Research > PATHS

Paths Over Time and Across Generations Project

Est. 1978

Princpial Investigator: Judith A. Crowell, MD

A child psychiatrist and researcher with expertise in family relationships, stress and adversity, and mental health, Dr. Crowell has been involved with the project since 1992-- when the original participants were in their mid-20s. She is a member of the faculty at the Stony Brook University Medical Center on Long Island.

Co-Investigators: Eric Dearing, Ph.D., Ayelet Barkai, MD, Christos Mantzoros, MD

Project Director: Cynthia R. Davis, Ph.D

Project Coordinator: Elizabeth Weber, Ed.M

Research Assistants: Mary Buckingham, Brittany Dorer, Taylor Gray, Jungwon Kim, Ashleigh Magnan, Sean McCormack, Maria Meidanis, Ally Skopelites, Nick Stelmach, Nicole Taylor, Sarah Trifiletti, Nicole Usher and Karen Waterman.

Founding Principal Investigator: Stuart T. Hauser, MD, PhD

About the Founding Principal Investigator

Dr. Stuart T. Hauser was both director and president of Judge Baker Children's Center from 1993 - 2004 and also worked as Professor of Psychiatry at Harvard Medical School. After stepping down as President, Dr. Hauser continued in his role as principal investigator of Judge Baker’s Paths Over Time and Across Generations Project. Dr. Hauser passed away in August 2008.

Full biosketch & publications

 

Scroll down for more information about:

Metabolic Syndrome

First Findings from the Study

Helping Participants

Preliminary Results

Keeping You Up-to-Date on Who's Who

 

We are currently recruiting for the fall of 2011

There are still many of our long-time participants who have yet to join us for this phase. We will be reconnecting with each of you soon. We are very interested in having you join us for this phase, either individually or with your partners – so if you have not yet participated, please call or email us at (888) 799-2690or email us at paths@jbcc.harvard.edu!


Or if you know someone who may be interested in participating please call or email us at paths@jbcc.harvard.edu. We would be happy to work with your schedule to find a time that’s convenient for you, and in addition to the monetary compensation that is available, we also give you your individual medical test results.

Have you moved?  Has your phone number changed?  Call or send us an email to stay in touch at (888) 799-2690 or paths@jbcc.harvard.edu.

 

Metabolic Syndrome

Metabolic syndrome is a condition that involves having multiple risk factors that increase the chances of developing cardiovascular disease, diabetes, or having a stroke.  People are diagnosed with metabolic syndrome if they have three or more of the following signs: 1) blood pressure equal to or greater than 130/85, 2) fasting blood sugar equal to or greater than 100 mg/dL, 3) a Body Mass Index (BMI) of 30 or more OR a large waist circumference (40 inches or more for men, 35 inches or more for women), 4) low HDL cholesterol (under 40 mg/dL for men, under 50 mg/dL for women), or 5) triglycerides equal to or higher than 150 mg/dL.


Although genes, hormonal changes, and aging can all increase risk for metabolic syndrome, other factors are also involved, such as diet and exercise.  By eating healthy foods, exercising, and losing weight if you are overweight, you can reduce your risk for metabolic syndrome – as well as for cardiovascular disease, diabetes, or stroke.


If you have questions or concerns about metabolic syndrome or any aspect of your health, please contact your physician. If you or someone you know would like to participate in the study – and receive test results related to this condition – please contact us at (888) 799-2690 or email us at paths@jbcc.harvard.edu.

 

First Findings from the Study: Establishing a Link between Childhood Adversity and Metabolic Syndrome

One of the most interesting and rewarding parts of the study for us is the chance to meet and talk with participants. We are grateful for the stories you’ve shared with us, as well as the feedback you’ve given us about your participation in the study. Many participants, both long-term and new, have told us that they’ve appreciated the chance to pause from their hectic schedules and take some time to think about themselves and their experiences. Some have told us that “it has been years” since they’d thought about a particular story or memory, and others have told us that they’ve made meaningful connections between past experiences and their current lives that they hadn’t considered before. On many occasions, participants have also asked us about the purpose of our questions and about our findings in the study.


