Table 2 Selected effect modifiers
From: Biological embedding of childhood adversity: from physiological mechanisms to clinical implications
Modifier | Examples of findings | Further reading |
|---|---|---|
Genetic variability | • Genetic polymorphisms found to moderate associations between ELA and various outcomes; Specific examples of outcomes impacted with implicated genes include: | |
o Emotional and neuroendocrine stress reactivity: 5-HTTLPR | Lester et al., 2006 [86] | |
o Inflammatory response to stress: 5-HTTLPR | Fredericks et al., 2010 [88] | |
o Common forms of psychopathology, including depression, ADHD, and substance addiction: NR3C1, CRHR1, OXTR, 5-HTTLPR, HTR3A, DRD2, MAOA, BDNF, COMT o Atherosclerosis risk: MAOA | Nemeroff et al., 2016 [25] Heim & Binder, 2012 [87] Zhao et al., 2013 [89] | |
Child sex and gender | • Complex sex differences in HPA and autonomic dysregulation after early stress observed in animals and humans | Essex et al., 2013 [19] |
• Differential effects of maternal vs. paternal stress on boys vs. girls leads some to posit ELA effect moderation by socially embedded gender roles | ||
• Genetic moderators of the effects of ELA may be sex and/or gender specific o Meta-analysis found stronger effect of MAOA genotype on psychopathology in boys o Different polymorphism on the 5-HTTLPR gene have been linked with increased risk of depression following ELA in males vs. females | Kim-Cohen et al., 2006 [90] Brummet et al., 2008 [91] | |
Other child characteristics | • Pre-existing health conditions, e.g., prematurity, poor physical health status, etc. alter social and physiological consequences of ELA | Doom & Gunnar, 2015 [36] |
• Child temperament, sensitivity to the environment, and emotion processing are associated with risk for psychopathology and may affect the ways in which children respond to adversity | Lester et al., 2006 [86] | |
Exposure characteristics | • Characteristics of the exposure, including type (e.g., sexual, physical, emotional abuse, or neglect), chronicity, and intensity, modify associations with physical and mental health outcomes | Nemeroff et al., 2016 [25] |
• Exposures occurring during early sensitive periods can have heightened impacts on specific developmental domains leading to “timing effects” | Bick & Nelson, 2016 [21] | |
Social context and caregiving | • Family structure and stability, birth order, caregiver stress and social support, community and societal context may modify effects of specific adversities | Doom & Gunnar, 2015 [36] |
• Presence of a dependable, supportive caregiver may “buffer” children from effects of otherwise adverse environment | ||
Cumulative occurrence | • Dose-response relationship between number of adversities and health and social effects are observed in large epidemiological studies | Felitti et al., 1998 [1] Danese et al., 2009 [3] |