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Can Childhood Trauma Shorten Your Life?

Doctors may be overlooking a significant risk factor in disease.

A man, 50, begins to experience shortness of breath and aching chest pains. He goes to his doctor, who diagnoses him with coronary heart disease, the leading cause of death in the United States. A year later the man has a heart attack and dies. Yet he had none of the risk factors associated with heart disease. So how did he get it?

The Framingham Heart Study, a long-term cardiovascular study on the residents of Framington, Massachusetts which ran from 1948 to the early 2000s, found that almost 90 percent of those with coronary heart disease have one of five recognized risk factors—smoking, high cholesterol, high blood pressure, obesity, diabetes, and physical inactivity. This information equipped doctors to provide preventive healthcare for heart failure by steering patients away from these risky or unhealthy behaviors.

The man above is hypothetical, but he's representative of 10 percent of Americans who die of coronary heart disease yet have none of the risk factors. Some of these people may, however, have something else in common: childhood trauma.

Dr. Vincent Felitti spoke about childhood trauma to an audience of therapists at the EMDR International Association's annual conference this year. (EMDR is an unconventional but increasingly popular treatment for childhood trauma.) “Not everyone is interested in serving out a full life sentence,” he said, referring to a life altered by an indelible childhood experience.

Over the past 18 years, Felitti and his professional partner, Dr. Robert Anda, have been researching the effects of adverse childhood experience (ACE) on long-term physical health. A researcher with the Centers for Disease Control, Felitti is the co-principal investigator of the Adverse Childhood Experiences Study that points to correlations between a person's ACE and his or her life expectancy and proclivity for certain diseases.

“When we looked at the 10 percent of patients dying of coronary heart disease without the recognized risk factors, we found that their ACE score explained it,” Felitti told AlterNet.

But the correlation may not stop with heart disease. Felitti's research has found correlations between ACE and cancer, pulmonary fibrosis, and sundry autoimmune diseases, among other biomedical diseases.

The ACE Study

In the early 1990s, Felitti and Anda designed an extensive questionnaire regarding individuals' personal history that they sent to members of Kaiser Permanente’s Department of Preventive Medicine in San Diego. Felitti established the department in 1975. Researchers have conducted detailed medical evaluations of approximately 58,000 adults every year.

The questionnaire asked respondents about eight categories of “adverse childhood experience” that included substance abuse in the household, parental divorce, sexual molestation, physical abuse, emotional neglect, or having a family member in prison. In designing the study, Felitti wanted to answer two questions: “Are major issues of childhood traumatic life experience common in a general population and if so how does it play out over time?”

Between 1995 and 1997, Felitti and Anda collected around 17,421 completed questionnaires—a 71 percent response rate of the initial 26,000 they contacted.

The demographic of the sample was characterized as mostly middle- to upper-middle-class: 74% had attended college; 69% were Caucasian; and the average age was 57.

For each category of trauma a patient had experienced, the doctors assigned one point that went toward the patient's overall ACE score. Of the over 17,000 respondents, one-third had an ACE score of zero; more than 25 percent had been beaten and another quarter had grown up in a house where alcoholism or drug use was present; one-sixth of the sample had an ACE score of four or higher.

The team of researchers then compared the respondent's ACE scores to their medical history and outcomes.

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