. The results add to the growing literature demonstrating the deleterious effects of ELT on mothering behaviors, demonstrate that some of these effects may be mediated by persistent changes in the HPA axis, and suggest that some of these effects on the outcomes of her offspring act independently of any diagnosable psychopathology (e.g. depression, PTSD) that she may have and so require separate targeted interventions. PubMed
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Metadaten
Titel
The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women
verfasst von
Nils C. Westfall
Charles. B. Nemeroff
Publikationsdatum
01.11.2015
Verlag
Springer US
Erschienen in
Current Psychiatry Reports / Ausgabe 11/2015
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-015-0625-6

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