The trauma conundrum
Our genetic code can determine whether we inherit our grandmother’s pigeon toes or our father’s flaming red hair.
But what if the experience of trauma, too, could be passed down through our DNA from generation to generation? What if the survivor of a mass shooting was so profoundly affected that the development of her fetus was altered? What if Dayton’s devastating 2019 tornados manifested themselves in the genetic makeup of the community for generations to come?
Such questions have fascinated University of Dayton assistant professor of psychology Lucy Allbaugh since her days as an undergraduate researcher studying the effects of domestic violence on pregnant women. Today she is leading a study of the impact of trauma across generations of Dayton families and factors that could make us more resilient.
It’s a study that could uncover information on how life events can affect our genetics, an exciting prospect for the nine students who are working in her lab collecting the potentially groundbreaking data.
Allbaugh is hoping the experience is as exciting for them as it was for her as a young researcher.
Alyssa Trivus, who graduated from UD in December 2021, agrees.
“Stress and trauma have such a profound impact on our lives, and it’s important to acknowledge how the world we live in is impacting people from one generation to the next,” said Trivus, who took a gap year after earning her undergraduate degree in pre-medicine to continue work as a research assistant for Allbaugh. “It’s important to provide a better future for generations to come. Those little people are our future.”
Groundbreaking
The goal of the five-year research program, known as the Dayton Kids Project, is to identify biological markers in the DNA samples of children and their families who are at high risk of depression, post-traumatic stress disorder or other mental health challenges before their onset.
“If those markers are identified, we can intervene early on and funnel resources to children who need them the most.”
“If those markers are identified, we can intervene early on and funnel resources to children who need them the most,” Allbaugh said. “We also hope that better understanding of these biological markers will point to resilience factors that can be increased in the lives of children exposed to stress and trauma.”
Allbaugh and her team of student research assistants are collecting data from hundreds of Dayton-area children and their families for the study headed by Dr. Kerry J. Ressler, chief scientific officer for McLean Hospital, an affiliate of Harvard University. He recruited Allbaugh for the Dayton Kids Project during the last week of her postdoctoral residency at the Emory University School of Medicine in Atlanta, where Ressler was then heading the landmark Grady Trauma Project, studying the lifelong impact of trauma.
The Dayton area seemed like fertile ground for this research after two community-wide traumas in 2019 — a tornado outbreak in May and the mass shooting in the Oregon District in August. The researchers reached a consensus, Allbaugh said, “that we have to bring this to Dayton, because the community has been exposed to all sorts of trauma.”
McLean Hospital’s president, Dr. Scott L. Rauch, has called the project “some of the most exciting and groundbreaking work being done in psychiatric research.” The study is a partnership between McLean Hospital and The Connor Group Kids and Community Partners, the nonprofit arm of the Dayton-based real estate investment firm The Connor Group. Founder and managing partner Larry Connor, who serves on the board of McLean Hospital, was instrumental in bringing the project to Dayton.
“Larry has a deep understanding of Dayton and a deep commitment to Dayton, and he wants to contribute to the improvement of people’s lives,” said project researcher Dr. Torsten Klengel, director of the Translational Molecular Genomics Laboratory at McLean Hospital.
Epigenetics
The research is founded on the relatively new and growing field of epigenetics, or the study of alterable biological mechanisms that regulate the function of the genome. Allbaugh describes the epigenome as the “brain’s instructional manual,” a set of instructions that wrap around your genetic code. Chemical compounds tell the cells what to do and when to do it.
While genes are set for life, Allbaugh said, the epigenome can be altered by stress, trauma, malnutrition or exposure to toxic chemicals. These changes can be passed to new cells through cell division, and changes can be passed down through generations.
“The field of epigenetics is the study of modifications to the genome that change how genes express themselves,” she said. “Studies have shown that factors like toxic stress and poverty can change these epigenetic markers and may lead to the development of mental and physical disorders over time.”
Cortisol is the body’s main stress hormone. When an individual is exposed to stress, excessive cortisol levels can be produced — a reaction that can be beneficial when preparing for an exam or giving a big speech.
