Tough childhood damages life prospects

"When we studied couples where both partners stated they'd had a hard time as children, the connection between negative childhood experience and a relatively unfavourable living situation in adulthood became especially clear," says Per Kristiansson, a specialist doctor in general medicine, senior lecturer at Uppsala University's Department of Public Health and Caring Sciences and the study's principal author.

Adverse childhood experiences (ACEs) have serious lifelong repercussions. Previous international studies (eg Felitti et al 1998, Hughes et al 2017, Merrick et al 2018) have shown that they entail a greater risk of falling ill, and of dying prematurely, from a range of common diseases and conditions. These include severe mental ill-health, cancer, cardiovascular disease and diabetes. The more numerous the ACEs, the higher the risk of negative consequences.

The present study is distinguished by the unusually large number of respondent couples. A total of 818 (1636 individuals, comprising 818 mothers and their 818 partners, 3 of whom were women) took part, submitting answers to the questionnaire, one year after having a child together.

The ACEs the researchers focused on were both mental and physical abuse and neglect; sexual assault; and problematic situations in the family like criminal behaviour, substance abuse, violence, mental disorders and separations.

Individual ACEs were common among all respondents, and 11 per cent of the women and 9 per cent of their partners reported having four or more such experiences. In 2 per cent of the couples, both individuals recounted at least four ACEs. If one person in a couple had undergone them, the other was more likely to have done so as well.

The greater the number of ACEs for the woman, the partner and the couple together, the worse their adult prospects turned out to be. Several couples who had experienced many problems in childhood had strikingly more problems in adulthood than the others. This group of respondents, compared with the couples who described their childhood as problem-free, were characterised by the following to a larger extent:

• low educational attainment
• low income
• poor couple relationships
• overweight
• smoking habits to a larger extent
• low sense of coherence (SOC)
• poor self-assessed health
• high stress level
• very high frequency of anxiety and depression.

Kristiansson explains: "The fact that ACEs in early life can have such grave consequences is connected with the severe, toxic stress that affects children's central nervous system and other organs while they are growing up. 'Toxic stress' means strong, frequent and lasting activation of the body's stress-response system (Shonkoff et al 2009). This indicates that ACEs have a far-reaching negative impact on people's lives and health up to an advanced age, and may also affect the next generation."

Previous studies (Shonkoff et al 2009, Heckman 2006) show, he points out, that combating toxic stress in the early years brings gains for society: it improves student performance, boosts economic productivity and enhances citizens' sense of responsibility.

"That's why we hope our results will prompt public agencies -- especially healthcare and social services, but also civil society -- to take the initiative in detecting, supporting and providing treatment for families and individuals affected by adverse childhood experiences."

Related Literature

1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245-58.

2. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e356-e66. Epub 2017/12/19. doi: 10.1016/S2468-2667(17)30118-4

3. Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatr. 2018;172(11):1038-44.

4. Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. Jama. 2009;301(21):2252-9. Epub 2009/06/06.

5. Heckman J. Skill Formation and the Economics of Investing in Disadvantaged Children. Science, 2006, vol 312 pp 1900-02.