Epigenetics and Trauma : The Interplay that Shapes Us

Epigenetics and Trauma : The Interplay that Shapes Us

Epigenetics and Trauma : The Interplay that Shapes Us

By Dr. Cassandra Aasmundsen-Fry, Psy.D., Founder and Clinical Psychologist at MindWell: Modern Psychology and Therapy

Unravelling the Ties that Bind Epigenetics and Trauma

Trauma has a lasting impact on our mental well-being, shaping our experiences and psychological health. However, recent discoveries in epigenetics have shed light on the profound interplay between trauma and our genetic makeup. Recent research has established findings which are extremely important concerning how our identities are developed and shaped. This research on epigenetics has shown that the trauma and stress of our parents and grandparents can be experienced directly by their children and explain diagnoses of PTSD, long-term stress and chronic conditions. In this article, we will explore the hidden imprints of trauma on our epigenetics and their implications for mental health. Understanding this intricate relationship can pave the way for new interventions and approaches to support healing and resilience.

Epigenetics, in essence, is the study of changes in gene activity that do not involve alterations to the underlying DNA sequence. It’s like adding annotations to the book of our genome without changing the words. Trauma, on the other hand, is an emotional or psychological response to an event or experience that is shockingly adverse, such as an accident, assault, or natural disaster.

At first glance, epigenetics and trauma may seem like vastly different areas. However, recent research has shown that we are impacted by stress and trauma, impacting up to three generations at a time. Traumatic experiences can leave marks on our psyche and epigenome, the plethora of chemical compounds that dictate how our genes are regulated. These epigenetic marks can influence how we respond to stress, our susceptibility to illness, and even the structure of our brains.

This article will navigate the multifaceted landscape where epigenetics and trauma converge. We’ll explore the science behind how our experiences, particularly traumatic ones, can write epigenetic notes in our genetic blueprint. We will also examine how these notes can be passed down through generations, the ongoing research in this field, and the burgeoning prospects for healing and intervention.

Embark on this journey to comprehend the scientific and profound human aspects of epigenetics and trauma. Through understanding, we can foster empathy and contribute to building a society that acknowledges and addresses the indelible impact of trauma through the lens of epigenetics.

What is Epigenetics? Decoding the Layers Beyond Genetics

Epigenetics involves changes in gene activity that do not involve alterations to the underlying DNA sequence. It’s like adding sticky notes to instructions, which helps understand when to pay attention to certain parts.

Epigenetics, a term coined by the biologist Conrad Waddington in the early 1940s, refers to changes in gene activity that don’t alter the DNA sequence. The prefix ‘epi’ in Greek means ‘above’ or ‘over’, fittingly capturing the essence of epigenetics as the layer of biological regulation above the genome. It’s about what happens on top of or in addition to the standard genetic process.

The Epigenome: A Dynamic Interface

Our genetic code DNA is like an encyclopaedia containing all the instructions needed to build and maintain the organism. The epigenome can be considered a set of markers and regulators that annotate this encyclopaedia, influencing which pages (genes) are read, when, and how much. These annotations are responsive to environmental factors and experiences.

The Epigenetic Machinery: Tools of the Trade

There are several mechanisms by which the epigenome can modify gene activity. These include:

  • DNA Methylation: This involves adding a methyl group to the DNA, typically at cytosine bases. DNA methylation generally reduces gene expression.
  • Histone Modifications: DNA is wound around proteins called histones. Modifications to these histones, such as acetylation or methylation, can affect how tightly the DNA is wound and, consequently, its accessibility for being read.
  • Non-coding RNA Molecules: These RNA molecules do not code for proteins but can regulate gene expression in various ways, such as blocking the machinery that reads DNA.

Significance in Development and Cell Differentiation

Epigenetic regulation is crucial during development. Though many different cells in an organism have the same DNA, they can have vastly different functions (e.g., a neuron versus a skin cell). Epigenetics plays a central role by selectively turning genes on or off during development, allowing cells to specialise.

Responsive and Adaptable

What makes epigenetics particularly enthralling is that it’s an adaptable system. Unlike DNA, which is relatively static, the epigenome can change in response to the environment or lifestyle. For instance, diet, stress, and toxins can all induce epigenetic changes. This has far-reaching implications for health, behaviour, and susceptibility to diseases.

