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The Long-Term Impact of Early Adversity on Late-Life Psychiatric Disorders

  • Geriatric Disorders (H Lavretsky, Section Editor)
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Abstract

Early adversity is a strong and enduring predictor of psychiatric disorders including mood disorders, anxiety disorders, substance abuse or dependence, and posttraumatic stress disorder. However, the mechanisms of this effect are not well understood. The purpose of this review is to summarize and integrate the current research knowledge pertaining to the long-term effects of early adversity on psychiatric disorders, particularly in late life. We explore definitional considerations including key dimensions of the experience such as type, severity, and timing of adversity relative to development. We then review the potential biological and environmental mediators and moderators of the relationships between early adversity and psychiatric disorders. We conclude with clinical implications, methodological challenges and suggestions for future research.

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References

Papers of particular interest, published recently, have been highlighted as:• Of importance

  1. Bifulco A, Brown GW, Adler Z. Early sexual abuse and clinical depression in adult life. Br J Psychiatry. 1991;159:115–22.

    Article  PubMed  CAS  Google Scholar 

  2. Green JG, McLaughlin KA, Berglund PA, et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry. 2010;67(2):113–23.

    Article  PubMed  Google Scholar 

  3. Kendler KS, Bulik CM, Silberg J, et al. Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Arch Gen Psychiatry. 2000;57(10):953–9.

    Article  PubMed  CAS  Google Scholar 

  4. Kendler KS, Gardner CO, Prescott CA. Toward a comprehensive developmental model for major depression in women. Am J Psychiatry. 2002;159(7):1133–45.

    Article  PubMed  Google Scholar 

  5. Kendler KS, Gardner CO, Prescott CA. Toward a comprehensive developmental model for major depression in men. Am J Psychiatry. 2006;163(1):115–24.

    Article  PubMed  Google Scholar 

  6. Kessler RC, Davis CG, Kendler KS. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med. 1997;27(5):1101–19.

    Article  PubMed  CAS  Google Scholar 

  7. Kessler RC, Magee WJ. Childhood family violence and adult recurrent depression. J Health Soc Behav. 1994;35(1):13–27.

    Article  PubMed  CAS  Google Scholar 

  8. MacMillan HL, Fleming JE, Streiner DL, et al. Childhood abuse and lifetime psychopathology in a community sample. Am J Psychiatry. 2001;158(11):1878–83.

    Article  PubMed  CAS  Google Scholar 

  9. Molnar BE, Buka SL, Kessler RC. Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. Am J Public Health. 2001;91(5):753–60.

    Article  PubMed  CAS  Google Scholar 

  10. Nelson EC, Heath AC, Madden PAF, et al. Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Arch Gen Psychiatry. 2002;59(2):139–45.

    Article  PubMed  Google Scholar 

  11. Widom CS. Posttraumatic stress disorder in abused and neglected children grown up. Am J Psychiatry. 1999;156(8):1223–9.

    PubMed  CAS  Google Scholar 

  12. Afifi TO, Mather A, Boman J, et al. Childhood adversity and personality disorders: results from a nationally representative population-based study. J Psychiatr Res. 2011;45(6):814–22.

    Article  PubMed  Google Scholar 

  13. Clark C, Caldwell T, Power C, et al. Does the influence of childhood adversity on psychopathology persist across the lifecourse? A 45-year prospective epidemiologic study. Ann Epidemiol. 2010;20(5):385–94.

    Article  PubMed  Google Scholar 

  14. Comijs HC, Beekman AT, Smit F, et al. Childhood adversity, recent life events and depression in late life. J Affect Disord. 2007;103(1–3):243–6.

    Article  PubMed  Google Scholar 

  15. Kivela SL, Luukinen H, Koski K, et al. Early loss of mother or father predicts depression in old age. Int J Geriatr Psychiatry. 1998;13(8):527–30.

    Article  PubMed  CAS  Google Scholar 

  16. Wilson RS, Krueger KR, Arnold SE, et al. Childhood adversity and psychosocial adjustment in old age. Am J Geriatr Psychiatry. 2006;14(4):307–15.

