Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-05-27T20:41:55.044Z Has data issue: false hasContentIssue false

Assembling a cohort for in-depth, longitudinal assessments of the biological embedding of child maltreatment: Methods, complexities, and lessons learned

Published online by Cambridge University Press:  06 May 2021

Hannah M. C. Schreier*
Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
Christine M. Heim
Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
Emma J. Rose
Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
Idan Shalev
Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
Chad E. Shenk
Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
Jennie G. Noll
Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
Author for Correspondence: Hannah M. C. Schreier, Department of Biobehavioral Health, 219 Biobehavioral Health Building, University Park, PA, 16802; E-mail:


As championed by the work of Ed Zigler, investing in nurturing environments for all children is a chief tenet of primary prevention that will have far-reaching benefits to the health and welfare of all members of society. Children who endure child maltreatment (CM) are among society's most vulnerable. Prospective longitudinal research aimed at a comprehensive understanding of the mechanisms linking CM to subsequent adverse health consequences is needed to improve outcomes and to strengthen causal inference. This paper outlines the methods of the Child Health Study (CHS), a large, state-wide longitudinal cohort of recently maltreated and nonmaltreated youth aged 8–13 who will be assessed every 2 years. The CHS is designed to include in-depth assessments of multiple environmental, behavioral, neural, physiological, and molecular mechanisms through which CM may impact a broad spectrum of youth development, including behavioral and physical health outcomes. In addition to describing the conceptual framework and methods underlying the CHS, we provide information on valuable “lessons learned” in the hopes of supporting future research efforts facing similar challenges. The ultimate goal of this research is demonstrating how policies regarding CM impact the well-being, resilience and recovery of survivors and that they are worthy of large public investment.

Special Issue Article
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Achenbach, T. (1991). Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Brulington, VT: University of Vermont.Google Scholar
Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 2541. doi:10.1016/j.psyneuen.2017.05.018CrossRefGoogle ScholarPubMed
American Academy of Child and Adolescent Psychiatry. (2001). Summary of the practice parameters for the assessment and treatment of children and adolescents with suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 495499. doi:10.1097/00004583-200104000-00024CrossRefGoogle Scholar
Anda, R. F., Brown, D. W., Dube, S. R., Bremner, J. D., Felitti, V. J., & Giles, W. H. (2008). Adverse childhood experiences and chronic obstructive pulmonary disease in adults. American Journal of Preventive Medicine, 34, 396403. doi:10.1016/j.amepre.2008.02.002CrossRefGoogle ScholarPubMed
Barnes-Holmes, D., Barnes-Holmes, Y., Stewart, I., & Boles, S. (2010). A sketch of the implicit relational assessment procedure (IRAP) and the relational elaboration and coherence (REC) model. Psychological Record, 60, 527542. doi:10.1007/BF03395726CrossRefGoogle Scholar
Beijers, R., Daehn, D., Shalev, I., Belsky, J., & de Weerth, C. (2020). Biological embedding of maternal postpartum depressive symptoms: The potential role of cortisol and telomere length. Biological Psychology, 150, 107809. doi:10.1016/j.biopsycho.2019.107809CrossRefGoogle ScholarPubMed
Bernard, K., Frost, A., Bennett, C. B., & Lindhiem, O. (2017). Maltreatment and diurnal cortisol regulation: A meta-analysis. Psychoneuroendocrinology, 78, 5767. doi:10.1016/j.psyneuen.2017.01.005CrossRefGoogle ScholarPubMed
