April 20, 2008 in City

Early trauma tied to adult problems

By The Spokesman-Review
 

A study that began in the 1980s as an inquiry into weight-loss program dropouts and evolved into potent childhood trauma research remains a catalyst for helping communities understand and treat the effects of abuse and neglect.

The groundbreaking research links a child’s traumatic experiences to myriad problems in adulthood, including drug addiction and troubled relationships; medical conditions ranging from heart disease to mental illness; and early death.

It’s the focus of this week’s sold-out conference, “From Hurt to Hope: Discovering Universal Approaches to Strengthening Supportive Learning Environments and Resilience,” in Spokane featuring Dr. Robert Anda, one of the country’s leading authorities on the issue.

Anda, a senior researcher at the U.S. Centers for Disease Control and Prevention, also will speak at events in Spokane and Coeur d’Alene on Thursday as part of the Our Kids: Our Business campaign.

While the main body of research, conducted in 1995 and again in 1997, found that 66 percent of adults claim some sort of childhood trauma, Anda said he brings a message of hope that communities such as Spokane can use the data for change.

“We need to ask, ‘How can big public systems like schools, day cares and juvenile justice pick up those kids when they’re young and understand that they have been traumatized and that their needs may be a little different?’ ” Anda said. “Right now I don’t think our society provides well for those children. We can change that.”

Roy Harrington, associate director of Washington State University-Spokane’s Area Health Education Center, said Spokane may be in a position to close a 20-year gap between science and public policy.

“One of the contributions of this research is to begin to wrap the science around what many of us in this business for years have suspected,” Harrington said, referring to the widely recognized link between childhood trauma and brain development that can lead to behavioral problems such as addiction.

“We must begin to discuss early intervention and prevention activities in ways that we have avoided doing for a long time.”

The science is based on the early work of study co-author Dr. Vincent Felitti, who wanted to find out why so many people who were succeeding at losing weight dropped out with little explanation.

So he began asking a series of structured questions, but they didn’t seem to be getting anywhere.

It wasn’t until he misstated a question – it should have asked how old a person was when they became sexually active, and instead asked how much a person weighed when they became sexually active – that the study came into focus, according to a special report on obesity that ran in the Sacramento Bee. The study participant innocently answered that she weighed 40 pounds – because the incident occurred in childhood, with her father.

Other researchers in the study began asking the same questions and a pattern of incest and sexual abuse emerged among the set of obese research participants.

When Anda learned of the study, he began working with Felitti on a broad investigation that drilled into the lifelong effects of what they called Adverse Childhood Experiences, or ACEs. The results have been published in numerous medical journals.

The study took place among 17,000 people in the Kaiser Permanente Health Plan in San Diego. Because the study involved those with private insurance coverage, they were generally middle- to upper-middle class; only 6 percent didn’t have a high school diploma.

The researchers examined whether early life traumas could help explain health and social behaviors later on.

ACE categories include things such as verbal, physical and sexual abuse, neglect and severe household dysfunction. The latter category includes criminal behaviors, parental discord, violence against another family member or an imprisoned parent.

Every ACE category experienced by a person was worth one point. For instance, a person who was repeatedly beaten would have a score of 1. A person who was sexually assaulted, witnessed his father dealing drugs, and watched his mother being beaten would have a score of 3.

After the interviews were completed and the data crunched, the results were startling. Two-thirds of the study participants recorded a score of at least 1, Anda said. “I was stunned to see most people suffered disruptive or severe experiences growing up,” he said.

The findings led him to believe that ACEs are the most important public health problem in the country. “I’ve never seen such powerful information in terms of gaining an understanding where so many public health problems have their origins, whether its drugs, alcohol, obesity, etcetera,” he said.

The unfortunate part of the study is that it underscores how society negatively affects a child’s development by allowing him or her to be exposed to adverse experiences, Anda said. Follow-up treatment also is lacking, he said.

“Let’s stop throwing an aspirin at it,” he said. “My hope is that the kind of information from this study could become a rallying point.”

Said Harrington, “We can choose to ignore the science, but we can no longer deny its relevance.

“Once you understand this, you’re overwhelmed by the tragedy in people’s lives and know that we must and can begin to treat people differently.”

He and Anda want destructive cycles to be stopped by earlier prevention strategies and more comprehensive treatment.

Harrington said he hopes Spokane is able to make educated decisions about how to intervene early to lower the odds of trauma. “We can no longer allow this to continue to happen to our children,” he said. “We must find ways to reduce this burden on their lives, and if we do that, and it’s done well, we can achieve tremendous reductions in the social, mental and health problems in the community.”

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