title: Associations of childhood adversity and adulthood trauma with C-reactive protein: A cross-sectional population-based study.
abstract: Mounting evidence highlights specific forms of psychological stress as risk factors for ill health. Particularly strong evidence indicates that childhood adversity and adulthood trauma exposure increase risk for physical and psychiatric disorders, and there is emerging evidence that inflammation may play a key role in these relationships. In a population-based sample from the Health and Retirement Study (n=11,198, mean age 69 ± 10), we examine whether childhood adversity, adulthood trauma, and the interaction between them are associated with elevated levels of the systemic inflammatory marker high sensitivity C-reactive protein (hsCRP). All models were adjusted for age, gender, race, education, and year of data collection, as well as other possible confounds in follow-up sensitivity analyses. In our sample, 67% of individuals had experienced at least one traumatic event during adulthood, and those with childhood adversity were almost three times as likely to have experienced trauma as an adult. Childhood adversities and adulthood traumas were independently associated with elevated levels of hsCRP (β=0.03, p=0.01 and β=0.05, p<0.001, respectively). Those who had experienced both types of stress had higher levels of hsCRP than those with adulthood trauma alone, Estimate=-0.06, 95% CI [-0.003, -0.12], p=0.04, but not compared to those with childhood adversity alone, Estimate=-0.06, 95% CI [0.03, -0.16], p=0.19. There was no interaction between childhood and adulthood trauma exposure. To our knowledge, this is the first study to examine adulthood trauma exposure and inflammation in a large population-based sample, and the first to explore the interaction of childhood adversity and adulthood trauma with inflammation. Our study demonstrates the prevalence of trauma-related inflammation in the general population and suggests that childhood adversity and adulthood trauma are independently associated with elevated inflammation.
authors.affiliation: School of Medicine, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, United States; San Francisco Veteran's Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, United States. Electronic address: joy.lin@ucsf.edu.
authors.forename: Joy E
authors.initials: JE
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, United States; San Francisco Veteran's Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, United States. Electronic address: thomas.neylan@ucsf.edu.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, United States. Electronic address: elissa.epel@ucsf.edu.
authors.forename: Elissa
authors.initials: E
authors.lastname: Epel
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, United States; San Francisco Veteran's Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, United States. Electronic address: aoife.odonovan@ucsf.edu.
authors.forename: Aoife
authors.initials: A
authors.lastname: O'Donovan
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000097:blood* / Q000453:epidemiology; D000068099:Trauma and Stressor Related Disorders / Q000097:blood* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Adulthood trauma; C-reactive protein; Childhood adversity; Immune system; Inflammation