Child abuse permanently modifies stress genes in brains of suicide victims

By Ed Yong

February 22, 2009 / Not Exactly Rocket Science

The trauma of child abuse can last a lifetime, leading to a higher risk of anxiety, depression and suicide further down the line. This link seems obvious, but a group of Canadian scientists have found that it has a genetic basis.

By studying the brains of suicide victims, Patrick McGowan from the Douglas Mental Health University Institute, found that child abuse modifies a gene called NR3C1 that affects a person's ability to deal with stress. The changes it wrought were "epigenetic", meaning that the gene's DNA sequence wasn't altered but it's structure was modified to make it less active. These types of changes are very long-lasting, which strongly suggests that the trauma of child abuse could be permanently inscribed onto a person's genes.

Child abuse, from neglect to physical abuse, affects the workings of an important group of organs called the "hypothalamic-pituitary-adrenal axis" or HPA. This trinity consists of the hypothalamus, a funnel-shaped part of the brain; the pituitary gland, which sits beneath it; and the adrenal glands, which sit above the kidneys.  All three organs secrete hormones. Through these chemicals, the HPA axis controls our reactions to stressful situations, triggering a number of physiological changes that prime our bodies for action.

The NR3C1 gene is part of this system. It produces a protein called the glucocorticoid receptor, which sticks to cortisol, the so-called "stress hormone". Cortisol is produced by the adrenal glands in response to stress, and when it latches on to its receptor,  it triggers a chain reaction that deactivates the HPA axis. In this way, our body automatically limits its own response to stressful situations.

Without enough glucocorticoid receptors, this self-control goes awry, which means that the HPA is active in normal situations, as well as stressful ones. No surprise then, that some scientists have found a link between low levels of this receptor and schizophrenia, mood disorders and suicide. So, childhood trauma alters the way the body reacts to stress, which affects a person's risk of suicide or mental disorders later in life. Now, McGowan's group have revealed part of the genetic (well, epigenetic) basis behind this link.

Silencing a promoter

The group looked at 24 samples of brain tissue taken from autopsies of male suicide victims, half of whom had been abused as children and half of whom had not. They compared these people to a dozen others, who had never been abused and had died suddenly through accidents. All the samples came from the hippocampus, a part of the brain where NR3C1 is particularly active.

McGowan found that the activity of the NR3C1 gene was much lower in abuse victims who took their own lives, than in either of the other groups. In their brains, he found lower levels of NR3C1's mRNA - a molecule that is transcribed from the gene's DNA sequence and provides the recipe for building the glucocorticoid receptor. With a shortfall of this mRNA, the abused suicide victims would also have had lower levels of this critical receptor.

It was clear that this deficit was because of the abuse rather than the suicide, since suicide victims who hadn't been abused had the same levels of NR3C1 mRNA as people who died of  other causes. McGowan even accounted for whether the victims suffered from mood disorders, alcoholism or drug addictions - none of these factors swayed the results.

Why was the NR3C1 gene less active in the abused victims? To find out, McGowan focused on the gene's "promoter region", a stretch of DNA that controls its activity. NR3C1 is activated by a protein called NGFI-A, which needs to dock at special landing sites in the promoter to switch on the gene.

In the abused suicide victims, these landing sites had been heavily altered. McGowan found that small molecules called methyl groups had been attached to the promoter region's DNA, which prevented the NGFI-A protein from docking. The underlying DNA hadn't changed - in fact, the sequence of NR3C1's promoter region was exactly the same in all 36 samples.

This is an example of an "epigenetic" change, where structural modifications change the way a gene behaves even though its DNA sequence is still the same. The methyl groups are the chemical equivalent of Post-It notes that obscure the underlying text without actually editing it. McGowan found over twice as many of these chemical add-ons in the abused suicide victims than in the others. It was their presence that slashed the activity of the NR3C1 gene.

Putting it together

Together, McGowan's results paint a very suggestive picture that links child abuse to later illness and death. Abuse leads to epigenetic changes that modify genes including NR3C1. These changes, especially those involving methyl groups, are very stable and they could slash the gene's activity for a very long time, potentially even for life. With the gene not working properly in many cells, the body can't produce enough glucocorticoid receptor.

