Is There A Link Between Childhood Trauma And Chronic Illness?

Traumatic experiences are known to cause many types of physical and mental issues in adults and children both. While it was earlier known that trauma has an impact on adults, the latest research has now been indicating that adverse childhood events have an impact on children as well, which can manifest itself in the form of various illnesses later on in life. And what about the effect of emotional trauma in childhood? The impact of the mental trauma of a childhood abuse survivor can be felt many years after their childhood comes to an end as well. Read on to find out if there is a link between childhood trauma and chronic illness.

Adverse childhood events (ACEs) are an umbrella term used to refer to any negative experiences that occur in a child’s life during the first 18 years. They can include many types of events, such as witnessing or receiving abuse, neglect, and any form of dysfunction inside the home. In 1998, a Kaiser study found that as the number of such adverse events in a child’s life increases, so do the chances of various risk factors for many of the leading causes of death in adults. This includes cancer, heart disease, liver disease, and chronic lung disease.^{(1, 2, 3, 4)}

Another study published in October 2015 and looking at trauma-informed care for those who survived some form of childhood trauma found that the survivors with higher ACE scores were also at a higher risk for developing autoimmune diseases like rheumatoid arthritis.⁽⁵⁾ They were also found to be at a higher risk for experiencing frequent headaches, depression, anxiety and insomnia, among other health issues. At the same time, there is also evidence that indicates that exposure to traumatic toxic stress can actually trigger changes within the immune system as well.⁽⁶⁾

This theory believes that an extreme amount of emotional stress can become a catalyst for a wide variety of physical changes in the body.

Post-traumatic stress disorder (PTSD) is one of the biggest examples of this theory that can be witnessed in action. Some of the common causes of PTSD are usually some of the same events that are recognized in the ACE questionnaire, such as neglect, abuse, accidents, war, disasters, and other such traumatic events in one’s life.^{(7, 8)}

Studies have shown that post-traumatic stress disorder causes changes in both structure and function of the brain. Parts of the brain most commonly affected in PTSD have been found to be the amygdala, the ventromedial prefrontal cortex, and the hippocampus.⁽⁹⁾ These parts of the brain are responsible for managing emotions, memories, fear, and stress. And when these areas malfunction, it increases the occurrence of hypervigilance and flashbacks, which keeps your brain in a state of high alert and on the lookout for danger at all times.

It has been observed that in children as well, the stress of experiencing any kind of trauma causes very similar changes to those observed in people with PTSD. Trauma is known to alter the body’s stress response system and push it to go into high gear for the remainder of the child’s life.

In turn, what happens is that there is increased inflammation in the body from the heightened stress responses, which may cause or trigger the development of autoimmune diseases and other medical conditions.^{(10, 11)}

If you look at it from a behavioral viewpoint as well, it can be observed that children, teenagers, and adults who have experienced some type of physical and/or psychological trauma are usually more prone to adopting unhealthy coping approaches such as substance abuse, smoking, hypersexuality and overeating. Such types of behaviors, apart from an increased inflammatory response, can put them at a greater risk of developing many types of medical conditions.

Apart from the CDC-Kaiser study, there have been many studies that looked at the effects of other types of trauma experienced in early life and what might cause better outcomes for survivors of trauma. While most of the research has been focused on physical trauma and the association with chronic health conditions, but lately, more and more studies have been exploring the connection between psychological trauma or stress as a predicting factor of whether the survivor will develop chronic illness later in life.⁽¹²⁾

A study published in the Clinical and Experimental Rheumatology Journal in 2010 looked at the rates of fibromyalgia in Holocaust survivors.⁽¹³⁾ The study looked at just how much more likely were these Holocaust survivors to have fibromyalgia as compared to a control group of their peers. The study defined Holocaust survivors as those people who lived in Europe during the Nazi occupation. They were found to be twice as likely to have fibromyalgia as compared to their peers.

But is there any way to find out what conditions might get triggered by childhood trauma? There is no clear answer to this as of today. Many medical conditions, especially autoimmune and neurological disorders, do not have a single known cause. However, there is more and more evidence to show that adverse childhood events may play a critical part in the development of such disorders.

At present, though, there are many definitive links that show that conditions like fibromyalgia and post-traumatic stress disorder have an association with childhood trauma. Other conditions that are suspected to be connected to adverse childhood events include headaches, migraines, cardiovascular disease, chronic obstructive pulmonary disease (COPD), liver disease, lung cancer, depression, sleep disturbances like insomnia and anxiety.^{(14, 15, 16, 17, 18)}

While there are many supporters of the ACE criteria, there has been some criticism as well. One critic of the adverse childhood events criteria says that the questionnaire used itself is too narrow and short. For example, in the section about sexual assault and molestation, if a survivor was to answer yes, the criteria say that the abuser needs to be at least five years older than the victim and must have made or attempted to make physical contact. The major issue here is that there are many forms of child sexual abuse, and many of them often occur outside these guidelines.

There are many types of adverse childhood experiences that are currently not accounted for in the ACE questionnaire, including forms of systemic oppression such as racism, living with a debilitating or chronic illness as a child, and even poverty.

Beyond this, the ACE questionnaire test also does not place the adverse childhood experiences in context with any positive experiences. Despite exposure to trauma, it has been shown that access to supportive communities and social relationships tend to have a long-lasting and positive impact on a survivor’s physical and mental health.⁽¹⁹⁾

While more research is still needed to adequately confirm the relationship between adverse childhood events and chronic illness in adulthood, there are steps that both survivors of childhood trauma and doctors both can take to better explore a patient’s health history more holistically. To begin with, doctors need to start asking questions to find out about the patient’s past emotional and physical trauma during, well, preferably, every visit.

Researchers of a 2012 study stated that according to their research, not enough attention is being paid in clinics or hospitals to childhood traumatic events and how these influence the survivor’s health.^{(20, 21)} The study explored the relationship between stress in childhood and chronic pain syndromes. The lead researchers of the study also found that basic scales such as what the ACE questionnaire lays out or even just asking about childhood trauma can make an important difference. At the same time, it can form the basis of preventative work based on finding out trauma history and exploring the symptoms. However, there is, of course, still the need for more research to find out exactly how demographics and socioeconomic status can also bring up several other ACE categories.

Furthermore, this also means that healthcare providers must become better informed about childhood trauma and how it impacts people in the future to better help the survivors of trauma, especially to help those who disclose any type of adverse childhood experiences to their doctors.

Despite the gaps in the criteria used for measuring adverse childhood events, there is no doubt that they represent a major public health issue. The good news here is that a lot of ACEs are preventable. According to the Centers for Disease Control and Prevention, there are many strategies that incorporate local and state-level violence prevention agencies, doctors, schools, and individuals to help prevent and address neglect and abuse in childhood.

Building a safe and supportive environment for children is essential to prevent ACEs, as well as tackling issues of having proper access to both mental and physical healthcare in order to address them.

The biggest change that needs to happen with regards to childhood trauma and chronic illnesses is that both patients and doctors have to take adverse experiences in childhood more seriously to be able to understand the exact link between chronic illness in adulthood and childhood trauma better. This may be able to prevent many health conditions for children in the future.

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• Do Therapies For Childhood Trauma Help?