The health effects on children who witness and/or directly experience domestic violence has been identified as a leading public health issue, although its impact on children's health has not been well delineated. Growing research demonstrates the short- and long-term adverse physical, psychological, and behavioral consequences among children growing up with chronic violence. Chronic traumatic stress related to intimate violence (including remote exposures during early childhood) is associated with lasting biological changes known to cause alterations in immune functions potentially important to the pathophysiology of many diseases including obesity. Chronic stress can lead to neuroendocrine dysregulation (HPA and HPG axes) and can in turn have profound inhibitory effects on growth and sex steroid hormones. Therefore, exposure to violence may be associated with the development of obesity/overweight by causing changes in growth and sex steroid hormones. Also, stress-induced neuroendocrine disruption may be associated with reproductive health outcomes including early menarche, menstrual irregularity, and chronic functional pelvic/abdominal pain. Furthermore, these shared pathways may in part explain the link between obesity and these reproductive outcomes. No prospective study has examined the relationship between early life family violence exposure and the trajectory of weight gain in childhood and adolescence or the incidence of childhood obesity. Moreover, no studies exist to date which explore the influence of obesity, as a mediator of the relationship between violence as a chronic stressor and reproductive health outcomes in adolescents and young adults. We propose to measure family violence exposure in a sub-cohort of adolescents and young adults participating in the Growing Up Today Study (GUTS) (n approximately 16000) which provides a working infrastructure to facilitate this undertaking. In addition, salivary cortisol rhythms will be examined in relation to history of violence exposure and as a mediator between violence exposure and the proposed outcomes in a subsample (n=1200).
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