As a result, the HPA trinity can't turn itself down properly and is constantly on high-alert. The body behaves as if it were stressed, even when nothing stressful is happening. The result is a higher risk of anxiety, depression and suicide. McGowan admits that this the whole picture is still speculative, but the individual steps make sense in the light of his results.  

Other groups have found incredibly similar results in the brains of rats. The quality of care that a baby rat receives from its mother is reflected in the degree of methylation in the promoter region of its NR3C1 gene. If the bond between a mother rat and her baby is disrupted at an early age, the number of methyl groups in this critical area goes up, and the baby's HPA system becomes hyper-responsive to stress. And mice that lack the glucocorticoid receptor altogether behave in ways that are similar to depressed humans.

Mothers could affect the fates of their children through this chain of events, even before they are born. One fascinating study found that a newborn baby's NR3C1 gene is more heavily methylated if its mother was depressed or anxious during her third trimester. The epigenetic changes to this gene could allow children to inherit a vulnerability for depression from their mothers. 

As a final note (and I hope he doesn't mind me pointing this out) but the lead author of this study is one Dr. Meaney. Which is a rather ironic name to crop up on a paper about abuse! A bit of unfortunate nominative determinism, surely?

Reference: Nature Neuroscience 10.1038/nn.2270

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In the therapist's office

My first break-down took place freshman year in college. 

My second break-down took place sophomore year.  I was asked to give oral sex, and suddenly I saw my first User looking down at me.

I freaked.  I also told campus police I was raped, even though I hadn't been.  Not that night, at least.

I knew at that point, I needed help;  I needed therapy, because something was not right with me, and it scared me.  I was 18, almost 19.

I went through 5 or 6 different therapists, over I'd say a 15-20 year period.  Each one said the same basic thing:  PTSD.  Not one therapist addressed what I thought was a core problem -- unresolved adoption issues.  Only 2 therapists did not prescribe pills (they were not licensed to do so.)

When I was on medication, I noticed a dulling of many senses was taking over.  I was able to withstand the same bullshit, but I would not freak, like I used to.  At first, I found this "not reacting" liberating.  Soon the not reacting to stress became a curse.... although, ask my spouse, and he'd say me being on medication was great -- I didn't cry or argue anymore.  I just smiled and said, "OK".

My third break-down took place some years ago.  I was on high doses of 3 medications:  Effexor, Lamictal, and Seroquel.  I found more pieces to my nightmare past, and could not take anymore.  As it was, something inside was no longer right. Even though I kept going to the Dr,(therapist), the visits were becoming more and more frustrating.  The more I wanted to share and disclose, and correct ("NO.... that is NOT what I mean... and NO, that would NOT help my current situation... NO I DO NOT want to go to a women's shelter.... do you HEAR WHAT THE FUCK I AM SAYING DOC?!?!?!?) the more the paid therapist wanted to add and increase meds to my treatment regime.  I wanted to talk, I wanted to make the necessary clear connections (and consequences) in my head, but there was not enough time or attention coming from the paid therapist to discuss a better repair program for myself.  I had 45 minutes for me to share my story, and glean some insight.  I spent most of the time crying, proving the medication was not doing what it should be doing.

So, when I found more documented proof, showing me just how many people were lying to me about the most insane details of my life, I literally lost all control and did what I knew best.  I smashed my head repeatedly on my hardwood kitchen floor, as my spouse watched in disbelief.  He did nothing to stop me.  My dog, however, did.

Since then, I have made a miraculous recovery, with very few people knowing what I was doing for over a year and a half. I have regained the ability to speak; even the ability to do math.  I have even been able to prove I can pass the nursing boards with flying, near-perfect scores, after 17 years of not working in the clinical arena.

My brain has always been amazing.  It's the people around me who have sucked.... they just didn't care enough to help, and s-l-o-w-l-y (and consistently) make things better.