Indeed, we ask participants about very personal topics, including their mental health and experiences of adversity and trauma. We know these are often difficult questions to answer and participants sometimes wonder why we ask them about such painful events. Our current focus is on understanding how certain early traumatic experiences impact physical health in mid-life. Although there is nothing that can be done to change the past, we are very interested in factors that help people overcome adversity and function well in later life. Such factors include relationships with others, religion and spirituality, and work. We recently presented our first results on this topic at the bi-annual conference for Society for Research in Child Development, in Montreal, Canada, in March 2011.


We know that the prevalence of metabolic syndrome -- a multiplex risk factor for coronary vascular disease and Type 2 diabetes mellitus -- is steadily increasing in Western societies. The rate and timing of age-related health changes interact with developmental history, including experiences of traumatic stressors, and repeated, severe, early stressors may increase sensitization and vulnerability to the impact of later stressors -- increasing risk for metabolic syndrome.


In this study, we examined the associations among a childhood history of physical abuse, current social functioning, the presence of metabolic syndrome, and its components.  We found that the experience of physical abuse experienced under the age of 18 is associated with high triglyceride levels and with low levels of HDL (“good”) cholesterol. Physical abuse was also associated with a higher body mass index (BMI) and higher diastolic blood pressure. When we looked at how many components of metabolic syndrome people had, from none to all 5 factors, we found people who were doing well in their lives in terms of work, leisure, and relationships had fewer metabolic syndrome components. Unfortunately though, people who had a history of physical abuse were more than 4-times as likely to have metabolic symptoms when compared to those who did not report physical abuse, even if they were doing well otherwise.


Because of the increased risks for health that are related to early trauma, it is especially important that researchers continue to seek to understand protective factors and to encourage people at risk to seek care and intervention if needed. Your participation continues to be fundamental to understanding these risks.

 

Helping Participants
This current phase is the first time that we are including medical tests as part of participation in the study. Working closely with the medical team at the Beth Israel Deaconess Medical Center, Dr. Crowell reviews each participant’s medical tests and prepares letters that inform them of the results. We have seen about 100 participants to date, and we have obtained results and sent letters to over half of them so far. We have informed 61.5% of participants in the current phase that they have a problem or potential problems that they had not reported in the medical history.

We always encourage participants to share the results with their doctors. In cases as above where participants’ results indicate that they may be at risk for particular issues, such as high blood pressure or diabetes, we emphasize that follow-up with a primary care physician (PCP) is important. We hope that people will use this information to follow-up as many of these problems can be effectively treated.


Some participants have told us that they do not have a PCP, that they have difficulty with their insurance coverage, or that they are interested in talking with a mental health professional regarding some challenges they are facing.  In each of these cases, we’ve worked with participants to help them identify the resources they need. We have helped several participants in these ways.


We are happy to be able to finally “give back” to participants, especially considering all that you have shared with us.  If you have begun to participate in this phase of the study, and would like to receive another copy of your letter from Dr. Crowell or if you or someone you know is interested in participating in this phase of the study, please contact us at (888) 799-2690 or email us at paths@jbcc.harvard.edu.

 

Preliminary Results
Since we began the study began in October of 2009, we’ve seen 100 participants – including 48 participants who we’ve been following since 1978 and their partners; and 52 new participants who entered the study in this phase. Although we continue to welcome participants into this phase, we’ve started looking at the data we’ve collected. The following information describes the participants we’ve seen so far.


Who You Are
While our participants generally fall within the same age bracket (between 40 and 50 years old). There is tremendous diversity in our participants from your ethnic backgrounds to the number of children you have.  We have gone from a predominantly European American sample, to a sample that contains 28% African American and Black Caribbean participants.  We have a fairly even number of women (52.5%) and men (47.5%) participating.  And while some of you are not parents, some have as many as seven children!


Physical Health
We are very interested in the decade between 40 and 50 as a time of potential development of health problems for some people, and indeed we see that in the sample we’ve studied so far, many of you are doing well while some may want to turn their attention toward health during these critical years.  In the table below we have presented the sample’s average on key health indicators and compared them to health standards:

 

 

Sample

Health Standard

Cholesterol

178.09

100-199 mg/dL

Triglycerides

110.37

0-149 mg/dL

Fasting Glucose

94.23

65-99 mg/dL

BMI

28.84

18.5-24.9

Blood Pressure

120/76

Under 135/85 mmHg
 

As a group, you’re getting on average 6.6 hours of sleep every night.  And you may be interested to know that the number of children you have is highly associated with the amount of sleep you get each night.  Those with more children get fewer hours of sleep than those with less children.  Are you surprised?


