In my practice I often see examples of the mind-body connection, of the ways exposure to violence or trauma impacts not only psychological but also physical health. Recent research recognizes the impact that childhood abuse can have on health in adulthood. For example, migraines, chronic pain, arthritis, chronic fatigue and irritable bowel syndrome have all been found to be more common among those with a history of childhood abuse. Fibromyalgia may be triggered by severe physical or emotional trauma. Girls with hostile or stressful home environments were found to reach puberty earlier, which in turn has been linked to various health problems.
The following study looks at the relationship between childhood abuse and autoimmune diseases.
Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD
From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.
Methods: Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia).
Results: Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with 2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05).
Conclusions: Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses. Abbreviations: ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone.
I believe that this research is important in that it can serve to increase awareness about the severity and lifelong impact of childhood abuse. Perhaps given the stigma that still exists around mental health issues, the public will take lasting physical health impact of earlier abuse more seriously?