Erika Kuzminskaite1, Brenda W J H Penninx2, Anne-Laura van Harmelen3, Bernet M Elzinga4, Jacqueline G F M Hovens5, Christiaan H Vinkers6. 1. Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands. Electronic address: e.kuzminskaite@ggzingeest.nl. 2. Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands. Electronic address: b.penninx@amsterdamumc.nl. 3. Department of Education and Child Studies, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Department of Psychiatry, University of Cambridge, Cambridge, UK. Electronic address: a.van.harmelen@fsw.leidenuniv.nl. 4. Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands. Electronic address: elzinga@fsw.leidenuniv.nl. 5. Department of Psychiatry, Leiden UMC, Leiden, the Netherlands. Electronic address: j.g.f.m.hovens@lumc.nl. 6. Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands; Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Vrije University, Amsterdam, the Netherlands. Electronic address: c.vinkers@amsterdamumc.nl.
Abstract
BACKGROUND: Childhood trauma (CT) has adverse consequences on mental health across the lifespan. The understanding of how CT increases vulnerability for psychiatric disorders is growing. However, lack of an integrative approach to psychological and biological mechanisms of CT hampers further advancement. This review integrates CT findings across explanatory levels from a longitudinal adult cohort - the Netherlands Study of Depression and Anxiety (NESDA). METHODS: We reviewed all studies (k = 37) from the NESDA cohort (n = 2981) published from 2009 to 2020 containing CT findings related to psychopathology and potential psychological and biological mechanisms of CT. RESULTS: CT was associated with a higher risk of anxiety and depressive disorders with the strongest associations in the comorbid group. CT predicted the onset of these disorders, recurrence, and poorer outcomes (more comorbidity and chronicity). CT was associated with maladaptive personality characteristics and cognitions (e.g., higher neuroticism and negative self-associations), mild stress systems dysregulations (heightened levels of cortisol and inflammation), advanced biological aging (increased epigenetic aging and telomere attrition), poorer lifestyle (higher smoking rate and body mass index), somatic health decline (e.g., increased metabolic syndrome dysregulations), and brain alterations (e.g., reduced mPFC volume and increased amygdala reactivity). LIMITATIONS: Literature review of one cohort using mixed analytical approaches. CONCLUSION: CT impacts the functioning of the brain, mind, and body, which together may contribute to a higher vulnerability for affective disorders. It is essential to employ an integrative approach combining different sources of data to understand the mechanisms of CT better.
BACKGROUND: Childhood trauma (CT) has adverse consequences on mental health across the lifespan. The understanding of how CT increases vulnerability for psychiatric disorders is growing. However, lack of an integrative approach to psychological and biological mechanisms of CT hampers further advancement. This review integrates CT findings across explanatory levels from a longitudinal adult cohort - the Netherlands Study of Depression and Anxiety (NESDA). METHODS: We reviewed all studies (k = 37) from the NESDA cohort (n = 2981) published from 2009 to 2020 containing CT findings related to psychopathology and potential psychological and biological mechanisms of CT. RESULTS: CT was associated with a higher risk of anxiety and depressive disorders with the strongest associations in the comorbid group. CT predicted the onset of these disorders, recurrence, and poorer outcomes (more comorbidity and chronicity). CT was associated with maladaptive personality characteristics and cognitions (e.g., higher neuroticism and negative self-associations), mild stress systems dysregulations (heightened levels of cortisol and inflammation), advanced biological aging (increased epigenetic aging and telomere attrition), poorer lifestyle (higher smoking rate and body mass index), somatic health decline (e.g., increased metabolic syndrome dysregulations), and brain alterations (e.g., reduced mPFC volume and increased amygdala reactivity). LIMITATIONS: Literature review of one cohort using mixed analytical approaches. CONCLUSION: CT impacts the functioning of the brain, mind, and body, which together may contribute to a higher vulnerability for affective disorders. It is essential to employ an integrative approach combining different sources of data to understand the mechanisms of CT better.
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