I cannot emphasize enough the role stress has on a victim.  The following are observations I have made, thanks to personal experience:

  • If the victim of a crime is put in an unhealthy/unstable environment, crazy shit is going to happen.
  • If the victim of a crime is a child, and that child is put in a home where the parents see themselves as victims, too, the child is going to lose (because self-protecting parents almost always care for themselves before they take the time to think/care about the immediate and future needs of the child)

Since so many AP's do NOT know who did what to the adopted child in their home, I think the following suggestion needs to be made:  children who have been victims of a crime are often not the same as children born with a mental disability.  [You can have both -- the mentally disabled child who is also the victim of a crime, but that's not to say all victims of a crime are mentally disabled.]  Therefore, what a foster/adoptive parent sees in child-behavior may not be the "mental disorder" you think it is; it may simply be a reaction to profound stress.  Wild behavior, wet sheets, shit on the floor, rage for no reason.... there is almost always a good valid reason for such unexpected reactions.  Much calm patient time has to slowly uncover the reason behind a child's reaction.  I say slowly, because with each baby-step, there comes a new re-discovery that may easily put the victim in a state of heightened alert (sensitivity) and stress.

One of two things is going to happen when a person's sympathetic nervous system gets triggered (feel stress):  flight (detachment/removal) or fight response.  For those not familiar with the sympathetic nervous system, in simple, easy terms,

Sympathetic nervous system: A part of the nervous system that serves to accelerate the heart rate, constrict blood vessels, and raise blood pressure. The sympathetic nervous system and the parasympathetic nervous system constitute the autonomic nervous system, the branch of the nervous system that performs involuntary functions.

[From: http://www.medterms.com/script/main/art.asp?articlekey=5607 ]

There IS a reason why the phrase, "Scared shitless" was coined.

A lot of lay-people will talk and act as if "problem behavior" is deliberate; the adoptee wants to control or manipulate.  To a degree, they are correct.  If keeping people away means I have to smear feces on myself, so be it.  However, most pissed-off victims don't go to that extent.  We're more messed-up and confused than that... we sabotage relationships in very strange ways... ways we're not even aware of, because we (the ignored victim) has become so re-programmed, the behaviors and reactions have become something like an innate first-nature.

The way I see the new-age AP family dynamic is not the same as many "authorities on adoption" will.  I strongly believe AP's need to educate themselves better, so they may see how slow patient calm, loving parenting can benefit the adopted child with a very limited (or fictitious) family history.  Your private adoption agency may not help you as much as you'd like or need, because adoption agencies have much to lose if they are honest with their paying clients.  Remember, as an AP, the buyer must be aware, even if all signs say, "We're open, honest, and transparent".  No adoption agency can guarantee no harm was done to the child put in-care.  Not one. 

Workshops + lessons = assistance

Now wouldn't a workshop, course or lesson on this topic be better in preparing an AP than...a 3 hour workshop on how to do a Lifebook?

The social worker reports done in foreign countries for ICA are not telling the whole story. There is alot of abuse of women and children in many countries where the women are on the lower strung of the ladder and childhood is not valued...add to that generational poverty and generational malnutrition.

Unfortunately most APs won't educate themselves...by the time that they are "interested" in getting help, it is for their own sake and sanity and not for that of the child. Seen this pattern repeated too many times over.

Parenting Classes, for the AP

I've been told the POV from the adult adoptee is a huge selling point for an adoption agency.  I'm not sure how it pays, but I've been told the perks are not bad.  [I get updates from adult adoptees who like to brag.... in private, of course...]

I have yet to get a phone call from any adoption service, asking if I'd like to speak to a group of PAP's.

An adoptee, like me?  <running to get the garlic and crosses, not to mention the lighters and the candles....>

Why, it would hafta mean Adoptionland has gone berserk AND insane. [Why on earth would agency owners, and AP's alike, want to admit not all is as hunky-dory, or as truthful as truth should be?]

No... the only thing that sells in Adoptionland is the well-adjusted adaptation story, with very few growing-pains, (but touched with just enough sorrow to make even a lost Bmother get misty, with emotion.)

While I am a firm believer the average Ahome is not nearly as bad as those homes PPL presents/features, I do believe the exceptions are not as rare as people like Pertman insist, and I do beleive abuse cases provide a good teaching tool, for ANY parent.

Maybe a three hour seminar dissecting the dysfunctional Afamily, and a brief look at women's studies in sending regions, would better serve the adoptees.  Please let me know if you ever find it... I myself would love to attend, provided it's not too expensive.

Meanwhile, craft/scrapbookig for the PAP, on a Saturday afternoon? You can do that stuff, later, with the child... as a "bonding activity".  A parent might be surprised to learn what really interests a fostered/adopted kid.

