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From Childhood Trauma to Elevated C-Reactive Protein in Adulthood: The Role of Anxiety and Emotional Eating

Schrepf, Andrew BA; Markon, Kristian PhD; Lutgendorf, Susan K. PhD

doi: 10.1097/PSY.0000000000000072
Original Articles

Objective Childhood trauma is known to be related to inflammatory processes in adulthood, but underlying psychological/behavioral mechanisms have not been fully characterized. To investigate associations between childhood trauma and inflammation (indexed by C-reactive protein [CRP]), we used a structural equation modeling approach on a subsample of the Midlife in the United States biomarker project.

Methods Participants included 687 men and women without history of cancer, diabetes, cardiovascular disease, or stroke who completed a physical examination and extensive questionnaires and provided blood. To test for sex differences, we held as many parameters invariant across sexes as possible while still retaining good model fit.

Results Tests of direct and indirect effects revealed that childhood trauma was significantly associated with elevated CRP, via elevated body mass index (BMI; p < .001). This relationship was mediated by a broad latent measure of distress, which was associated with using food as a coping mechanism. Men and women differed in reported levels of physical abuse, sexual abuse, and physical neglect. Compared with men, women showed a stronger association between BMI and CRP, whereas men had a stronger association between use of food to cope and elevated BMI.

Conclusions Our results are consistent with a model in which childhood trauma is associated with elevated CRP, a relationship associated with stress reactivity and compensatory emotional eating. Men and women may experience trauma in qualitatively distinct patterns but share many vulnerabilities, which can lead to elevated health risks. Emotional eating may be an important target for intervention in this population.

Supplemental digital content is available in the text.

From the Departments of Psychology (A.S., K.M., S.K.L.), Obstetrics and Gynecology (S.K.L.), and Urology (S.K.L.) and Holden Comprehensive Cancer Center (S.K.L.), University of Iowa, Iowa City, Iowa.

Address correspondence and reprint requests to Susan K. Lutgendorf, PhD, Department of Psychology, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242. E-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received for publication December 14, 2013; revision received April 13, 2014.

Copyright © 2014 by American Psychosomatic Society
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