Epidemiology of Childhood Adversity

A variety of adverse childhood experiences are linked to higher rates of childhood, adolescent and adult clinical neuroscience disorders.  The U.S. Center for Disease Control and Prevention recently published a summary of the epidemiology of adverse childhood experiences from a survey of five states.  Their survey queried adults on their childhood experience with eight adverse experiences.

• Verbal Abuse
• Physical Abuse
• Sexual Abuse
• Mentally Ill Household Member
• Household Member in Prison
• Substance-abusing Household Member
• Parents Separated/Divorced
• Witness to Domestic Violence

The survey found that 59% of adults reported at least one adverse childhood experience and about 9% reported five or more adverse childhood experiences.  One of the findings stood out to me.  The prevalence of reported adverse childhood experiences is larger in more recent cohorts (those under age 35 have higher rates than those currently 55 years of age or older.  I'm in the 55 years and older group and the survey suggest my generation benefited from a period when these adverse experiences were relatively uncommon.  Below is a chart that demonstrates this trend.  About 57% of those in the oldest cohort were free of any adverse childhood experience.

I consider myself very fortunate to not have experienced any of these events during my childhood.  It looks like my experience was similar to many in the older cohort but less common among younger adults.  Digging into the specific adverse effects, several appear to contribute to rising prevalence rates.  Younger cohorts report higher rates of nearly every adverse experience.  The experiences standing out with a marked younger cohort increase include: having a household member in prison, parents separated or divorced, having a mentally ill household member and experiencing verbal abuse.

Multiple traumatic experiences hold the potential for increased psychological and physical outcomes.  The experience of multiple traumas (3 or more) shows a similar trend.  The chart below summarizes the prevalence of three or more adverse events by age cohort:

 

Traumatic experiences are not destiny.  Many experience multiple adverse experiences and through resilience escape any adverse outcomes.  But I do agree with the conclusions from the CDC about these findings:

"The high prevalence of ACEs (adverse childhood experiences) underscores the need for 1) additional efforts at the state and local level to reduce and prevent child maltreatment and associated family dysfunction and 2) further development and dissemination of trauma-focused services to treat stress-related health outcomes associated with ACEs."

To access the complete CDC report in MMWR go here.

Centers for Disease Control and Prevention (CDC) (2010). Adverse childhood experiences reported by adults --- five States, 2009. MMWR. Morbidity and mortality weekly report, 59 (49), 1609-13 PMID: 21160456