Impacts differ depending on sex

A new study led by UCLA Health found that a person’s sex and their unique experiences of childhood trauma can have specific consequences for their biological health and risk of developing 20 major diseases later in life.

Although a large body of research has shown that childhood adversity can have long-lasting impacts on a person’s biology and health, there has been little research looking into how different types of stressors affect specific biological functions and health risks.

The new findings, published in the journal Brain, Behavior, and Immunity on Sept. 17, not only reveal that these early stressors can cause specific health impacts, but that these impacts also systematically differ for males and females.

The findings are believed to represent one of the most comprehensive analyses of the biological and clinical consequences of adverse childhood experiences, said the study’s senior author, Dr. George Slavich, director of the Laboratory for Stress Assessment and Research at UCLA.

“Most people who have experienced significant stress or early-life trauma never get assessed,” said Slavich. “These findings highlight the critical importance of screening for stress in clinical settings. They also move us beyond a one-size-fits-all approach and toward a precision medicine approach based on patients’ sex and specific stress profile.”

To examine how early exposure to adversity impacts health later in life, Slavich and colleagues used a large data source that includes measurements of early-life adversity, disease biology, and mental and physical health. The data came from more than 2,100 participants in the “Midlife in the United States: A National Longitudinal Study of Health and Wellbeing” study.

Participants reported on the types and severity of adverse childhood experiences they experienced, including financial distress, abuse, neglect, how often they moved, whether they lived away from their biological parents, and whether they had been on welfare. Additionally, participants provided biological samples for calculating 25 disease biomarkers and indicated whether they had ever been diagnosed with any of twenty major health conditions.

Slavich and his team conducted a latent-class analysis of the data to identify clusters of adults who had experienced multiple childhood stressors. Researchers then tested how these clusters and independent stressors were related to 25 biomarkers of inflammation, metabolism, and stress, as well as 20 major health conditions.

The result was two stressor classes for males (High Stress and Low Stress) and three for females (High Stress, Moderate Stress, and Low Stress.) Overall, those in the low-stress classes exhibited the fewest major health issues, with participants’ risk increasing as their stressor exposure increased.

Both males and females in the high-stress classes had the poorest metabolic health and the greatest inflammation. However, there were differences between the sexes. The impacts of adverse childhood experiences on metabolic health biomarkers were greater for females than for males. Emotional abuse and neglect also tended to have greater effects in males than females for several biomarkers and health conditions such as blood disorders, mental and behavior health issues, and thyroid issues.

Slavich said the findings underscore the need to integrate assessments of stress biology and exposure into clinical care, and to ensure that patients’ risk profiles take sex and specific stressor exposure into account.

“Stress is implicated in 9 of the 10 leading causes of death in the United States today,” Slavich said. “It’s about time we take that statistic seriously and begin screening for stress in all pediatric and adult clinics nationwide.”