Cumulative Childhood Stress and Autoimmune Diseases in Adults

By Shanta R. Dube, D. Fairweather, W. Pearson, V. Felitti, R. Anda, J. Croft. Psychosomatic Medicine, 2009

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Objective: To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Methods: Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Results: Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with ≥2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05). Conclusions: Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses. ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone.

Subfields: Behavioral Neuroscience, Clinical Psychology, Hematology

View Paper: https://www.semanticscholar.org/paper/cdb6f2ecf6839e0a286f4ec3489cfc2fc621f7df

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Citations in the corpus

Complex Trauma and Aggression in Secure Juvenile Justice Settings (2012, neutral): “…with especially particularly severe emotional and behavioral impairment (Anda et al., 2006; Briere, Kaltman, & green, 2008; Cloitre et al., 2009; Dube et al., 2009; Ford, Stockton, Kaltman, & green, 2006; Koenen, Moffitt, Poulton, Martin, & Caspi, 2007; Lu, Mueser, Rosenberg, & Jankowski,…”
Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. (2016, background): “For the reader who might not recognize the magnitude of this public health problem, it is worthwhile to briefly summarize the latest data on prevalence rates of childhood maltreatment.”
Health consequences of adverse childhood experiences: A systematic review (2015, background): “, 2008), headaches (Anda, Tietjen, Schulman, Felitti, & Croft, 2010), autoimmune disease (Dube et al., 2009), and sleep disturbances (Chapman et al.”
Psychological Stress in Childhood and Susceptibility to the Chronic Diseases of Aging: Moving Towards a Model of Behavioral and Biological Mechanisms (2011, background): “It found a 1.5–2.0-fold greater incidence of cardiovascular disease, autoimmune disorders, and premature mortality among those exposed to early adversity (Anda et al., 2009; Dong et al., 2004; Dube et al., 2009).”
Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the U.S. (2013, background): “Results have shown that greater exposure to ACEs increases the risk of mortality and many forms of morbidity, including autoimmune, liver, coronary, and pulmonary diseases (Anda et al., 2008; Dong, Dube, Felitti, Giles, & Anda, 2003; Dong, Giles, et al., 2004; Dube et al., 2009; Felitti et al., 1998”
Sex differences in anxiety and depression clinical perspectives (2014, background): “2% of men in the United States (Gorey and Leslie, 1997) has been linked to both depression and anxiety disorders and to inflammatory illnesses during adolescence and adulthood (Felitti et al., 1998; Dube et al., 2009; DeBellis et al., 2011).”