Long-term alteration of heart rate variability following childhood maltreatment: Results of a general population study

Abstract

BACKGROUND: Childhood maltreatment (CM) is a risk factor for mental and physical health problems in adulthood, potentially mediated by long-term autonomic nervous system (ANS) dysregulation. To explore this link, the association between CM and vagal-sensitive heart rate variability (HRV) metrics in adults was examined, accounting for biopsychosocial factors. METHODS: Data from 4,420 participants in the Study of Health in Pomerania were analyzed, with CM assessed using the Childhood Trauma Questionnaire. HRV was derived from 10-second electrocardiograms and 5-minute pre-sleep polysomnographic recordings. Post hoc analyses examined abuse and neglect. RESULTS: CM was associated with reduced HRV (logRMSSD: β = -0.20 [95%-CI: -0.28, -0.12], p = 1.2e-06), driven by neglect (β = -0.27 [-0.35, -0.18], p = 1.9e-09) rather than abuse (β = 0.01 [-0.12, 0.14], p = 1). Adjustments for age, sex, and medication attenuated these effects, which remained robust after additionally controlling for socioeconomic, lifestyle, body mass index, and depressive symptoms (fully adjusted model: CM β = -0.08 [-0.15, -0.001], p = .047; neglect β = -0.11 [-0.19, -0.03], p = .009; abuse β = -0.08 [-0.20, -0.04], p = .174). Age-related differences were found, with reduced HRV in both young and older participants but not in middle-aged participants (fully adjusted: F(2,743) = 6.75, p = .001). CONCLUSIONS: This study highlights long-term ANS dysregulation following CM, particularly neglect, indicated by altered vagal-sensitive HRV metrics. Although small in magnitude, the effect on the ANS was independent of adult biopsychosocial factors. This long-term dysregulation may contribute to an increased risk of adverse health outcomes in adulthood.