How childhood trauma can affect mental and physical health into adulthood

May 24, 2017 by Shanta R. Dube, The Conversation
Childhood trauma can have an impact across generations. Credit: ambrozinio/Shutterstock

For millions of children in the U.S., poverty, neglect or abuse is a reality of everyday life, though these struggles are often hidden from view.

Adult survivors often feel ashamed about and stigmatized for their adversity. This makes it difficult to recognize that these events occur.

While it's easier to turn away than to face these issues, we can no longer afford to do so. Stress, mental illness and substance abuse – all health outcomes linked to childhood – occur in the U.S. today at very high rates.

In 1999, I joined the Centers for Disease Control and Prevention (CDC) as an early investigator on a study to examine how childhood trauma can impact health decades later. Little did I know that I was about to begin both a professional and personal journey that would forever change my understanding of medicine, public health and the human capacity to heal.

That seminal study provided insight into the lifelong health consequences of adverse childhood experiences (ACEs). It was the beginning of our understanding that these experiences can have negative effects on , leading to physical and mental health problems throughout life.

It brought to light the importance of preventing ACEs from ever occurring. It also drew attention to the healing and recovery needed to prevent these experiences from having an impact across generations.

The ACE Study

In the early 1990s, Vincent Felitti, a physician at Kaiser Permanente in San Diego, questioned why patients who successfully lost weight dropped out of a weight loss program. He could not make sense of it. He interviewed each patient individually and learned that the weight loss made patients feel vulnerable. A large proportion of the patients disclosed experiences of . The weight protected them.

Felitti's findings caught the interest of Dr. Robert Anda at the CDC. Together, they launched the CDC-Kaiser Adverse Childhood Experiences Study.

How childhood trauma can affect mental and physical health into adulthood

The ACE Study was one of the first and largest research efforts conducted to examine the impact of childhood trauma on health decades later.

From 1995 to 1997, more than 17,000 adult members of Kaiser Permanente in San Diego took part in the study. Researchers gathered information on their health and behaviors. Participants also answered questions about adverse childhood experiences, including physical, emotional and sexual abuse; physical and emotional neglect; and growing up in a home with divorced parents, domestic violence, substance abuse, or mentally ill or incarcerated household members.

One day, while reviewing the completed questionnaires, I came across several notes penned by the , thanking us for asking these questions. One said, "I thought I would die never having told anyone about my childhood." The messages were a true testament to the hidden nature of childhood adversities.

Key takeaways

The ACE Study offered groundbreaking insight into childhood trauma.

First, the ACE Study showed that childhood trauma is very common, even among white, highly educated adults with health care.

This was a novel finding, given that populations of low socioeconomic status and racial minorities are disproportionately represented in child welfare systems. For example, a large percentage of African-American and Native American children are seen in the child welfare system. The ACE Study helped us understand that childhood trauma cuts across multiple populations.

We learned that close to 30 percent of ACE study participants experienced physical abuse as a child. Fifteen percent experienced childhood emotional neglect.

A separate study showed that one in six men and one in four women reported childhood sexual abuse. Both men and women experienced similar risk for health outcomes like alcohol abuse and symptoms of depression.

Most importantly, we discovered that the 10 separate categories of abuse, neglect and related household stressors we assessed rarely occur as single events. For example, among adults who reported sexual , 80 percent reported at least one additional ACE and 60 percent at least two. A large proportion of study participants, sixty-seven percent, reported at least one of the 10 ACEs.

How childhood trauma can affect mental and physical health into adulthood

It's true that, during adolescence, youth tend to engage in risk-taking behaviors. Our research showed that increased the risk of alcohol use by age 14 and illicit drug use by age 15. Childhood trauma also contributed to the likelihood of adolescent pregnancies and adolescent suicide attempts.

But the story doesn't end there. ACEs were also found to be associated with multiple adverse outcomes in adulthood, such as cardiovascular disease, liver disease, chronic obstructive pulmonary disease, suicide attempts, alcohol dependence, marital problems, intravenous drug use and many more.