Religion and Spirituality
One of the new things we ask about is how religion and spirituality plays a role in their lives and whether this has an impact on physical health.  We’re already seeing that African American participants and White participants tend to think about religion differently.  Increased religiosity and spirituality are related to better psychological functioning in African American participants. However, religiosity and spirituality are not related to functioning for European American participants.

 

Keeping You Up-to-Date on Who’s Who

Dr. Judith Crowell is our Principal Investigator. A child psychiatrist and researcher with expertise in family relationships, stress and adversity, and mental health, Dr. Crowell has been involved with the project since 1992-- when the original participants were in their mid-20s.  Although Dr. Crowell lives on Long Island and works at Stony Brook University, she comes to Boston monthly and is in touch with the rest of the staff on a daily basis.


Dr. Cynthia Davis has been involved with the project since 2008, and she officially took on the role of Project Director in the fall of 2010. Dr. Davis, a developmental psychologist, oversees the day-to-day management of the project and meets with participants as well. She also uses her extensive experience with statistics to analyze the data we collect from participants in order to answer our research questions. Dr Davis replaced Dr. Dorothy Warner as Project Director. Dr. Warner continues to actively consult with the project, and has begun her internship training in clinical psychology.


Elizabeth Weber, Ed.M. initially joined the project as a research assistant during her senior year in college, and in the summer of 2010, she became the Project Coordinator.  Working closely with the Beth Israel Deaconess Medical Center, Ms. Weber oversees the recruiting and scheduling of participants – including the in-person visits and phone calls. Ms. Weber took over for Marisa Marraccini who began graduate studies at the University of Rhode Island in the fall of 2010.


Mary Brinkoetter, MS, is the new clinical research coordinator at the Beth Israel Deaconess Medical Center. She has recently taken over this role from Ingrid Boyd, MPH. Ms. Brinkoetter has extensive experience in both the clinical and laboratory aspects of the project.


LeSette Wright, Ed.M., MA, MDiv., has been working with us since the fall of 2009 as our Community Consultant. Ms. Wright has been instrumental in guiding us as we recruit our new participants, and she has introduced us to many wonderful individuals and organizations in the greater-Boston area.


Claudia Miranda-Julian, MA, joins our team as a research associate and interviewer. She is a doctoral student at Tufts University with extensive experience in childhood attachment relationships and experiences of trauma.


Although these are the people you’re most likely to meet through the study, there are many others who make important contributions to the project. These include Co-Investigator Dr. Christos Mantzoros, the endocrinologist at the Beth Israel Deaconess Medical Center who heads the project at that facility and directs the medical aspects of the study; Co-Investigator Dr. Eric Dearing, a developmental psychologist at Boston College who is our expert in statistical analyses; and Dr. Ayelet Barkai who directed the adolescent sub-study and continues to consult with us.


Our research assistants come to us from a variety of undergraduate programs in psychology and human development in the Boston area, New Hampshire, and Long Island. Mary Buckingham, Brittany Dorer, Taylor Gray, Jungwon Kim, Ashleigh Magnan, Sean McCormack, Maria Meidanis, Ally Skopelites, Nick Stelmach, Nicole Taylor, Sarah Trifiletti, Nicole Usher and Karen Waterman are assisting with telephone interviews and scheduling. The research associates also work to ensure that the data we collect from you are carefully prepared for analysis.

 

We are currently recruiting for the fall of 2011

There are still many of our long-time participants who have yet to join us for this phase. We will be reconnecting with each of you soon. We are very interested in having you join us for this phase, either individually or with your partners – so if you have not yet participated, please call or email us at (888) 799-2690or email us at paths@jbcc.harvard.edu!


Or if you know someone who may be interested in participating please call or email us at paths@jbcc.harvard.edu. We would be happy to work with your schedule to find a time that’s convenient for you, and in addition to the monetary compensation that is available, we also give you your individual medical test results.

Have you moved?  Has your phone number changed?  Call or send us an email to stay in touch at (888) 799-2690 or paths@jbcc.harvard.edu.