Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Study Eligibility
2.3. Data Extraction and Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Study Characteristics
3.2. Synthesis of Effect Sizes
3.3. Subgroup Analyses
3.4. Sensitivity Analysis
3.5. Publication Bias
4. Discussion
5. Strengths, Limitations, and Future Research
6. Implications
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study Characteristics | Participants’ Characteristics | Exposure of Violence | Telomere Measurement | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Authors (Year) | Country | Sample | Study Design | Sample Size | Mean Age (s.d.) | Female (%) | Education | Types of Violence | Specific Age Range of Violence Happened | Measures to Detect Violence | Mode of Reporting | TL Cell Type | Period of TL Measurement | TL Assay Type |
Aas et al., 2019 [28] | Norway | The participants were recruited from psychiatric units (outpatient and inpatient) of four major hospitals | CS | Schizophrenia (SZ) = 373, bipolar disorder (BD) = 249, healthy (HC) = 402 | SZ: 29.1 (9.3), BD: 31.8 (11.3), HC: 31.4 (7.6) | SZ: 41%, BD: 58%, HC: 43% | NA | Sexual abuse, physical abuse, and emotional abuse | Not reported | Childhood Trauma Questionnaire (CTQ) | Self-report | Blood | Adulthood | qPCR |
Boeck et al. 2018 [30] | Germany | Women giving birth in the maternity ward of the University Hospital Ulm were invited to participate in the study | CS | 30 | CM− = 31.5 (5.56), CM+ = 30.9 (6.4) | All female | University: CM− = 60.0%, CM+ = 33.3% | Physical/emotional/sexual abuse and physical/emotional neglect | ≤18 | CTQ | Interview | Blood | Adulthood | qFISH |
Çevik et al., 2019 [44] | Turkey | Participants of a large gene-environment interaction study: European Network of National Schizophrenia Networks Studying Gene-Environment Interactions | CS | Schizophrenia (SCZ) = 100 | SCZ = 31.69 (8.01) | SCZ = 32% | ≥university: SCZ = 15% | Physical abuse, psychological abuse, and sexual abuse | ≤17 | Childhood Experience of Care and Abuse- Interview (CECA-Interview) | Interview | Blood | Adulthood | qPCR |
Etzel et al., 2020 [45] | The United States | Female subjects with substantiated sexual abuse were referred to the study by Child Protective Services (CPS) agencies. Control subjects were recruited from the same communities as the childhood sexual abuse (CSA)-exposed participants through local advertisements | CS | 108 | At DNA collection: 36.3 (3.3) | All female | 16.5 (1.9) | Sexual abuse | 6–16 | Substantiated by Child Protective Services | Referred by Child Protective Services | Buccal | Adulthood | qPCR |
Kuehl et al., 2022 [46] | Germany | Patients and healthy participants were recruited from the specialized affective disorder unit and by public postings | CS | 90 | MDD+/ACE+ (N = 23): 38.1 (11.4); MDD+/ACE− (N = 24): 32.7 (11.5); MDD−/ACE+ (N = 22): 34.7 (10.7); MDD−/ACE− (N = 21): 36.1 (11.4) | 64.44% | MDD+/ACE+: 11.3 (1.6); MDD+/ACE−: 12.0 (1.4); MDD−/ACE+: 11.8 (1.4); MDD−/ACE−: 12.1 (1.3) | Physical or sexual abuse | ≤18 | CTQ | Self-report | Blood | Adulthood | qPCR |
Küffer et al., 2016 [25] | Germany | Participants were recruited via advertisements in local and national newspapers and magazines, and via specific indentured child laborers’ societies and associations | CS | Former indentured child laborers = 62, healthy controls = 58 | Former indentured child laborers = 76.19 (6.18), healthy controls = 71.85 (5.97) | Former indentured child laborers = 43.55%, Controls = 44.11% | Former indentured child laborers = 10.45 (2.16), controls = 13.35 (3.57) | Emotional/physical/sexual abuse and emotional/physical neglect | Not reported | Childhood Trauma Questionnaire − Short Form (CTQ-SF) | Self-report | Buccal | Adulthood | qPCR |
Mason et al., 2015 [26] | The United States | The Nurses’ Health Study II (NHSII) follows 116,430 female registered nurses | CS | 1135 | Between the ages of 25 and 42 | All female | NA | Physical and sexual abuse | ≤17 | Revised Conflict Tactics Scale Sexual experiences survey | Self-report | Blood | Adulthood | qPCR |
