Abstract
It is well established that adverse childhood experiences (ACEs) contribute to the development of mental disorders in adulthood. However, less is known about how childhood trauma impacts the mind and the body, whether the resulting mental disorders have different characteristics than those occurring without these antecedent conditions, and if treatment modalities need to reflect the unique nature of mental disorders rooted in trauma. Survey and biomarker data were gathered from a sample of college students (n = 93) to explore the relationship between childhood trauma and mental health. We examine how neuroimmune systems (inflammation and neuroplasticity) relate to depression and anxiety and whether these associations vary for those with and without a history of childhood trauma. Findings reveal that students with 4 or more ACEs are more likely to have depression and anxiety than students without these experiences. In addition, we find that inflammation (CRP) and neuronal health (BDNF) are associated with mental health disorders among students with four or more ACEs, but not for students without this history. These findings suggest that mental disorders associated with four or more ACEs may be uniquely tied to physiological processes, and consequently, warrant tailored treatments. The implications for mental health intervention include, 1) screening for childhood trauma, inflammation, and neuronal health and 2) referral to treatments which are theoretically and empirically tied to the root causes of mental disorders rather than those designed merely to suppress their symptoms.
Similar content being viewed by others
References
Banerjee, T. D., Middleton, F., & Faraone, S. V. (2007). Environmental risk factors for Attention deficit hyperactivity disorder. Acta Paediatrica, 96(9), 1269–1274.
Baumeister, D., Akhtar, R., Ciufolini, S., Pariante, C. M., & Mondelli, V. (2016). Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α. Molecular Psychiatry, 21(5), 642–649.
Boris, M., & Mandel, F. S. (1994). Food and additives are common causes of the attention deficit hyperactive disorder in children. Annals of Allergy, Asthma & Immunology, 72, 462–468.
Ceballos, N., & Sharma, S. (2016). Risk and resilience: The role of brain-derived neurotropic factor in alcohol use disorder. Neuroscience, 3(4), 398–432.
Cockerham, W. C. (2017). In Taylor and Francis Group (Ed.), Sociology of Mental Disorder. 10th Edition. Routledge. New York, NY.
Dale, L. P., et al. (2018). College females with maltreatment histories have atypical autonomic regulation and poor psychological wellbeing. Psychological Trauma: Theory, Research, Practice, and Policy, 10(4), 427–434.
Danese, A., Pariante, C. M., Caspi, A., Taylor, A., & Poulton, R. (2007). Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences, 104(4), 1319–1324.
Danese, A., Moffitt, T. E., Pariante, C. M., Ambler, A., Poulton, R., & Caspi, A. (2008). Elevated inflammation levels in depressed adults with a history of childhood maltreatment. Archives of General Psychiatry, 65(4), 409–415.
Danese, A., Caspi, A., Williams, B., Ambler, A., Sugden, K., Mika, J., et al. (2011). Biological embedding of stress through inflammation processes in childhood. Molecular Psychiatry, 16(3), 244–246.
Dash, S., Clarke, G., Berk, M., & Jacka, F. N. (2015). The gut microbiome and diet in psychiatry: Focus on depression. Current Opinion in Psychiatry, 28(1), 1–6.
Daskalakis, N. P., de Kloet, E., Yehuda, R., Malaspina, D., & Kranz, T. M. (2015). Early life stress effects on glucocorticoid-BDNF interplay in the hippocampus. Frontiers in Molecular Neuroscience, 8, 68–80.
DeGruy F. (1996) Mental health care in the primary care setting. Primary Care: America’s Health in a New Era. Institute of Medicine. Committee on the Future of Primary Care. National Academies Press. 1996.
Dube, S. R. (2018). Continuing conversations about adverse childhood experiences (ACEs) screening: a public health perspective. Child Abuse & Neglect, 85, 180–184.
Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma-informed or trauma-denied: Principles and imple- mentation of trauma-informed services for women. Journal of Community Psychology, 33, 461–477.
Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., … Kramer, A.F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences of the United States of America, 108, 3017–3022.
Evans, G. W. (2003). The built environment and mental health. Journal of Urban Health, 80(4), 536–555.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258.
Finkelhor, D. (2017). Screening for adverse childhood experiences (ACEs): Cautions and suggestions. Child Abuse & Neglect, 85, 174–179.
Frances, A. (2013). Saving normal: An insider’s revolt against out-of- control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York, NY: William Morrow & Company.
