Severe childhood stress and changes in gene expression

Young children are fragile. Evidence is mounting that health in adulthood can be influenced by the environment in which a child grows up. We have offered posts on this subject previously (http://phcprimarycare.org/?p=392  and http://phcprimarycare.org/?p=408). A recently published study in the journal Child Development provides startling findings which add to this growing body of research.

Researchers found epigenetic changes in the glucocorticoid receptor (GR) gene in older children who had suffered severe childhood trauma or stress early in life. Compared to children who grew up without severe stress or trauma, those who had experienced significant maltreatment had greater methylation of a segment of the GR gene. While the significance of this epigenetic change was not defined, it appears this change may affect human stress and immune response mechanisms. Animal studies have provided good correlation between changes in this gene and difficulties with stress responses and immune function.

The fact that such a change was identified years after the stressful experiences occurred is obviously concerning. It suggests that early childhood trauma may lead to long-lasting genetic changes whose influences continue long into the future. Studies like this may eventually help identify the biology behind the findings of the ACE study (see above links).

Many questions remain to be answered, including what level of childhood trauma leads to genetic changes? Are these changes reversible later in life through living in a different environment, counseling, or perhaps medication?

The study mentioned does not and could not provide direct clinical guidance which physicians can use in their daily practice. But it provides more evidence which can be used to educate parents about the importance of appropriate disciplining of their children, and the possible lifelong consequences when children are raised in a severely stressful environment. Guidance and boundaries are important. But they need to be established in a loving and supportive way.

Richard Fleming, MD

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