Topical Review: The Emerging Field of Epigenetics: Informing Models of Pediatric Trauma and Physical Health.

OBJECTIVE Trauma experienced during childhood and adolescence has been linked to a number of chronic medical concerns. We highlight major findings from the pediatric trauma literature to provide a model for understanding this association. METHODS Studies examining the effects of trauma were systematically reviewed and synthesized into a model proposing a central role for epigenetics in the ways that childhood experiences can affect health. RESULTS Early hypothalamic pituitary adrenal (HPA) axis response may impact initial trauma experience, with downstream effects on posttrauma adjustment reflected in posttrauma neurobiology, psychological health, and physical health. CONCLUSIONS Prospective research with children and adolescents exposed to trauma is needed to better characterize the genetic and epigenetic influences on the course of HPA and immune processes as related to posttrauma psychological and physical health outcomes.