Birmaher, B., & Brent, D. (2007). Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 15031526. doi:10.1097/chi.0b013e318145ae1cCrossRefGoogle ScholarPubMed
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. K. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 545553. doi:10.1097/00004583-199704000-00018CrossRefGoogle ScholarPubMed
Blakemore, S. J., Burnett, S., & Dahl, R. E. (2010). The role of puberty in the developing adolescent brain. Human Brain Mapping, 31, 926933. doi:10.1002/hbm.21052CrossRefGoogle ScholarPubMed
Bond, F., Hayes, S., Baer, R., Carpenter, K., Guenole, N., Orcutt, H., … Zettle, R. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676688.CrossRefGoogle ScholarPubMed
Boynton-Jarrett, R., Wright, R. J., Putnam, F. W., Lividoti Hibert, E., Michels, K. B., Forman, M. R., & Rich-Edwards, J. (2013). Childhood abuse and age at menarche. Journal of Adolescent Health, 52, 241247. doi:10.1016/j.jadohealth.2012.06.006CrossRefGoogle ScholarPubMed
Brown, D. W., Anda, R. F., Felitti, V. J., Edwards, V. J., Malarcher, A. M., Croft, J. B., & Giles, W. H. (2010). Erratum: Adverse childhood experiences are associated with the risk of lung cancer: A prospective cohort study (BMC Public Health (2010) 10 (20)). BMC Public Health, 10, 112. doi:10.1186/1471-2458-10-311Google Scholar
Brown, A., Chouldechova, A., Putnam-Hornstein, E., Tobin, A., & Vaithianathan, R. (2019). Toward algorithmic accountability in public services: A qualitative study of affected community perspectives on algorithmic decision-making in child welfare services. CHI Conference on Human Factors In Computing Systems Proceedings, 112. doi:10.1145/3290605.3300271CrossRefGoogle Scholar
Cohen, J. A. (2010). Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 414430. doi:10.1016/j.jaac.2009.12.020Google ScholarPubMed
Danese, A., Caspi, A., Williams, B., Ambler, A., Sugden, K., Mika, J., … Arseneault, L. (2011). Biological embedding of stress through inflammation processes in childhood. Molecular Psychiatry, 16, 244246. doi:10.1038/mp.2010.5CrossRefGoogle ScholarPubMed
Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology and Behavior, 106, 2939. doi:10.1016/j.physbeh.2011.08.019CrossRefGoogle ScholarPubMed
Danese, A., Pariante, C. M., Caspi, A., Taylor, A., & Poulton, R. (2007). Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences, 104, 13191324. doi:10.1073/pnas.0610362104CrossRefGoogle Scholar
Derogatis, L. R. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13, 595605. doi:10.1017/S0033291700048017CrossRefGoogle Scholar
Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease. Circulation, 110, 17611766. doi:10.1161/01.cir.0000143074.54995.7fCrossRefGoogle ScholarPubMed
Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71, 243250. doi:10.1097/PSY.0b013e3181907888CrossRefGoogle ScholarPubMed
Espelage, D. L., & Holt, M. K. (2005). Bullying and victimization during early adolescence. Journal of Emotional Abuse, 2, 123142. doi:10.1300/j135v02n02_08CrossRefGoogle Scholar
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14, 245258. doi:10.1016/s0749-3797(98)00017-8CrossRefGoogle ScholarPubMed
Fruzzetti, A. (2001). Validating and invalidating behaviors coding scale. Reno, NV: University of Nevada.Google Scholar
German, J. B., Hammock, B. D., & Watkins, S. M. (2005). Metabolomics: Building on a century of biochemistry to guide human health. Metabolomics, 1, 39. doi:10.1007/s11306-005-1102-8CrossRefGoogle ScholarPubMed
Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. (2015). Behavior rating inventory of executive function (2nd ed.) (BRIEF-2). Odessa, FL: Psychological Assessment Resources.Google Scholar
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 4154. doi:10.1023/B:JOBA.0000007455.08539.94CrossRefGoogle Scholar