    Article  PubMed  Google Scholar 

  17. • Chu DA, Williams LM, Harrisa AWF, et al. Early life trauma predicts self-reported levels of depressive and anxiety symptoms in nonclinical community adults: relative contributions of early life stressor types and adult trauma exposure. J Psychiatr Res. 2013;47(1):23–32. One of the few and largest studies to investigate how exposure to early life trauma contributes to depression and anxiety disorders in later life, using a fine-grained assessment of early life stress than is typical of epidemiological investigations. Findings underline the relative importance of early exposure tointerpersonal violationrelative to other types of early stressors for future psychiatric risk.

    Article  PubMed  Google Scholar 

  18. McMahon SD, Grant KE, Compas BE, et al. Stress and psychopathology in children and adolescents: is there evidence of specificity? J Child Psychol Psychiatry. 2003;44(1):107–33.

    Article  PubMed  Google Scholar 

  19. McLaughlin KA, Green JG, Gruber MJ, et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders. Arch Gen Psychiatry. 2010;67:124–32.

    Article  PubMed  Google Scholar 

  20. Kessler RC, McLaughlin KA, Green JG, et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry. 2010;197(5):378–85.

    Article  PubMed  Google Scholar 

  21. Finkelhor D, Ormrod RK, Turner HA. Re-victimization patterns in a national longitudinal sample of children and youth. Child Abuse Negl. 2007;31(5):479–502.

    Article  PubMed  Google Scholar 

  22. Wise LA, Zierler S, Krieger N, et al. Adult onset of major depressive disorder in relation to early life violent victimisation: a case-control study. Lancet. 2001;358(9285):881–7.

    Article  PubMed  CAS  Google Scholar 

  23. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.

    Article  PubMed  CAS  Google Scholar 

  24. Evans GW, Schamberg MA. Childhood poverty, chronic stress, and adult working memory. Proc Natl Acad Sci U S A. 2009;106(16):6545–9.

    Article  PubMed  CAS  Google Scholar 

  25. Draper B, Pfaff JJ, Pirkis J, et al. Depression and Early Prevention of Suicide in General Practice Study Group. Long-term effects of childhood abuse on the quality of life and health of older people: results from the Depression and Early Prevention of Suicide in General Practice Project. J Am Geriatr Soc. 2008;56(2):262–71.

    Article  PubMed  Google Scholar 

  26. Kaplow JB, Dodge KA, Amaya-Jackson L, et al. Pathways to PTSD, part II: sexually abused children. Am J Psychiatry. 2005;162(7):1305–10.

    Article  PubMed  Google Scholar 

  27. Rudolph KD, Flynn M. Childhood adversity and youth depression: influence of gender and pubertal status. Dev Psychopathol. 2007;19(2):497–521.

    Article  PubMed  Google Scholar 

  28. Schoedl AF, Costa MC, Mari JJ, et al. The clinical correlates of reported childhood sexual abuse: an association between age at trauma onset and severity of depression and PTSD in adults. J Child Sex Abus. 2010;19(2):156–70.

    Article  PubMed  Google Scholar 

  29. Kaplow JB, Widom CS. Age of onset of child maltreatment predicts long-term mental health outcomes. J Abnorm Psychol. 2007;116(1):176–87.

    Article  PubMed  Google Scholar 

  30. Yehuda R, Golier JA, Halligan SL, et al. Learning and memory in Holocaust survivors with posttraumatic stress disorder. Biol Psychiatry. 2004;55(3):291–5.

    Article  PubMed  Google Scholar 

  31. Miller GE, Chen E, Parker KJ. Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms. Psychol Bull. 2011;137(6):959–97.

    Article  PubMed  Google Scholar 

  32. Hazel NA, Hammen C, Brennan PA, et al. Early childhood adversity and adolescent depression: the mediating role of continued stress. Psychol Med. 2008;38(4):581–9.

    Article  PubMed  CAS  Google Scholar 

  33. Pearlin LI. The sociological study of stress. J Health Soc Behav. 1998;30(3):241–56.

    Article  Google Scholar 

  34. Gunnar M, Quevedo K. The neurobiology of stress and development. Ann Rev Psychol. 2007;58:145–73.

    Article  Google Scholar 

  35. Heim C, Newport DJ, Bonsall R, et al. Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. Am J Psychiatry. 2001;158(4):575–81.

    Article  PubMed  CAS  Google Scholar 

  36. Kaufman J, Plotsky PM, Nemeroff CB, et al. Effects of early adverse experiences on brain structure and function: clinical implications. BPS. 2000;48(8):778–90.

