Childhood Trauma and Biological Aging
Childhood trauma and stress are associated with biological age acceleration.
Posted April 17, 2025 | Reviewed by Michelle Quirk
Folklore and urban legends are replete with pithy sayings and grim anecdotes expressing the belief that trauma and adversity prematurely age a person. Now we are acquiring new tools to test these beliefs scientifically, as well as to investigate just how broadly and deeply childhood trauma and adversity are biologically embedded and subsequently expressed over an individual’s lifespan.
Epigenesis refers to any heritable biochemical process that changes the expression of genes without changing their nucleotide sequence. Epigenesis changes the timing and frequency of when a given gene is expressed—i.e., turned on or off—but not the number or order of the DNA base pairs that comprise that gene.
Foremost among our new epigenetic tools are measures of biological aging called “clocks.” Epigenetic clocks (now in their second generation) are measures of the accumulation of methyl groups on an individual’s DNA compared with a standard “age estimator” based on thousands of representative samples. Some clocks also include behavioral or environmental variables such as the number of packs of cigarettes smoked daily.
If an individual has more methylation of his DNA than would be expected for his chronological age, he has an “accelerated (older) biological age.” If another person has fewer methyl groups, she is said to be biologically younger than her birth age. In the same person, different organs or bodily systems can have different biological ages. So someone’s heart may be biologically older or younger than his or her brain.
Accelerated biological aging in a given organ or biological system, such as the immune system, is increasingly being associated with younger ages of onset for many leading medical causes of death—primarily common disorders, such as heart disease, stroke, cancers, diabetes, and dementia , conditions that we normally associate with old age. Conversely, “biologically younger” individuals are statistically likely to remain healthy longer as they age.
Biological Age Acceleration Is Linked to Childhood Stress and Trauma
Although research indicates that lifestyle (e.g., diet , exercise, smoking , drug and alcohol use) can have noteworthy epigenetic effects, for better or for worse, two personal history variables are also emerging as important predictors of accelerated biological aging: childhood trauma and childhood socioeconomic stress (Palma-Gudiel, 2019).
About two-thirds of studies done with adults find significant correlations between commonly accepted retrospective measures of trauma and adversity and accelerated biological aging. The effects of trauma on accelerating biological aging in adults are strongest for individuals with a history of childhood trauma, especially childhood sexual abuse . Thus far, the few studies conducted with maltreated or traumatized children have all found evidence of accelerated epigenetic aging associated with trauma.
Not all studies, especially those focusing solely on adult-onset traumas, have found that stress and adversity accelerate epigenetic biological aging. Discrepant results are attributed to the limited number of studies, wide variations in the tissues sampled, differences in the measures of stress and trauma administered, and differences in the sensitivity of the epigenetic clocks used to measure aging.
Age Acceleration at the Time of Trauma Predicts Future PTSD
A unique prospective study by Anthony Zannas and colleagues using a cohort of men and women (N=289) who provided a blood sample when first seen in an emergency room after an acute trauma, found that accelerated epigenetic aging (using the GrimAge clock) at the time of the trauma predicted increased risk for a diagnosis of posttraumatic stress disorder ( PTSD ) six months later (Zannas et al., 2023). Moreover, there was a dose-response relationship between the degree of epigenetic age acceleration and risk for a diagnosis of PTSD, as well as for specific PTSD symptoms such as intrusive memories and nightmares. In addition, in a subsample for whom they obtained neuroimaging data, the GrimAge clock score was correlated with reduced amygdala volume and other neuroanatomical alterations commonly associated with trauma exposure. They recommend using the GrimAge clock after a traumatic event to assess risk for future PTSD.
Poverty and Biological Age Acceleration
Epigenetic biological age acceleration has also been associated with childhood socioeconomic status (SES) (Palma-Gudiel, 2019). Specifically, individuals who grew up in low-SES settings had higher rates of biological age acceleration than individuals who did not experience similar deprivation in childhood. Even individuals who have markedly improved their adult SES relative to their childhood circumstances continue to show significant epigenetic age acceleration, indicating that their childhood exposure was essential.
In aggregate, the research to date supports the use of epigenetic measures of biological age acceleration as potential biomarkers of stress and trauma, especially childhood trauma and adversity such as sexual abuse and poverty, which, in combination, are powerfully synergistic (Briggs et al., 2012). Epigenetic biomarkers of age acceleration could provide revolutionary opportunities to investigate how stress and trauma, especially childhood experiences, contribute to the leading medical causes of death as well as serious, trauma-associated mental illnesses such as major depression , PTSD, and the dissociative disorders (Putnam, in press).
Briggs, E.C., Amaya-Jackson, L., Putnam, K.T., Putnam, F.W., (2021). All adverse childhood experiences are not equal: The contribution of synergy to Adverse Childhood Experience Scores. American Psychologist . 76:243–252. https://doi.org/10.1037/amp0000768
Palma-Gudiel, H., Fañanás, L., Sorvath, S., Zannas, A.S. (2019). Psychosocial stress and epigenetic aging. International Review of Neurobiology . 150, 107–128. doi: 10.1016/bs.irn.2019.10.020
Putnam, F.W. (in press). Old Before Their Time: A Scientific Life Investigating How Maltreatment Harms Children and the Adults They Become . New York: Routledge.
Zannas, A.S., Linnstaedt, S.D., An, X., Stevens, J.S., Harnett, N.G., Roeckner, A.R., Oliver, K.I., Rubinow, D.R., Binder, E.B.,. Koenen, K.C., Ressler, K.J., and McLean, S.A., (2023) Epigenetic aging and PTSD outcomes in the immediate aftermath of trauma. Psychological Medicine 53:7170–7179. https://doi.org/ 10.1017/S0033291723000636
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Judith Lewis Herman, M.D., is a semi-retired professor of psychiatry at Harvard Medical School. Frank W. Putnam, M.D. , is a professor of clinical psychiatry at the University of North Carolina School of Medicine.
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