If there is one common thread to many of the preventable diseases we face in the U.S., why are we not paying closer attention?

Addressing ACEs

In 2012, the American Academy of Pediatrics called for a focused effort to prevent and address childhood toxic stress.

The policy was informed by the ACE Study and research on the impact that childhood trauma has on brain development. Neuroimaging of people who have experienced ACEs shows changes in the structure and function of areas of the brain responsible for memory, learning, and emotions.

What's more, many of the outcomes associated with ACEs among adult survivors – such as and mental illness – may make it likelier that the next generation will experience ACEs as well.

But not all hope is lost. Research strongly suggests that humans have an innate capacity to adapt and positively transform, even after traumatic and stressful events. Most importantly, positive, supportive and healthful activities can contribute to positive well-being among adult survivors of childhood adversity. Change has to start with ourselves first, so we can provide children with the safety, support, love, and protection they need.

We must recognize – without judgment, but rather with compassion – that trauma is widespread, affecting children and adults across generations. We cannot afford to wait any longer to address trauma and break the cycle of .

Explore further: Adverse events affect children's development, physical health and biology

Related Stories

Adverse events affect children's development, physical health and biology

October 21, 2016
It's known that adverse childhood experiences carry over into adult life, but a new study is focusing on the effect of these experiences in the childhood years.

Childhood trauma linked to adult smoking for girls

July 12, 2012
Adverse childhood experiences (ACEs) can stay with us for life. New research published in BioMed Central's open access journal Substance Abuse Treatment, Prevention, and Policy explains how these events can be tied up with ...

Trauma and stress in teen years increases risk of depression during menopause, study shows

March 29, 2017
Although depression is common during a woman's transition to menopause, understanding who is at-risk of experiencing major depressive disorder (MDD) during this period of hormonal fluctuation were previously unknown. Now, ...

New study links opioid epidemic to childhood emotional abuse

March 14, 2017
A study by researchers at the University of Vermont has revealed a link between adult opioid misuse and childhood emotional abuse, a new finding that suggests a rethinking of treatment approaches for opioid abusers.

Childhood trauma linked to early psychosis later in life

March 18, 2015
Research showing that patients with early psychosis report high rates of childhood trauma has important implications for clinicians, a University of Queensland psychologist has found.

Connection between adverse childhood experiences and juvenile delinquency

April 1, 2016
A recent study co-authored by University of New Mexico School of Law Associate Professor Yael Zakai Cannon shows the relationship between "adverse childhood experiences," or ACEs, and juvenile delinquency. The study also ...

Recommended for you

The illusion of multitasking boosts performance

November 13, 2018
Our ability to do things well suffers when we try to complete several tasks at once, but a series of experiments suggests that merely believing that we're multitasking may boost our performance by making us more engaged in ...

Brain changes found in self-injuring teen girls

November 13, 2018
The brains of teenage girls who engage in serious forms of self-harm, including cutting, show features similar to those seen in adults with borderline personality disorder, a severe and hard-to-treat mental illness, a new ...

Major traumatic injury increases risk of mental health diagnoses, suicide

November 12, 2018
People who experience major injuries requiring hospital admission, such as car crashes and falls, are at substantially increased risk of being admitted to hospital for mental health disorders, found a study in CMAJ (Canadian ...

Nearly one in ten Americans struggles to control sexual urges

November 9, 2018
(HealthDay)—The #MeToo movement has given many Americans a glimpse into an unfamiliar world that may have left many wondering, "What were they thinking?"

Brain activity pattern may be early sign of schizophrenia

November 8, 2018
Schizophrenia, a brain disorder that produces hallucinations, delusions, and cognitive impairments, usually strikes during adolescence or young adulthood. While some signs can suggest that a person is at high risk for developing ...

Social media use increases depression and loneliness

November 8, 2018
The link between the two has been talked about for years, but a causal connection had never been proven. For the first time, University of Pennsylvania research based on experimental data connects Facebook, Snapchat, and ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.