Adverse Childhood Experiences and Psychiatric Disorders

 

In my last post, I mentioned that the American Psychiatric Association rejected the diagnosis of Developmental Trauma Disorder in 2011, and refused to acknowledge that “…childhood adverse experiences lead to substantial developmental disruptions” and added that this idea is “more clinical intuition than research-based fact.”

In fact, there have been numerous studies showing a correlation between ACEs and a wide variety of clinical conditions. Below are brief descriptions of the results of four studies, recently published, addressing this contention. One is a review and meta-analysis, which is a research process used to systematically synthesize or merge the findings of, in this case, 39 (!) single, independent studies, using statistical methods to calculate an overall or 'absolute' effect.

Of course, the studies do only show correlations, which means that they do not “prove” that ACE’s actually cause psychiatric disorders or even symptoms. But the correlations are as good as any in the psychiatric research literature, which is pretty much minimal in findings that prove actual causation for almost every psychiatric disorder.

 

Adverse Childhood Experiences Among Adults With Eating Disorders: Comparison To A Nationally Representative Sample And Identification Of Trauma

The primary objectives of the current study were: (1) to examine and compare ACEs between two samples: treatment-seeking adults, and a nationally representative sample of adults, (2) to characterize ACEs items and total scores across demographic and diagnostic information in adults seeking treatment for an ED, (3) to statistically classify ACEs profiles using latent class analysis, and (4) to examine associations between ACEs profiles and diagnosis.  Results: Patients with EDs had significantly higher ACEs scores than the nationally representative sample. Within patients with EDs, four latent classes of ACEs item endorsement were identified. Patients with other specified feeding or eating disorder (OSFED) and binge eating disorder (BED) were more likely to fall into the "Household ACEs" and "Abuse ACEs" groups, respectively, compared to anorexia nervosa-restricting subtype (AN-R). Conclusion: Patients with EDs reported more ACEs than the nationally representative sample, across all ED diagnoses.

“Adverse childhood experiences among adults with eating disorders: comparison to a nationally representative sample and identification of trauma profiles.” Rienecke, Johnson et.al. Journal of Eating Disorders , volume 10, Article number: 72 (2022). 

 

Considerable Mental Health Burden Associated With Childhood Trauma

Trauma is associated with increased odds of anxiety disorders and any psychiatric disorder at age 6 years. There is a considerable mental health burden in association with childhood trauma. 

 “The association between childhood trauma and psychiatric disorders in low-income and middle-income Countries." Alckmin-Carvalho et. al., The Lancet Psychiatry, Oct. 31, 2022.

Association of Neural Connectome With Early Experiences of Abuse in Adults

In this cohort study of 768 participants, individuals with abuse experienced during childhood (but not adolescence) demonstrated an altered connectome [connections between brain neurons] of greater functional connectivity [changes in usual and not pathological connections in various brain areas] associated with somatomotor and dorsal-ventral attention brain networks, irrespective of current diagnosis or symptom state. These findings suggest that a history of child abuse is associated with altered functioning of systems responsible for perceptual processing and attention, and these findings were found in the presence of many different psychiatric conditions.

"Association of Neural Connectome With Early Experiences of Abuse in Adults." Korgaonkar et. al., JAMA Network Open. 2023;6.

 

A  Systematic Review and Meta-Analysis of the Relationship Between Childhood Adversity and Adult Psychiatric Disorder.

A review and analysis of 39 different studies suggests that childhood and adolescence is an important time for risk for later mental illness, and an important period in which to focus intervention strategies for those known to have been exposed to adversity, particularly multiple adversities. There was some evidence of a dose-response relationship with those exposed to multiple forms of maltreatment having more two and a half times odds of developing a mental disorder. 

“A revised and extended systematic review and meta-analysis of the relationship between childhood adversity and adult psychiatric disorder  [Review]." McKay et. al., Journal of Psychiatric Research, 156 (2022).