O’Donovan et al., 2011 [47] | The United States | Participants were recruited through ads and flyers distributed in the community, as well as through relevant local clinics for the PTSD sample | CS | PTSD = 43, controls = 47 | PTSD = 30.60 (6.63), controls = 30.68 (8.19) | PTSD = 47%, controls = 56% | PTSD: female (n = 20) = 15.2 (2.1), male (n = 22) = 14.4 (2.3); Controls: female (n = 25) = 15.4 (2.0), male (n = 21) = 15.5 (2.1) | Physically harmed, physical neglect, family violence, physical abuse, forced sexual touch, or forced sexual intercourse | ≤14 | Life Stressor Checklist (LSC) | Interview | Blood | Adulthood | qPCR |
Puterman et al., 2016 [27] | The United States | The participants were from an ongoing longitudinal, nationally representative sample of >26,000 US residents over 50 years of age and their spouses | CS | 4598 | <60: 25.7% | 55.90% | College and above: 25.4% (n = 4597) | Physically abuse | ≤18 | Major childhood adversity items were asked across the survey modules | Self-report | Saliva | Adulthood | qPCR |
Révész et al., 2016 [29] | The Netherlands | Respondents were recruited from community, primary care, and specialized mental health care settings | L | Baseline = 2936, 6-year follow-up = 1860 | Baseline = 41.81 (13.07) | 66.40% | 12.15 (3.27) | Emotional neglect, psychological abuse, physical abuse or sexual abuse | ≤16 | Childhood Trauma Interview (CTI) | Interview | Blood | Adulthood | qPCR |
Ridout et al., 2019 [24] | The United States | Children with maltreatment were identified from the local child welfare agency or an emergency maltreatment assessment service via recorded review. Families without maltreatment were recruited at a pediatric medical clinic during a well-child visit or at childcare centers | L | No maltreatment = 123, maltreated = 133 | No maltreatment = 50.1 (9.0) (months), maltreated = 51.9 (8.8) (months) | No maltreatment = 51.2%, maltreated = 53.4% | NA | Physical/sexual abuse, physical neglect/failure to provide, physical neglect/lack of supervision, emotional maltreatment | Not reported | System for Coding Subtype and Severity of Maltreatment in Child Protective Records | Official record | Saliva | Childhood | qPCR |
Robakis et al., 2020 [48] | The United States | The clinical-women sample was recruited from local obstetric clinics, community postings, and the Stanford University reproductive psychiatry clinic. The epigenetic sample was recruited in part from the clinical sample population and in part from a second study with equivalent recruitment criteria and follow-up procedures | CS | Epigenetic sample = 54, clinical sample = 124 | Epigenetic sample: 32.33 (4.40), clinical sample: 32.31 (4.79) | All female | Above bachelor: epigenetic sample = 87.04%, clinical sample = 82.26% | Physical/emotional/sexual abuse and physical/emotional neglect | Not reported | CTQ | Self-report | Buccal | Adulthood | qPCR |
Shalev et al., 2013b [23] | United Kingdom | The sample was drawn from a larger birth register of twins born in England and Wales in 1994–1995 | L | 236 | Baseline = age 5 | 49% | NA | Domestic violence and physical maltreatment | 5–10 | Conflict Tactics Scale Physical maltreatment | Interview mothers (or the primary caregiver) | Buccal | Childhood | qPCR |
Sosnowski et al., 2019 [33] | The United States | The present study group consisted of a subset of female–female (FF) monozygotic (MZ) twins who participated in the population-based Virginia Adult Twin Study for Psychiatric and Substance Use Disorders | CS | 97 | 52.74 (8.55) | All female | 14.67 (2.14) | Childhood sexual abuse | ≤16 | A single item from an adapted version of a previously developed measure | Self-report | Blood | Adulthood | MMqPCR |
Surtees et al., 2011 [34] | United Kingdom | As virtually 100% of people in the United Kingdom are registered with general practitioners through the National Health Service, the age–sex registers form a population-based sampling frame | CS | 4441 | 62 years (range 41 and 80) | All female | NA | Physical abuse | ≤17 | the Health and Life Experiences Questionnaire (HLEQ) | Self-report | Blood | Adulthood | qPCR |
Tyrka et al., 2010 [31] | The United States | Subjects were recruited via advertisements in the community for a larger study of stress reactivity and psychiatric symptoms | CS | No-maltreatment = 21, maltreatment = 10 | 26.9 (10.1) | No maltreatment = 67%, Maltreated = 80% | Above College: No maltreatment = 61.9%; Maltreated = 40% | Physical/sexual/emotional abuse and physical/emotional neglect | Not reported | CTQ | Self-report | Blood | Adulthood | qPCR |