Getting picked to SHOW OFF your children...

Kerry said, "I've been told the POV from the adult adoptee is a huge selling point for an adoption agency."

Now look at a huge selling point from a different perspective:  The BIG thing for the AP's about 20 years ago was to see which family could have their kids picked by the adoption agency to come for "Show and Tell."  They would ask the new PAP's to come to the office on a Saturday to SEE some examples of adopted children; especially "special needs" adopted children; not too old, though.

The AP's were very competitive by staying in close contact with the SW: sending pictures and making extra visits to the office; staying in view and fresh on the mind of the SW would get you picked to come oftener for "Show and Tell."   Having your kids enrolled in every sport or musical or Baby Contest would supply a ton of pictures to send to the office, where the SW would pick the ones she would tape to her door. 

If a family had their kids picked more than once, it would cause a stink among the Adopted Families support group, and make sure that others found ways to "one-up" the rest.  How do you "one-up?"  You send pictures to the Agency's MAGAZINE, along with a "story about one or more of your kids."  When you are a LARGE adoptive family, there is no end to the stories. 

20 years ago we only saw little babies and toddlers at these special "Show and Tell" get-togethers.  I would have loved to have seen teens or adult adoptees back then; it would have made it more real.

Teddy

"Trick Ponies"

Know the role, like the back of my hand.  I WAS the Trick Pony, used like... well, whatever.

I found those who are really insecure, NEEDY, and greedy use  "Trick Ponies" to prove they (the owners of a circus) know how to pick talent.

May I puke now?

You put that into perspective...

Somehow, I knew you could identify with this...  and yes, NOW you may  puke!

Teddy

Adaptation, adoption, and a natural-born talent

I want to clarify... there is a very real difference between the parent who truly LOVES a child's natural talent.  There's no harm or shame wanting to promote a child's natural talent.  [It's what a good parent should do.]

However, in Adoptionland, there are AP's who act as though they must prove their purchase was a wise choice.

I was forced to perform, whether I liked the "act", or not.  [Many times I'd cry, telling my Adad how much I hated having to practice and perform.]  There are those Afamilies where the needs of the needy Aparent comes first.

I have a HUGE itchy finger when it comes to that trigger.

NEVER allowing myself to have happiness...

Kerry said, "we sabotage relationships in very strange ways... ways we're not even aware of, because we (the ignored victim) has become so re-programmed, the behaviors and reactions have become something like an innate first-nature."

I remember when I first realized that I NEVER allowed myself to "continue" with something that made me happy.  SO many things I started, only to find myself far away from that happiness, hiding in fear.  I couldn't possibly allow myself to do "that."  Whatever "that" was, it was not to be allowed in my life.  And then I wondered where all this "flight" came from.

As a child, my parents did their level best to ignore me: locking the door so I would GO PLAY:  never allowing me to have friends over because that would take away from my mothers needs (sitting and listening to how horrible her marriage was).  See how polar opposite that was, and how confusing to a child that would be?  I learned to not expect happiness, therefore it didn't hurt so much when we moved every year and I had to be pulled from one school and put into another.  I learned to sabotage relationships when I was very young.  I remember a very rewarding relationship as a grown-up:  Singing with my son and the pastor of our church (one of MANY because I had never learned to stay put) in a trio.  I remember sabotaging that relationship by yelling at the pastor when what he said triggered a HUGE memory of neglect as a child.  It WASN'T him... it was "something" in my past that was hidden so deeply that I didn't remember it until the pastor said what he said.  Strange....

So I can truly see how an adopted child could be triggered by something (maybe even in another language but still translated to fear in the now) and the AP's flipping out because they take it personally.  That child, being a child, might not even realize what happened; all they know is SOMETHING is wrong.  And here is where we add what Kerry said that would help:  "  Much calm patient time has to slowly uncover the reason behind a child's reaction.  I say slowly, because with each baby-step, there comes a new re-discovery that may easily put the victim in a state of heightened alert (sensitivity) and stress." 

