Wednesday August 03, 2016

All In The Family, Part 1

(Mary O'Connell/CBC)

Listen to Full Episode 53:59

Cardio-vascular disease. Obesity. Alcoholism. Diabetes. These conditions may have one surprising factor in common: childhood trauma -- according to a massive study called "Adverse Childhood Experiences", or ACE.  In part one of this series, a version of which was first broadcast in 2011, IDEAS producer Mary O'Connell explores the ACE study and how its findings are being integrated into medical practice today. Part 2 airs Wednesday, August 10; Part 3 airs Wednesday, August 17. **This episode originally aired April 7, 2016.


 
 

Dr. Vincent Felitti

At the time, it seemed to be a medical mystery. Dr. Vincent Felitti was running a clinic in San Diego in the 1980's for the morbidly obese.  Under his supervision, many patients lost 200 to 400 pounds -- only to gain it all back again. Or lose the weight then drop out of the program.  

These results puzzled Dr. Felitti. One day, while interviewing a new patient, he asked her when she'd become sexually active.  The patient looked down and said, "four years old". A lightbulb went on. Could childhood trauma trigger not only obesity, but a whole host of psychological and physiological illnesses?  

The link between early trauma and ill health later was untilled soil in the world of medicine.  But the possibility of a connection captured the interest of the Centres for Disease Control and Prevention.  And it was the beginning of a 25-year odyssey for Vincent Felitti when he teamed up with researchers to study the health of 17,000 members of a preventive care program at Kaiser Permanente, a private insurer.  Beyond routine physicals, workers (mostly middle-class and middle-aged) filled out an extensive  trauma questionnaire covering ten categories of abuse, from physical violence to attempted suicide.  Past and present health problems were also tabulated. The results were astonishing.  
The more categories of abuse that participants suffered, the higher their chances of illness were.  For example, women who experienced physical violence were 60% more likely to experience depression, compared to 18% for women who reported no categories of abuse. The figures for attempted suicide were even more startling. Only 2% of those who reported no categories of abuse attempted suicide.  However, those who reported four or more categories were breathtakingly 1,200% likelier to attempt killing themselves.  

Similar results for smoking, cancer, diabetes, among other diseases, followed the same pattern. Today, the Adverse Childhood Experiences (ACE) Study has become a fixture in the fields of medicine, psychiatry and pediatrics. Six state legislatures in the U.S. have passed legislation to stimulate the routine collection of data on childhood trauma. And now, the World Health Organization also uses the ACE model to explore global health. 


Guests in this episode:

  • Dr. Vincent Felitti is an international expert on child trauma and a co-principal investigator of the Adverse Childhood Experiences Study (ACE). 
     
  • John Medina is a developmental molecular biologist and best-selling author.  He is also an affiliate Professor of Bioengineering at the University of Washington School of Medicine.  
     
  • Dr. Kenneth Kunz is a Victoria-based oncologist and lecturer. 
     
  • Nadine Burke-Harris is a San Francisco-based pediatrician and runs the Center for Youth Wellness. She lectures widely.   


Infographic: The Truth About ACEs (click on the image)



Related websites: 

Reading List: 

  • The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, Bessel van der Kolk, Penguin Books, New York, 2014. 
     
  • Trauma and Recovery:  The Aftermath of Violence - From Domestic Abuse to Political Terror, Judith L Herman, Basic Books, New York, 1997.   
     
  • Childhood Disrupted: Your Biography Becomes Your Biology, and How You Can Heal, Donna Jackson Nakazawa, Atria Books, 2015. 
     
  • Felitti, VJ and RF Anda. The Relationship of Adverse Childhood Experiences to Adult Medical Disease, Psychiatric Disorders, and Sexual Behaviors: Implications for Healthcare, in The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease, eds. Ruth A. Lanius, Eric Vermetten, and Clare Pain. Cambridge University Press: 2010.
     
  • Teicher, Martin H. Scars that Won't Heal: The Neurobiology of Child Abuse, Scientific American, March, 2002.  
     
  • Perry, Bruce Duncan, and Maia Szalavitz. The Boy Who Was Raised as a Dog: And Other Stories From a Child Psychiatrist's Notebook - What Traumatized Children Can Teach Us about Loss, Love, and Healing. New York: Basic, 2006. 

  • Brain Rules by John Medina, Pear Press, Seattle, 2008.  
     
  • Brain Rules for Baby by John Medina, Pear Press, Seattle, 2010.