Greco, L. A., Lambert, W., & Baer, R. A. (2008). Psychological inflexibility in childhood and adolescence: Development and evaluation of the avoidance and fusion questionnaire for youth. Psychological Assessment, 20, 93102. doi:10.1037/1040-3590.20.2.93CrossRefGoogle ScholarPubMed
Heim, C. M., Entringer, S., & Buss, C. (2019). Translating basic research knowledge on the biological embedding of early-life stress into novel approaches for the developmental programming of lifelong health. Psychoneuroendocrinology, 105, 123137. doi:10.1016/j.psyneuen.2018.12.011CrossRefGoogle ScholarPubMed
Hotamisligil, G. S. (2006). Inflammation and metabolic disorders. Nature, 444, 860867. doi:10.1038/nature05485CrossRefGoogle ScholarPubMed
Irish, L., Kobayashi, I., & Delahanty, D. L. (2010). Long-term physical health consequences of childhood sexual abuse: A meta-analytic review. Journal of Pediatric Psychology, 35, 450461. doi:10.1093/jpepsy/jsp118CrossRefGoogle ScholarPubMed
Jaffee, S. R. (2017). Child maltreatment and risk for psychopathology in childhood and adulthood. Annual Review of Clinical Psychology, 13, 525551. doi:10.1146/annurev-clinpsy-032816-045005CrossRefGoogle ScholarPubMed
Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the future national results on drug use: 2012 overview, key findings on adolescent drug use. Ann Arbor, MI: Institute for Social Research, The University of Michigan.Google Scholar
Jones, E. J., Lam, P. H., Hoffer, L. C., Chen, E., & Schreier, H. M. C. (2018). Chronic family stress and adolescent health: The moderating role of emotion regulation. Psychosomatic Medicine, 80, 764773. doi:10.1097/PSY.0000000000000624CrossRefGoogle ScholarPubMed
Kim, H., Wildeman, C., Jonson-reid, M., & Drake, B. (2017). Lifetime prevalence of investigating child maltreatment among US children. American Journal of Public Health, 107, 274280. doi:10.2105/AJPH.2016.303545CrossRefGoogle ScholarPubMed
Kingsley, C., & Mauro-Nava, S. D. (2017). First, do no harm: Ethical guidelines for applying predictive tools within human services. MetroLab Network Report.Google Scholar
Klengel, T., Mehta, D., Anacker, C., Rex-Haffner, M., Pruessner, J. C., Pariante, C. M., … Binder, E. B. (2013). Allele-specific FKBP5 DNA demethylation mediates gene-childhood trauma interactions. Nature Neuroscience, 16, 3341. doi:10.1038/nn.3275CrossRefGoogle ScholarPubMed
Kovacs, M. (2015). Children's Depression Inventory (CDI and CDI 2). In Cautin, R. L. & Lilienfeld, S. O. (Eds.), The encyclopedia of clinical psychology (pp. 15). Hoboken, NJ: Wiley-Blackwell.Google Scholar
Kugler, K. C., Guastaferro, K., Shenk, C. E., Beal, S. J., Zadzora, K. M., & Noll, J. G. (2019). The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health. Child Abuse & Neglect, 87, 112119. doi:10.1016/j.chiabu.2018.06.005CrossRefGoogle ScholarPubMed
Lee, T., Fouras, G., & Brown, R. (2015). Practice parameter for the assessment and management of youth involved with the child welfare system. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 502517. doi:10.1016/j.jaac.2015.03.005CrossRefGoogle ScholarPubMed
MacDermott, S. T., Gullone, E., Allen, J. S., King, N. J., & Tonge, B. (2010). The emotion regulation index for children and adolescents (ERICA): A psychometric investigation. Journal of Psychopathology and Behavioral Assessment, 32, 301314. doi:10.1007/s10862-009-9154-0CrossRefGoogle Scholar
Manly, J. T., Cicchetti, D., & Barnett, D. (1994). The impact of subtype, frequency, chronicity, and severity of child maltreatment on social competence and behavior problems. Development and Psychopathology, 6, 121143.CrossRefGoogle Scholar
Mariani, E., Meneghetti, A., Formentini, I., Neri, S., Cattini, L., Ravaglia, G., … Facchini, A. (2003). Different rates of telomere shortening and telomerase activity reduction in CD8 T and CD16 NK lymphocytes with ageing. Experimental Gerontology, 38, 653659. doi:10.1016/S0531-5565(03)00058-5CrossRefGoogle Scholar