The Scope and Impact

Epigenetics bridges the gap between nature and nurture, offering insights into how the environment and experiences can shape an individual’s genetics. Epigenetics can foreshadow the chance of our children and grandchildren expressing stress or trauma symptoms of our own traumatic experiences and shared cultural experiences (like war or genocide). We can use this information to nurture resilience and aid future generations in understanding what is impacting them before they are born.

In summary, epigenetics represent a dynamic and responsive layer of regulation that guides how, when, and which genes are expressed. Its role in development, adaptability in response to environmental factors, and impact on health and behaviour make it a central component of biological sciences. By understanding epigenetics, we can better comprehend the nuanced interplay between our genetic blueprint and the world we interact with.

Defining Trauma

Trauma is an emotional or psychological response to an event or experience that is shocking, distressing, or harmful. The impacts of trauma can be far-reaching and may include physical and psychological symptoms.

When we hear ‘trauma,’ we often think of physical injuries, such as a broken bone or a wound. However, in epigenetics and mental health, trauma refers to an emotional, psychological, or physical response to an event or series of shocking, distressing, or harmful events. Trauma is about the events and how they are experienced and processed, making it a highly subjective and individualised concept.

There is a common understanding that facing trauma impacts your functioning; however, the idea that the trauma of your parents and grandparents can be alive in you is a new concept. Based on the research of Bruce Lipton and Rachel Yehuda, we now know that we are three times more likely to develop PTSD if a parent has PTSD and that individuals often feel similar symptoms to parents who have experienced trauma.

Types of Traumas

  • Physical Trauma: Refers to injuries or damage to the body due to accidents, falls, or violence.
  • Emotional/Psychological Trauma: This arises from experiences that are emotionally painful, distressful, or shocking. This can result from abuse, bullying, losing a loved one, or witnessing violence.
  • Developmental Trauma: Occurs during childhood and can have long-lasting effects on an individual’s ability to form relationships and cope with stress. It is often associated with neglect, abuse, or household dysfunction.
  • Complex Trauma: Involves multiple traumatic events, often of an invasive or interpersonal nature. It is generally long-term and can have a cumulative effect.
  • Secondary Trauma occurs when an individual is indirectly exposed to trauma through a first-hand account or narrative of a traumatic event.

The Subjectivity of Trauma

Not all individuals who experience a potentially traumatising event will be traumatised. Personal characteristics, past experiences, and coping skills can influence how an event is experienced. Furthermore, cultural, social, and familial contexts play a significant role in understanding and processing trauma. Owning trauma and accepting its widespread impact has always been difficult for individuals; however, we must understand that acknowledging and processing the trauma of our immediate ancestors may feel even harder to accept.

The Physiological and Psychological Impact

Trauma can leave a profound mark on both body and mind. Physically, it can trigger a stress response, affecting the nervous and endocrine systems. Psychologically, it can lead to anxiety, depression, or post-traumatic stress disorder (PTSD). The memories associated with the traumatic event can also become deeply embedded and may trigger strong emotional responses.

Trauma and Resilience

Recognising that trauma can also catalyse growth and change is essential. Some individuals demonstrate resilience and find ways to cope and adapt following traumatic experiences. Understanding the factors that contribute to resilience can be just as important as understanding the effects of trauma itself.

In conclusion, trauma is a multifaceted and highly individualised concept encompassing various experiences and responses. Understanding trauma requires an appreciation for the complexity of human experience, the subjectivity of perception, and the interplay between an individual and their environment. Through this lens, we can approach trauma with empathy, sensitivity, and a recognition of its broad spectrum.

How Epigenetics and Trauma Are Connected

Research has shown that trauma can result in epigenetic changes. These changes can affect how genes associated with stress and mental health are expressed. Essentially, trauma can alter how our genes work, which can, in turn, affect how we react to the environment and stress.

When discussing the connection between epigenetics and trauma, we explore the interface of environment and genetics. How does a traumatic experience, which is an external environmental factor, influence the internal workings of our genes? Let’s unravel this by examining the stress response and its epigenetic regulation.

Stress Response and the Hypothalamus-Pituitary-Adrenal Axis

Trauma typically activates the body’s stress response. A key player in this response is the hypothalamus-pituitary-adrenal (HPA) axis. The HPA axis is a complex set of direct influences and feedback interactions among the hypothalamus (a portion of the brain), the pituitary gland (a pea-shaped structure located below the brain), and the adrenal glands (small, conical organs on top of the kidneys).