    CAS  Google Scholar 

  37. Abercrombie HC, Jahn AL, Davidson RJ, et al. Cortisol’s effects on hippocampal activation in depressed patients are related to alterations in memory formation. J Psychiatr Res. 2011;45(1):15–23.

    Article  PubMed  Google Scholar 

  38. de Quervain DJ, Henke K, Aerni A, et al. Glucocorticoid-induced impairment of declarative memory retrieval is associated with reduced blood flow in the medial temporal lobe. Eur J Neurosci. 2003;17(6):1296–302.

    Article  PubMed  Google Scholar 

  39. Karst H, Nair S, Velzing E, et al. Glucocorticoids alter calcium conductances and calcium channel subunit expression in basolateral amygdala neurons. Eur J Neurosci. 2002;16(6):1083–9.

    Article  PubMed  Google Scholar 

  40. Mitra R, Sapolsky RM. Gene therapy in rodent amygdala against fear disorders. Expert Opin Biol Ther. 2010;10(9):1289–303.

    Article  PubMed  CAS  Google Scholar 

  41. Spangler G, Grossmann KE. Biobehavioral organization in securely and insecurely attached infants. Child Dev. 1993;64(5):1439–50.

    Article  PubMed  CAS  Google Scholar 

  42. King JA, Mandansky D, King S, et al. Early sexual abuse and low cortisol. Psychiatry Clin Neurosci. 2001;55(1):71–4.

    Article  PubMed  CAS  Google Scholar 

  43. De Bellis MD, Chrousos GP, Dorn LD, et al. Hypothalamic–pituitary–adrenal axis dysregulation in sexually abused girls. J Clin Endocrinol Metab. 1994;78(2):249–55.

    Article  PubMed  Google Scholar 

  44. Gerritsen L, Geerlings MI, Beekman AT, et al. Early and late life events and salivary cortisol in older persons. Psychol Med. 2010;40(9):1569–78.

    Article  PubMed  CAS  Google Scholar 

  45. Stein MB, Yehuda R, Koverola C, et al. Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse. Biol Psychiatry. 1997;42(8):680–6.

    Article  PubMed  CAS  Google Scholar 

  46. Heim C, Newport DJ, Heit S, et al. Pituitary–adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA. 2000;284(5):592–7.

    Article  PubMed  CAS  Google Scholar 

  47. Yehuda R, Golier JA, Kaufman S. Circadian rhythm of salivary cortisol in Holocaust survivors with and without PTSD. Am J Psychiatry. 2005;162(5):998–1000.

    Article  PubMed  Google Scholar 

  48. Sudheimer K, Flournoy J, Gershon A, et al. HPA axis and late life depression. In: Lavretsky H, Sajatovic M, Reynolds CF, editors. Late-life mood disorders. New York: Oxford University Press; 2013.

    Google Scholar 

  49. Graham JE, Christian LM, Kiecolt-Glaser JK. Stress, age, and immune function: toward a lifespan approach. J Behav Med. 2006;29(4):389–400.

    Article  PubMed  Google Scholar 

  50. Langley-Evans SC, McMullen S. Developmental origins of adult disease. Med Princ Pract. 2010;19(2):87–98.

    Article  PubMed  Google Scholar 

  51. Merlot E, Couret D, Otten W. Prenatal stress, fetal imprinting and immunity. Brain Behav Immun. 2008;22(1):42–51.

    Article  PubMed  CAS  Google Scholar 

  52. Miller GE, Chen E, Fok AK, et al. Low early-life social class leaves a biological residue manifested by decreased glucocorticoid and increased proinflammatory signaling. Proc Natl Acad Sci U S A. 2009;106(34):14716–21.

    Article  PubMed  CAS  Google Scholar 

  53. Bellinger DL, Lubahn C, Lorton D. Maternal and early life stress effects on immune function: relevance to immunotoxicology. J Immunotoxicol. 2008;5(4):419–44.

    Article  PubMed  CAS  Google Scholar 

  54. Bauer ME, Wieck A, Lopes RP, et al. Interplay between neuroimmunoendocrine systems during post-traumatic stress disorder: a minireview. Neuroimmunomodulation. 2010;17(3):192–5.

    Article  PubMed  CAS  Google Scholar 

  55. Danese A, Pariante CM, Caspi A, et al. Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci U S A. 2007;104(4):1319–24.

