A new Tulane University School of Medicine study finds that children whose families are fractured by domestic violence or other trauma can ‘bear the scars down to their DNA.’
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres — a cellular marker of aging — than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate; much like the plastic tips of shoelaces, telomeres prevent DNA from ‘unraveling.’ Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood.
In the new study, researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events.
“Family-level stressors, such as witnessing a family member get hurt, created an environment that affected the DNA within the cells of the children,” said lead author Dr. Stacy Drury, director of the Behavioral and Neurodevelopmental Genetics Laboratory at Tulane. “The greater the number of exposures these kids had in life, the shorter their telomeres were — and this was after controlling for many other factors, including socioeconomic status, maternal education, parental age and the child’s age.”
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said.
In a similar study, published in 2013, researchers at Duke University found that children with a history of two or more kinds of violent exposures (including domestic violence, frequent bullying victimization, and/or physical maltreatment) have significantly more telomere loss than other children. Telomeres are known to get shorter each time cells divide, putting a limit on the number of times a given cell can go on dividing. Smoking, obesity, psychological disorders and stress have been found to possibly accelerate that process of telomere loss. In that sense, our telomeres may reflect biological age, not just chronological age.
The findings from these two studies suggest a mechanism linking cumulative childhood stress to telomere maintenance and accelerated aging, even at a young age. This appears to be an important way that childhood stress may get “under the skin” at the fundamental level of our cells.
Spotlight on Childhood Exposure to Violence
By the Numbers
Shockingly, children in the United States are more likely to be exposed to violence and crime than are adults. A nationwide study conducted in 2009 found that more than 60 percent of children were exposed to violence within the past year, either directly or indirectly (i.e., as a witness to a violent act; by learning of a violent act against a family member, neighbor, or close friend; or from a threat against their home or school). Nearly half of the children in the study were assaulted at least once in the past year, and more than 1 in 10 were injured in an assault within the past 12 months. These estimates increase substantially with age, such that more than 9 in 10 older adolescents (ages 14-17) had been exposed to violence, either directly or indirectly. Disturbingly, more than 10 percent of those older adolescents had witnessed a shooting within the past year.
This all adds up to millions of children and adolescents in the United States who are exposed to violence in their homes, schools, and communities as both victims and witnesses. Even if they are not physically present, children may be affected by intentional harm done by another (for example, the murder of or an assault on a family member or close neighbor). Children react to exposure to violence in different ways, and many children show remarkable resilience. All too often, however, children who are exposed to violence undergo lasting physical, mental, and emotional harm. The nature of the impact is dependent on the timing, type, and chronicity of the exposure to violence.
The Public Health Impact
Violence is clearly a public health problem, and children are particularly vulnerable to its effects. Besides being a leading source of injury, violence takes a toll on more subtle aspects of functioning, such as cognitive, behavioral, social, and emotional functioning. Disruption in these domains can affect children’s progression through typical developmental processes, leading to permanent, long-term consequences.
Children who are exposed to violence of any kind may exhibit behavioral disorders such as aggression and delinquency; emotional and mood disorders such as depression and anxiety; posttraumatic stress symptoms such as exaggerated startle, nightmares, and flashbacks; health-related problems and somatic symptoms such as sleep disturbances; and academic and cognitive problems. Some forms of violence tend to have specific consequences. For example, sexual acting out sometimes is a specific consequence of sexual abuse.
One specific mechanism through which early, chronic exposure to violence affects children is by disrupting the developing brain. Specific brain structures (amygdala, hippocampus, prefrontal cortex) are adversely affected by stress. Executive functions (such as planning, memory, focusing attention, impulse control, and using new information to make decisions) can become impaired. Moreover, children who have had chronic exposure to real or perceived threats may become conditioned to react with fear and anxiety to a broad range of circumstances. Their diminished capacity to differentiate between genuine threats and objectively safe or neutral situations can impair their ability to learn and interact with others, and may lead to serious anxiety disorders.
Posttraumatic stress symptoms and posttraumatic stress disorder (PTSD) are important consequences of exposure to violence because they can impair social and behavioral functioning. Many children who do not meet diagnostic criteria for PTSD may experience troublesome symptoms. Physical and sexual abuse, community violence, and exposure to domestic violence are linked with posttraumatic stress symptoms, with links particularly well documented for sexual abuse. The degree to which exposure leads to posttraumatic stress symptoms in children may vary with the intensity of the violence and the degree to which the violence has lasting effects on the people most important to them (e.g., witnessing a stranger being punched vs. seeing a parent being assaulted vs. being directly victimized).