When an individual experiences trauma, the hypothalamus secretes corticotropin-releasing hormone (CRH), which prompts the pituitary gland to secrete adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal glands to produce and release cortisol, a stress hormone. Cortisol helps the body cope with stress, but excessive cortisol release can harm the brain and body.

Epigenetic Regulation of the Stress Response

Epigenetic mechanisms play a significant role in regulating the HPA axis. For example, DNA methylation and histone modifications can influence the genes’ expression in this stress response.

If an individual is exposed to chronic stress or trauma, the epigenetic regulation of genes associated with the HPA axis can change. For instance, changes in methylation patterns in the glucocorticoid receptor gene, pivotal for the functioning of the HPA axis, have been observed in individuals who have experienced early-life trauma. Such changes can render the stress response hyperactive or hypoactive, contributing to psychiatric disorders such as depression, anxiety, or post-traumatic stress disorder (PTSD).

Epigenetic Memory of Trauma

Additionally, the epigenetic changes associated with trauma can form a ‘cellular memory’. The cells may ‘remember’ the stress or trauma through these epigenetic marks, which can alter how they respond to future stressors. This aspect is particularly relevant in understanding why individuals who have experienced trauma may have heightened or altered responses to stressors, even long after the traumatic event has passed. Research by Rachel Yehuda, has shown that cellular memory is passed on in the womb, resulting in the emotions, distress and trauma experienced during pregnancy becoming a part of the biological and cellular development of a child.

The Neuro-Epigenetics of Trauma

When studying the connections between epigenetics and trauma, looking at the brain is essential. Trauma can alter the epigenetic landscape of the brain’s cells. There is increasing evidence that epigenetic changes in neurons and other brain cells play a crucial role in learning, memory, and mood regulation. These changes can affect synaptic plasticity, which is fundamental for the brain’s ability to adapt and learn from experiences.

In trauma, altered synaptic plasticity can mean the brain becomes more wired to recognise and respond to stress and danger, even when inappropriate. This can manifest as anxiety disorders, depression, and other mental health issues.

In conclusion, the interplay between epigenetics and trauma is a dynamic and complex process that involves multiple physiological systems, especially the stress response and the nervous system. Understanding this interplay can provide insights into the long-lasting effects of trauma and open avenues for interventions that address the epigenetic aspects of psychiatric disorders.

The Intricacies of Epigenetic Modifications

When delving into the connection between trauma and epigenetics, it is essential to shed light on the underlying mechanisms at play. Epigenetic changes are principally orchestrated through DNA methylation, histone modification, and RNA-based mechanisms.

DNA Methylation

DNA methylation is one of the most extensively studied epigenetic mechanisms. It involves adding a methyl group (CH3) to the DNA molecule, usually at cytosine bases. This addition can hinder the binding of transcription factors and, as a result, suppress gene expression. In trauma, changes in methylation patterns have been observed in genes involved in the body’s stress response. For instance, altered methylation levels in the gene regulating cortisol, a stress hormone, have been associated with experiences of childhood abuse. These changes can have long-lasting effects on how an individual responds to stress.

Histone Modification

Histones are protein structures around which DNA is wound, resembling beads on a string. Post-translational modifications of histone proteins, such as acetylation or methylation, can impact gene expression. For example, histone acetylation usually results in the loosening of the DNA around the histones, making the genes more accessible and increasing their expression. Conversely, deacetylation leads to the condensation of the DNA, rendering the genes less accessible and reducing their expression. Traumatic experiences can induce changes in histone modifications, particularly in genes associated with stress response and neuronal plasticity.

RNA-based Mechanisms

Another facet of epigenetic regulation is through RNA molecules. While DNA is the blueprint, RNA acts as the messenger and builder. Small RNA molecules, such as microRNAs, can control gene expression post-transcriptionally. They bind to the messenger RNA (mRNA), destabilising or blocking their translation into proteins. Trauma can influence the expression levels of these microRNAs, which in turn can have cascading effects on a multitude of genes.

Crosstalk Between Mechanisms

It’s vital to recognise that these mechanisms operate in collaboration. There is an intricate crosstalk among DNA methylation, histone modifications, and RNA-based mechanisms. This interplay can form a complex, dynamic network of gene regulation influenced by environmental factors, including trauma.

