# ETIOLOGICAL PROCESSES IN THE ONSET AND MAINTENANCE OF ADVERSE HEALTH OUTCOMES IN MALTREATED YOUTH

> **NIH NIH P50** · PENNSYLVANIA STATE UNIVERSITY, THE · 2021 · $914,570

## Abstract

The CDC estimates a $124 billion aggregate lifetime economic burden incurred by victims of child 
maltreatment. A large literature supports positive associations between child maltreatment and adverse 
physical health outcomes including cardiovascular disease, obesity, diabetes, lung cancer, chronic pain, 
headaches, sexually-transmitted infections, and autoimmune diseases. However, the majority of these findings 
derive from cross-sectional, short-term, or adult retrospective study designs, severely limiting scientific 
credibility and causal inferences. Moreover, putative etiological processes leading to such outcomes remain 
largely unknown and not every child who has been maltreated will experience any long-term health effects, 
suggesting the presence of unique risk and resilience pathways. This lack of understanding in the basic 
mechanisms conferring risk or resilience for victims of child maltreatment has stymied translational research 
where preventative interventions targeting identified pathways can be developed or modified in an effort to 
reduce these health disparities and their corresponding healthcare costs. Project 1 will raise the rigor of this 
science and address critical gaps by implementing a large, prospective cohort study to examine the effects of 
child maltreatment on multiple etiological processes believed to play a role in the onset and maintenance of 
adverse health outcomes for victims. Through a large-scale partnership with the State of Pennsylvania's 
Department of Human Services, Project 1 will recruit a large cohort of 1200 children aged 8–13 (50% males), 
including 900 who experienced substantiated maltreatment within the past year (300 sexual abuse, 300 
physical abuse, and 300 neglect), along with demographically matched control children (300). The processes 
of biological embedding (BE) at the neuroendocrine, autonomic, immunologic, epigenetic, and cellular (i.e., 
mitochondria and telomere biology) levels will be examined as mechanisms of child health, including brain 
health (i.e., optimal neurodevelopmental trajectories), behavioral & emotional health, and physical health. 
Psychosocial and behavioral processes such as resilience (i.e., school engagement, self-esteem, family and 
peer support, adaptive coping, flexibility, cognitive ability, emotion regulation, and executive functioning); 
healthy lifestyle behaviors (i.e., exercise, sleep, diet, sexual attitudes, and substance use); and treatment 
utilization will be examined as plausible malleable factors that mitigate the relationship between BE and health. 
Aims include: (Aim 1) a comprehensive understanding of the interplay among child maltreatment, biological 
embedding (BE), and health status; (Aim 2) testing how BE operates independently and in conjunction with 
psychosocial and behavioral factors to explain the relationship between maltreatment and health status; and 
(Aim 3) testing the moderating effects of genotype, gender, ethnicity, pubertal ...

## Key facts

- **NIH application ID:** 10187608
- **Project number:** 5P50HD089922-05
- **Recipient organization:** PENNSYLVANIA STATE UNIVERSITY, THE
- **Principal Investigator:** CHRISTINE M HEIM
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $914,570
- **Award type:** 5
- **Project period:** 2017-04-20 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10187608

## Citation

> US National Institutes of Health, RePORTER application 10187608, ETIOLOGICAL PROCESSES IN THE ONSET AND MAINTENANCE OF ADVERSE HEALTH OUTCOMES IN MALTREATED YOUTH (5P50HD089922-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10187608. Licensed CC0.

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