Long-term alteration of heart rate variability following childhood maltreatment: Results of a general population study.

BACKGROUND

Childhood maltreatment (CM) is a risk factor for mental and physical health problems in adulthood, potentially mediated by long-term autonomic nervous system (ANS) dysregulation. To explore this link, the association between CM and vagal-sensitive heart rate variability (HRV) metrics in adults was examined, accounting for biopsychosocial factors.

METHODS

Data from 4,420 participants in the Study of Health in Pomerania were analyzed, with CM assessed using the Childhood Trauma Questionnaire. HRV was derived from 10-second electrocardiograms and 5-minute pre-sleep polysomnographic recordings. Post hoc analyses examined abuse and neglect.

RESULTS

CM was associated with reduced HRV (logRMSSD:  = -0.20 [95%-CI: -0.28, -0.12],  = 1.2e-06), driven by neglect ( = -0.27 [-0.35, -0.18],  = 1.9e-09) rather than abuse ( = 0.01 [-0.12, 0.14],  = 1). Adjustments for age, sex, and medication attenuated these effects, which remained robust after additionally controlling for socioeconomic, lifestyle, body mass index, and depressive symptoms (fully adjusted model: CM  = -0.08 [-0.15, -0.001],  = .047; neglect  = -0.11 [-0.19, -0.03],  = .009; abuse  = -0.08 [-0.20, -0.04],  = .174). Age-related differences were found, with reduced HRV in both young and older participants but not in middle-aged participants (fully adjusted: (2,743) = 6.75,  = .001).

CONCLUSIONS

This study highlights long-term ANS dysregulation following CM, particularly neglect, indicated by altered vagal-sensitive HRV metrics. Although small in magnitude, the effect on the ANS was independent of adult biopsychosocial factors. This long-term dysregulation may contribute to an increased risk of adverse health outcomes in adulthood.