“The nice thing about cortisol is that it can gear us up to address the stressor and then shut that response down,” Allbaugh said. “We rise to the occasion and then return to the baseline.”
With chronic or toxic stress, however, those elevated cortisol levels can lead to physiological changes that affect the environment in the uterus while the fetus is developing. Exposure to trauma, Allbaugh explained, is strongly associated with a range of health conditions, such as heart disease and certain cancers. Those who have been exposed to trauma have been known to develop academic difficulties or be inclined to a range of dangerous behaviors, such as drinking, smoking, high-risk sexual practices or criminal behavior.
Ripple effects
As a Michigan State University student, Allbaugh worked with faculty members and graduate students on a research project studying women who survived domestic abuse during pregnancy. As she interviewed the women, she was struck by their stories of strength and resilience, by the complexity of their lives and by their coping mechanisms.
“It was my first exposure to the idea that harmful things that happen to one member of a family can impact other family members, and that exposure can affect parenting practices,” recalled Allbaugh, who joined the UD faculty in 2018. “It was such an honor to hear all of those stories; it was so moving, and it sparked my longstanding interest in the subject.”
Allbaugh has seen her students also respond positively to their research opportunity.
She told of a student who helped recruit families for the Dayton Kids Project at
East End Community Services, a nonprofit providing services for the people in Dayton’s eastern neighborhoods. The student, a Dayton native, was moved by the
experience.
The student told Allbaugh, “It means so much to give back to the community where I grew up and to be able to provide assistance to families who need it.”
Similar to Allbaugh, some of her former students have been inspired to pursue related fields, such as medicine or clinical mental health counseling. “It is cool to see the multiple ripple effects, and to see students becoming so interested in trauma,” Allbaugh said.
Students learn a great deal from observing Allbaugh, Trivus said.
“She is a very kind and compassionate person, and I can tell how passionate she is about her research from the way that she discusses it in lab meetings and the depth of knowledge that she brings,” Trivus said. “She teaches in a way that makes you want to know more.”
Even when the researchers could meet only on Zoom, Allbaugh found a way to look out for her team. “I was holding down another job, and she arranged our meetings around my schedule,” Trivus recalled.
Allbaugh coaches her clinical psychology students in the art of crafting the right questions to ask of the families.
“Authenticity is so important in research,” Allbaugh said. “You have to show people who you are so that they feel comfortable talking about difficult things and sharing their hopes and dreams.”
Trivus particularly enjoys talking with families in person and explaining the research to them.
“It has been very helpful to learn communication skills and interpersonal skills, and to learn how to break down scientific knowledge in layman’s terms so that the average person who isn’t familiar with medical terminology can understand it,” she said.
Allbaugh and her student team are responsible for recruiting Dayton-area families with children between the ages of 8 and 12. Children that age go through changes during puberty and pre-puberty, said Klengel from McLean Hospital. “We know that kids that age are very susceptible to stress.”
Research partners Emory University, Wayne State University and McLean Hospital are conducting similar outreach to families in Atlanta, Detroit and Boston, with the goal of recruiting 1,000 participants. The four organizations confer weekly during Zoom meetings to coordinate efforts and measure progress.
“This is what the future of research looks like.”
“This is what the future of research looks like,” Klengel said. “It looks into phenomena we don’t understand, and it combines four sites and conducts studies across different populations.”
Mutual aid
The program’s original protocol called for meeting with families face-to-face and collecting in-person a saliva sample that would be analyzed to identify biological differences in how individuals react to stress. That all changed with the COVID-19 pandemic.
“When the pandemic hit, we put everything on pause for a while,” Allbaugh said. “We decided to pivot to remote collection processes only. We decided it would not morally and ethically be right to send students in person.”
Despite that setback, many families responded to social media advertisements and flyers looking for participants. Dr. Jack Pascoe at Dayton Children’s Hospital helped with recruitment efforts, Allbaugh said: “Children’s has a great deal of intellectual interest in this work and a great deal of experience doing community-based work in Dayton.”
