It is well known that child maltreatment affects long-term health and development. However, important scientific questions about the impact of child maltreatment remain and require answers if we are to allocate resources commensurate with the risks these children face. For instance, why do effect sizes vary across studies of child maltreatment examining the same health outcome? What are the causal pathways that explain why child maltreatment leads to diverse outcomes across the health spectrum? How can we improve the effectiveness of interventions, both preventive and treatment, for those children affected by maltreatment?
These questions spur three interrelated aims in my research laboratory: 1) advance methods that facilitate the accurate estimation of the impact of child maltreatment across adverse health outcomes, 2) identify risk mechanisms leading to multiple adverse health outcomes in the child maltreatment population, and 3) optimize the prevention and treatment of psychopathology by targeting and engaging identified mechanisms.
Currently accepting graduate students and postdoctoral scholars
1. Identifying and Controlling Contamination in Prospective Cohort Studies of Child Maltreatment
Variation in the significance and magnitude of effect size estimates reported across prospective studies has led to replication failures and the weakening of causal inferences about the long-term health effects of child maltreatment. In the first study of its kind, my lab examined whether the presence of child maltreatment in a comparison condition, a phenomenon known as contamination, produces such variation in effect size estimates across a number of health outcomes in young adulthood: obesity, teenage birthrates, clinical levels of major depressive symptoms, and past-month cigarette use. The prevalence of contamination was high in this study (44.8%), truncating effect size estimates and increasing the probability of Type II errors. However, a multi-informant method measuring child maltreatment at each prospective assessment provided optimal control of contamination with sizeable increases in effect size magnitudes for all outcomes. The lab is now leading efforts at replicating these findings using the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) dataset, including multiple means for controlling contamination, to strengthen causal inferences about the effects of child maltreatment through more precise estimation of risk magnitudes.
2. The Biological Embedding of Child Maltreatment and Subsequent Health
The Epigenetic Age Acceleration and Mid-life Cognitive Function Study (Shenk, PI) is an NIH-funded grant gathering data from nearly 3000 participants across four international cohorts to examine the impact of child maltreatment on epigenetic age acceleration, a cross-tissue index of the biological aging of cells that differs from chronological age. This study will first examine epigenetic age acceleration and its relation to mid-life cognitive function in the Female Growth and Development Study (FGDS), a 30-year prospective cohort study of the long-term effects of childhood sexual abuse. The FGDS cohort also provides an unprecedented opportunity to test the mediational properties of glucocorticoid remodeling occurring over the 20 years following exposure to substantiated child sexual abuse on epigenetic age acceleration. Once statistical models of epigenetic age acceleration and cognitive outcomes are developed using data from the FGDS discovery cohort, they will be exported for replication in three independent and international cohorts obtained from the U.S., Canada, and Germany to extend models to more diverse samples, including older ages and alternative cognitive outcomes (e.g. mild cognitive impairment). Results will inform precision-based efforts at preventing, delaying, or reversing the onset of various cognitive aging outcomes across different points of the lifespan. Graduate students are needed to promote data coordination and migration, data management, interpretation, and statistical analysis.
The Child Health Study (Shenk, Co-I) is an NIH-funded prospective cohort study examining the impact of child maltreatment on multiple biological systems and subsequent pediatric health. Children and their families participate in a Child Health Day where they complete several health assessments, including a health and physical exam, cognitive testing, diet and exercise, dyadic interactions, an MRI, a psychological task, and a battery of emotional and social health surveys. The data generated from this study, including genetics and epigenetics, intellectual abilities, observational data, structural and functional neuroimaging, and stress reactivity, will inform models of how the experience of child maltreatment “gets under the skin” to increase the risk for adverse health. Both graduate and undergraduate students are needed to work on the Child Health Study in a variety of capacities, including recruitment, active data collection with families, administration of study tasks, and data entry and coding.
The Life Events and Reactions Study (Shenk, PI) is a genetic case-control association study examining the genetic and epigenetic mechanisms associated with the onset of psychiatric disorders in the child maltreatment population. Children between the ages of 8 and 15 years of age who have experienced substantiated child maltreatment participated in this study. Graduate and undergraduate students are analyzing biospecimens (oral fluid, buccal swab) from this study and relating variation in a number of markers to the course and severity of psychiatric symptoms and diagnoses obtained from a structured psychiatric interview. Students are also actively involved in the entry, coding, and cleaning of data to facilitate statistical analysis. Results from this study will provide insight into the genetic, epigenetic, and psychological contributions for these disorders in the child maltreatment population so that interventions targeting these processes can be developed or applied more effectively. This multi-site project is funded by a KL2 award from Penn State.
3. Prevention and Treatment of Psychiatric Disorders following Child Maltreatment
The Prevention of Psychopathology Subsequent to Child Maltreatment Trial (Shenk, PI) is a randomized feasibility trial examining the active contributions of individual treatment components commonly applied within larger treatment packages for the child maltreatment population. Recent research on the etiology of psychiatric disorders suggests that child maltreatment affects a circumscribed set of centralized risk mechanisms, known as transdiagnostic mechanisms, responsible for the increased incidences of multiple psychiatric disorders in this population. This study is testing the feasibility and initial efficacy of delivering individual components to alter unique transdiagnostic mechanisms following an act of child maltreatment to optimize intervention effects and reduce the incidences of multiple psychiatric disorders. Graduate students and clinical staff are actively recruiting subjects, managing and allocating treatment randomization sequences, conducting treatment evaluations, and developing databases for statistical analysis. This project is supported by a Level II SSRI award from Penn State.
The Animal-Assisted Trauma-focused Cognitive Behavioral Therapy (AAT+TF-CBT) Trial (Shenk, Co-I) is an NIH-funded randomized feasibility trial examining the tolerability and acceptability of delivering TF-CBT while a service dog is present throughout the active phase of treatment. Preliminary research has shown that animal assisted therapy may provide a relaxing and supportive environment during clinical intervention. TF-CBT is the only well-established intervention for children experiencing maltreatment. This study will examine whether introducing a service dog during standard administration of TF-CBT enhances treatment effects above and beyond TF-CBT alone. Graduate students in the lab assisting with the AAT+TF-CBT trial are collecting, editing, and analyzing data collected through electrocardiograms delivered at pre-treatment, post-treatment, as well as during each session of the active treatment phase.
For more information about Dr. Shenk, click here.