Understanding these mechanisms and their interplay is not just academically fascinating; it can potentially revolutionise our approach to mental health. With more profound insights into how trauma interacts with our epigenetic makeup, we can pave the way for novel therapeutic strategies to reverse or mitigate the epigenetic scars left by traumatic experiences.

The Mechanisms at Play

Epigenetic changes mainly happen through processes like DNA methylation and histone modification. DNA methylation involves adding a chemical group to DNA, which can change its activity. Histone modification changes the proteins around which DNA is wound, affecting how genes are expressed.

These changes might alter how someone reacts to stress or contribute to the risk of mental health issues.

How Epigenetics and Trauma are Connected: A Deeper Dive

The connection between epigenetics and trauma is both intricate and profound. When an individual experiences trauma, it can instigate a cascade of biological changes. The body’s response to trauma typically includes activating the stress response systems. This activation is essential in the short term for coping with the immediate threat. However, when trauma is severe or persistent, this short-term adaptive response can have long-lasting effects on regulating genes that control these stress response systems.

One of the critical aspects of this interplay is how trauma can affect the biochemical markers atop the DNA. These markers are like switches that turn genes on or off, regulating gene expression. Trauma can change the placement or presence of these markers, thereby affecting which genes are active or inactive.

For instance, consider the gene responsible for regulating the stress hormone cortisol. Under normal conditions, this gene maintains our body’s response to stress. However, when trauma occurs, the epigenetic changes might alter the functioning of this gene, making an individual more susceptible to stress, which can contribute to mental health issues like anxiety and depression.

DNA methylation is one of the primary mechanisms through which this happens. When a methyl group is added to the DNA strand, it can inhibit the gene from being read and translated into a protein, effectively turning it off. This process can be affected by trauma. For example, in individuals who have experienced severe childhood trauma, studies have found changes in DNA methylation of the genes involved in stress regulation.

Similarly, histone modification is another mechanism by which trauma can exert its effects. Histones are proteins around which DNA is wound, and they can be chemically modified in response to environmental stimuli, including trauma. These modifications can affect how tightly or loosely the DNA is wound around the histones, affecting gene expression. For example, when the DNA is tightly wound, it’s not accessible for gene expression.

The repercussions of these epigenetic modifications are vast and varied. They can affect an individual’s mood, immune response, susceptibility to addictions, and even alter the structure and functions of their brain.

Understanding the interrelationship between epigenetics and trauma not only unravels the biological underpinnings of the impact of traumatic experiences but also opens doors to targeted interventions that might be able to reverse or mitigate these epigenetic changes.

Epigenetic Changes and Future Generations: An Intricate Legacy

Interestingly, the epigenetic changes due to trauma can sometimes be passed down to future generations. This means that the experiences of our ancestors can indirectly affect our gene expression. The consequences of trauma can extend beyond the individual who directly experiences it, cascading through generations via epigenetic changes. This phenomenon, known as transgenerational epigenetic inheritance, has been a topic of immense interest and research.

When epigenetic changes occur due to trauma, these alterations in gene expression can sometimes be passed on to the offspring. This means that children and even grandchildren may have altered gene expression due to traumas experienced by their parents or grandparents.

One striking historical example that has been extensively studied is the Dutch Hunger Winter, which occurred towards the end of World War II. People experienced severe malnutrition during this time. Researchers found that not only did individuals in utero during the famine have increased rates of health issues such as obesity and cardiovascular disorders, but even their children showed similar changes in DNA methylation patterns.

Another example includes studies on the descendants of Holocaust survivors. These studies indicate altered stress hormone profiles in survivors and their offspring, suggesting that extreme trauma can result in epigenetic changes passed through generations.

This intergenerational transmission raises several questions about the inheritance of trauma. What mechanisms allow epigenetic marks to be transmitted to the next generation? How do these inherited changes in gene expression affect the health and behaviour of descendants? And can the cycle be interrupted or reversed?

In animal studies, particularly in mice, researchers have shown that experiences such as stress or exposure to toxins can lead to epigenetic changes passed down to future generations. These studies often look at DNA methylation patterns or histone modifications and how they affect the expression of genes involved in stress response, metabolism, and other processes.

