الفهرس 
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Abstract
Childhood adversities have detrimental effects on children’s development with bio- psycho-social consequences throughout life. Children are impacted by many types of adversities but mainly childhood abuse and neglect.
The aim of the current study was to assess the association of exposure to early childhood adversities with epigenetic alterations of glucocorticoid receptor gene, hair cortisol level, cognitive and behavioral status in a sample of Egyptian primary schools children.
The study was carried out on 114 students aged between 7 – 11.5 years. All recruited children were interviewed individually and responded to the Adverse Childhood Experiences International Questionnaire. Child behavior and IQ assessment were achieved using Pediatric Symptom Checklist (PSCL) and Wechsler Intelligence Scale respectively. Assessment of chronic alteration of hypothalamic-pituitary-adrenal axis through hair cortisol level measurement and epigenetic alterations of glucocorticoid receptor gene were performed in a subsample of the recruited students.
Three out of the 114 were not exposed to previous adverse experiences, the rest of the sample was divided into 2 groups: group A; the exposed group (55 students) who were exposed frequently to one or two adverse experiences, group B; the highly exposed group (56 students) with frequent or multiple exposure to three or more adverse experiences. The children of the two groups were matched as regards their age, sex, and socioeconomic status.
Current study showed that The highly exposed children were nearly 3 times at risk to develop symptoms of psychosocial disorders more than the exposed group (P = 0.003); 2.5 times more likely to develop attention deficit (P = 0.02) and nearly 5 times more likely to develop externalizing behavior (P <0.001) than the exposed group. They were 1.6 times more susceptible to develop internalizing behavior than the exposed group, but this difference didn’t reach a significant level as (P >0.05).
The highly exposed children were more likely to have below average performance IQ 2.5 times more than the exposed group (P = 0.03). The increased odds of below average verbal and full scale IQ in the highly exposed children (OR>1), didn’t reach statistical significant level (p>0.05).
The estimated median hair cortisol levels of the exposed and highly exposed groups (32.5 pg. /mg) were highly above the reference levels of this age group, nevertheless they showed non-significant statistical difference between them. About 63% of genetically studied children showed methylation alteration of glucocorticoid receptor gene. However, there was non-significant statistical difference between exposed and highly exposed groups as regard the number of students with DNA methylation change.
The current study concluded that: Children exposed to multiple adverse experiences are more likely to develop psychosocial disorders, attention deficit, externalizing behavior and low performance IQ. Early exposure rather than the multiplicity of exposure to adverse life experiences is associated with high hair cortisol level. Exposure to adverse experiences could lead to epigenetic alterations in the form of DNA methylation irrespective to the number of adversities.