CHILDHOOD TRAUMATIC EXPERIENCES AND MENTAL HEALTH: INVESTIGATING BIOLOGICAL, PSYCHOLOGICAL AND SOCIAL CORRELATES

BACKGROUND: Childhood traumatic experiences, including physical and sexual abuse, antipathy, and neglect, are significantly associated with higher risk of developing both mental disorders and medical conditions. AIM: To elucidate the effects of childhood trauma on health, especially mental health, taking into account some literature-selected biological, psychological, and social correlates. METHODS: Investigations were conducted in three different sample groups: (1) a group of First Episode Psychosis (FEP) patients belonging to the “Genetics, Endophenotypes and Treatment: Understanding early Psychosis” (GET UP) Research Project; (2) a group of hepatitis C patients included in the "Chronic Inflammation and Depression” Research Project; and (3) a sample of healthy subjects. In these three samples, childhood traumatic experiences were evaluated by the Childhood Experience of Care and Abuse Questionnaire (CECA) questionnaire (Bifulco et al., 2005): physical punishments, sexual unwanted experiences, loss, separation, antipathy, and neglect were investigated. HPA axis functioning, cannabis use, and glucose metabolism were investigated as potentially involved biological correlates. HPA axis functioning was estimated by measuring salivary cortisol levels, as both diurnal cortisol levels and Cortisol Awakening Response (CAR). The Cannabis Experiences Questionnaire (CEQ) (Barkus et al., 2006) evaluated cannabis use. The concentrations of C-peptide, Ghrelin, GIP, GLP-1, Glucagon, Insulin, Leptin, PAI-1, Resistin and Visfatin were determined using Bio-PlexPro™ Human Diabetes Assays (Bio-Rad, CA, USA). Coping strategies, age, gender, education, socio-economic status, and recent severe stressful life events were taken into account as potentially involved psychosocial correlates. RESULTS: (1) Significant associations between severe sexual abuse and a diagnosis of affective psychosis and between childhood trauma, severe sexual abuse in particular, and lifetime cannabis use were found in FEP subjects. No gender difference was detected. Moreover, C-peptide and insulin levels were found increased in traumatized FEP subjects. Indeed, we found that C-peptide was higher in patients who experienced childhood trauma (with or without severe life events), while Insulin was higher in patients who reported childhood trauma (with no mention of severe recent stressful life events), in comparison to FEP subjects without traumatic events. (2) In subjects affected by Hepatitis C, childhood trauma, parental antipathy, and neglect were found significantly associated with higher levels of depressive and anxious symptomatology and with greater emotional distress. Exploring different types of trauma, we found that subjects with a history of physical punishments demonstrated significantly increased levels of depression, emotional distress, and fatigue in comparison with subjects not recalling this history. An even stronger association was found between sexual unwanted experiences and levels of depression, anxiety, and emotional distress. Healthy subjects (3) with a history of childhood trauma showed higher lifetime frequency of positive psychotic-like symptomatology, while maternal antipathy was significantly associated with lower lifetime frequency of negative symptoms and lower levels of distress in response to depressive symptoms. Lifetime cannabis use and salivary cortisol levels were explored as potentially mediating factors, but no mediational effect was found. Finally, higher insulin levels were significantly associated in healthy subjects with physical abuse and childhood trauma plus severe life events (SLEs); Body Mass Index (BMI), which was also significantly associated with higher insulin levels, completely mediated the association with physical abuse, while childhood trauma plus SLEs and BMI gave independent contributions to higher insulin levels. Higher PAI-1 levels were found in subjects reporting childhood trauma and SLEs. Finally, physical abuse, severe sexual abuse and childhood trauma plus SLEs were found significantly associated with higher C-peptide levels. BMI completely mediated the association between physical abuse and C-Peptide, while severe sexual abuse or childhood trauma plus SLEs and BMI independently contributed to C-Peptide levels. CONCLUSION: Our findings confirmed the detrimental consequences of childhood trauma, even at non-clinical level. On the other side, some of our results evoked a potential increased resilience in subjects with a history of childhood traumatic experiences.