April 2011: Childhood Trauma's Impact on Health Risks
As the number of traumatic events experienced during childhood increases, the risk for the following health problems in adulthood increases:
•Depression
•Alcoholism
•Drug abuse
•Suicide attempts
•Heart, liver, and pulmonary diseases
•Fetal death during pregnancy
•High stress
•Uncontrollable anger
•Family, financial, and job problems
With help from families, providers, and the community, young children can demonstrate resilience when dealing with trauma.
As the number of adverse events (i.e., physical, emotional, and sexual abuse; neglect; violence; and natural disasters) experienced in childhood increases, the risk for the following health problems increases: depression; alcoholism; drug abuse; suicide attempts; heart, liver, and pulmonary diseases1; fetal death during adolescent pregnancy; high stress; uncontrollable anger; and family, financial, and job problems.2,3 The effects of these events are long-term, powerful, cumulative, and may be invisible to health care providers, educators, social service organizations, and policymakers because the linkage between trauma and problems later in adulthood is concealed by time, the inability to “see” the process of neurodevelopment, and the effects of the original traumatic events, which may not become evident until much later in life.4
Research has shown that caregivers can buffer the impact of trauma and promote better outcomes for children even under stressful times when the following Strengthening Families Protective Factors5 are present:
•Parental resilience
•Social connections
•Knowledge of parenting and child development
•Concrete support in times of need
•Social and emotional competence of children
The graphs demonstrate that the percentage of adults who report abusing substances increases as the number of adverse childhood events they experienced increases. Approximately 3 percent of adults with no adverse childhood experiences reported being an alcoholic, approximately 5 percent of adults with one adverse childhood experience were alcoholics, nearly 8 percent of adults with two adverse childhood experiences were alcoholics, approximately 10 percent of adults with three adverse childhood experiences were alcoholics, and approximately 16 percent of adults with four adverse childhood experiences were alcoholics. Approximately 9 percent of adults with no adverse childhood experiences reported ever using illicit drugs, more than 15 percent of adults with one adverse childhood experience had used illicit drugs, more than 22 percent of adults with two adverse childhood experiences had used illicit drugs, approximately 25 percent of adults with three adverse childhood experiences had used illicit drugs, more than 28 percent of adults with four adverse childhood experiences had used illicit drugs, and more than 37 percent of adults with five or more adverse childhood experiences had used illicit drugs.
The graph demonstrates that the likelihood of having a depressive disorder as an adult woman increases as the number of adverse childhood events experienced increases. Adults who have been exposed to one adverse childhood experience are slightly more likely to have a depressive disorder when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to two adverse childhood experiences are nearly twice as likely to have a depressive disorder when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to three to four adverse childhood experiences are three times as likely to have a depressive disorder when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to five or more adverse childhood experiences are approximately five times as likely to have a depressive disorder when compared to adults who have not been exposed to any adverse childhood experiences.
The graph illustrates that the risk for adult heart disease increases as the number of adverse childhood events experienced increases. Adults who have been exposed to one to two adverse childhood experiences are slightly more likely to have a heart disease when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to three to four adverse childhood experiences are about one and a half times more likely to have heart disease when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to five to six adverse childhood experiences are nearly twice as likely to have a heart disease when compared to adults who have not been exposed to any adverse childhood experiences. Adults who have been exposed to seven to eight adverse childhood experiences are more than three times as likely to have a heart disease when compared to adults who have not been exposed to any adverse childhood experiences.
For more information on the impact of adverse childhood experiences, please visit http://www.cdc.gov/ace/index.htm .
1.Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., & Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study, American Journal of Preventive Medicine, 14 (4), 245-258. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract .
2.Hillis, S.D., Anda, R.F., Dube, S.R., Felitti, V.J., Marchbanks, P.A., & Marks, J.S. (February 2004). The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics,113(2), 320–327. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14754944?dopt=Abstract .
3.Anda, R.F., Felitti, V.J., Fleisher, V.I., Edwards, V.J., Whitfield, C.L., Dube, S.R., & Williamson, D.F. (2004). Childhood abuse, household dysfunction and indicators of impaired worker performance in adulthood. The Permanente Journal, 8(1), 30–38.
4.Perry, B.D. (2009). Examining child maltreatment through a neurodevelopmental lens: clinical application of the Neurosequential Model of Therapeutics. Journal of Loss and Trauma, 14, 240-255.
5.Horton, C. (2003). Protective factors literature review. Early care and education programs and the prevention of child abuse and neglect. Center for the Study of Social Policy. Retrieved from http://strengtheningfamilies.net/images/uploads/pdf_uploads/LiteratureReview.pdf (PDF).
Graphs were created by the Center on the Developing Child at Harvard University from the cited articles and are used by permission. For more information from the Center about early childhood development, please visit http://www.developingchild.harvard.edu .
Dube, S.R., Anda, R.F., Felitti, V.J., Edwards, V.J., & Croft J.B. (2002). Adverse childhood experiences and personal alcohol abuse as an adult, Addictive Behaviors 2002;27(5):713–725. Retreived from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12201379 .
Dube, S.R., Felitti, V.J., Dong, M., Chapman, D.P., Giles, W.H., & Anda, R.F. (March 2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experiences Study. Pediatrics, 111(3), 564-572.
Chapman, D.P., Whitfield, C.L., Felitti, V.J., Dube, S.R., Edwards, V.J., & Anda, R.F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15488250 .
Dong, M., Giles, W.H., Felitti, V.J., Dube, S.R., Williams, J.E., Chapman, D.P., & Anda, R.F. (2004). Insights into causal pathways for ischemic heart disease: adverse childhood experiences Study. Circulation, 110(13),1761–1766. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15381652 .
Use these sample messages to share this early childhood trauma and resilience data point with your connections on Twitter and Facebook and via email.
Twitter: More trauma in childhood = increased risk for serious #health issues in adulthood. Which ones? Read:
http://1.usa.gov/eXqVRX via @samhsagov #1in5
Facebook: Research shows that more traumatic experiences in childhood increases the risk for serious health problems in adulthood. Learn more about childhood trauma’s impact on health risks in adulthood and pass it on to observe National Children’s Mental Health Awareness Day: http://1.usa.gov/eXqVRX
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Awareness Day Social Media April 2011
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