Neglect, abuse, violence and trauma endured early in life can ripple directly into a child’s molecular structure and distort their DNA, according to a new study this week from the University of Wisconsin-Madison.
The genetic changes leave them biologically more vulnerable in later life to psychiatric afflictions like depression, anxiety, mood disorders and high-risk behavior like drug abuse, the researchers found.
“We may be seeing the mechanism via which childhood stress can cause social or behavioral problems,” said Leslie Seltzer, a UW-Madison researcher and one of the study's lead authors.
The study amounts to the latest validation to emerge in the last 10 years that childhood trauma often acts as the root cause of mental illness, addiction, alcoholism, incarceration, homelessness and even suicide. In Milwaukee, which hosts a crippling epidemic of childhood trauma, the drumbeat of new research has prompted the creation of a new collaborative effort to address the city’s widespread trauma and its aftereffects.
The group, called “Scaling Wellness in Milwaukee” or SWIM, held its latest meeting Wednesday. Because trauma has emerged as the unifying factor behind a wide spectrum of social and economic ills, which typically are treated in isolation, the SWIM collaboration has attracted an equally wide spectrum of members: social agencies, therapists, university researchers, behavioral health clinics, community activists and even criminal justice.
The SWIM objective is to tackle the trauma epidemic under a “collective impact” strategy that cuts over all the segmented disciplines and silos. “There are a lot of great things happening, but they still remain siloed,” said Marquette University President Mike Lovell, who launched the SWIM initiative earlier this year with his wife, Amy, a mental health activist.
The researchers in Madison wanted to study the impact of childhood stress on genetic chemistry. Seltzer said the biological impact of trauma can put markers on specific genes that act as an on-off switch, which in turn determine whether the natural function of those specific genes are activated or repressed.
Those markers, which scientists call epi-genetic modification, affect emotional regulation or depressive disorders. “We know that early life stress and the development of psychiatric disorders are related,” Seltzer said. “We want to know how one leads to the other.
“Our analysis identified differences in genes that help regulate mood and attachment,” Seltzer said.
Seltzer and her collaborators worked with a group of 22 girls, ages 9 to 12, who were carefully selected for the study. Eleven of them had lived through violent or tragic life experiences at an early age, including homelessness, abuse, separation from parents and lack of security. Another 11 girls of the same age were selected because they had relatively tranquil childhoods.
Using saliva samples — common in all sorts of DNA test kits — the researchers were able to study their genes as well as their genetic markers. Their work, supported by a grant from the National Institutes of Health and the National Science Foundation, was published Tuesday.
One finding was that the epi-genetic markers can embed themselves for years, suggesting that they could affect a person their entire lives, said UW–Madison neurosurgery professor Reid Alisch, who oversaw the genetic lab work for the study.
“What some people in the field weren’t sure about is whether molecular changes that occur during a stressful period very early in life are stable,” he said. “What we’re finding is that after 10 years or so there are still markers, like fossils in our genome, telling us there was a trauma here. And that trauma may make this individual more susceptible to a second trauma or, even worse, a behavioral change, later in life.”
The Madison study also could lead the way to create new diagnostic tools, Alisch said.
One side-effect of childhood trauma is that victims sometimes cannot recall with accuracy what happened to them.
Genetic tests, however, are less subjective and can help make a reliable diagnosis, Alisch said, adding: “This can help us treat the individual.”
Genomics is a new science and the study likely will lead to further research. “We’ve also flagged a lot of genes whose jobs still aren’t clear," Alisch said. "Now we know that they may deserve more study for playing a part in stress-related psychiatric disorders."
'A psychological connection'
The notion that neuroscience and genetics lies at the heart of the nation's economic and social debate is new, driven by data collected in the last 10 years. "A Time to Heal," a series of articles last year by the Milwaukee Journal Sentinel, documented how widespread trauma worsens the ongoing social crisis in a city that for decades has defined the national extremes of poverty, unemployment, incarceration, infant mortality and broken homes.
At Wednesday's SWIM meeting in Milwaukee, participants said they've seen enough trauma science to know they need to take action. They also concur that the sheer enormity of the trauma in Milwaukee overwhelms individual agencies and activists, meaning the city has no choice but to collaborate.
“We can no longer say we don’t know what to do," said Susan Gadacz, chief executive of the Outreach Community Health Centers. Gadacz's group, formerly called Health Care for the Homeless, serves all patients whether they are insured or not.
SWIM has been meeting monthly since January, looking for strategies to align agencies and activists who never previously worked together.
In a new development, the American Heart Association joined Wednesday's meeting, adding another organization that many might not associate with psychological trauma, at least not at first glance. "There's definitely a psychological connection that's hard and fast," because those with mental illness often cannot care for their physical or cardiovascular health, said Oby Nwabuzor, a health strategies official at the Milwaukee chapter of the Heart Association.
"At the Heart Association, we also are moving to a collective impact model," in an effort to improve public health, Nwabuzor said. SWIM was a natural outlet.
The Heart Association, with decades of experience in policy advocacy in Washington and Madison, will help launch a new policy advocacy arm of SWIM, Lovell said.
The idea makes sense because political decisions affect how trauma activists can treat Milwaukee's high-risk population. In a brainstorming session on policy Wednesday, SWIM participants cataloged areas where political coordination is vital to make headway.
Notably, government mental health reimbursements are 20% below conventional medicine payments, which makes it difficult to provide services, said Jon Lehrmann, chair of psychiatry and behavioral medicine at the Medical College of Wisconsin. "I struggle to hire psychiatrists," Lehrman said.
"If we want to move the needle, we will need policy coordination," Lovell told the gathering. "That's why the American Heart Association joined — they are good at policy."