Resilient McDowell

How childhood trauma affects health across a lifetime

Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain.

This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. An impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on.

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Toxic Stress

ACEs produce toxic stress. This persistent stress can create neuron-level damage in the child’s brain. Children who have been exposed to trauma have a harder time concentrating, following directions, forming positive social connections, and even learning because the development of their prefrontal cortex (the area responsible for self-regulation and executive functioning) has been disrupted by early stress. Poor executive functioning has several consequences such as:

• The inability to control impulses,
  
  
• Difficulty regulating emotions, and
  
  
• Difficulty handling challenges.

Toxic stress can also inhibit the ability to process events (good or bad) properly. This can lead to the development of unhealthy coping skills such as substance abuse.

The stress response affects our immune system, which our bodies need in order to fight off disease and illnesses. Our immune system also serves to control the levels of inflammation in our bodies. Therefore, when our stress response prevents our immune system from effectively regulating inflammation levels, illnesses like heart disease and type 2 diabetes can develop.

ACE's-Adverse Childhood Experiences

The ACE study was a groundbreaking research project that examined connections between childhood trauma and adult health problems. The knowledge gained from this study can provide helpful insight into working with clients who have experienced childhood trauma and provides context for better understanding of health problems experienced by the general population. 

 Dr. Vincent Felitti, the primary researcher on this study, began his research on patients in his obesity clinic. After Dr. Felitti started questioning why so many of his trial patients were dropping out of his obesity study prematurely, he realized that many of the participants leaving his study had experienced sexual abuse during their childhoods. This discovery inspired a large-scale investigation that explored the relationship between ACEs and the adult development of mental health problems and physical illnesses.

This large scale study was conducted from 1995-1997 by the Center for Disease Control (CDC) and the health insurance company, Kaiser-Permanente. The study included more than 17,000 male and female participants from Southern California. The participants during two different “waves” or rounds of the study were asked whether they encountered ten traumatic or stressful events (ACEs) during their childhood (before the age of 18). Based on these responses, an ACE score was assigned to each participant by calculating how many of the ten types of ACEs they reported experiencing. It is important to note that an ACE score does not reflect the frequency or the severity of the adverse experiences. Participants were also asked about their current health status and any health risk behaviors they exhibit.