The Cycle of Violence
Because exposure to violence typically occurs in familiar settings, the safe havens of family and community are marred by danger. Parents have not been able to prevent the violence and may be the perpetrators, the victims, or themselves affected in ways that compromise their caretaking. Distressing consequences of violence may include breakup or relocation of the family or repercussions following disclosure of abuse. Children living with violence may also experience family conflict and other life stresses, such as poverty, parents’ unemployment, or parents’ substance abuse and psychopathology. In an iterative fashion, these life stresses increase the risk for continued violence, and violence increases the likelihood of these stresses.
An estimated 30 to 60 percent of children who are exposed to violence between their parents will go on to become victims of the violence themselves. These children are subsequently far more likely to be involved in violent relationships in adulthood. Without help, girls who witness and experience domestic violence as children are more vulnerable to all forms of abuse as teens and adults. Similarly, without help, boys who witness and experience domestic violence are far more likely to become abusers of their own partners and children as adults, thus continuing the cycle of violence in the next generation.
Ending the Violence: Policy Priorities
Although the legal system is beginning to recognize the need to protect and care for these children, less than half of the states in the country currently address in statute the issue of children who witness violence in their homes. When it comes to the mental and physical health effects of exposure to violence, a child is considered a witness to domestic violence when an act that is defined as domestic violence is committed in the presence of or perceived by the child. However, only six states have laws consistent with that definition. In 14 states and Puerto Rico, the language used is more restrictive, stating that witnessing by a child occurs only when the child is physically present or can see or hear the act of violence. Only five states consider the commission of violence in the presence of a child as a separate crime that may be charged independently from or in addition to the original act of violence.
As I discussed just yesterday on PublicHealthWatch, the inseparable connections between intimate partner violence/spousal abuse and children’s exposure to violence indicate a strong need for coordination between child welfare and domestic abuse agencies and advocates. Further, because of the correlation between spouse and child abuse, it is important that the laws governing child abuse and child custody do not have unintended effects on battered women. In the United States, for example, child welfare laws that determined custody according to the “best interests of the child” often held that a women was an unfit parent because she did not protect her child from abuse—even though she was also abused and may not have felt it was safe for her and her child to leave.
Recent child trauma research programs in the United States have adopted a “dual victim treatment” approach. This approach is based on the premises that mother and child witnesses are dual victims of domestic abuse, and that strengthening the mother-child bond in dual victim cases helps minimize the harm experienced by children. Reports from programs that work to develop the relationship between the two victims through counseling have been dramatic: Not only did the children’s mental and emotional health improve significantly, but only one in forty-five women returned to her abuser.
Recognizing this critical link between violence against women and childhood exposure to violence is key to stopping the cycle of violence that hurts millions of women, children, and families every single year. Abused women and children are among the most vulnerable members of society; often, they have no voice to speak up or ask for help. It’s up to us to fulfill our societal responsibility by standing up for those silenced by violence and demanding a change.
“The twentieth century will be remembered as a century marked by violence….. Less visible, but even more widespread, is the legacy of day-to-day, individual suffering. It is the pain of children who are abused by people who should protect them, women injured or humiliated by violent partners, elderly persons maltreated by their caregiver, youths who are bullied by other youths, and people of all ages who inflict violence on themselves….. No country, no city, no community is immune. But neither are we powerless against it…… Violence can be prevented….. We owe it to our children – the most vulnerable citizens in our society, a life free from violence and fear. In order to insure this, we must be tireless in our efforts not only to attain peace, justice and prosperity for country, but also for communities and members of the same family. We must address the roots of violence. Only then will we transform the past century’s legacy from a crushing burden into a cautionary lesson.” — Nelson Mandela, in his forward to the World Report on Violence and Health, 2002
To learn more about family violence (including child abuse and intimate partner violence) and to see how you can get involved in the fight to end family violence, check out the following resources:
- Futures Without Violence
- The Advocates for Human Rights: Stop Violence Against Women
- Office on Women’s Health, U.S. Department of Health and Human Services: Help End Violence Against Women
- National Children’s Advocacy Center: Stop Child Abuse and Neglect
- National Coalition Against Domestic Violence
- U.S. Department of Health and Human Services, Family and Youth Services Bureau: Family Violence Prevention and Services
- New Study Shows Devastating Impact Of Domestic Violence On Children (publichealthwatch.wordpress.com)
- Spanking Your Kids Is Ineffective And Harmful — So Why Is It Still Legal? (publichealthwatch.wordpress.com)
- Child Abuse Has ‘Serious Consequences For Brain Development’ (publichealthwatch.wordpress.com)
- New Research On Domestic Violence Shows Devastating Impact On New Mothers (publichealthwatch.wordpress.com)