Telomere length and early severe social deprivation: linking early adversity and cellular aging
Open accessAbstract
Accelerated telomere length attrition has been associated with psychological stress and early adversity in adults; however, no studies have examined whether telomere length in childhood is associated with early experiences. The Bucharest Early Intervention Project is a unique randomized controlled trial of foster care placement compared with continued care in institutions. As a result of the study design, participants were exposed to a quantified range of time in institutional care, and represented an ideal population in which to examine the association between a specific early adversity, institutional care and telomere length. We examined the association between average relative telomere length, telomere repeat copy number to single gene copy number (T/S) ratio and exposure to institutional care quantified as the percent of time at baseline (mean age 22 months) and at 54 months of age that each child lived in the institution. A significant negative correlation between T/S ratio and percentage of time was observed. Children with greater exposure to institutional care had significantly shorter relative telomere length in middle childhood. Gender modified this main effect. The percentage of time in institutional care at baseline significantly predicted telomere length in females, whereas the percentage of institutional care at 54 months was strongly predictive of telomere length in males. This is the first study to demonstrate an association between telomere length and institutionalization, the first study to find an association between adversity and telomere length in children, and contributes to the growing literature linking telomere length and early adversity.
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Previous studies have shown that telomere shortening differs by sex, with males generally having shorter telomeres and a faster rate of decline.
“previous studies have shown that telomere shortening differs by sex (Drury et al., 2012), with males generally having shorter telomeres and a faster rate of decline.”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Results (Modification by gender; page unavailable) explicitly report no significant difference in telomere length between boys and girls, contrary to the claim that males generally had shorter telomeres. The sex-related finding concerns how institutional exposure was associated with later telomere length, not a faster rate of shortening in males; the Discussion says the typical rate of telomere change in children is little known. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredEarly life adversities such as abuse, violence, and financial strain are linked to shorter telomere length in children and adolescents.
“Early life adversities, such as abuse, violence, and financial strain are linked to shorter TL in children and adolescents (Coimbra et al., 2017; Drury et al., 2012; Humphreys et al., 2016; Shalev et al., 2013)”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Results (page unavailable) link greater exposure to institutional care with shorter telomere length in middle childhood. This supports the general association with early adversity in children, but the paper does not establish that abuse, violence, or financial strain have this association in children or adolescents. (LLM, conf=0.87)
Experimental — accuracy not yet measuredTelomere shortening reflects cumulative stress and is strongly associated with early adversity.
“Telomere shortening, a key marker of cellular aging, reflects cumulative stress and is strongly linked to early adversity.”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Results section reports that more time in institutional care was significantly associated with shorter telomeres in middle childhood, supporting a link to this form of early adversity. But the Discussion says telomere length may be a biomarker of adversity and cautions that shortening may reflect a particular aspect of institutional care rather than cumulative psychosocial exposure. The claim states that telomere shortening reflects cumulative stress more definitively than the paper does; page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn previous analyses through age 15, children with a history of institutionalization (EIG) had shorter TL compared to those never institutionalized (NIG).
“in the previous analyses through age 15, children with a history of institutionalization (EIG) had shorter TL compared to those who were never institutionalized (NIG) (Drury et al., 2012; Humphreys et al., 2016).”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Results section (‘Association between early social deprivation and telomere length in middle childhood’; page unavailable) reports that more time in institutional care was associated with shorter telomeres. But the Methods (‘Participants’; page unavailable) describe children who had all lived in institutions, not a comparison with never-institutionalized children. This paper reports telomere length in middle childhood, not findings through age 15. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBEIP findings indicate that children who spent a greater proportion of their lives in institutional care had significantly shorter telomere lengths at age 8 than those with lower proportions.
“Findings from BEIP indicate that children who spent a greater proportion of their lives in institutional care had significantly shorter telomere lengths at age 8 relative to those with lower portions of time in institutions (Drury et al., 2012; Humphreys et al., 2016)”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Results (Association between early social deprivation and telomere length in middle childhood; page unavailable) report a significant inverse association between the proportion of time in institutional care and telomere length. However, the Methods (Measures; page unavailable) say DNA was collected when children were aged 6–10, not specifically at age 8. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Earlier BEIP studies measuring TL between ages 6 and 10 and between ages 6 and 15 did not detect significant differences in TL between CAUG and FCG.
“earlier studies of BEIP participants that measured TL between the ages 6 and 10 (Drury et al., 2012) and between the ages 6 and 15 (Humphreys et al., 2016) did not detect significant differences in TL between children who remained in institutions (CAUG) and those placed in foster care (FCG).”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
The Methods (Measures; page unavailable) state that telomere length was measured from samples obtained at ages 6–10, and the Methods (Participants; page unavailable) identify the CAUG and FCG groups. The passages found do not report whether telomere length differed significantly between those groups; the Results instead report an association with time spent in institutional care. The ages 6–15 study is attributed to a different citation and is not assessed here. (LLM, conf=0.78)
Experimental — accuracy not yet measuredCaregiving-focused interventions may mitigate the physiological effects of ELA.
