New research from the University of Aberdeen challenges the current view that trauma in childhood increases the risk of all health conditions.
The study found instead that some conditions are more affected than others and women are more affected than men.
A team of scientists from the University of Aberdeen analysed data from over 16,000 people born in the UK in 1958 and followed them into adult life to understand how difficult childhood experiences can affect health at 50 years old. They looked at 14 types of adverse childhood experiences (ACEs), including abuse, neglect, family conflict, bullying, financial hardship, and family illness.
Adverse childhood experiences (ACEs) refer to potentially traumatic events or circumstances during childhood. As well as affecting childhood wellbeing, ACEs have been associated with long-term adverse health and social outcomes.
Most studies report associations between adverse childhood experiences (ACEs) and a single health outcome. This is the first study to look at a broad range of health outcomes and offers insight into more targeted interventions.
They found, for the first time, that mental health problems and severe pain showed the strongest connections to childhood trauma. Adults who experienced childhood adversity were significantly more likely to suffer from depression, anxiety, and chronic pain at 50 years old.
The team also found that the more trauma experienced, the greater the impact on health at 50. Specifically, people who experienced four or more types of childhood adversity had the highest risk of developing health problems as adults.
In both sexes, severe pain and poor mental health displayed the largest associations, while in women, gastrointestinal problems and asthma and bronchitis were also associated with childhood trauma, as measured by ACE scores.
The full paper is published today in JAMA Network Open
Professor Gary Macfarlane
The team used data from the National Child Development Study also known as the 1958 Birth Cohort Study, which follows approximately 17,000 people born during one week in 1958 in England, Scotland, and Wales. Once they reached 50 years old, they were interviewed about their current health, using a comprehensive list of 16 conditions.
The team investigated health outcomes which have not typically been examined by previous studies such as pain which is amongst the leading causes worldwide of years of disability.
Professor Gary Macfarlane, Chair in Epidemiology at the University of Aberdeen, who led the study explains their findings: “Our study provides evidence of the multifaceted potential health consequences of ACEs but showing greatest excess risks in relation to mental ill-health and severe pain.
“This emphasises the role of childhood adversity as a key driver of health inequalities, and a public health priority.
“Our findings highlight the importance of considering prevention strategies to mitigate the potential long-term health consequences of ACEs.
“Going forward, screening for ACEs in primary care settings, and targeted interventions for at-risk individuals, may help reduce the burden of chronic pain, mental ill-health, and other poor health outcomes. There may also be a need for tailored approaches accounting for sex differences in ACE-related vulnerabilities, while specific ACEs were shown to have the most wide-ranging associations.
“While ‘broad spectrum’ interventions remain important to ameliorate the impact of ACEs, a targeted approach, considering types of ACE, could address specific vulnerabilities – particularly mental ill-health and severe pain.
“The findings also highlight the importance of preventing childhood trauma and providing early support to at-risk families.”
Deborah Alsina MBE, Chief Executive of Versus Arthritis who part-funded the research added: “This important research, part-funded by Versus Arthritis, highlights the strong relationship between early childhood adversity and severe pain in adulthood. Findings suggest that our earliest experiences may be driving the health inequalities we know exist for people living with chronic pain.
“We must confront inequalities in musculoskeletal health. That requires bold investment in local, personalised, evidence-based care and addressing the wider social and economic factors that shape health. That is why we are proud to have invested in this research as part of the Advanced Pain Discovery Platform.
“Tackling childhood adversity is vital, if our governments are serious about reducing the burden of chronic pain for the next generation.”
This research was conducted as part of the CAPE Consortium (Consortium Against Pain InEquality) within the APDP initiative (Advanced Pain Discovery Platform) which is funded by UK Research and Innovation (UKRI), Versus Arthritis, Medical Research Foundation, and Eli Lilly and Company.