ABUSE THAT LINGERS: A new study looks at the effects of childhood abuse on life expectancy and risk of death among adults.
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A difficult childhood reduces life expectancy by 20 years among adults who experienced six or more particular types of abuse or household dysfunction as kids, while those who suffered fewer types of trauma lost fewer years of life, a large-scale epidemiological study finds.
The study, published this week in the American Journal of Preventive Medicine, reports that participants who were exposed to six or more different types of adverse childhood events (ACEs), such as physical or sexual abuse, were also 54 percent more likely to die during the 10-year period of the study. On the other hand, people who reported fewer than six ACEs did not have a statistically increased risk of death compared with the control group (those reporting no adverse childhood events). Still, those with one to five ACEs who did pass away during the study period were on average three to 5.4 years younger than those who died in the control group.
"As far as we know, this is the first cohort study to examine the association between ACEs and mortality," wrote David Brown, an epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC) and lead author of the study.
To explore the effect that childhood trauma could have on life span, the Kaiser Permanente San Diego Department of Preventive Medicine, in collaboration with the CDC, mailed questionnaires to adults who were 18 years and older, and who had visited the Kaiser clinic in San Diego from 1995 to 1997. Overall, the study subjects were middle-class and had good health coverage. The participants were asked about their exposure to eight categories of abuse or dysfunction based on previous Kaiser studies. Three were direct abuse—emotional, physical or sexual—and the remaining five addressed household dysfunctions: separated or divorced parents; domestic violence against the mother; a household member who abused drugs, was mentally ill or in prison.
One third of the 17,337 participants who replied to the questionnaires had an ACE score of zero, meaning they had not been exposed to any of the eight types of abuse or household dysfunction. The majority of the remaining responders registered a score of between one and four, whereas about 8 percent of the scoring participants were rated five, and roughly three percent, six to eight.
The most commonly reported abuses were physical, followed by two of the dysfunctions: a household member with a substance abuse problem and then by separated or divorced parents. The rates of certain abuses calculated in the ACE study (for instance, 16 percent sexual abuse among of men and 25 percent among women) were in keeping with results from earlier national surveys.
During the next decade, the study authors, kept records of which of the 17,337 participants passed away by matching identifying information such as Social Security numbers from the questionnaire with data from the National Death Index. In total 1,539 of the participants died during the follow-up period.
When the increased number of deaths in those subjects with an ACE score of six or greater was compared with the control group, their mortality risk was 1.5 times higher than for people whose childhoods had been free of all eight types of abuse. They lost about 20 years from their lives, living to 60.6 years on average, whereas the average age of death for the control group was 79.1.
Although a similar number of people died who had an ACE score of five or less as in the control group, the average age at which they died varied depending on score. People in the control group died on average at 79.1 years, whereas the average age of death for people who had had two ACEs was 76; for people with three to five ACEs it was 73.5.
The fact that subjects with a score of less than six lost fewer years from their lives could mean that the authors would see a difference in mortality risk if they followed the subjects over more than 10 years, the CDC's Brown wrote. "There is really no way to tell, but there are plans to repeat the match to the National Death Index in a few years to capture an additional five years of follow-up," he says.
It is unclear why the authors saw more deaths during the 10-year period only for the group with an ACE score of six or greater. Previous studies by these authors found that the risk of chronic illnesses, such as heart disease, lung disease and cancer, was greater only for people with these high ACE scores. In contrast, the risk of substance abuse and suicide increased stepwise from low to high scores. The authors found that ACE-related health risks, namely mental illness, social problems and prescription medication use, accounted for about 30 percent of the 50 percent greater risk of death seen in this population. "As would be expected, the documented ACE-related conditions among participants appear to account for some, although not all, of the increased risk of premature death observed in the current study," Brown wrote.
As Brown notes, various types of childhood abuse and household dysfunction are highly interrelated. For example, people who reported one ACE were 52 percent more likely to report at least three other types of ACEs, according to an earlier study by Kaiser and the CDC.
"The central message of the publications from the ACE Study," Brown says, "is that our children are confronted with a terrible burden of stressors that negatively affect their [development], which leads to health problems and diseases throughout the life span."
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14 Comments
Add CommentThis study seems a flawed. Yes, it says that the number of children who were exposed to ACE's had a shorter life span. But, didn't take in alcohol, narcotics, or other abuse that would have been factor.
Reply | Report Abuse | Link to thisYes, ACE's are a problem. I have a history of sexual abuse and dysfunctional family to my credit, as well as verbal abuse, poverty, and poor parenting.
But don't publish a study without taking in all the factors of what makes the life span shorter.
In fact the investigators did look at a range of negative health behaviors and health outcomes inlcuding illicit drug use and alcoholism that are associated with adverse childhood experiences. This reporter did not write up the best of reports. I urge you to read the paper for yourself.
Reply | Report Abuse | Link to thisIn fact the investigators did take into account a wide range of negative health behaviors and health outcomes linked to adverse childhood experiences, including illicit drug use and alcoholism. This reporter did not write up the best of reports. I urge you to go read the paper for yourself.
Reply | Report Abuse | Link to thisUm, shouldn't this be blatantly obvious, is it surprising that the myriad factors surrounding the measurement of any 'ACE' would negatively impact life span? What would be a lot more interesting than this obvious correlation would be teasing apart various causation.
Reply | Report Abuse | Link to this1) psychotic mother 2) physical Abuse 3) emotional abuse 4) sexual abuse 5) alcoholic parents. Been clawing my way to recovery since age 27. Now at 57 I discover all that stuff may snuff me out earlier then those not steeped in insanity. Yeah, its the gift that just keeps on giving. Sigh. I'll get over this shock, just like all the others. TO LIFE!
