Literature DB >> 12914833

The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.

Shanta R Dube1, Vincent J Felitti, Maxia Dong, Wayne H Giles, Robert F Anda.   

Abstract

BACKGROUND: We examined the relationship of the number of adverse childhood experiences (ACE score) to six health problems among four successive birth cohorts dating back to 1900 to assess the strength and consistency of these relationships in face of secular influences the 20th century brought in changing health behaviors and conditions. We hypothesized that the ACE score/health problem relationship would be relatively "immune" to secular influences, in support of recent studies documenting the negative neurobiologic effects of childhood stressors on the developing brain.
METHODS: A retrospective cohort study of 17,337 adult health maintenance organization (HMO) members who completed a survey about childhood abuse and household dysfunction, as well as their health. We used logistic regression to examine the relationships between ACE score and six health problems (depressed affect, suicide attempts, multiple sexual partners, sexually transmitted diseases, smoking, and alcoholism) across four successive birth cohorts: 1900-1931, 1932-1946, 1947-1961, and 1962-1978.
RESULTS: The ACE score increased the risk for each health problem in a consistent, strong, and graded manner across four birth cohorts (P < 0.05). For each unit increase in the ACE score (range: 0-8), the adjusted odds ratios (ORs) for depressed affect, STDs, and multiple sexual partners were increased within a narrow range (ORs: 1.2-1.3 per unit increase) for each of the birth cohorts; the increase in risk for suicide attempts was stronger but also in a narrow range (ORs: 1.5-1.7).
CONCLUSIONS: Growing up with ACEs increased the risk of numerous health behaviors and outcomes for 20th century birth cohorts, suggesting that the effects of ACEs on the risk of various health problems are unaffected by social or secular changes. Research showing detrimental and lasting neurobiologic effects of child abuse on the developing brain provides a plausible explanation for the consistency and dose-response relationships found for each health problem across birth cohorts, despite changing secular influences.

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Year:  2003        PMID: 12914833     DOI: 10.1016/s0091-7435(03)00123-3

Source DB:  PubMed          Journal:  Prev Med        ISSN: 0091-7435            Impact factor:   4.018


  257 in total

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4.  Trajectories of maltreatment re-reports from ages 4 to 12:: evidence for persistent risk after early exposure.

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5.  Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice.

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6.  The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women.

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Review 8.  Post-traumatic stress disorder and cardiometabolic disease: improving causal inference to inform practice.

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9.  Childhood violence exposure and the development of sexual risk in low-income African American girls.

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Review 10.  Stress and brain atrophy.

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