Wednesday, September 17, 2014

Mindfulness Protects Adults' Health from the Impacts of Childhood Adversity

A recently developed model (late 1990s) for assessing early childhood experience as it relates to adult physical and mental health is the Adverse Childhood Experiences (ACE) assessment (Felitti, et al., 1998; get your score here). The ACE scale identifies ten forms of adverse childhood experience (occurring before the age of 18): (1) verbal and emotional abuse, (2) physical abuse, (3) sexual abuse, (4) emotional neglect, (5) physical neglect, (6) battered parent (originally included as “battered mother”), (7) household substance abuse, (8) household psychological distress, (9) parental separation or divorce, and (10) criminal household member(s) (Dong, et al., 2003). The more ACEs that have been experienced, the greater the risk for later life health issues (Weiss & Wagner, 1998), including heart disease (Dong, et al., 2004), obesity (Williamson, et al., 2002), cancer (Brown, et al., 2010), drug use (Dube, et al., 2003), suicide risk (Dube, et al., 2001), smoking (Anda, et al., 1999), and psychological distress (Anda, et al., 2007; Chapman, et al., 2004; Chapman, et al., 2007; Edwards, et al., 2003), among many others (Felitti, et al., 1998, Felitti, 2002).

None of this deals with the intense mental distress (depression, anxiety, PTSD, psychosis) than can result from ACEs.

The new study below shows that the impact of ACEs can be mitigated by mindfulness meditation.  

1. Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P. & Marks, J.S. (1998, May). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine; 14(4):245-58.
2. Maxia Dong, M., Anda, R.E., Dube, S.R., Giles, W.H., and Felitti, V.J. (2003). The relationship of exposure to childhood sexual abuse to other forms of abuse, neglect, and household dysfunction during childhood. Child Abuse & Neglect; 27: 625–639.
3. Weiss JS, Wagner SH. (1998). What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research (editorial). American Journal of Preventive Medicine; 14:356-360.
4. Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. (2004). Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation; 110:1761-1766.
5. Williamson DF, Thompson TJ, Anda RF, Dietz WH, Felitti VJ. (2002). Adult Body Weight, Obesity, and Self-Reported Abuse in Childhood. International Journal of Obesity; 26: 1075–1082.
6. Brown DW, Anda RA, Felitti VJ, Edwards VJ, Malarcher AM, Croft JB, Giles WH. (2010). Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study. BMC Public Health; 10: 20-32.
7. Dube SR, Anda RF, Felitti VJ, Chapman DP, Giles WH. (2003). Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study. Pediatrics; 111:564-572.
8. Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. (2001). Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study. Journal of the American Medical Association; 286:3089-3096.
9. Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, Giovino GA. (1999). Adverse childhood experiences and smoking during adolescence and adulthood. Journal of the American Medical Association; 282:1652-1658.
10. Felitti VJ. (2002). The relationship between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal; 6:44-47.
Here, then, is the article (a summary press release of the original article, which is behind a paywall).

Mindfulness protects adults' health from the impacts of childhood adversity

Date: September 13, 2014
Source: Temple University
Adults who were abused or neglected as children are known to have poorer health, but adults who tend to focus on and accept their reactions to the present moment—or are mindful—report having better health, regardless of their childhood adversity, researchers report.
Adults who were abused or neglected as children are known to have poorer health, but adults who tend to focus on and accept their reactions to the present moment -- or are mindful -- report having better health, regardless of their childhood adversity. These findings, to be published in the October issue of Preventive Medicine, are based on the first study ever conducted to examine the relationship between childhood adversity, mindfulness, and health.

Led by Robert Whitaker, professor of public health and pediatrics at Temple University, the researchers surveyed 2,160 adults working in Head Start, the nation's largest federally-funded early childhood education program.

Survey respondents, who worked in 66 Pennsylvania Head Start programs, were asked if they experienced any of eight types of childhood adversity, such as being abused or having a parent with alcoholism or drug addiction. In addition, respondents were asked questions about their current health, as well their mindfulness, meaning their tendency in daily life to pay attention to what is happening in the moment and to be aware of and accepting of their thoughts and feelings.

Nearly one-fourth of those surveyed reported three or more types of adverse childhood experiences, and almost 30 percent reported having three or more stress-related health conditions like depression, headache, or back pain, noted the researchers. However, the risk of having multiple health conditions was nearly 50 percent lower among those with the highest level of mindfulness compared to those with the lowest. This was true even for those who had multiple types of childhood adversity.

Regardless of the amount of childhood adversity, those who were more mindful also reported significantly better health behaviors, like getting enough sleep, and better functioning, such as having fewer days per month when they felt poorly -- either mentally or physically, said Whitaker.

"Our results suggest that mindfulness may provide some resilience against the poor adult health outcomes that often result from childhood trauma," he said. "Mindfulness training may help adults, including those with a history of childhood trauma, to improve their own well-being and be more effective with children."

While many smaller studies have shown that learning mindfulness practices like meditation can improve psychological and physical symptoms such as depression and pain, more research is needed to see if interventions to increase mindfulness can improve the health and functioning of those who have had adverse childhood experiences, Whitaker said.

With nearly two-thirds of U.S. adults reporting one or more types of adverse childhood experiences, Whitaker noted that "mindfulness practices could be a promising way to reduce the high costs to our society that result from the trauma adults experienced during childhood."

The findings are a follow-up to the researchers' previous study which found that women working in Head Start programs reported higher than expected levels of physical and mental health problems. That study was published in 2013 in the journal Preventing Chronic Disease.

Story Source:
The above story is based on materials provided by Temple University. Note: Materials may be edited for content and length.

Journal Reference:
Robert C. Whitaker, Tracy Dearth-Wesley, Rachel A. Gooze, Brandon D. Becker, Kathleen C. Gallagher, Bruce S. McEwen. (2014). Adverse childhood experiences, dispositional mindfulness, and adult health. Preventive Medicine; 67: 147 DOI: 10.1016/j.ypmed.2014.07.029

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