Marshall, W. A., & Tanner, J. M. (1969). Variations in pattern of pubertal changes in girls. Archives of Disease in Childhood, 44, 291303. doi:10.1136/adc.44.235.291CrossRefGoogle ScholarPubMed
Matheny, A. P., Wachs, T. D., Ludwig, J. L., & Phillips, K. (1995). Bringing order out of chaos: Psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology, 16, 429444. doi:10.1016/0193-3973(95)90028-4CrossRefGoogle Scholar
Mazur, J. E. (1987). An adjusting procedure for studying delayed reinforcement. In Commons, M. L., Mazur, J. E., Nevin, J. A. & Rachlin, H. (Eds.), Quantitative analyses of behavior: The effect of delay and of intervening events on reinforcement value (pp. 5573). Hillsdale, NJ: Earlbaum.Google Scholar
Negriff, S., & Susman, E. J. (2011). Pubertal timing, depression, and externalizing problems: A framework, review, and examination of gender differences. Journal of Research on Adolescence, 21, 717746. doi:10.1111/j.1532-7795.2010.00708.xCrossRefGoogle Scholar
Negriff, S., & Trickett, P. K. (2010). The relationship between pubertal timing and delinquent behavior in maltreated male and female adolescents. Journal of Early Adolescence, 30, 518542. doi:10.1038/jid.2014.371CrossRefGoogle ScholarPubMed
Nemeroff, C. B. (2016). Paradise lost: The neurobiological and clinical consequences of child abuse and neglect. Neuron, 89, 892909. doi:10.1016/j.neuron.2016.01.019CrossRefGoogle ScholarPubMed
Noll, J. G., Zeller, M. H., Trickett, P. K., & Putnam, F. W. (2007). Obesity risk for female victims of childhood sexual abuse: A prospective study. Pediatrics, 120, e61e67. doi:10.1542/peds.2006-3058.CrossRefGoogle ScholarPubMed
Oyola, M. G., & Handa, R. J. (2017). Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes: Sex differences in regulation of stress responsivity. Stress, 20, 476494. doi:10.1016/j.physbeh.2017.03.040CrossRefGoogle ScholarPubMed
Palomer, X., Salvadó, L., Barroso, E., & Vázquez-Carrera, M. (2013). An overview of the crosstalk between inflammatory processes and metabolic dysregulation during diabetic cardiomyopathy. International Journal of Cardiology, 168, 31603172. doi:10.1016/j.ijcard.2013.07.150CrossRefGoogle ScholarPubMed
Petersen, A. C., Crockett, L., Richards, M., & Boxer, A. (1988). A self-report measure of pubertal status: Reliability, validity, and initial norms. Journal of Youth and Adolescence, 17, 117133. doi:10.1103/PhysRevLett.78.1396CrossRefGoogle ScholarPubMed
Peterson, A., Joseph, J., Feit, M., Institute of Medicine, & National Research Council (2014). New directions in child abuse and neglect research. Washington, DC: National Academies Press.Google Scholar
Pynoos, R. S., & Stenberg, A. M. (2014). The UCLA PTSD Reaction Index – DSM-5. Los Angeles, CA: University of California, Los Angeles.Google Scholar
Ripple, C., & Zigler, E. (2003). Research, policy, and the federal role in prevention initiatives for children. American Psychologist, 58, 482490.CrossRefGoogle ScholarPubMed
Rudolph, K. D., & Hammen, C. (1999). Age and gender as determinants of stress exposure, generation, and reactions in youngsters: A transactional perspective. Child Development, 70, 660677. doi:10.1111/1467-8624.00048CrossRefGoogle ScholarPubMed
Schludermann, S., & Schludermann, E. (1988). Questionnaire for Children and Youth (CRPBI-30): Unpublished manuscript. Winnipeg, MB: University of Manitoba.Google Scholar
Schrank, F., Mather, N., & McGrew, K. (2014). Woodcock–Johnson IV tests of cognitive abilities examiner's manual, standard and extended batteries. Rolling Meadows, IL: Riverside.Google Scholar
Schreier, H. M. C., Roy, L. B., Frimer, L. T., & Chen, E. (2014). Family chaos and adolescent inflammatory profiles: The moderating role of socioeconomic status. Psychosomatic Medicine, 76, 460467. doi:10.1097/PSY.0000000000000078CrossRefGoogle ScholarPubMed