Research assistants at UD scheduled meetings with the families via Zoom, explaining how to fill out the self-reporting questionnaires through a secure data collection platform and how to submit saliva samples by mail.
“We have had a really good return rate, because families are excited to participate,” Allbaugh said. “Participants tell us they want to share their experiences so they can be helpful to others.”
Initially hesitant to approach families about such a sensitive topic, Trivus has been surprised by their level of investment in the research. “They are grateful to be contributing to such an overarching world issue,” she said.
One mother confided to Trivus that her life is highly stressful. “I’m so glad you’re looking into this,” the mother told her.
That moment was a revelation for Trivus about the nature of her research.
“I always thought we were trying to make an impact on women in the future,” Trivus said. “It was meaningful to see that you can impact women right here in the moment.”
Many types of trauma are covered in the questionnaire: child abuse and neglect; assault by a romantic partner; community violence; gun violence; verbal, physical or emotional abuse; natural disasters; and losses due to homicide or overdose.
The self-reporting questionnaires, Allbaugh said, allow the families to respond with more freedom and candor than if they were talking to the researchers directly. Participants answer questions such as, “Have you had recurrent or intrusive distressing thoughts or recollections about the event(s)?” They also rate the frequency with which they experience a variety of emotions, including: “When I am upset, I have trouble knowing exactly what I am feeling; I just feel bad.”
Every six months, the participating families are asked to fill out another questionnaire and to submit a saliva sample, enabling researchers to examine markers in their epigenome over two-and-a-half years.
Resiliency
Allbaugh believes that not everything that happens to us results in negative effects to our epigenome. Positive experiences and relationships can fortify us.
Allbaugh’s past research frequently has focused on the importance of protective
relationships.
“Safe, stable and nurturing relationships are widely recognized as one of the best protective factors for kids exposed to adversity ...”
“Safe, stable and nurturing relationships are widely recognized as one of the best protective factors for kids exposed to adversity, and we do expect to see some of that in this study, as well,” she said. “One of my primary interests in this project is to look at the quality of the parenting relationship on these outcomes. If you have at least one parent or grandparent or teacher who is supportive and safe to be with and can affirm your worth as a person, we believe those protective experiences may modify the genome.”
There’s also the question of what makes some survivors more resilient than others.
“Only 6-to-7% of trauma survivors experience PTSD,” Klengel said. “What distinguishes them from the others?”
Klengel said it is too early to forecast
results from the study; the first set of samples is only now starting to be analyzed.
“One of the most important questions is whether we can modify the epigenome,” he said. “Can the long-term effects of stress be reversed? We think that therapy and support as well as a changed environment can reverse the long-term effects of stress.”
The educational component of the study, he said, is just as invaluable as any scientific results: “Our research is important because it provides evidence that stress has long-term effects that we can measure. We hope our work contributes to the understanding of the effects of trauma and the socioeconomic factors that contribute to that.”
It’s groundbreaking research that students are engaged with hands on at the community level.
The Dayton Kids Project has complemented UD’s emphasis on undergraduate student research, Allbaugh said: “I love working at a university where students are excited about doing this kind of work and engaging in the community.”
Trivus, who is also working as a medical assistant at Magee Women’s Hospital in Pittsburgh, said her interest in the research stems partially from the influence of a grandfather, who was a psychiatrist. But she was most attracted because of the project’s focus on families and children.
“I like being part of something that advocates for future patients,” said Trivus, who plans to attend medical school in 2023. “The world of science is discovering more and more about how mental health is affecting physical health. I hope that approach becomes more prevalent in every medical practice.”
Allbaugh, too, is thankful to be at the vanguard of epigenetic research and to have the opportunity to make a difference in the lives of future generations of
children.
“It’s a way to keep learning, which is always the goal,” she said. “I’m excited to be connected early in my career to this kind of research and to be able to contribute to a really important piece of the trauma
conundrum.”
Mary McCarty is a longtime Dayton-area journalist who has worked as a columnist and investigative reporter for the Dayton Daily News and as a senior editor for Cincinnati Magazine.