Understanding the differential effects of co-occurring childhood maltreatment prior to age 12 and co-occurring poly-victimization prior to age 18 and until young adulthood on physical chronic illnesses are critical due to their far-reaching public health and economic consequences, particularly for sexual minorities such as lesbian, gay, and bisexual or LGB individuals. Of equal importance is the identification of immune mechanisms that get activated by victimization and meditate the association between each victimization type and chronic physical illnesses, as well as the developmental stage during which exposure to each victimization occurs. Such an evaluation will expand our knowledge of which co-occurring victimization types are most influential for specific chronic biological dysregulation and give us a better understanding of the stability and plasticity of victimization related biological dysregulation. Given that LGB individuals are at a greater risk for each victimization type and at greater risk for health disparities, it is equally likely that compared to heterosexual individuals, LGB individuals will experience greater victimization related biological dysregulation and subsequently higher levels of chronic illnesses. Similarly, victimization exposures in childhood (before age 12) are also generally considered worse for lifelong health outcomes. Therefore, the overarching goal of this project is to address three primary aims: 1) establish the relationship between a) co-occurring childhood maltreatment prior to age 12, b) co-occurring poly-victimization until age 18, and c) co-occurring poly-victimization until young adulthood, and chronic physical illnesses. 2) Examine mediating role of DNA methylation of pro-inflammatory cytokine and CRP genes as well as serum biomarkers of inflammation (e.g. CRP, IL-6, TNF-?) as a mechanism between each victimization type, and chronic physical illnesses. 3) Understand whether and how (stronger vs. weaker associations) the biosocial processes by which co-occurring childhood maltreatment and co-occurring poly- victimization is related to adult health varies by sexual orientation and development stage. This F32 will also allow the Candidate the time and training required to build on her existing expertise required to become an independent and interdisciplinary researcher. Through training with experienced mentors who are leaders in the field, the Candidate will gain 1. expertise in social genomics research and novel statistical methods for analyzing DNA methylation data, 2. knowledge in behavioral immunology and immune mechanisms of physical health, 3. in-depth knowledge of sexual minority health disparities such as LGB individuals, and 4. integration of theory, data and methods across social, biological, and developmental domains and translation of research findings. Training in these areas and in research ethics is integral for completing the research aims, and preparing the Candidate for a career as a NIH-funded researcher investigating victimization related health outcomes among sexual minorities.
The first objective of this research is to understand how three types of victimization ? co-occurring childhood maltreatment prior to age 12, co-occurring poly-victimization until age 18, and cumulative co-occurring poly- victimization until young adulthood - differentially impact chronic physical illnesses in adulthood via two biomarkers of immune functioning. The second objective is to determine if the direct and indirect associations in objective 1 are more pronounced among sexual minorities (lesbian, gay, and bisexual or LGB individuals) due to higher risk of victimization in this group and for individuals that experience these victimizations earlier in the life-course. Findings will increase theoretical and practical knowledge of the victimization and chronic physical health associations in LGB and heterosexual individuals and will help delineate the role of early vs. later exposures to victimization on physical health and biological processes.