Intergenerational epigenetic changes represent a complex interplay between genetics, environment, and experience. They suggest that our health and behaviours might be influenced not just by our own experiences but also by the experiences of our ancestors. Moreover, this knowledge carries a responsibility – the awareness that our actions and experiences can shape the genetic legacy we pass on to future generations. It makes understanding and addressing trauma and its epigenetic effects even more imperative for the well-being of current and future generations.

Implications and Future Prospects

Understanding the interplay between epigenetics and trauma holds promise for new therapeutic strategies. Knowing how trauma can change gene expression, finding new treatments for mental health conditions or better understanding how these conditions develop might be possible.

However, it’s also essential to proceed with caution. The field of epigenetics is still young, and more research is needed to fully understand the mechanisms and their implications.

On the Horizon: Ongoing Research in Epigenetics and Trauma

As the fields of epigenetics and trauma are ever-evolving, cutting-edge research is continually unfolding. Scientists and psychologists are delving deeper into the mechanisms through which trauma can leave epigenetic marks. Ongoing studies are exploring the potential for interventions that might alter these epigenetic changes, offering avenues for prevention and treatment. Furthermore, research extends into transgenerational epigenetics to understand how trauma’s impact might cascade through generations. Technological advancements in gene sequencing and data analysis also propel this research forward. As we continue to amass knowledge, epigenetics and trauma research synthesis promises to revolutionise how we understand human biology and mental health and approach treatment.

Professional Resources: A Beacon of Hope

Professional resources can play a pivotal role in mitigating the effects of trauma on epigenetics. Mental health professionals, psychologists, and therapists can employ evidence-based interventions such as cognitive behavioural therapy, eye movement desensitisation and reprocessing (EMDR), and other trauma-focused approaches. These strategies are designed to help individuals process and manage traumatic experiences. Moreover, healthcare providers can offer medications to manage symptoms of depression or anxiety that often accompany trauma. Community support groups and educational resources can also be invaluable with therapy. These combined efforts can contribute to an individual’s resilience, potentially preventing or reversing some epigenetic trauma-related changes. Professional support acts as a beacon, guiding individuals towards healthier gene expression and improved mental well-being.

Conclusion

The interplay between epigenetics and trauma is a growing field uncovering how our experiences can shape our minds and biology. Through continued research, there is potential to understand the complex ways trauma affects individuals and generations and find new avenues for therapy and healing. We can work towards better mental health outcomes for trauma victims with knowledge and understanding.

Glossary

DNA:  Deoxyribonucleic Acid is a molecule that carries most of the genetic instructions used in the development, functioning, and reproduction of all known living organisms and many viruses. It is the hereditary material in humans and almost all other organisms, located in the cell nucleus and, in smaller amounts, in the mitochondria.

EMDR: Eye Movement Desensitization and Reprocessing. It’s a type of psychotherapy developed to alleviate the distress associated with traumatic memories.

Epigenetics: A branch of biology which studies changes in gene activity not caused by alterations in the DNA sequence. It involves modifications that affect how genes are turned on or off.

Epigenome: The collection of chemical compounds and proteins that can attach to DNA and direct various gene activities, including turning genes on or off and controlling the production of proteins in particular cells. The epigenome helps determine how genes are expressed.

Gene Expression: The process by which the information contained in a gene is used to synthesise a functional gene product, such as a protein. It is how a gene gets turned into a physical trait.

Genome: The complete set of genetic material in an organism. It comprises all the DNA, including all the genes. In humans, the genome consists of 23 pairs of chromosomes.

Histone: A protein that helps package DNA into a compact, organised form. Histones can undergo chemical modifications that can affect the structure of the DNA and, subsequently, gene expression.

HPA: The HPA axis, or the hypothalamic-pituitary-adrenal axis, is a complex set of direct influences and feedback interactions among three endocrine glands: the hypothalamus, the pituitary gland, and the adrenal glands. The HPA axis is critical to the body’s stress response system.

Methylation: A chemical process where a methyl group is added to the DNA molecule. DNA methylation can change the activity of a DNA segment without changing its sequence and is one of the mechanisms of epigenetic change.

PTSD: Post-traumatic stress disorder is a mental health condition that can develop after experiencing or witnessing a traumatic event, such as a natural disaster, a severe accident, a terrorist act, war/combat, rape, or other violent personal assault.

RNA: Ribonucleic Acid is a molecule that plays several critical roles in translating genetic information from DNA into protein products that function in the body’s cells. Like DNA, RNA is a type of nucleic acid with a few key differences.