    Article  PubMed  CAS  Google Scholar 

  56. Kiecolt-Glaser JK, Gouin JP, Weng NP, et al. Childhood adversity heightens the impact of later-life caregiving stress on telomere length and inflammation. Psychosom Med. 2011;73(1):16–22.

    Article  PubMed  Google Scholar 

  57. Gouin JP, Glaser R, Malarkey WB, et al. Childhood abuse and inflammatory responses to daily stressors. Ann Behav Med. 2012;44(2):287–92.

    Article  PubMed  Google Scholar 

  58. Macphee AG, Divol L, Kemp AJ, et al. Limitation on prepulse level for cone-guided fast-ignition inertial confinement fusion. Phys Rev Lett. 2010;104(5):055002.

    Article  PubMed  CAS  Google Scholar 

  59. McLeod JD. Childhood parental loss and adult depression. J Health Soc Behav. 1991;35:205–20.

    Article  Google Scholar 

  60. Gorey KM, Leslie DR. The prevalence of child sexual abuse: integrative review adjustment for potential response and measurement biases. Child Abuse Negl. 1997;21(4):391–8.

    Article  PubMed  CAS  Google Scholar 

  61. MacMillan HL, Fleming JE, Trocme N, et al. Prevalence of child physical and sexual abuse in the community. Results from the Ontario Health Supplement. JAMA. 1997;278(2):131–5.

    Article  PubMed  CAS  Google Scholar 

  62. Gershon A, Minor K, Hayward C. Gender, victimization, and psychiatric outcomes. Psychol Med. 2008;38(10):1377–91.

    Article  PubMed  CAS  Google Scholar 

  63. Caspi A, Hariri AR, Holmes A, et al. Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. Am J Psychiatry. 2010;167(5):509–27.

    Article  PubMed  Google Scholar 

  64. Williams LM, Gatt JM, Schofield PR, et al. ‘Negativity bias’ in risk for depression and anxiety: brain–body fear circuitry correlates, 5-HTT-LPR and early life stress. NeuroImage. 2009;47(3):804–14.

    Article  PubMed  Google Scholar 

  65. Aas M, Djurovic S, Athanasiu L, et al. Serotonin transporter gene polymorphism, childhood trauma, and cognition in patients with psychotic disorders. Schizophr Bull. 2010;38(1):15–22.

    Article  Google Scholar 

  66. Caspi A, Sugden K, Moffitt TE, et al. Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science. 2003;301(5631):386–9.

    Article  PubMed  CAS  Google Scholar 

  67. O’Hara R, Schroder CM, Mahadevan R, et al. Serotonin transporter polymorphism, memory and hippocampal volume in the elderly: association and interaction with cortisol. Mol Psychiatry. 2007;12(6):544–55.

    Article  PubMed  Google Scholar 

  68. Gillespie NA, Whitfield JB, Williams B, et al. The relationship between stressful life events, the serotonin transporter (5-HTTLPR) genotype and major depression. Psychol Med. 2005;35(1):101–11.

    Article  PubMed  Google Scholar 

  69. Bet PM, Penninx BW, Bochdanovits Z, et al. Glucocorticoid receptor gene polymorphisms and childhood adversity are associated with depression: new evidence for a gene–environment interaction. Am J Med Genet B Neuropsychiatr Genet. 2009;150B(5):660–9.

    Article  PubMed  CAS  Google Scholar 

  70. Binder EB, Bradley RG, Liu W, et al. Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults. JAMA. 2008;299(11):1291–305.

    Article  PubMed  CAS  Google Scholar 

  71. Lesch KP. When the serotonin transporter gene meets adversity: the contribution of animal models to understanding epigenetic mechanisms in affective disorders and resilience. Curr Top Behav Neurosci. 2011;7:251–80.

    Article  PubMed  Google Scholar 

  72. Sterley TL, Howells FM, Russell VA. Effects of early life trauma are dependent on genetic predisposition: a rat study. Behav Brain Funct. 2011;7:11.

    Article  PubMed  Google Scholar 

  73. Hariri AR. Genetic polymorphisms: a cornerstone of translational biobehavioral research. Sci Transl Med. 2010;2(18):18ps6.

    Article  PubMed  Google Scholar 

  74. Macrì S, Spinelli S, Adriani W, et al. Early adversity and alcohol availability persistently modify serotonin and hypothalamic–pituitary–adrenal–axis metabolism and related behavior: what experimental research on rodents and primates can tell us. Neurosci Biobehav Rev. 2007;31(2):172–80.

