TCCMS Research Projects

The Translational Center for Child Maltreatment Studies (TCCMS) is committed to advancing scientific understanding, developing innovative interventions, and translating research into practice to improve outcomes for children and families affected by child maltreatment. The center's research is organized into two major projects, each addressing critical gaps in the field. 

---

Project 1: The Child Health Study (CHS) 

Lead: Hannah Schreier, Ph.D. (Penn State BBH) 
Co-Investigators: Eric Claus, Ph.D. (Penn State BBH), Zachery Fisher (University of North Carolina), Christine Heim (Charité Universitätsmedizin Berlin), Shalev, Ph.D. (Penn State BBH).

The Child Health Study (CHS) is a large-scale, prospective, longitudinal cohort study designed to explore the long-term health impacts of child maltreatment. With a diverse sample of 700 youth (525 with maltreatment histories and 175 demographically matched controls), the CHS aims to uncover the biological, psychosocial, and contextual factors that shape health trajectories across the lifespan. Key features of the study include: 

1. Comprehensive Biological Assessment: Biannual evaluations include a wide array of biological embedding (BE) mechanisms, such as neuroendocrine, immunologic, epigenetic, and cellular aging indicators, to identify how early adversity influences long-term health. 
2. Broadly Representative Sample: The study includes youth from a range of geographic contexts, including both rural and urban settings, and aims to capture a wide spectrum of experiences to ensure comprehensive insights into factors that influence long-term outcomes. 
3. Rigorous Design: The CHS employs state-of-the-art measurement approaches, including full blood panels, MRI scans, cognitive testing, and caregiver reports, to capture a comprehensive picture of child development. 

Specific Aims: 

Phase 1

• Aim 1: a comprehensive understanding of the interplay among child maltreatment, biological embedding (BE), and health status;
• Aim 2: testing how BE operates independently and in conjunction with psychosocial and behavioral factors to explain the association between maltreatment and health status;
• Aim 3: testing the moderating effects of genotype, gender, ethnicity, pubertal stage, and maltreatment type on models tested in Aims 1 & 2.

Phase 2

• Aim 1: Extend the CHS into the critical transition to adulthood (T2A), examining the interaction between BE mechanisms and psychosocial factors. 
• Aim 2: Investigate how T2A milestones are associated with concurrent health outcomes and long-term trajectories. 
• Aim 3: Identify pathways to resilience and recovery, including the role of race, ethnicity, and culturally relevant protective factors. 

Publications

Assembling a cohort for in-depth, longitudinal assessments of the biological embedding of child maltreatment: Methods, complexities, and lessons learned | Development and Psychopathology | Cambridge Core

Obesity and accelerated epigenetic aging in a high-risk cohort of children | Scientific Reports

Comparing qPCR and DNA methylation-based measurements of telomere length in a high-risk pediatric cohort | Aging

The Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y): Adaptation and Validation Across a Varied Sample of Children and Adolescents - Ann-Christin Haag, Christine B. Cha, Jennie G. Noll, Dylan G. Gee, Chad E. Shenk, Hannah M. C. Schreier, Christine M. Heim, Idan Shalev, Emma J. Rose, Alana Jorgensen, George A. Bonanno, 2023

Investigating the effects of maltreatment and acute stress on the concordance of blood and DNA methylation methods of estimating immune cell proportions | Clinical Epigenetics | Full Text

Sex differences in the roles of nicotine use and puberty on youth C-reactive protein levels: Effects above and beyond adversity - ScienceDirect

Cross-tissue comparison of telomere length and quality metrics of DNA among individuals aged 8 to 70 years | PLOS One

Pre-pandemic individual and household predictors of caregiver and child COVID-19-related stress in a high-risk sample - ScienceDirect

Cross-Tissue Comparison of Epigenetic Aging Clocks in Humans | bioRxiv

---

Project 2: SAFE-T Center Adolescent Study 

Lead: Sheridan Miyamoto, Ph.D. (Penn State Nursing) 
Co-Investigator: Damon Jones, Ph.D. (Penn State Prevention Research Center) 

The SAFE-T Center Adolescent Study is a clinical trial focused on improving access to high-quality, trauma-informed care for adolescent survivors of sexual abuse in rural and underserved communities. The project tests the impact of the Sexual Assault Forensic Examination Telehealth (SAFE-T) model, a nurse-led, telehealth-based approach designed to enhance care quality, support forensic evidence collection, and improve survivor outcomes. 

1. Innovative Telehealth Model: The SAFE-T model provides 24/7 real-time support to on-site nurses through a secure telehealth system, ensuring best practices in forensic care and psychological support. 
2. Community-Engaged Design: The project involves eight established partner hospitals, leveraging interdisciplinary data to inform study aims. 
3. Comprehensive Evaluation: The study assesses the impact of the SAFE-T model on health outcomes, service utilization, and justice system engagement for survivors. 

Specific Aims: 

• Aim 1: Evaluate differences in the quality of forensic care between SAFE-T and usual care, including completeness of evidence collection and survivor experience. 
• Aim 2: Assess long-term health and well-being outcomes, including PTSD, coping, and healthcare utilization. 
• Aim 3: Examine the impact of SAFE-T on prosecutorial decision-making and case progression. 
• Exploratory Aim 4: Conduct a cost-benefit analysis to assess the economic impact of SAFE-T implementation. 

Click here to view SAFE-T Center research. 

---

Project 2 (Concluded): Pediatric Abusive Head Trauma Study 

Lead: Kent Hymel, M.D. (Penn State Pediatrics, retired) 

The pediatric Abusive Head Trauma (AHT) Study aimed to improve the early identification and evaluation of AHT in pediatric intensive care settings. The study included an implementation trial of a validated clinical decision rule (CDR) for AHT screening across eight pediatric intensive care unit (PICU) sites nationwide. These sites, matched into four intervention-control pairs, represented varied patient populations and care settings. The CDR was designed to be applied at or near the time of PICU admission, using four highly reliable predictor variables to identify high-risk patients who should undergo comprehensive abuse evaluations. 

1. Groundbreaking trial design: This is the first study to rigorously test an evidence-based clinical decision rule (CDR) for abusive head trauma in real-world settings through a randomized design. 
2. Bias-reducing intervention: The CDR aims to reduce diagnostic disparities linked to child race, age, and family background by standardizing how abuse evaluations are initiated. 
3. Sustainability-focused rollout: A unique phase repeals implementation supports one by one, revealing which strategies are essential for lasting adoption in clinical practice. 

Specific Aims: 

• Aim 1: The SCRT will compare AHT screening accuracy after the deployment of active multifaceted implementation strategies designed to promote CDR acceptance, utilization, and accuracy at the intervention sites 
• Aim 2: The SCRT will determine what—if any—site-, provider-, and patient-specific factors predict CDR application in PICU settings 
• Aim 3 (Exploratory): Conduct a 12-month sustainability trial at intervention sites, systematically repealing the implementation strategies one by one to discern their relative importance to sustainability 

Additional details about the Pediatric AHT Study can be found here.

Coming Soon - AHT publications.