Trauma: A psychological, emotional, or physical response to an event or series of events that are shocking, distressing, or harmful, which can have lasting adverse effects on a person’s mental, physical, social, emotional, or spiritual well-being.

References

  1. Meaney, M. J., & Szyf, M. (2005). Environmental programming of stress responses through DNA methylation: life at the interface between a dynamic environment and a fixed genome. Dialogues in clinical neuroscience, 7(2), 103–123. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/)
  2. Yehuda, R., & Bierer, L. M. (2009). The relevance of epigenetics to PTSD: Implications for the DSM-V. Journal of Traumatic Stress, 22(5), 427-434. [DOI: 10.1002/jts.20448](https://doi.org/10.1002/jts.20448)
  3. Champagne, F. A. (2010). Epigenetic influence of social experiences across the lifespan. Developmental psychobiology, 52(4), 299-311. [DOI: 10.1002/dev.20436](https://doi.org/10.1002/dev.20436)
  4. Klengel, T., & Binder, E. B. (2015). Epigenetics of Stress-Related Psychiatric Disorders and Gene × Environment Interactions. Neuron, 86(6), 1343-1357. [DOI: 10.1016/j.neuron.2015.05.036](https://doi.org/10.1016/j.neuron.2015.05.036)
  5. Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and resilience. Neuroscience, 264, 157-170. [DOI: 10.1016/j.neuroscience.2013.12.003](https://doi.org/10.1016/j.neuroscience.2013.12.003)
  6. Vinkers, C. H., Kalafateli, A. L., Rutten, B. P., Kas, M. J., Kaminsky, Z., Turner, J. D., & Boks, M. P. (2015). Traumatic stress and human DNA methylation: a critical review. Epigenomics, 7(4), 593-608. [DOI: 10.2217/epi.15.12](https://doi.org/10.2217/epi.15.12)
  7. Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
  8. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. The Lancet, 373(9657), 68-81. [DOI: 10.1016/S0140-6736(08)61706-7](https://doi.org/10.1016/S0140-6736(08)61706-7)
  9. Lutz, P. E., & Turecki, G. (2014). DNA methylation and childhood maltreatment: from animal models to human studies. Neuroscience, 264, 142-156. [DOI: 10.1016/j.neuroscience.2013.07.069](https://doi.org/10.1016/j.neuroscience.2013.07.069)
  10. Jirtle, R. L., & Skinner, M. K. (2007). Environmental epigenomics and disease susceptibility. Nature Reviews Genetics, 8(4), 253-262. [DOI: 10.1038/nrg2045](https://doi.org/10.1038/nrg2045)
  11. Weaver, I. C., Cervoni, N., Champagne, F. A., D’Alessio, A. C., Sharma, S., Seckl, J. R., … & Meaney, M. J. (2004). Epigenetic programming by maternal behavior. Nature Neuroscience, 7(8), 847-854. [DOI: 10.1038/nn1276](https://doi.org/10.1038/nn1276)
  12. Szyf, M. (2013). DNA methylation, behavior and early life adversity. Journal of Genetics and Genomics, 40(7), 331-338. [DOI: 10.1016/j.jgg.2013.06.004](https://doi.org/10.1016/j.jgg.2013.06.004)
  13. Roth, T. L., Lubin, F. D., Funk, A. J., & Sweatt, J. D. (2009). Lasting epigenetic influence of early-life adversity on the BDNF gene. Biological psychiatry, 65(9), 760-769. [DOI: 10.1016/j.biopsych.2008.11.028](https://doi.org/10.1016/j.biopsych.2008.11.028)
  14. De Bellis, M. D., & Zisk, A. (2014). The biological effects of childhood trauma. Child and adolescent psychiatric clinics of North America, 23(2), 185-222. [DOI: 10.1016/j.chc.2014.01.002](https://doi.org/10.1016/j.chc.2014.01.002)
  15. Perroud, N., Paoloni-Giacobino, A., Prada, P., Olié, E., Salzmann, A., Nicastro, R., … & Malafosse, A. (2011). Increased methylation of glucocorticoid receptor gene (NR3C1) in adults with a history of childhood maltreatment: a link with the severity and type of trauma. Translational psychiatry, 1(12), e59. [DOI: 10.1038/tp.2011.60](https://doi.org/10.1038/tp.2011.60)

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