title: Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis.
abstract: Exposure to psychological trauma (for example, childhood/early life adversity, exposure to violence or assault, combat exposure, accidents or natural disasters) is known to increase one's risk of developing certain chronic medical conditions. Clinical and population studies provide evidence of systemic inflammatory activity in trauma survivors with various psychiatric and nonpsychiatric conditions. This transdiagnostic meta-analysis quantitatively integrates the literature on the relationship of inflammatory biomarkers to trauma exposure and related symptomatology. We conducted random effects meta-analyses relating trauma exposure to log-transformed inflammatory biomarker concentrations, using meta-regression models to test the effects of study quality and psychiatric symptomatology on the inflammatory outcomes. Across k=36 independent samples and n=14,991 participants, trauma exposure was positively associated with C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α (mean rs =0.2455, 0.3067, 0.2890, and 0.2998, respectively). No significant relationships were noted with fibrinogen, IL-2, IL-4, IL-8, or IL-10. In meta-regression models, the presence of psychiatric symptoms was a significant predictor of increased effect sizes for IL-1β and IL-6 (β=1.0175 and 0.3568, respectively), whereas study quality assessment scores were associated with increased effect sizes for IL-6 (β=0.3812). Positive correlations between inflammation and trauma exposure across a range of sample types and diagnoses were found. Although reviewed studies spanned an array of populations, research on any one specific psychiatric diagnosis was generally limited to one or two studies. The results suggest that chronic inflammation likely represents one potential mechanism underlying risk of health problems in trauma survivors.
authors: Department of Psychiatry, University of Western Ontario, London, ON, Canada.
authors: M
authors: M
authors: Tursich
authors: 1] Department of Psychiatry, University of Western Ontario, London, ON, Canada [2] Department of Psychology, University of Western Ontario, London, ON, Canada [3] Department of Neuroscience, University of Western Ontario, London, ON, Canada.
authors: R W J
authors: RW
authors: Neufeld
authors: 1] Department of Psychiatry, University of Western Ontario, London, ON, Canada [2] Department of Psychology, University of Western Ontario, London, ON, Canada [3] Department of Neuroscience, University of Western Ontario, London, ON, Canada.
authors: P A
authors: PA
authors: Frewen
authors: Department of Biology, University of Western Ontario, London, ON, Canada.
authors: S
authors: S
authors: Harricharan
authors: Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL, USA.
authors: J L
authors: JL
authors: Kibler
authors: Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada.
authors: S G
authors: SG
authors: Rhind
authors: 1] Department of Psychiatry, University of Western Ontario, London, ON, Canada [2] Department of Neuroscience, University of Western Ontario, London, ON, Canada.
authors: R A
authors: RA
authors: Lanius
mesh_terms: D002097:C-Reactive Protein; D016207:Cytokines; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D008016:Life Change Events; D040921:Stress Disorders, Traumatic / Q000276:immunology*; D017741:Survivors
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein