Biological Burden of Adverse Childhood Experiences in Children. Issue 2 (5th February 2023)

• Record Type: Journal Article
• Authors: de la Rosa, Rosemarie; Zablotny, David; Ye, Morgan; Bush, Nicole R.; Hessler, Danielle; Koita, Kadiatou; Bucci, Monica; Long, Dayna; Thakur, Neeta
• Is Part Of: Psychosomatic medicine. Volume 85:Issue 2(2023)
• Page Start: 108
• Page End: 117
• Publication Date: 2023-02-05
• Subjects: adversity -- allostatic load -- pediatric -- mental illness -- health -- obesity -- ACE = adverse childhood experience -- AL = Allostatic load -- DBP = diastolic blood pressure -- ET-1 = endothelial-1 -- HPA = hypothalamic-pituitary-adrenal -- IGFBP-1 = insulin-like growth factor–binding protein 1 -- IGFBP-3 = insulin-like growth factor–binding protein 3 -- IL-1β = interleukin 1β -- IL-6 = interleukin 6 -- IL-8 = interleukin 8 -- IL-10 = interleukin 10 -- IRR = incidence rate ratio -- PEARLS = PEdiatric ACEs and Related Life Event Screener -- PROMIS PGH-7 = Patient-Reported Outcomes Measurement Information System Parent-Proxy Pediatric Global Health Measure -- RHR = resting heart rate -- SBP = systolic blood pressure -- SD = standard deviation -- TNF-α = tumor necrosis factor α; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000001167
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: This study aimed to examine relationships between adverse childhood experiences (ACEs) and related life events and allostatic load (AL)—"wear and tear" from chronic stress—in a pediatric population. Methods: Children were screened with the PEdiatric ACEs and Related Life Event Screener (PEARLS) tool, a 17-item questionnaire capturing experiences of abuse, neglect, household challenges, and related life events. Biological data were available for 207 participants, and AL was operationalized using clinical or empirical cutoff points across 4 physiological systems (i.e., cardiac, metabolic, inflammatory, neurologic). Covariate-adjusted multivariable regression models were used to examine associations between AL with adversity and health. Results: Children (mean age = 6.5 years, range = 1–11 years) had an average AL score of 1.9 (standard deviation = 1.7), and a U-shaped relationship was observed with child's age. Continuous PEARLS and original ACE scores were not associated with AL. However, children with a reported PEARLS score of 1 to 2 or original ACEs score of 1 to 3 had 1.5 (incidence rate ratio [IRR] = 1.50, 95% confidence interval [CI] = 1.09–2.08) and 1.4 (IRR = 1.41, 95% CI = 1.08–1.84) times greater AL, respectively, compared with participants with none reported. In secondary analyses, caregiver mental illness was associated with higher child AL (adjusted IRR = 1.27, 95% CI = 1.01–1.58). AL was also associated with poorer perceived child general health (adjusted β = −0.87, 95% CI = −1.58 to −0.15) and greater odds of child obesity (adjusted odds ratio = 1.51, 95% CI = 1.23–1.89). Conclusions: Measuring AL in a pediatric population requires careful consideration of age. Higher AL was associated with a greater number of reported adversities and worse child health.