Risky behavior as a coping mechanism
The researchers suspect that extreme childhood adversity makes people more likely to take risks to their health.
“This adult population is much more likely to participate in risky behaviors — such as using food as a coping mechanism, which can lead to weight and obesity problems,” says Pierce, a fourth-year medical student at university.
“They also have higher smoking rates, which is directly related to cardiovascular disease,” he adds.
The study used data from the coronary artery risk development study in young adults (CARDIA), which recruited a racially and socio-economically diverse group of people aged 18 to 30 years in 1985—1986. CARDIA took place in four cities across the United States: Birmingham, AL, Chicago, IL, Minneapolis, MN, and Oakland, CA.
Over the three decades of the CARDIA study until 2018, researchers regularly reviewed the physical and mental health of participants.
In 2000—2001, more than 3,600 participants completed a questionnaire to assess their experiences with regard to the following seven characteristics in their childhood:
- parental love and support
- verbal abuse
- physical affection
- physical abuse
- Presence of an alcohol or drug addict in the home
- Organization and administration of the budget
- The extent to which their parents or caregivers knew what they were up to
The questionnaire included questions such as, “How many times has a parent or other adult in the household made you feel that you were loved, supported, and cared for? “and “How many times has a parent or other adult in the household sworn by you, insulted you, depressed you, or acted in a way that made you feel threatened?
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Level of adversity associated with CVD risk
The participants’ responses allowed the authors of the new study to divide them into groups of low, medium, and high childhood adversity.
They found that during a 30-year follow-up period, people exposed to high childhood adversity were more than 50% more likely to suffer a CVD event than people in the low adversity group.
Pierce says the question that best predicted cardiovascular disease later in life was: “Did your family know what you were up to as a child?
Even moderate exposure to childhood adversity was associated with a more than 50% increased risk of mortality from all causes compared to minor adversity.
“Early childhood experiences have a lasting impact on the mental and physical well-being of adults, and a large number of American children continue to suffer from abuse and dysfunction, which will cause health and social functioning problems throughout their lives,” says senior author Prof. Joseph Feinglass from the Feinberg School of Medicine.
Several risk factors play a role
When scientists used a fully adapted data model at the start of the CARDIA study to account for other variables such as smoking, blood pressure, and education level, the association between childhood adversity and CVD was no longer statistically significant.
They believe this suggests that multiple socio-economic, clinical, demographic, and psychological factors can work together to mediate the link between childhood adversity and middle-aged CVD.
In addition to physiological changes such as higher blood pressure, higher cortisol, and more inflammation, childhood trauma can lead to unhealthy management of stress.
The authors write:
“Childhood adversity is known to cause behavioral disorders associated with several known CVD risk factors in both childhood and adulthood. For example, childhood trauma affects children’s ability to deal with and respond to emotionally stressful experiences in an appropriate way. As a result, people often use high-calorie foods as a mechanism to manage psychosocial stress, which contributes to the development of obesity.”
In principle, early interventions could help. Researchers write that there are programs designed to help children and young adults develop healthier strategies to deal with stressful experiences, but funding is limited.
“Social and economic support for young children in the USA, which is low compared to other industrialized countries, has the biggest “bang for the buck” of all social programs,” says Prof. Feinglass.
However, the authors recognize that their study had some limitations. For example, the study only involved participants who were alive 15 years after the CARDIA study began, so the results may underestimate the link that childhood adversity has with CVD and mortality.
In addition, the study relied on participants remembering exactly what happened in their childhood more than 15 years ago.