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Early Life Adversity and Adult Biological Risk Profiles

Friedman, Esther M. PhD; Karlamangla, Arun S. MD, PhD; Gruenewald, Tara L. PhD; Koretz, Brandon MD; Seeman, Teresa E. PhD

doi: 10.1097/PSY.0000000000000147

Objectives To determine whether there is a relationship between early life adversity (ELA) and biological parameters known to predict health risks and to examine the extent to which circumstances in midlife mediate this relationship.

Methods We analyzed data on 1180 respondents from the biomarker subsample of the second wave of the National Survey of Midlife Development in the United States. ELA assessments were based on childhood socioeconomic disadvantage (i.e., on welfare, perceived low income, and less educated parents) and other stressors (e.g., parental death, parental divorce, and parental physical abuse). The outcome variable was cumulative allostatic load (AL), a marker of biological risk. We also incorporate information on adult circumstances, including than following: education, social relationships, and health behaviors.

Results Childhood socioeconomic adversity and physical abuse were associated with increased AL (B = 0.094, standard error = 0.041, and B = 0.263, standard error = 0.091 respectively), with nonsignificant associations for parental divorce and death with AL. Adult education mediated the relationship between socioeconomic ELA and cumulative AL to the point of nonsignificance, with this factor alone explaining nearly 40% of the relationship. The association between childhood physical abuse and AL remained even after adjusting for adult educational attainments, social relationships, and health behaviors. These associations were most pronounced for secondary stress systems, including inflammation, cardiovascular function, and lipid metabolism.

Conclusions The physiological consequences of early life socioeconomic adversity are attenuated by achieving high levels of schooling later on. The adverse consequences of childhood physical abuse, on the other hand, persist in multivariable-adjusted analysis.

Supplemental digital content is available in the text.

From the RAND Corporation (Friedman), Santa Monica, California; Department of Medicine/Geriatrics (Karlamangla, Koretz, Seeman), Geffen School of Medicine, University of California, Los Angeles; and Davis School of Gerontology (Gruenewald), University of Southern California, Los Angeles.

Supplemental Content

Address correspondence and reprint requests to Esther M. Friedman, PhD, RAND Corporation, Santa Monica, CA. E-mail:

Received for publication January 14, 2013; revision received December 3, 2014.

Copyright © 2015 by American Psychosomatic Society
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