Does trauma lead to faster ageing in children?

This blog was written by Julie Cameron, Associate Director for Mental Health Foundation (Scotland and Northern Ireland).

Improving our understanding of how experiences of trauma and adversity in childhood impact on health outcomes as adults is of increasing interest and importance.  Trauma and adversity would include a wide range of factors including the experience of abuse, neglect, sudden death or abandonment, parental alcohol or drug misuse, parent being in jail, divorce, poverty, violence within the family unit and wider community. This sits within the broader context of the significant health inequalities in our society where people living in poverty are more likely to experience mental health problems, physical health problems, and die younger than those from more affluent backgrounds.

The role of adversity and trauma within this picture came to prominence following the US Adverse Childhood Experience (ACEs) survey which found that as the number of ACEs increased so did the risk of experiencing negative health conditions in adulthood.  This included mental health problems such as anxiety and depression, as well as physical health conditions like cardiovascular disease, diabetes, and cancer.  The relationship between mental health and physical health conditions is not fully understood.  Studies exploring this association have cited the impact of trauma on wider behavioural and relational factors, experiences of stigma, and discrimination, as well as neurobiological research on the impact of ‘toxic stress’ on brain development.  A recently published study provides further insight into the association between childhood trauma and later life experiences of poor physical and mental health.

What did this study do?

The study, led by Dr Katie McLaughlin at Harvard University, reported that children who suffer trauma from abuse or violence biologically age faster than children who have never experienced adversity. The study built on previous mixed findings on whether childhood adversity is linked to premature ageing.  The authors more clearly defined adversity into two categories (1) threat-related adversity of violence or abuse, and (2) deprivation related adversity of neglect and poverty. The study also used three signs of biological aging – early puberty, cellular aging, and changes in brain structures – to undertake a meta-analysis of almost 80 studies.  A meta-analysis is a systematic approach to the review of findings from multiple studies, which explore the same question or area of interest, to identify whether there are statistically significant common findings or conclusions that can be drawn. The study found that threat-related trauma was associated with all three signs of premature biological aging, but deprivation-related adversity was not significantly associated with premature aging.

How well does the media describe the study?

The study was covered in many media reports, including The Guardian and science news outlets.  Although the ‘science’ behind the association was reported in varying levels of detail what is interesting to note is the strong inequalities focus within the reporting.  This was clearly led by the author who highlights in her quotes the implications this study has for understanding health disparities and the need to focus prevention in the early years.  However, there are gaps in how these findings are presented.  Overall, there is a strong emotional detachment from the findings and little clarity into whether particular sub-groups are more or less impacted

This study provides evidence that exposure to violence makes children grow up faster, not only emotionally but biologically.  The severity of this situation within the articles is at times hidden behind terms such as trauma and adversity with little insight into the human cost.  There is no clarity within the reports as to whether particular sub-populations, particularly girls, are more or less impacted.  This is interesting as two of the media reports mention early onset of puberty in girls.  

The findings are also emphasised within a medical model, with little discussion on the implications of the findings on public mental health – the art and science of improving mental wellbeing and preventing mental health problems via organised efforts and informed choices of society, organisations, public and private, communities, and individuals. This is evident in the reporting of the lead author’s view of the findings. Quotes from Dr. McLaughlin frame implications of the study as the need to use existing evidence-based treatments to improve mental health in children experiencing trauma to slow down the pattern of accelerated biological aging.  There is no reporting into what this means from a public mental health perspective.  In particular,  for breaking cycles of violence and abuse so that fewer children and young people are exposed to these in the first place.  This would move the analysis and implications of the study from a very individualised approach to one that explores the policy and community supports required to create strong family units and thriving communities. 

Another important point to keep in mind is that the results of the meta-analysis were of a small effect, rendering them as potentially trivial. Even the authors themselves acknowledge that the findings are preliminary and so further research will be needed in the area before it can be stated that ‘Children who suffer violence or trauma age faster’. Additionally, the meta-analysis only focused on combining results from studies that have been published. Publishing non-significant findings (i.e. where results don’t show a strong relationship) can be more difficult to publish. As such, it cannot be ruled out that including unpublished scientific data could have changed the results.

Useful links:

www.cdc.gov/violenceprevention/aces

Adverse childhood experiences in context briefing paper (Aug 2019) Public Health Scotland: http://www.healthscotland.scot/population-groups/children/adverse-childhood-experiences-aces/overview-of-aces

Tackling Social Inequalities to reduce mental health problems: how everyone can flourish equally (Jan 2020) Mental Health Foundation: https://www.mentalhealth.org.uk/publications/tackling-social-inequalities-reduce-mental-health-problems