Kerry said: " I strongly believe AP's need to educate themselves better..."
Adoption agencies  DESPERATELY need to teach parenting skills in a WHOLE different way.  You have AP/PAP's who have biological children and are obsessed with thinking they can handle an adopted child...  This is not even logical!  PAP's who have NO biological children are at an advantage IMO because they COULD be open to parenting classes in a whole different way than PAP's who have children.  Those with children would have to be re-programed on a lot of thinking.  Your children, raised by you from birth, are within the family from the start.  They are programed to adjust to certain things, because that's the way the family does it. An adopted child is brought from a totally different culture: different smells and customs; and can you imagine the culture shock and separation anxiety that is suddenly thrust upon them?  It's kinda like "your kids, my kids and our kids" finding their order in the family, only, the adopted child can't even understand a word you are saying and can't TELL your what is wrong even if he/she knew.

And another thing:  WHY, over the past 20 years have SW and sending countries become so lenient with the AGE of the PAP?  Here we have a "special needs" child, and here we have an older couple who have no children, or their children are grown.  The younger couples want the babies, SOOOOO, while beating the bushes to find a family for the "special needs" child, along comes the older couple.  And the sending country KNOWS there is not another family for the SP child, so both countries, not wanting to miss out on their quota for the month, STAMP their approval on the home study and ship that poor child off to another country where he will find him/herself once again alone when that OLDER couple dies or is in the nursing home at the most needful time of that child's life...  BOTH countries need to say NO!

I have been very upset for the last 5 years; since my husband went to prison and left me, the OLDER parent to raise my children alone.  I grieve for my children and what they will lose out on by being adopted by an OLDER COUPLE.

Teddy

First-timers

 PAP's who have NO biological children are at an advantage IMO because they COULD be open to parenting classes in a whole different way than PAP's who have children.  Those with children would have to be re-programed on a lot of thinking.  Your children, raised by you from birth, are within the family from the start. 

I TOTALLY agree!  In this regard, I think ALL first-parents would do well with parenting classes, but there's something about good AP's -- they want to learn.  That's not to say or suggest all AP's are the same.  Our abuse pages prove that.  But AP's pay the fees.  They should get a service worth the money.

Another issue, which may or may not be addressed in AP Training, in the matter of incest.  In PAL, there is really no such thing within the Afamily, so women married to closet pedophiles or those not at all familiar with secret sexual relations in the home may have no idea what signs and symptoms to look-out for ("just in-case").  It's my strong opinion it's the mother's job to ensure safety for the child, because by nature, she is supposed to be the nurturer. [Of course gay parents can start screaming, but the way I see it, mature adult parents know which roles feel most comfortable to follow.  There are lots of times I've seen it where the husband in the relationship is far more "female" --  loving and nurturing than the wife; and the wife is a much more "male" -- the more aggressive bread-winner, and MUCH better with tools and repairs.  Roles can be switched, provided the positive role-model remains consistent, and the child is not led, only to be confused with harmful (angry/resentful) messages.]

As far as the older parent issue is concerned, I married a man almost 15 years older than me.  [Can we say, "Father Issues"?]  Because I was (still am) a young mom, his age didn't matter as much as it would if we were much closer in age.  However, let's remember the effects of long-term stress.  I'm by far the more long-term stressed-out parent in our duo.  If any one is going to have a stroke or heart attack, it's going to be me, thanks to my high blood pressure and limited time/funds to get out and have "fun" or "relax".  Nevertheless, you make an excellent point:

The younger couples want the babies, SOOOOO, while beating the bushes to find a family for the "special needs" child, along comes the older couple.  And the sending country KNOWS there is not another family for the SP child, so both countries, not wanting to miss out on their quota for the month, STAMP their approval on the home study and ship that poor child off to another country where he will find him/herself once again alone when that OLDER couple dies or is in the nursing home at the most needful time of that child's life...  BOTH countries need to say NO!

The problem is, some sending countries DO set limits. [Limits the age-gap between PAP and adoptable child.]  It's often the angry "outraged" PAP who protests and makes a big stink and cries discrimination and does the ol' "What about the poor orphan?" routine.  If a ban is placed, it's placed for a reason.  PAP's need to be instructed BY THEIR AGENCY to wake-up and not act so entitled or spoiled -- the future grief  and worry they may prevent may easily be their own. But again, honest transparency by the adoption facilitator does not make a good salary-producing selling point.

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