Exploring Biological Consequences of Psychosocial Intervention Implementation

The purpose underlying our work is to improve health equity and quality of life for those who experienced early life adversity. It is through investigating the molecular consequences in association with intervention implementation that the possible relevance of these signals with both social environments and health provides potentially insightful and extensive data to better understand the biological impacts of interventions.

Dr. Merrill has pursued collaborations with programs helping children experiencing child maltreatment and/or high-risk environments from two perspectives: the functional utility of DNA methylation (DNAm) as an outcome in children and the potential molecular changes that can be observed and interpreted. For example, in collaboration with Dr. Nicole Bush (UCSF) they are examining whether the evidence-based child-parent psychotherapy (CPP) intervention can potentially prevent continued adverse biological embedding in children and families who have experienced trauma compared to a high-risk community sample. When employing the PedBE clock, they discovered that children who experienced high levels of trauma in the community sample continued to accelerate their rate of biological aging. This indicated the potential for wear-and-tear on their physiology. On the other hand, children with high levels of trauma who received the CPP intervention did not. While these results do not support the reversal of extant biological age acceleration, they do provide evidence for preventing further biological disruption. We hope to further investigate these findings, both in this cohort, and in other intervention contexts.

Dr. Merrill began working at Brown University with Dr. Justin Parent (URI), Dr. Leslie Brick (Brown), and the Brown Stress, Trauma, and Resilience (STAR) center on a study that employed parent-child interaction training (PCIT) in young, largely Latin American immigrant children with developmental delay. The results from this study are promising, indicating improvements in negative parenting practices moderate the molecular benefits of social interventions. We intend to pursue an expansion of this study to a larger, multi-state format as an upcoming NIH proposal. The randomized control trial (RCT) ATTACH intervention with Dr. Letourneau is an attachment intervention for parents struggling with mental health issues and their at-risk children. This has been implemented in Calgary and submitted for funding to be assessed in Denmark with Dr. Johanne Smith-Nelson (Københavns). Finally, in collaboration with Dr. Rana Dajani (MIT/Hashemite) in Jordan, Dr. Merrill is extremely grateful to study the molecular effect of socioemotional learning (SEL) interventions.

SEL interventions have been implemented with Syrian refugees living in Jordan and Jordanian community members. Two interventions collected DNAm with Dr. Dajani: We Love Reading and Advancing Adolescence. The We Love Reading waitlist-RCT is to improve cognitive outcomes and purposeful social bonding time in families through books on stressful socioemotional experiences. The Advancing Adolescence waitlist-RCT, also in collaboration with Dr. Catherine Panter-Brick (Yale), is an effective, evidence-based resilience-promoting intervention that emphasizes stress reduction, future thinking, and social connection. Longitudinal samples and data for these programs have been collected. We intend to submit funding of these analyses through the NIH.

These investigations, both preventative and restorative, focus on a range of profoundly stressful social environments and DNAm at key phases of biological plasticity: early childhood and adolescence. By studying these associations and potential molecular processes, we can better understand the idiosyncratic responses to adverse social environments for prevention efforts, as well as the biological systems benefited by effective interventions in potentially high-risk circumstances such as maltreatment. Ultimately, Dr. Merrill’s goal is to build on the foundations of her work and her collaborations to continue characterizing the biology of social experiences in this burgeoning field. Her aim is to best inform intervention from a molecular health perspective.