Gatt, J. M., Burton, K. L., Williams, L. M., & Schofield, P. R. (2015). Specific and common genes implicated across major mental disorders: A review of meta-analysis studies. Journal of Psychiatric Research, 60, 1–13.
Giugliano, D., Ceriello, A., & Esposito, K. (2006). The effects of diet on inflammation: emphasis on the metabolic syndrome. Journal of the American College of Cardiology, 48(4), 677–685.
Grace, A. A. (2016). Dysregulation of the dopamine system in the pathophysiology of schizophrenia and depression. Nature Reviews Neuroscience, 17(8), 524.
Hanson, J. L., Nacewicz, B. M., Sutterer, M. J., Cayo, A. A., Schaefer, S. M., Rudolph, K. D., et al. (2015). Behavior problems after early life stress: Contributions of the hippocampus and amygdala. Biological Psychiatry, 77(4), 314–323. https://doi.org/10.1016/j.biopsych.2014.04.020.
Heckbert, S. R., Rutter, C. M., Oliver, M., Williams, L. H., Ciechanowski, P., Lin, E. H., et al. (2010). Depression in relation to long-term control of glycemia, blood pressure, and lipids in patients with diabetes. Journal of General Internal Medicine, 25, 524–529.
Heim, C., Newport, D. J., Mletzko, T., Miller, A. H., & Nemeroff, C. B. (2008). The link between childhood trauma and depression: Insights from HPA axis studies in humans. Psychoneuroendocrinology, 33(6), 693–710.
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., et al. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366.
Kalamakis, K. A., Meyer, J. S., Chiodo, L., & Leung, K. (2015). Adverse childhood experiences and chronic hypothalamic–pituitary–adrenal activity. Stress, 18(4), 446–450.
Karatekin, C. (2017). Adverse childhood experiences (ACEs), stress and mental health in college students. Stress and Health, 34(1), 36–45.
Kasapis, C., & Thompson, P. D. (2005). The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. Journal of the American College of Cardiology, 45(10), 1563–1569.
Khrapatina, I., & Berman, P. (2017). The Impact of adverse childhood experiences on health in college students. Journal of Child and Adolescent Trauma, 10, 275–287.
Ko, S. J., Ford, J. D., Kassam-Adams, N., Berkowitz, S. J., Wilson, C., & Wong, M. (2008). Creating trauma-informed systems: Child welfare, education, first responders, health care, juvenile justice. Professional Psychology: Research and Practice, 39(4), 396–404.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.
Lu, B., & Gottschalk, W. (2000). Modulation of hippocampal synaptic transmission and plasticity by neurotrophins. Progress in Brain Research, 128, 231–241.
Mannarino, A. P., Cohen, J. A., & Deblinger, E. (2014). Trauma-focused cognitive-behavioral therapy. Evidence-based approaches for the treatment of maltreated children (pp. 165–185). Dordrecht: Springer.
McNally, L., Bhagwagar, Z., & Hannestad, J. (2008). Inflammation, glutamate, and glia in depression: a literature review. CNS Spectrums, 13(6), 501–510.
Miller, A. H., & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews Immunology, 16(1), 22.
Nestler, E. J., Peña, C. J., Kundakovic, M., Mitchell, A., & Akbarian, S. (2016). Epigenetic basis of mental illness. The Neuroscientist, 22(5), 447–463.
Notaras, M., Hill, R., & van den Buuse, M. (2015a). The BDNF gene Val66Met polymorphism as a modifier of psychiatric disorder susceptibility: Progress and controversy. Molecular Psychiatry, 20, 916–930.
Notaras, M., Hill, R., & van den Buuse, M. (2015b). A role for the BDNF gene Val66Met polymorphism in schizophrenia? A comprehensive review. Neuroscience & Biobehavioral Reviews, 51, 15–30.
Nusslock, R., & Miller, G. E. (2016). Early-life adversity and physical and emotional health across the lifespan: A neuroimmune network hypothesis. Biological Psychiatry, 80(1), 23–32.
Oyama, O., Burg, M. A., Fraser, K., & Kosch, S. G. (2012). Mental health treatment by family physicians: current practices and preferences. Family Medicine, 44(10), 704–711.
Pace, T. W., Mletzko, T. C., Alagbe, O., Musselman, D. L., Nemeroff, C. B., Miller, A. H., & Heim, C. M. (2006). Increased stress-induced inflammatory responses in male patients with ma- jor depression and increased early life stress. American Journal of Psychiatry, 163(9), 1630–1633.
Pace, T. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., et al. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), 87–98.
