Science and Technology

Pioneering Study Unveils Measurement of Stress Impact On Teen Health

PHILADELPHIA, May 14, 2024 – New findings from the Children's Hospital of Philadelphia (CHOP) present significant advances in understanding adolescent stress, linking early-life adversity to stress, and consequent mental health challenges in teens. The groundbreaking research, published today in Nature Mental Health, introduces a novel approach to measuring allostatic load (AL)—the body's cumulative burden from chronic stress—in adolescents as young as 12. This study marks the first successful effort to quantify AL at such an early developmental stage, providing insights into how childhood experiences correlate with later stress and mental health outcomes.

The study arrives in the wake of mounting behavioral health challenges among young people, exacerbated by the COVID-19 pandemic. Leveraging CHOP’s dedication to combatting the pediatric mental health crisis, the team of researchers set out to demystify how environmental exposures—or the exposome—"get under the skin" to influence physiological systems and mental health. The study also evaluated the role of gene-environment interplay in contributing to AL, proposing that understanding these dynamics could pave the way for more tailored prevention and intervention tactics.

Lead author Dr. Ran Barzilay, a psychiatrist with CHOP's Youth Suicide Prevention, Intervention, and Research Center, emphasized the conventional belief that chronic stress incurs a physical toll on the body over time. However, the study's findings reveal that such biological stress markers can indeed be quantified in early adolescence, correlating with prior exposure to adversity and inequality.

The meticulous research was carried out by Dr. Kevin Hoffman, a child and adolescent psychiatry fellow at CHOP, with a dataset exceeding 5,000 diverse youths averaging 12 years of age, originating from the Adolescent Brain Cognitive Development Study. To calculate a latent AL score, the team incorporated measurements such as body mass index, waist circumference, blood pressure, blood sugar levels, cholesterol, and salivary stress hormones. The researchers meticulously reviewed the children's pre-adolescent environments, scrutinizing factors such as diet, exposure to abuse, socioeconomic status, and pollutants to establish a childhood exposomic risk profile. Additionally, genetic predispositions to metabolic and psychiatric conditions, such as Type 2 Diabetes and major depressive disorder, were assessed using polygenic risk scores.

Through linear mixed-effects models, the interconnections between exposomic risks, genetic predispositions, and AL were meticulously evaluated. The study found that childhood environmental exposures bore a more significant relationship to adolescent AL in youths with higher genetic predispositions to metabolic and psychiatric conditions. Moreover, adverse childhood experiences, such as abuse, family dysfunction, and poverty, were shown to elevate AL, which subsequently influenced mental health outcomes in adolescents.

Dr. Barzilay elaborated on the import of the findings, noting the substantial contribution to the literature suggesting that AL mediates the path from childhood adversity to adult mental health. Furthermore, the research supports the idea that AL may be a key factor in the genesis of health disparities, showcasing that such disparities manifest at a significantly younger age than the typical onset of many chronic medical illnesses.

The analysis also highlighted ethnic and racial disparities, where Non-Hispanic White youth exhibited markedly lower AL than their Hispanic and Non-Hispanic Black peers. The everyday challenges faced at home and within communities served as a primary determinant of heightened AL during adolescence. This crucial insight illuminates the profound effects of environmental stressors on the physical and mental well-being of youths and underscores the necessity for urgent action to address such inequities.

The study's implications prompt the call for further investigations within diverse populations. The measurement of AL is anticipated to significantly enhance the understanding of pediatric health outcomes, as well as the disparities therein.

"The future of mental health hinges on precision medicine, encapsulating a comprehensive understanding of individual and structural environmental factors, alongside genetic contributions, to health outcomes from an early age," stated Dr. Barzilay. Such a multifaceted perspective is seen as invaluable for advancing both the physical and mental health sectors.

This research received support from the National Institute of Mental Health grant K23MH120437.

Barzilay and colleagues present their comprehensive findings in "Exposomic and polygenic contributions to allostatic load in early adolescence," published in Nature Mental Health. The research can be accessed at the following DOI link: 10.1038/s44220-024-00255-9.

About Children's Hospital of Philadelphia

Founded in 1855, Children's Hospital of Philadelphia boasts the title of the nation's first pediatric hospital. Throughout its storied history, CHOP has remained committed to delivering exceptional patient care, cultivating the next generation of pediatric healthcare professionals, and spearheading significant research initiatives. As a result of these endeavors, the institution has generated numerous discoveries that have greatly benefited children across the globe. CHOP’s robust pediatric research program ranks as one of the most extensive nationwide.

The hospital has consistently demonstrated advanced pediatric care through its CHOP Care Network, a comprehensive assembly of over 50 primary care practices, specialty care and surgical centers, urgent care facilities, and community hospital alliances spread throughout Pennsylvania and New Jersey. The network expands to include the Middleman Family Pavilion, which features a dedicated pediatric emergency department located in King of Prussia.

Recognized as a foremost advocate for children and adolescents, CHOP's unique approach to family-centered care and its array of public service programs further distinguish it as a pioneer in pediatric health and wellness. For more in-depth information, visit CHOP's official website at https://www.chop.edu.

Contact for further information and inquiries:

Kaitlyn Tivenan Children's Hospital of Philadelphia (610) 618-0542 Email Kaitlyn Tivenan

The original PR Newswire source for the announcement, containing the study details and the Children's Hospital of Philadelphia logo, can be found here.

In a world where the well-being of our younger generation is paramount, research of this caliber is not solely an academic victory but a beacon calling for real-world application. By elucidating the tangible manifestations of childhood adversity in teens' physiological stress profiles, these revelations set the stage for informed intervention strategies. The ability to identify and measure allostatic load in adolescents carries the power to transform how society addresses the silent burden borne by our youth. It calls for targeted, evidence-based interventions that will pave the way for more resilient generations to come.

In the ongoing journey to unravel the complex interplay between our environment, our genetics, and our health, studies like this from the Children's Hospital of Philadelphia are both enlightening and vital. They not only shed light on the crucial nature of our early years and the unseen consequences of adversity but also serve as a harrowing reminder of the inequities that persist in our healthcare systems. As initiatives like precision medicine continue to advance, they fortify the arsenal with which healthcare professionals can combat these disparities head-on.

As society heeds the call to action precipitated by pioneering studies such as this one, the horizon for mental health care brightens considerably. This synergy between compassionate patient care, rigorous research, and the unwavering pursuit of knowledge exemplified by Children's Hospital of Philadelphia may very well mark the advent of a new era in pediatric and adolescent health—one where every child, regardless of background, has the opportunity to thrive unburdened by the weight of early-life stressors.

In summary, CHOP's landmark study underscores the profound and measurable impact of childhood environment on adolescent stress and mental health. These findings offer hope and actionable insight into improving the futures of our youth through informed, evidence-based healthcare practices. The challenge now lies in the hands of practitioners, policymakers, and society at large to heed this wisdom and invest in a future that upholds the health and well-being of all children, irrespective of their race, socioeconomic status, or past adversities.

For additional information and resources regarding the study and pediatric mental health, please refer to the Children's Hospital of Philadelphia’s website or contact their dedicated representatives.

This has been a news report based on the recent study published in Nature Mental Health and the institutional commitment to pediatric health by the Children's Hospital of Philadelphia.