“Considerable evidence suggests that caregiving-focused interventions, for instance, may mitigate the physiological effects of ELA.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [99]
The Introduction says improved caregiving through foster care or adoption may mitigate some detrimental outcomes of institutionalization, which it describes as affecting biological as well as other domains. But the paper does not establish that the caregiving intervention mitigated a physiological effect: its telomere analysis relates length to time spent in institutional care, not to an intervention benefit. The Discussion also treats the effects of improved environments on telomere length as a question for future research. (LLM, conf=0.82)
Experimental — accuracy not yet measuredCaregiving-focused interventions improved ELA-associated chronic inflammation, telomere shortening, and gray matter volumetric changes in longitudinal research.
“Some parameters improved by caregiving-focused interventions in longitudinal research include ELA-associated chronic inflammation [98], telomere shortening (accelerated genetic aging) [99], and gray matter volumetric changes [100].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [99]
The Abstract (page unavailable) reports that children with greater exposure to institutional care had shorter telomeres in middle childhood, supporting the link between early adversity and telomere length. But the Discussion (page unavailable) says longitudinal telomere measurements are needed to determine whether adversity accelerates telomere decline; this study does not show that the foster-care intervention improved telomere shortening. The other outcomes in the citing sentence have separate citations and are not attributed to this source. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn an earlier BEIP analysis, sex modified the main effect between institutional care and telomere length: institutional care earlier in life (at baseline) was more strongly linked to shorter telomeres in girls, whereas institutional care later (at 54 months) was more strongly linked to shorter telomeres in boys.
“In an earlier BEIP analysis, sex modified the main effect between institutional care and telomere length; institutional care earlier in life (at baseline) was more strongly linked to shorter telomeres in girls, whereas institutional care later (at 54 months) was more strongly linked to shorter telomeres in boys (Drury et al., 2012).”
From Telomere trajectories from early adolescence to adulthood following early institutionalization: Protective effects of foster care in the Bucharest Early Intervention Project (2026) · cites this paper as Drury et al., 2012
Institutionally reared children with profound psychosocial deprivation have shorter telomeres as a function of time spent in institutions and show accelerated telomere shortening from age 6 to 15 compared with never-institutionalized children.
“institutionally-reared children raised under conditions of profound psychosocial deprivation have been shown to have shorter telomeres as a function of time spent in institutions,9 as well as accelerated telomere shortening from age 6 to 15 compared to never-institutionalized children.10”
From Telomere Length and Psychopathology: Specificity and Direction of Effects Within the Bucharest Early Intervention Project (2020) · cites this paper as [9]
Chronic psychological stress has been associated with shorter telomeres during childhood and adulthood, though not consistently.
“Chronic psychological stress has been associated with shorter telomeres during childhood and adulthood, though not consistently.”
From Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter (2015) · cites this paper as [24]
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Self-citation
- Authors
- Drury, S. S., Theall, K., Gleason, M. M., Smyke, A. T., De Vivo, I., Wong, J. Y. Y., Fox, N. A., Zeanah, C. H., & Nelson, C. A.
- Affiliations
- Tulane University (US)
- Harvard University (US)
- University of Maryland, College Park (US)
- Corresponding author
- Drury, S S
- Venue
- Molecular Psychiatry
- Published
- 2011-05-17
- Volume
- 17
- Issue
- 7
- Pages
- 719-727
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- PMC
- PMC3518061
- OpenAlex
- W2143367709
- Cited by
- 316
- References
- 57
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 5 · 2023: 12 · 2022: 17 · 2021: 13 · 2020: 26 · 2019: 26 · 2018: 18 · 2017: 32 · 2016: 31 · 2015: 28 · 2014: 34 · 2013: 24 · 2012: 23
- FWCI
- 19.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R21MH094688, R01MH091363)
- National Institute of Environmental Health Sciences (R01ES020447)
- Topics
- Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- telomere length, childhood adversity, social deprivation, institutional care, foster care, cellular aging, gender differences, Bucharest Early Intervention Project, middle childhood, psychological stress
- MeSH terms
- Child, Child, Institutionalized, Child, Preschool, Female, Foster Home Care, Humans, Infant, Male, Psychosocial Deprivation, Sex Characteristics, Time Factors, Randomized Controlled Trials as Topic, Cellular Senescence, Telomere Homeostasis, Telomere Shortening
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