Adverse childhood experiences and future mortality risk

A major international study led by researchers at UL and published in the journal of Psychosomatic Medicine: Journal of Biobehavioral Medicine has examined the association between adverse childhood experiences and the increased risk of premature mortality.

Adverse childhood experiences such as emotional and physical abuse, household instability, socioeconomic climate and ill health can lead to people having a shorter life, but it was not clear how.

The researchers believed that, as individuals with these adverse experiences in their childhood can suffer from lower self-acceptance and purpose in life, that these could be a pathway or a 'mechanism' linking these experiences to future mortality risk.

The new study, which followed 6,128 people across 24 years in the United States, found that self-acceptance -- positive attitudes towards oneself and acknowledging and accepting multiple aspects of yourself -- and purpose in life -- a sense of a goal-directed direction in life -- do explain part of the reason why childhood adversity is related to future longevity.

The project was led by Associate Professor of Psychology at University of Limerick Dr Páraic Ó Súilleabháin, Director of the Personality, Individual Differences and Biobehavioural Health Laboratory and member of the Health Research Institute.

The work was conducted in collaboration with others from University of Limerick, West Virginia University, Open University of the Netherlands, University of Minnesota, and Florida State University.

Commenting on the study, Dr Ó Súilleabháin said: "It is very important to find the ways in which experiences such as these early in life can have an impact across our lives. We have previously found that these experiences are related to a shortening of life expectancy. It is important to understand the mechanisms linking them, so that ways to increase life expectancy can be identified.

"We found that self-acceptance and purpose in life are very important in the link between these childhood experiences and risk of death in adulthood. In other words, of all the possible factors in the link between childhood adversity and risk of future death, it appears that self-acceptance and purpose in life are two important drivers."

The research team used the 'Midlife in the United States Survey' to test whether these factors were indirect pathways that increased the association between adverse childhood experiences and mortality hazards over 24 years of follow-up.

They included 20 possible childhood adversities, and the results show that adverse childhood experiences do significantly increase mortality risk and that self-acceptance and purpose does account for a percentage of those -- effects which withstood a range of adjustments and sensitivity analyses, according to the researchers.

Given that self-acceptance and purpose can change through intervention, these factors may be useful targets for individuals with adverse childhood experiences that could reduce the health risks in later life, Dr Ó Súilleabháin explained.

"Research suggests that self-acceptance and purpose can change through intervention. These interventions are not just needed at the individual level, but also at the societal level," Dr Ó Súilleabháin explained.

"For instance, while it is relatively straightforward to think of avenues with various therapies and so on, it is incredibly challenging for someone to foster self-acceptance and purpose without basic needs being met in healthcare, housing, education, and so on.

"Impacting self-acceptance and purpose in life in adulthood for those who have had childhood adversity, may ultimately impact their longevity," Dr Ó Súilleabháin added.