Childhood stress, ongoing relationships, with implications for health
Feb 27, 2013
Referred to elsewhere, in several places, on my site are observations from a number of researchers into the longterm consequences of childhood interpersonal distress and later-age illness -- names to search would include New Zealand's own Kate Scott [LINK], along the lines of the research by Kaiser Permanente in the 1980s (See Anda et al, 2006 [LINK]
Recently, though, Lisa Jeremka, of Ohio State University, has given me excuse to use one of my favourite words "commingling", almost onomatopoeic. Her research "commingles" research from biological, social, and individual psychological sciences, as expressed in the title of her recent "summary paper" summarising a number of previous research studies she has done -- her website, with links to her articles is accessible here: [LINK] and, in particular, her most recent article: "Synergistic relationships among stress, depression, and troubled relationships: Insights from Psychoneuroimmunology" [LINK] For citation, see [LINK]
From the abstract:
Stress and depression consistently elevate inflammation. Stress and depression are often experienced simultaneously, which is exemplified by people in troubled relationships. Troubled relationships also elevate inflammation, which may be partially explained by their ability to engender high levels of stress and depression. People who are stressed, depressed, or in troubled relationships are also at greater risk for health problems than their less distressed counterparts. Inflammation, a risk factor for a variety of age-related diseases including cardiovascular disease, Type II diabetes, metabolic syndrome, and frailty, may be one key mechanistic pathway linking distress to poor health. Obesity may further broaden the health implications of stress and depression; people who are stressed or depressed are often overweight, and adipose tissue is a major source of pro-inflammatory cytokines. Stress, depression, and troubled relationships may have synergistic inflammatory effects; loneliness, subclinical depression, and major depression enhance inflammatory responses to an acute stressful event. The relationship between distress and inflammation is bi-directional; depression enhances inflammation and inflammation promotes depression. Interesting questions emerge from this literature. For instance, some stressors may be more potent than others and thus may be more strongly linked to inflammation. In addition, it is possible that psychological and interpersonal resources may buffer the negative inflammatory effects of stress. Understanding the links among stress, depression, troubled relationships and inflammation is an exciting area of research that may provide mechanistic insight into the links between distress and poor health.
Clearly, Jeremka's article is not specifically about the longterm effects of childhood abuse or trauma, but one can see its relevance to the longterm effects of such abuse -- a research link I've not seen made elsewhere, yet, in the literature: ".... some stressors may be more potent than others and thus may be more strongly linked to inflammation", and as many have noted, stressed interpersonal relationships are more the rule with those from such backgrounds than the exception, resulting, based on the results of research by Jeremka and others, in the health effects reviewed and summarised by Anda et al (ibid.), and still being researched by Kate Scott, thankfully! Of course, given that some of the "interpersonal relationships" those abused as children have is with their care providers (including primary care providers, but this needs much more research), what are some other implications of this research. Jeremka et al suggests looking at patients' personal and interpersonal resources, supporting those relationships, including relationships with Primary Care Providers, but notes also that the relationship is "bi-directional" -- highlighting the need for health interventions targeted at reducing inflammatory responses.