    Article  PubMed  Google Scholar 

  75. George ED, Bordner KA, Elwafi HM, et al. Maternal separation with early weaning: a novel mouse model of early life neglect. BMC Neurosci. 2010;11:123.

    Article  PubMed  Google Scholar 

  76. Baram TZ, Davis EP, Obenaus A, et al. Fragmentation and unpredictability of early-life experience in mental disorders. Am J Psychiatry. 2012;169(9):907–15.

    Article  PubMed  Google Scholar 

  77. Wilkin MM, Waters P, McCormick CM, et al. Intermittent physical stress during early- and mid-adolescence differentially alters rats’ anxiety- and depression-like behaviors in adulthood. Behav Neurosci. 2012;126(2):344–60.

    Article  PubMed  Google Scholar 

  78. Harro J. Animal models of depression vulnerability. Curr Top Behav Neurosci. 2012. doi:10.1007/7854_2012_221.

  79. Berton O, Hahn CG, Thase ME. Are we getting closer to valid translational models for major depression? Science. 2012;338(6103):75–9.

    Article  PubMed  CAS  Google Scholar 

  80. Dzirasa K, Covington 3rd HE. Increasing the validity of experimental models for depression. Ann N Y Acad Sci. 2012;1265:36–45.

    Article  PubMed  Google Scholar 

  81. Pajer K, Andrus BM, Gardner W, et al. Discovery of blood transcriptomic markers for depression in animal models and pilot validation in subjects with early-onset major depression. Transl Psychiatry. 2012;2:e101.

    Article  PubMed  CAS  Google Scholar 

  82. Pryce CR, Rüedi-Bettschen D, Dettling AC, et al. Long-term effects of early-life environmental manipulations in rodents and primates: potential animal models in depression research. Neurosci Biobehav Rev. 2005;29(4–5):649–74.

    Article  PubMed  Google Scholar 

  83. • Reed AE, Carstensen LL. The theory behind the age-related positivity effect. Front Psychol. 2012;3:339. doi:10.3389/fpsyg.2012.00339. A striking finding from the field of aging is thepositivity effect”, which refers to older adultstendency to attend to and remember more positive than negative information, relative to younger adults. This article provides an overview of the theoretical basis of the positivity effect, discussing the implications of this phenomenon for consideration of emotional processing in older adults.

    Article  PubMed  Google Scholar 

  84. Brewin CR, Andrews B, Gotlib IH. Psychopathology and early experience: a reappraisal of retrospective reports. Psychol Bull. 1993;113(1):82–98.

    Article  PubMed  CAS  Google Scholar 

  85. Brown GW, Harris TO. Social origins of depression: a study of psychiatric disorder in women (1st American ed.). New York: Free Press; 1998.

    Google Scholar 

  86. Thompson WK, Hallmayer J, O’Hara R. Design considerations for characterizing psychiatric trajectories across the lifespan: application to effects of APOE-epsilon4 on cerebral cortical thickness in Alzheimer’s disease. Am J Psychiatry. 2011;168(9):894–903.

    Article  PubMed  Google Scholar 

  87. MacLeod J, Nelson G. Programs for the promotion of family wellness and the prevention of child maltreatment: a meta-analytic review. Child Abuse Negl. 2000;24:1127–49.

    Article  PubMed  CAS  Google Scholar 

  88. Haroon E, Raison CL, Miller AH. Psychoneuroimmunology meets neuropsychopharmacology: translational implications of the impact of inflammation on behavior. Neuropsychopharmacology. 2012;37(1):137–62.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

Preparation of this report was supported by the Department of Veterans Affairs Advanced Fellowship Program in War Related and Unexplained Illness awarded to A. Gershon.

Conflict of Interest

Anda Gershon declares that she has no conflict of interest.

Keith Sudheimer declares that he has no conflict of interest.

Rabindra Tirouvanziam declares that he has no conflict of interest.

Leanne M. Williams declares that she has no conflict of interest.

Ruth O’Hara declares that she has no conflict of interest.

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Correspondence to Anda Gershon.

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Gershon, A., Sudheimer, K., Tirouvanziam, R. et al. The Long-Term Impact of Early Adversity on Late-Life Psychiatric Disorders. Curr Psychiatry Rep 15, 352 (2013). https://doi.org/10.1007/s11920-013-0352-9

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