The Dangers of Childhood Trauma: An Unaddressed Health Epidemic
Nearly 30 years ago I set out to answer a very piercing question that was at the heart of an enigma that yearned to be solved. The question can be summed up by the need to develop a lucid perspicacity of the forces at play that resulted in 120 years (153 years currently) of quasi-freedom for Blacks with virtually no substantive social, political, or economic progression. My background in psychology led me to an initial theory which I entitled Collective Cognitive Bias Dominance Theory, which proposed that Blacks were suffering from a collective distortion in our thinking, paradigms, social views and more. This theory suggested that the slavery experience resulted in a mal-adaption in social reasoning.
While I was able to uncover a wealth of empirical data as well as accumulate new data to support the CCBD theory, it was not long before I realized that there was substantially more at play than a warped sense of thinking that had been passed down through social learning theory and cognitive distortions. It seemed that psychopathological behavior was somehow ingrained into the psychology of a large percentage of Blacks in this country and other colonized geographic locations.
This gap between what I was able to prove concerning cognitive influences on the behavior of a large portion of the Black collective, forced me to examine the intergenerational transmission of trauma. It was during my research on the intergenerational trauma that I was introduced to the world of epigenetics. In simple, epigenetics is the study of heritable changes in gene expression that do not involve changes to the underlying DNA sequence — a change in phenotype without a change in genotype — which in turn affects how cells read the genes.
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Every cell in the body has the ability to read DNA sequences, interpret and transcribe what it reads to determine how it will express itself. Environmental influences create what are known as epigenetic tags that have the ability to activate and deactivate genes based on cellular transcriptions. This explains how identical twins — sharing identical DNA can end up with such different physical outcomes in life. One twin dies early from cancer, while the other lives to be 95-years-old. Environmental experiences serve to rewire genetic expression causing abnormal cellular mutation — resulting in disease.
Looking At the Broader Picture
While my research began with a focus on the Black collective and the central issues therein, I quickly learned that epigenetics was not confined by race, socioeconomic status, political affiliation, etc. People from all backgrounds deal with epigenetic influences at varying degrees. Yes, Blacks have unique experiences that contribute to their current condition and these experiences must be addressed and mitigated to see significant and lasting change. What I want to do here is focus on another group that has been impacted through epigenetics — children.
As it turns out, childhood trauma has an immense impact on social development, brain function, and general health. The Adverse Childhood Experiences Study, a study sponsored by the CDC and Kaiser, produced startling results that illuminated a health epidemic that was unaddressed at the core level. The study examined the impact of childhood trauma on the overall health of children and adults.
For the purpose of brevity, I am going to simplify the elements of the study, which involved 17,000 subjects between 1995 to 1997. The study looked to identify what it classified as adverse childhood experiences (ACEs). These experiences included:
- Physical and emotional sexual abuse
- Physical and emotional neglect
- Parental mental illness
- Dometic violence
- Substance abuse
- Parental separation (divorce or legal separation)
During the study, each of these unique experiences was given a point value of one. It was discovered that 67 percent of the subjects had at least one point (one adverse childhood experience), and at least one in eight had four points or higher. The correlation here is that the higher the score the poorer the health outcome of these subjects. That’s right, adverse childhood experiences have a direct correlation with predictable health outcomes. There are multitudinous birth cohorts that are impacted by an increased ACE score, but there are five highly prevalent areas worth noting — depression, certain forms of cancer, sexual promiscuity, ischemic heart disease and arrested brain development.
One finding that is noteworthy is the fact that an ACE score of four increases the risk for suicide by 12 times.
While certain health issues can be connected to poor lifestyles and poor decisions, the conditions under which these decisions are made is not adequately understood. When a child or an adult experience trauma in the form of any type of threat, but especially those listed as adverse childhood experiences, it triggers a fear response that serves to shut down the prefrontal cortex, which is responsible for making executive decisions and impulse control. In situations in which you have seen inexplicable behavior in which you knew the person knew better, it could be that they were functioning through the lack of inhibition created by an incapacitated prefrontal cortex. There was no impulse control.
In addition to the fear response, there is the stress response, which activates the hypothalamus — sending a signal to the adrenal gland to produce adrenaline and cortisol — placing the body in fight or flight mode. This is a great thing to have when you are in the wild and you stumble upon a lion or a tiger. The rush of adrenaline and cortisol prepares you to either run or defend yourself. This stress response also works to pull blood (oxygen) from major organs like the heart and brain to send to your extremities to support combat or flight. This is not a problem as long as the experience is shortlived (happening over the course of seconds). However, what is the outcome when you are constantly bringing the lion home with you — constantly experiencing the fear and anxiety associated with paradigms that have been shaped by adverse childhood experiences. Something that was meant to save you ends up killing you.
A Deeper Look At Environment
When we speak of environment most people tend to think of things like the home and community and maybe even what a person eats on a regular basis. Ischaemic heart disease is the number one killer in the western hemisphere, which includes the United States. Most people either view ischaemic heart disease as a result of genetics or poor diet. What should be considered is the fact that a person with an ACE score of four or higher significantly increased BMI, WC, and an increased resting heart rate.
One point that Dr. Bassel van der Kolk, one of the foremost leading experts in trauma, points out constantly is that it is the body that keeps the score when it comes to trauma. The act of becoming traumatized by an event is first physiological (experienced in the body) and then psychological (processed through the mind). The absorption and processing of trauma by the body have a massive impact on health outcomes.
There is a standing belief that children are highly resilient, which they are; however, the presence of resilience does not exempt children from the residual negative impact of ACEs.
One of the most common misdiagnoses among children under the age of 10, especially males, is ADHD. As we learn more about the impact of ACE on human behavior as children and adults, we are discovering that what was once believed to be symptoms of ADHD is most likely the results of untreated ACEs. ADHD, which is usually treated with stimulants like Vyvanse, Adderall, Ritalin, and Concerta, is a phantom used to explain both natural and disruptive behavior in young children. Children learn better through movement and discovery, not by sitting still and listening, so a certain amount of hyperactivity should be expected. When this behavior becomes excessive, it is usually due to exposure to multiple ACEs.
What is interesting is that this is not primarily a racial or socioeconomic issue. While some groups are impacted more, almost everyone has been impacted by it or knows someone who has. How many people reading this has a person in their family who drinks too much? What about someone whose parents were divorced when they were young? Are there any readers who witnessed domestic violence as a child? The statistics bear out the fact that regardless of race or socioeconomic status, approximately 67 percent of the population has an ACE score of at least one.
While there is still work to be done in the area of quantitative and qualitative research, it is clear that the use of ACEs as a predictive mechanism to help identify potential poor health outcomes long before they occur. We should also work to reduce ACEs whenever possible. ~ Rick Wallace, Ph.D., Psy.D.
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