Pearson, T. A., Mensah, G. A., Alexander, R. W., Anderson, J. L., Cannon, R. O., Criqui, M., et al. (2003). Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation, 107(3), 499–511.
Pickersgill, M. D. (2014). Debating DSM-5: Diagnosis and the sociology of critique. Journal of Medical Ethics, 40, 521–525.
Pietras, S. A., & Goodman, E. (2013). Socioeconomic status gradients in inflammation in adolescence. Psychosomatic Medicine, 75(5), 442–448.
Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: A review of comparison studies. The Journal of Alternative and Complementary Medicine, 16(1), 3–12.
Rudolph, K. D., Troop-Gordon, W., & Granger, D. A. (2011). Individual differences in biological stress responses moderate the contribution of early peer victimization to subsequent depressive symptoms. Psychopharmacology, 214, 209–219.
Schmitt, A., Malchow, B., Hasan, A., & Fallkai, P. (2014). The impact of environmental factors in severe psychiatric disorders. Frontiers in Neuroscience, 8, 19.
Shonkoff, J. P., Garner, A. S., & Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, Section on Developmental and Behavioral Pediatrics. (2012). The Lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246.
Slopen, N., Kubzansky, L. D., McLaughlin, K. A., & Koenen, K. C. (2013). Childhood adversity and inflammatory processes in youth: A prospective study. Psychoneuroendocrinology, 38(2), 188–200.
Slopen, N., Koenen, K. C., & Kubzansky, L. D. (2014). Cumulative adversity in childhood and emergent risk factors for long-term health. The Journal of Pediatrics, 164(3), 631–638.
Spitzer, R. L., Williams, J. B. W., Kroenke, K., Hornyak, R., & McMurray, J. (2000). Validity and utility of the Patient Health Questionnaire in assessment of 3000 obstetrics-gynecologic patients. American Journal of Obstetrics and Gynecology, 183(3), 759–769.
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097.
Steven Stephens, J. E. (2015). Pediatricians Screen Parents for ACES to improve health of babies in ACE Study, Adverse Childhood Experiences, Child Trauma, Chronic Disease, Resilience, Solutions, & Comments. https://acestoohigh.com/2015/08/03/pediatricians-screen-parents-for-aces-to-improve-health-of-babies/. Accessed 1 March 2019.
Substance Abuse and Mental Health Services Administration. (2014). Trauma Informed Care in Behavioral Health Services: Treatment Improvement Protocol. Series, no. 57. Rockville (MD): SAMSHA.
Tolahunase, M. R., Sagar, R., Faiq, M., & Dada, R. (2018). Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial. Restorative Neurology and Neuroscience, 36, 423–442. https://doi.org/10.3233/RNN-170810.
Velikis, I., Anagnostopoulou, T., Mastorakou, A., Triliva, S., & Gouva, M. (2009). Correlation between childhood abuse and neglect, alexithymia and current health problems in college students. Nosileftiki, 48(3), 325–331.
Vogelzangs, N., Beekman, A. T. F., De Jonge, P., & Penninx, B. W. J. H. (2013). Anxiety disorders and inflammation in a large adult cohort. Translational Psychiatry, 3(4), e249.
Watt, T. T. (2017). Paradigm Shifts Don’t Come Easy: Confrontations between the Trauma Perspective and the DSM in Mental Health Treatment for Abused and Neglected Children. Journal of Child & Adolescent Trauma, 10(4), 395–403.
Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. New York, NY: Random House.
Whitaker, R. (2017). Psychiatry under the influence. In The Sedated Society, pp. 163–188.
Whitaker, R., & Cosgrove, L. (2015). Psychiatry under the influence: Institutional corruption, social injury, and prescriptions for reform. Springer.
Whooley, O. (2014). Nosological reflections: The failure of DSM-5, the emergence of RDoC, and the decontextualization of mental distress. Society and Mental Health, 4(2), 92–110.
Williams, J. H., & Ross, L. (2007). Consequences of prenatal toxin exposure for mental health in children and adolescents. European Child & Adolescent Psychiatry, 16(4), 243–253.
Wu, J. J., Yang, Y. S., Kang, M. S., Jung, S. C., Park, H. K., Yeun, H. Y., et al. (2014). Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor. Complementary Therapies in Medicine, 22, 456–462.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Watt, T., Ceballos, N., Kim, S. et al. The Unique Nature of Depression and Anxiety among College Students with Adverse Childhood Experiences. Journ Child Adol Trauma 13, 163–172 (2020). https://doi.org/10.1007/s40653-019-00270-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-019-00270-4