Cumulative Childhood Stress and Autoimmune Diseases in Adults

Psychosom Med. Author manuscript; available in PMC 2012 Apr 4.Published in final edited form as:Psychosom Med. 2009 Feb; 71(2): 243–250.Published online 2009 Feb 2. doi: 10.1097/PSY.0b013e3181907888PMCID: PMC3318917NIHMSID: NIHMS341921PMID: 19188532

Shanta R. Dube, PhD, MPHNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia

DeLisa Fairweather, PhDDepartment of Environmental Health Sciences, Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland

William S. Pearson, PhD, MHANational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia

Vincent J. Felitti, MDDepartment of Preventive Medicine, Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California

Robert F. Anda, MD, MSNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia

Janet B. Croft, PhDNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia

Author information

Copyright and License information

DisclaimerThe publisher’s final edited version of this article is available at Psychosom MedSee other articles in PMC that cite the published article.Go to:

Abstract

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.

Keywords: childhood abuse, traumatic stress, autoimmune diseases, stress, inflammatory response

Direct link to research

About S. R. Zelenz 117 Articles
S.R. Zelenz has worked in education for 20 years. Working with students from all walks of life, cultures, races, and social diversity, Zelenz’s research in Educational Leadership led to finding a better way to approach learning for students with trauma histories. Many were juvenile offenders, gang members, diagnosed with varying behavioral disorders, or had family histories of violence, murder, or narcissistic parenting. This research could not be effectively accomplished without further understanding: how epigenetic trauma inheritance may be impacting these students; how brain development from trauma may be impacting their behavioral and emotional development; as well as deep understanding of psychology and its varying classifications for behavioral and personality disorders. The goal is to find solutions for changing the conversation and making a real difference for these students. She has also worked with nonprofits of varying focus areas for the last 25 years. Her undergraduate degree in Arts Administration and Music prepared her for managing nonprofits of any size as well as procuring funding so that they can achieve their goals. Pairing her nonprofit background with her education background, she has been able to make a difference for over 200 nonprofits worldwide, written curriculum for schools across the globe, and assisted many arts organizations through performance and management.