Behavioral and emotional difficulties in maltreated children: Associations with epigenetic clock changes and visual attention to social cues

Research indicates that childhood maltreatment leads to adverse outcomes later in life and accelerated aging. However, few studies have investigated how age acceleration manifests during childhood. This study aimed to investigate the impact of child maltreatment on DNA methylation age (mAge) acceleration using a case-control study design and its association with visual attention and behavioral and emotional outcomes in maltreated children (CM). We hypothesized that CM experience atypical aging, which adversely affects their behavioral and emotional outcomes by disrupting the cognitive development necessary for forming interpersonal relationships. The study included 36 CM and 60 typically developing (TD) children with an average age of 4-5 years. We compared their DNA mAge acceleration, measured through buccal DNA samples. Additionally, we conducted a behavioral assessment of their cognitive functions related to interpersonal interactions, using an eye-tracking system to measure their gaze points at various social stimuli. Behavioral and emotional outcomes were evaluated using the Strength and Difficulties Questionnaire (SDQ). The results showed that CM exhibited significantly higher mAge acceleration and spent significantly less time gazing at the eye region during facial expression presentations. While a significant association between these attributes was observed, a comprehensive path analysis revealed that each attribute independently correlated with higher SDQ scores, suggesting that child maltreatment leads to these difficulties through accelerated aging and decreased eye contact. This study provides significant insights into how child maltreatment impacts children's development. It demonstrates that mAge acceleration and reduced attention to the eye region are critical factors associated with the adverse behavioral and emotional outcomes observed in maltreated children. These findings highlight the importance of early intervention and support for maltreated children to mitigate the long-term effects of accelerated aging and social cognitive deficits.