Worse general health and increased depression severity in children with early childhood adverse experiences were shown to be correlated with sequential smaller inferior frontal gyrus volumes and poor emotional awareness, according to the results of a study published in JAMA Pediatrics.

In this longitudinal study, the study investigators enrolled 119 children age 3 to 6 and then prospectively evaluated them for early adverse childhood experiences before the age of 8. Magnetic resonance imaging scans were collected when participants were between age 6 and 13, and mental and physical health data were collected when participants were between age 9 and 15. The associations between early adversity, brain structure, emotional development, and health outcomes were evaluated with sequential mediation models.

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Adverse childhood events were associated with smaller inferior frontal gyrus volumes after correcting for sex and age (P =.002). Reduced inferior frontal gyrus volumes were associated with poorer emotional awareness, which was subsequently associated with higher depression severity in adolescence (model parameter estimate = 0.007; 95% CI, 0.001-0.021), suggesting sequential mediation following adverse childhood events. In a similar fashion, reduced interior frontal gyrus volumes and poorer emotional awareness sequentially mediated poorer general physical health (model parameter estimate = 0.002; 95% CI, 0.0002-0.056).

Compared with participants who had no early adverse childhood events, participants who had 3 adverse events had a 15% increase in depression severity and a 25% increase in physical health problems in adolescence.

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The study investigators called the results “intriguing,” and suggested that “a common biological embedding process may operate linking early adversity and poor emotional and physical health outcomes.” They concluded that future studies to “address the specific biological and physiological processes on an epigenetic, immune, and neurobiological level” will be important for understanding the underlying mechanisms.


Luby JL, Barch D, Whalen D, Tillman R, Belden A. Association between early life adversity and risk for poor emotional and physical health in adolescence: a putative mechanistic neurodevelopmental pathway [published online October 30, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.3009