Abstract
Background: Adverse childhood experiences (ACEs) have been associated with poor mental and somatic health. Accumulating evidence indicates that accelerated biological aging—indexed by altered telomere-related markers—may contribute to associations between ACEs and negative long-term health outcomes. Telomeres are repeated, non-coding deoxyribonucleic acid (DNA) sequences at the end of chromosomes. Telomeres shorten during repeated cell divisions over time and are being used as a marker of biological aging.Objectives: The aim of the current paper is to review the literature on the relationship between ACEs and telomere length (TL), with a specific focus on how the heterogeneity of sample and ACEs characteristics lead to varying associations between ACEs and TL.Methods: Multiple databases were searched for relevant English peer-reviewed articles. Thirty-eight papers were found to be eligible for inclusion in the current review.Results: Overall, the studies indicated a negative association between ACEs and TL, although many papers presented mixed findings and about a quarter of eligible studies found no association. Studies with smaller sample sizes more often reported significant associations than studies with larger samples. Also, studies reporting on non-clinical and younger samples more often found associations between ACEs and TL compared to studies with clinical and older samples. Reviewing the included studies based on the “Stressor Exposure Characteristics” recently proposed by Epel et al. (2018) revealed a lack of detailed information regarding ACEs characteristics in many studies.Conclusion: Overall, it is difficult to achieve firm conclusions about associations of ACEs with TL due to the heterogeneity of study and ACE characteristics and the heterogeneity in reported findings. The field would benefit from more detailed descriptions of study samples and measurement of ACEs.
Highlights
Adverse childhood experiences (ACEs) are a large societal problem, often with long-lasting health consequences
The combination of several instruments reported in the papers to assess ACEs with “telomere length” was examined: Childhood Trauma Questionnaire [CTQ] (Bernstein et al, 1994, 2003); Childhood Trauma Interview [CTI] (Foote and Lovejoy, 1995); Adverse Childhood Experiences [ACE] Questionnaire (Felitti et al, 1998); and the Early Trauma Inventory [ETI] (Bremner et al, 2000)
A total of 38 studies were included in this review based on the criteria of eligibility defined in the method section
Summary
Adverse childhood experiences (ACEs) (e.g., physical abuse, sexual abuse, emotional neglect, loss of a close family member) are a large societal problem, often with long-lasting health consequences. ACEs are found to be related to poor health outcomes, including various mental health problems (e.g., depression, anxiety, post-traumatic stress disorder [PTSD], suicidal ideation), substance abuse problems, self-reported illness, obesity, and overall morbidity (Felitti et al, 1998; Widom, 1999; Dube et al, 2001, 2003; Anda et al, 2006, 2010; Widom et al, 2007; Brown et al, 2009; Green et al, 2010; Heim et al, 2010; Kessler et al, 2010; Heim and Binder, 2012; Moffitt and the Klaus-Grawe Think Tank, 2013). Telomeres shorten during repeated cell divisions over time and are being used as a marker of biological aging
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