Wednesday 20/3/2024
PHOTO: @aidan
Text: Lucía Zapata, Lina Camacho y Alejandra Misiolek
Childhood experiences have a profound influence on our development, shaping not only our immediate well-being but also our long-term health outcomes. Recent research has delved deep into the relationship between childhood adversity and a multitude of health outcomes, particularly in the realm of mental health. This exploration not only underscores the gravity of childhood trauma but also highlights avenues for intervention and reform in healthcare systems.
Already since the mid-1900s, animal and human studies have provided increasing evidence that experiencing, especially high or sustained levels of psychosocial stress, primary parental absence/ neglect and/or maltreatment in childhood, severely impacts adult behavior. A study of 8,629 survey respondents showed that more than 81% who reported experiencing one type of maltreatment also reported at least one other type of adverse experience. The increased risk of experiencing at least one other event has been found looking specifically at childhood sexual trauma and witnessing interpersonal violence at home.
Moreover, a seminal study conducted by researchers from the University of Iceland and Karolinska Institutet in Sweden provides crucial insights into the association between childhood trauma and adult psychiatric illness. Analyzing data from a staggering 25,252 adult twins in Sweden, the study uncovered a stark correlation: individuals reporting experiences such as abuse, neglect, or witnessing interpersonal violence at home, were 2.4 times more likely to be diagnosed with conditions like depression, anxiety, substance abuse, or stress disorders.
What sets this study apart is its innovative approach to examining “discordant twins.” By focusing on twin pairs where only one sibling experienced maltreatment, researchers could disentangle the effects of genetics and shared environment. This meticulous analysis revealed the profound impact of childhood trauma on mental health outcomes, providing a naturally controlled experiment that illuminates the intricate interplay between nature and nurture.
¿How can we measure these impacts?
The Adverse Childhood Experiences-Questionnaire (ACE-Q) is one of the different ways, it is a 10-item scale used to correlate childhood maltreatment and adverse nurture contexts, with adult health outcomes, is a brief rating scale designed by Vincent J. Felitti, MD, from the University of California. It provides substantial epidemiological evidence concerning the link between adverse childhood experiences and adult mental and physical illnesses. In the questionnaire, different questions are asked to assess the person’s memories before the age of 19. It explores exposure to psychological, physical, and sexual abuse as well as household dysfunction including interpersonal violence, substance use, and incarceration.
Repeatedly, it has been shown a connection between adverse experiences in childhood (ACEs) and a higher risk of acquiring a wide range of psychiatric disorders, addictions, and medical diseases (multiorgan) in adulthood, ultimately implying high-cost medical care and premature death.
Further exploration of the data uncovered a dose-response relationship, that is to say, each additional adverse experience heightened the risk of psychiatric illness and medical diseases, not only for the person with the traumatic childhood experience but for their children as well, as it can also impair parental skills needed for protecting future generations from these same illness-risks. This finding highlights the urgent need for targeted interventions and preventive measures to mitigate the lifelong and intergenerational consequences of early trauma.
Findings have shown that there is a relationship between ACE-Q scores and various indicators of general mental health, including relationship issues, emotional distress, impaired work performance, financial struggles, family conflicts, high-stress levels, and difficulty controlling anger.
Furthermore, the risk of depression and Post-traumatic stress disorder (PTSD), severity increases with ACE scores, especially in cases of childhood emotional abuse and exposure to interpersonal violence. Also, substance use disorders show a strong association, significantly elevating the likelihood of cigarette smoking and alcohol consumption. Moreover, they are linked to earlier initiation of illicit drug use and increased odds of addiction. Additionally, scores correlate with suicidal ideation and attempts, intimate partner violence, chronic pain conditions, sleep disturbances, sexually transmitted diseases, risky sexual behaviors, and adverse pregnancy outcomes.
Now, while invaluable in quantifying the overall convergence of ACEs is, the questionnaire falls short in capturing nuances such as the severity, duration, and timing of each experience. Future research must address these limitations to gain a more comprehensive understanding of childhood trauma’s multifaceted impact.
Translating these results, meaningful healthcare reforms require an effort to strengthen brain-behavioral health as a core public health mission. Integration of mental health and addiction services, along with medical and surgical care, is essential for addressing the holistic needs of individuals affected by childhood trauma. By prioritizing prevention and early intervention, healthcare systems can mitigate the long-term burden of psychiatric illness and chronic multi-organ diseases associated with adverse childhood experiences.
In conclusion, two decades of ACE-Q studies show how childhood adversity can greatly influence a person’s health and lifespan. In the same way, by understanding how trauma affects the brain and parenting, we can see why some health problems pass down through families. We need to work even harder to protect kids and stop the cycle of trauma and sickness passing from one generation to the next.
References:
- Barry, E. (2024, 7 marzo). One Twin Was Hurt, the Other Was Not. Their Adult Mental Health Diverged. The New York Times. https://www.nytimes.com/2024/03/06/health/one-twin-was-hurt-the-other-was-not-their-adult-mental-health-diverged.html?smid=nytcore-ios-share&referringSource=articleShare
- Zarse, E. M., Neff, M. R., Yoder, R., Hulvershorn, L. A., Chambers, J. E., & Chambers, R. A. (2019). The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Medicine, 6(1), 1581447. https://doi.org/10.1080/2331205x.2019.1581447