Verhoeven et al., 2015 [49] | The Netherlands | Participants were assessed during a 4-hour clinic visit | CS | 2936 | 41.8 (13.1) | 66.4% | 12.2 (3.3) | Emotional neglect, psychological abuse, physical abuse, or sexual abuse | ≤16 | Childhood Trauma Interview (CTI) | Interview | Blood | Adulthood | qPCR |
Womersley et al., 2021 [50] | South Africa | Women were recruited over 8 years (2008–2015) from community health care facilities in and around Cape Town, South Africa | L | 286 | Baseline = HIV−ve: 28.58 (8.36); HIV + ve: 33.11 (6.90) | All female | HIV−ve: 10.83 (1.45); HIV + ve: 10.12 (1.68) | physical, emotional and sexual abuse, as well as physical and emotional neglect | ≤18 | CTQ | Self-report | Blood | Adulthood | qPCR |
Xavier et al., 2018 [32] | Brazil | Participants from a large prospective community school-based study | CS | 561 | 10.19 (1.91) | 45.10% | NA | Physical abuse, neglect, emotional maltreatment, and sexual abuse | Not reported | Four questions regarding the history of adverse environment and trauma | Self and the parent-report | Blood | Childhood | qPCR |
Moderator | Random Effect Size Estimate | Heterogeneity Analysis | ||||||
---|---|---|---|---|---|---|---|---|
k | r | 95% CI | p | Q | df | p | I2 | |
Gender, Q (1) = 0.008, p = 0.931 | ||||||||
Both genders | 12 | −0.038 | [−0.080, 0.005] | 0.082 | 40.897 | 11 | <0.001 | 73.103 |
Females only | 7 | −0.041 | [−0.103, 0.021] | 0.194 | 10.188 | 6 | 0.117 | 41.110 |
Co-occurrence of violence a, Q (1) = 8.143, p = 0.004 | ||||||||
Non-co-occurrence (single type of occurrence) | 17 | −0.025 | [−0.056, 0.005] | 0.106 | 40.894 | 16 | 0.001 | 60.874 |
Co-occurrence | 2 | −0.209 | [−0.325, −0.087] | 0.001 | 0.558 | 1 | 0.455 | <0.001 |
Violence measurement, Q (1) = 0.360, p = 0.549 | ||||||||
Self-report | 10 | −0.029 | [−0.075, 0.018] | 0.225 | 21.790 | 9 | 0.010 | 58.696 |
Others | 9 | −0.050 | [−0.100, 0.001] | 0.054 | 27.722 | 8 | 0.001 | 71.143 |
Source of tissue, Q (2) = 4.396, p = 0.111 | ||||||||
Blood (e.g., Leukocytes, peripheral cells) | 13 | −0.056 | [−0.098, −0.014] | 0.009 | 28.300 | 12 | 0.005 | 57.598 |
Buccal swabs | 4 | −0.054 | [−0.158, 0.052] | 0.318 | 12.000 | 3 | 0.007 | 74.999 |
Saliva | 2 | 0.050 | [−0.041, 0.139] | 0.283 | 8.875 | 1 | 0.003 | 88.733 |
Telomere measurement technique, Q (1) = 0.002, p = 0.963 | ||||||||
qPCR | 17 | −0.038 | [−0.072, −0.004] | 0.027 | 52.187 | 16 | <0.001 | 69.341 |
Other techniques | 2 | −0.033 | [−0.220, 0.155] | 0.730 | 0.595 | 1 | 0.441 | <0.001 |
Time of telomere measure, Q (1) = 0.280, p = 0.597 | ||||||||
Adulthood | 16 | −0.042 | [−0.078, −0.005] | 0.025 | 35.927 | 15 | 0.002 | 58.249 |
Childhood | 3 | −0.017 | [−0.101, 0.066] | 0.685 | 16.861 | 2 | <0.001 | 88.138 |
Whether covariates controlled b, Q (1) = 0.618, p = 0.432 | ||||||||
Yes | 4 | −0.015 | [−0.084, 0.053] | 0.663 | 17.370 | 3 | 0.001 | 82.729 |
No | 15 | −0.047 | [−0.088, −0.006] | 0.023 | 35.366 | 14 | 0.001 | 60.414 |
Sample size, Q (2) = 3.398, p = 0.183 | ||||||||
Large (>1000) | 5 | −0.023 | [−0.067, 0.021] | 0.311 | 9.806 | 4 | 0.044 | 59.209 |
Medium (100–1000) | 8 | −0.036 | [−0.090, 0.018] | 0.189 | 27.718 | 7 | <0.001 | 74.746 |
Small (<100) | 6 | −0.132 | [−0.237, −0.024] | 0.017 | 9.505 | 5 | 0.091 | 47.397 |
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Chen, X.Y.; Lo, C.K.M.; Chan, K.L.; Leung, W.C.; Ip, P. Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 12151. https://doi.org/10.3390/ijerph191912151
Chen XY, Lo CKM, Chan KL, Leung WC, Ip P. Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(19):12151. https://doi.org/10.3390/ijerph191912151
Chicago/Turabian StyleChen, Xiao Yan, Camilla K. M. Lo, Ko Ling Chan, Wing Cheong Leung, and Patrick Ip. 2022. "Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis" International Journal of Environmental Research and Public Health 19, no. 19: 12151. https://doi.org/10.3390/ijerph191912151
APA StyleChen, X. Y., Lo, C. K. M., Chan, K. L., Leung, W. C., & Ip, P. (2022). Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis. International Journal of Environmental Research and Public Health, 19(19), 12151. https://doi.org/10.3390/ijerph191912151