Shalev, I., Heim, C. M., & Noll, J. G. (2016). Child maltreatment as a root cause of mortality disparities: A call for rigorous science to mobilize public investment in prevention and treatment. JAMA Psychiatry, 73, 897898. doi:10.1001/jamapsychiatry.2016.1748CrossRefGoogle Scholar
Shalev, I., Moffitt, T. E., Braithwaite, A. W., Danese, A., Fleming, N. I., Goldman-Mellor, S., … Caspi, A. (2014). Internalizing disorders and leukocyte telomere erosion: A prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder. Molecular Psychiatry, 19, 11631170. doi:10.1038/jid.2014.371CrossRefGoogle ScholarPubMed
Shalev, I., Moffitt, T. E., Sugden, K., Williams, B., Houts, R. M., Danese, A., … Caspi, A. (2013). Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: A longitudinal study. Molecular Psychiatry, 18, 576581. doi:10.1038/mp.2012.32.Exposure.CrossRefGoogle ScholarPubMed
Shenk, C. E., Noll, J. G., Peugh, J. L., Griffin, A. M., & Bensman, H. E. (2016). Contamination in the prospective study of child maltreatment and female adolescent health. Journal of Pediatric Psychology, 41, 3745. doi:10.1093/jpepsy/jsv017CrossRefGoogle ScholarPubMed
Shields, A., & Cicchetti, D. (1998). Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation. Journal of Clinical Child Psychology, 27, 381395. doi:10.1207/s15374424jccp2704CrossRefGoogle ScholarPubMed
Stice, E., Presnell, K., & Bearman, S. K. (2001). Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Developmental Psychology, 37, 608619.CrossRefGoogle ScholarPubMed
Suglia, S. F., Koenen, K. C., Boynton-Jarrett, R., Chan, P. S., Clark, C. J., Danese, A., … Zachariah, J. P. (2018). Childhood and adolescent adversity and cardiometabolic outcomes: A scientific statement from the American heart association. Circulation, 137, e15e28. doi:10.1161/CIR.0000000000000536CrossRefGoogle ScholarPubMed
Trickett, P. K., Allen, L., Schellenbach, C. J., & Zigler, E. (1998). Integrating and advancing the knowledge base about violence against children: Implications for intervention and prevention. In Tricket, P. K. & Schellenbach, C. J. (Eds.), Violence against children in the family and the community (pp. 419437). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Y. and F., & Children's Bureau. (2020). Child Maltreatment 2018.Google Scholar
Wickrama, K. A. S., Bae, D., & O'Neal, C. W. (2017). Explaining the association between early adversity and young adults’ diabetes outcomes: Physiological, psychological, and behavioral mechanisms. Journal of Youth and Adolescence, 46, 24072420. doi:10.1007/s10964-017-0639-yCrossRefGoogle Scholar
Wildeman, C., Emanuel, N., Leventhal, J. M., Putnam-Hornstein, E., Waldfogel, J., & Lee, H. (2014). The prevalence of confirmed maltreatment among US children, 2004 to 2011. JAMA Pediatrics, 168, 706713. doi:10.1001/jamapediatrics.2014.410CrossRefGoogle ScholarPubMed
Yamada, T., Hashimoto, R. I., Yahata, N., Ichikawa, N., Yoshihara, Y., Okamoto, Y., … Kawato, M. (2017). Resting-state functional connectivity-based biomarkers and functional MRI-based neurofeedback for psychiatric disorders: A challenge for developing theranostic biomarkers. International Journal of Neuropsychopharmacology, 20, 769781. doi:10.1093/ijnp/pyx059CrossRefGoogle ScholarPubMed
Zigler, E., Finn-Stevenson, M., & Hall, N. W.. (2002). Child abuse and the brain. In Zigler, E., Finn-Stevenson, M., & Hall, N. W. (Eds.), The first three years and beyond: Brain development and social policy (pp. 123138). New Haven, CT: Yale University Press.Google Scholar
Zigler, E., Pfannenstiel, J. C., & Seitz, V. (2008). The parents as teachers program and school success: A replication and extension. Journal of Primary Prevention, 29, 103120. doi:10.1007/s10935-008-0132-1CrossRefGoogle Scholar
Zigler, E., & Styfco, S. J. (2000). Preventing child abuse through quality care and education: A plea for policy makers to act. UMKC Law Review, 69, 1524.Google Scholar