Reply | Report Abuse | Link to thisThis article would have been ten fold better if it had also pointed out some study that correlates an activity that an adult has the opportunity to choose with INCREASED lifespan; for example, exercise and social activities (I’m sure Kaiser has done some of those studies, too). As inboulder points out, it's obvious that abuse leads to stress and that stress correlates to disease/dysfunction, ergo earlier death. s13cyergal speaks for the 66% of folks that will just be blithely reminded of this to NO useful end. A truly exceptional article would have pointed out that the article itself is a stressor, but that there are ways to mitigate the stress and dysfunction they had no control over.
Reply | Report Abuse | Link to thisThis article would have been ten fold better if it had also pointed out some study that correlates an activity that an adult has the opportunity to choose with INCREASED lifespan; for example, exercise and social activities (I’m sure Kaiser has done some of those studies, too). As inboulder points out, it's obvious that abuse leads to stress and that stress correlates to disease/dysfunction, ergo earlier death. s13cyergal speaks for the 66% of folks that will just be blithely reminded of this to NO useful end. A truly exceptional article would have pointed out that the article itself is a stressor, but that there are ways to mitigate the stress and dysfunction they had no control over.
Reply | Report Abuse | Link to thisI am sure that the science of this article is sound, however...
Reply | Report Abuse | Link to thisI worked in direct patient care in hospital intensive care units for over three decades, and in that time I have known a great many people who lived to advanced ages (85+) who survived trauma in their childhoods. Many of these patients survived as children in concentration camps, watched as parents and siblings were killed in the war in Russia in the early 1900's, Africian-Ameican seniors who survived visits of linch mobs, and I could go on but I am sure one sees where this is going. It would be interesting to do this study on octagenarians. Adversity and trauma might lessen the life span in some but in others it might instill a fighting spirit that refuses to give in with out a darn good fight.
In a society with the best interests of the child (UN Convention on the Child gives the formal criteria) at heart (not to mention adults) all these circumstances would be the target of a huge eradication effort. AND THIS INCLUDES THE POOR, THE DISADVANTAGED AND THE EXCLUDED.
Reply | Report Abuse | Link to thisAs for the "opportunity to choose" comment, don't make me laugh. The people who take advantage of advice to exercise, eat healthily, have sex regularly etc, are not the poor, the disadvantaged or the excluded (unless you consider backbreaking work or scooting around looking for the next fix as exercise).
This kind of study is NOT reporting the blatantly obvious but providing evidence of what those in power and their lickspittle media deny as often and as loud as they can. Or haven't you seen the blatantly obvious (heh) policies of criminalizing the poor and vulnerable (the gulag system of prisons-for-profit to lock up poor blacks and latinos, "welfare queens", "welfare-to-work")?
What I'd like to see would be some indication of how effective the efforts of brave folks like Cybergal are who fight to overcome the physical and emotional beatings they got as kids and young adults. These active rebels against the machine aren't many but they're a beacon of hope.
I will take for granit that the first part of your name indicates that you are a catholic priest and your knowledge and understanding of the human psychic should be far more advanced than most. What I am about to say, most Americans refuse to believe, and the psychology department I worked for at the time would not grant me permission to publish the results, but I know you will understand, whither you want to accept it or not. For many years I worked with children, from age three to 11, who were not sexually abused, but who sexually abused other children and adults. For these children, this was an internal protective defence against a "sensed abuser". These children were not making things up as they went along to justify their behavior; they actually had an uncanny ability to sense things in people that others couldn't. I investigated every one of these childrens' stories, and the people they abused background, and they came up over 90% accurate. The other 7%, I believe, were natural born predators. Over and over, these children basically told me that they felt they had to "get the abuser before the abuser got them". In doing this, they somehow diminished their trama and increased their survival and seemed fairly content and happy. The children who did not use this method as a defensive posture had great difficulty and suffered from numerous phobies and deep depression.
Reply | Report Abuse | Link to thisI have long since left the psychology department and only two of these children called to do a follow-up. They reported a happy family life; suffering from no depressions, phobies, or repercussions from their childhood acts. Basically, they survived a childhood trama that they knew was going to happen but would not allow it to happen.
I do not know how this would relate to this article other than giving the survivors a different look at how they may had survived a childhood trama that could had destroyed them.
The commenters here don't seem to understand why this is obvious. It is not obvious that childhood abuse _causes_ a shortened lifespan, and this study did not manage to show that causation at all. The obvious part is that those that suffer childhood abuse will obviously tend toward traits and situations that shorten life, for whatever reason, like poverty, untreated disease, substance abuse, poor nutrition, poverty in adulthood, violence, suicide etc...
Reply | Report Abuse | Link to thisIt is obvious. If the adults show a lower life expectancy due to various stress ors, the same paradigm should apply to youngsters, who carry the burden of stressors to adult hood and consequent early death.
Reply | Report Abuse | Link to thisit's unconvincing.a smooth childhood always come from a high class family with better education and medicine care ,they have better living condition,so a longer life shouldn't be a surprise at all
Reply | Report Abuse | Link to thisHi, uh yeah umm I think this study is a study on something that should be considered common sense, however, doesn't every question need to have "proof" in the world today? So I'm sure this is the "proof" for someone looking to back up the question. It would be more interesting though if there was a study conducted on how many children with ACE's develop resiliences and become sucessful in life. Then take that study and compare it to another one conducted on children who did not experience ACE's and how many of them are sucessful in life. I am curious to know if the Big Guys of this world are the ones who had to develop resilience and maybe are better problem solvers than those who havent ...
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