Schrepf Andrew, Markon Kristian, Lutgendorf Susan K
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.
Psychosom Med. 2014 Jun;76(5):327-36. doi: 10.1097/PSY.0000000000000072.
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.
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.
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.
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.
童年创伤已知与成年期的炎症过程相关，但潜在的心理/行为机制尚未完全明确。为了研究童年创伤与炎症（以C反应蛋白[CRP]为指标）之间的关联，我们在美国中年生物标志物项目的一个子样本上采用了结构方程建模方法。
参与者包括687名无癌症、糖尿病、心血管疾病或中风病史的男性和女性，他们完成了体格检查、填写了详细问卷并提供了血液样本。为了检验性别差异，我们在保持良好模型拟合的同时，尽可能使跨性别参数保持不变。
直接和间接效应检验表明，童年创伤通过体重指数（BMI）升高与CRP升高显著相关（p <.001）。这种关系由一种广泛的痛苦潜在指标介导，该指标与将食物作为应对机制有关。男性和女性在报告的身体虐待、性虐待和身体忽视水平上存在差异。与男性相比，女性的BMI与CRP之间的关联更强，而男性使用食物应对与BMI升高之间的关联更强。
我们的结果与一个模型一致，即童年创伤与CRP升高相关，这种关系与应激反应性和补偿性情绪化进食有关。男性和女性可能以质的不同模式经历创伤，但有许多共同的脆弱性，这可能导致健康风险升高。情绪化进食可能是该人群干预的一个重要靶点。
