Childhood traumas linger as health risk factors for adults

Research from the Institute of Psychiatry at King's College London has found that negative experiences in childhood may alter not only mental health but also physical health, into middle age and beyond.

1,000 individuals have been followed from birth to age 32 as part of the Dunedin Multidisciplinary Health and Development Study in New Zealand. This latest research from the study suggests that sustained health risks stem from childhood abuse, neglect, social isolation or economic hardship.

The findings, which appear in the December issue of Archives of Pediatric and Adolescent Medicine, suggest that childhood experiences can affect nervous, immune and endocrine functioning, which agrees with earlier findings in animal experiments.

At age 32, the study subjects who had experienced these childhood traumas were more likely to exhibit depression, chronic inflammation and metabolic markers of increased health risk. These three factors are known to be associated with the physiology of stress-response systems, and predict higher risk for age-related illnesses such as cardiovascular disease, diabetes and dementia.

Adults who had been maltreated as children were twice as likely to suffer major depression and chronic inflammation. Children who grew up poor or socially isolated were twice as likely to show metabolic risk markers at age 32. After the analysis controlled for family history and other established risk factors, it showed that adults who had two or more of the adverse childhood experiences were nearly twice as likely to have disease risk factors as those who hadn't had suffered in childhood.

"We live increasingly longer lives and our extra years of life should be healthy, productive and enjoyable, not years of disease and disability," says lead author Dr Andrea Danese, Clinical Lecturer at Department of Child and Adolescent Psychiatry and MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry at King's. "In this study, we observed that childhood experiences may affect health in old age, regardless of the risk factors that health policies are currently targeting. Therefore the promotion of healthy positive experiences for children is a necessary and potentially cost-effective target for the prevention of age-related disease."

Co-author Professor Avshalom Caspi, Duke University, US, adds: "What we're learning is that poor adult health is, in part, manufactured in childhood. It is multiple and cumulative childhood experience that predisposes adults to poor health."

The authors now wish to further study how adverse psychosocial experiences can become biological risks in childhood.

The authors are Andrea Danese, Terrie E Moffitt, HonaLee Harrington, Barry J Milne, Guilherme Polanczyk, Carmine Pariante, Richie Poulton, Avshalom Caspi.

The study was conducted with colleagues from Duke University, North Carolina, US and Dunedin School of Medicine, New Zealand. It was funded by the UK Medical Research Council and the National Institute for Mental Health and the National Institute on Aging. Dr Danese was a Wellcome Trust Research Training Fellow.

'Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease' Arch Pediatr Adolesc Med. 2009;163[12]:1135-1143. Available pre-embargo to the media at www.jamamedia.org. JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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