How do (adverse) life experiences in childhood end up in disease states half a century later?

[drwex]

(trigger warning for ALL the bad things that are done to children - sexual & emotional abuse, neglect, etc. as well as adult mental health and suicide discussions)

The Adverse Childhood Experiences (ACE) Study is a massive, ongoing effort to understand the connections between what are generally labeled "adverse experiences" in childhood and their effects on adults decades later, even adults who don't remember or consciously acknowledge those experiences. You can go to their site and see how the ACE Score is calculated (pdf). And if you're brave enough, you can calculate your own score.

As the study's founder, Dr. Vincent Felitti, describes in a Big Think video, a score of six or more on this simple diagnostic is highly predictive of a wide range of adult diseases and behaviors, including dangerous obesity, IV drug use, attempted suicide, depression, and so on. The effect is not small - people with high scores on this assessment are 5000% more likely than the average for their age/gender/race/economic status to attempt suicide or have some form of eating disorder. Yes, that's five THOUSAND percent. The average life expectancy of the affected population goes down by 20 years.

Of course, discovering a massive effect is important but it's really only one step. Understanding the mechanisms is still a work in progress. Dr Felitti believes that in addition to the somewhat obvious (we engage in short-term pleasurable/long-term destructive behaviors in order to feel better) we also need to understand just how long-term, untreated stress affects every system in our bodies. In the past decade work has begun to emerge connecting untreated stress to subtle things like hormone production as well as its obvious effects on things like blood pressure.

Most sad for me is his final point, which is that he has come to believe that we cannot possible cope with the wide array of symptoms and diseases that crop up in people decades later - the only right solution is "primary prevention". In English, that means we have to treat our kids better, as a society. It's not enough to remove children from abusive situations and help them heal from it - we have to find ways to prevent that abuse. I'm sad because I don't even have the foggiest idea how to do that, or even what questions should be asked if we agree that's the goal we want to make progress against.

(For the record, my ACE score is exactly six.)

Comments

Familiar with the ACE study

[sweetmmeblue.livejournal.com]

This is something that has been presented at The Philly Trans Conference and other places about adverse early life experiences. It's HUGE and as a parent makes me worry about the kids.

There is the places where the ACE study doesn't take into account the impact of non-family of origin (bullying, community violence, institutional isms... etc.) as well as inherited trauma of behavior patterns in families if the parents have trauma. There is some research that shows there are biologic markers that get passed on from generation to generation within families where there has been trauma. I wish I can remember where that study was, I'll look through the trauma mailings I have and see if I can find it.

Re: Familiar with the ACE study

[drwex]

One of the questions on the ACE evaluation asks about mother's childhood trauma.

Re: Familiar with the ACE study

[sweetmmeblue.livejournal.com]

Yep, but in this age where there are a lot of male veterans and it's biasing for early trauma happening to females it seems.

RE: Re: Familiar with the ACE study

[fordprfct.livejournal.com]

I am reading through the ACE evaluation (ACE Score Calculator - English), and am not seeing a question about mother's childhood trauma. The closest I am seeing (unless I am reading it wrong) is question 7, asking about whether my mother was abused in various ways.

Maybe I am just not seeing it as a childhood thing, because I witnessed all three.

(Score: 7-9, depending on when, exactly, he spent his time in jail, and whether my judgment of their mental illnesses is correct. Would be rather higher if the "A or B or C" type questions counted extra if it was "A and B and C")

Found it

[sweetmmeblue.livejournal.com]

http://www.ncbi.nlm.nih.gov/pubmed/24832930

RE: Familiar with the ACE study

[goddessfarmer.livejournal.com]

I'm interested in hearing more about this. By this ACE assessment my score would be 4 or 5 (Don't have data on my mother's childhood trauma, because no one talked about it) or maybe even 6 if alcohol was a factor (but no one's talking about that either). However, as noted, it doesn't take into account school bullying. Nor does it take into account the possibility of a mother abusing the father.

Re: Familiar with the ACE study

[drwex]

There are many reasons why other factors are not included, most prominent being that they don't have significant predictive power or cannot be disentangled from other factors to a sufficient degree. So for example while no one doubts that school bullying is detrimental it's not shown to have this magnitude of effect. Given the scale of the ACE study it's not surprising that it has some limits.

[zzbottom.livejournal.com]

Well that was a depressing little trip down memory lane. I very much appreciate the pointer, though. I'm being ever vigilant to not repeat the sins of the father, as it were.

[drwex]

Yeah, sorry. That's why I put the content warning up top.

[heather mccrillis (from livejournal.com)]

"3. Did an adult or person at least 5 years older than you
ever Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?" What if the abuser was younger?