“As the Twig is Bent”

There is a recent article at http://www.psychotherapynetworker.org/magazine/currentissue/1107-as-the-twig-is-bent (great magazine, btw) about research that has revealed something surprising.  Vincent Felitti was running a weight loss clinic in the US and he continued to be frustrated by the fact that his ‘successful’ clients would often relapse/rebound to being obese once again, and then drop out of the program – often right after amazing weight reduction.

In conjunction with Robert Anda from the CDC he launched “the largest research study ever done on the effects of childhood abuse, neglect, and other serious stressors on adult mental and physical health”, called the Adverse Childhood Experiences (ACE) Study.  Over 17,000 subjects were interviewed to find if they had been exposed to any of the following in their childhood (before the age of 18):

  1. Recurrent physical abuse
  2. Recurrent emotional abuse
  3. Contact sexual abuse
  4. An alcohol and/or drug abuser in the household
  5. An incarcerated household member
  6. Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
  7. Mother is treated violently
  8. One or no parents
  9. Emotional or physical neglect

A ‘yes’ to any category resulted in one point to the ACE score.  Therefore scores could range from 0-9, with higher scores indicating a high level of adverse childhood events. In addition to giving overwhelming confirmation to the general insight that a high level of adverse childhood events correlates with adult levels of psychological distress, the study also revealed many specific interesting facts, such as the fact that “a male child with an ACE score of 6 is 46 times as likely to use intravenous drugs in adulthood than one who scores 0″.

In essence, it has found that “that abuse, neglect, parental alcoholism, severely dysfunctional family patterns, and other stresses in childhood can severely affect adult physical health, and even mortality”.  The link is remarkably strong and has led some to state that childhood adversity and its lifetime effects on health and well-being are “America’s most important public health issue”.

Intuitively it makes sense that (as the article says) “maltreated children are much likelier to become hooked on the self-soothing habits—smoking, drinking, overeating, promiscuous sex, drug abuse—that are known risk factors for most illnesses.”  However, the article also describes how the ACE study found that high ACE scores:

… are correlated with diseases, including cancer, coronary artery disease, and chronic obstructive pulmonary disease, even controlling for or without conventional risk factors like smoking, air pollution, or high cholesterol. In other words, diseases that were once considered exclusively hard-core structural, biomedical conditions arising in adulthood may have unsuspected origins many decades earlier in physiological stress reactions arising from childhood abuse and trauma.

As psychologists we know that adverse childhood events affect us emotionally.  This study helps reveal the tragic physical effects as well.

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