Advertisement
Academic Pediatrics
Advanced SearchSave search
Child Mental Health| Volume 9, ISSUE 3, P150-156, May 01, 2009

Adverse Childhood Exposures and Reported Child Health at Age 12

  • Emalee G. Flaherty
    Correspondence
    Address correspondence to Emalee G. Flaherty, MD, Children's Memorial Hospital, 2300 Children's Plaza, Box 16, Chicago, Illinois 60614.
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Richard Thompson
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Alan J. Litrownik
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Adam J. Zolotor
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Howard Dubowitz
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Desmond K. Runyan
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Diana J. English
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
  • Mark D. Everson
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
    Search for articles by this author
DOI:https://doi.org/10.1016/j.acap.2008.11.003
Adverse Childhood Exposures and Reported Child Health at Age 12
Previous ArticleEarly Childhood Health Promotion and Its Life Course Health Consequences
Next ArticleViolence Exposure and the Association Between Young African American Mothers' Discipline and Child Problem Behavior

      Objective

      The relationship between adverse childhood exposures and poor health, illness, and somatic complaints at age 12 was examined.

      Methods

      LONGSCAN (Consortium for Longitudinal Studies of Child Abuse and Neglect) tracks a group of children with variable risk for maltreatment. Of the participating child-caregiver dyads, 805 completed an interview when the child was age 4 or age 6, as well as interviews at age 8 and 12. The relationships between 8 categories of childhood adversity (psychological maltreatment, physical abuse, sexual abuse, child neglect, caregiver's substance/alcohol use, caregiver's depressive symptoms, caregiver's being treated violently, and criminal behavior in the household) and child health at age 12 were analyzed. The impact of adversity in the first 6 years of life and adversity in the second 6 years of life on child health were compared.

      Results

      Only 10% of the children had experienced no adversity, while more than 20% had experienced 5 or more types of childhood adversity. At age 12, 37% of the children sampled had some health complaint. Exposure to 5 or more adversities, particularly exposure in the second 6 years of life, was significantly associated with increased risks of any health complaint (odds ratio [OR] 2.24, 95% confidence interval [95% CI] 1.02–4.96), an illness requiring a doctor (OR 3.69, 95% CI 1.02–15.1), and caregivers’ reports of child's somatic complaints (OR 3.37, 95% CI 1.14–1.0). There was no association between adverse exposures and self-rated poor health or self-rated somatic complaints.

      Conclusions

      A comprehensive assessment of children's health should include a careful history of their past exposure to adverse conditions and maltreatment. Interventions aimed at reducing these exposures may result in better child health.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Felitti V.J.
        • Anda R.F.
        • Nordenberg D.
        • et al.
        Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.
        Am J Prev Med. 1998; 14: 245-258
        View in Article
        • Dube S.R.
        • Felitti V.J.
        • Dong M.
        • et al.
        The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.
        Prev Med. 2003; 37: 268-277
        View in Article
        • Walker E.A.
        • Gelfand A.
        • Katon W.J.
        • et al.
        Adult health status of women with histories of childhood abuse and neglect.
        Am J Med. 1999; 107: 332-339
        View in Article
        • Arias I.
        The legacy of child maltreatment: long-term health consequences for women.
        J Womens Health. 2004; 13: 468-473
        View in Article
        • Samelius L.
        • Wijma B.
        • Wingren G.
        • et al.
        Somatization in abused women.
        J Womens Health. 2007; 16: 909-918
        View in Article
        • McNutt L.-A.
        • Carlson B.E.
        • Persaud M.
        • Postmus J.
        Cumulative abuse experiences, physical health and health behaviors.
        Ann Epidemiol. 2002; 12: 123-130
        View in Article
        • Flaherty E.G.
        • Thompson R.
        • Litrownik A.J.
        • et al.
        Effect of childhood adversity on child health.
        Arch Pediatr Adolesc Med. 2006; 160: 1232-1238
        View in Article
        • English D.J.
        • Graham J.C.
        • Litrownik A.J.
        • et al.
        Defining maltreatment chronicity: are there differences in child outcomes?.
        Child Abuse Negl. 2005; 29: 575-595
        View in Article
        • Kotch J.B.
        • Lewis T.
        • Hussey J.M.
        • et al.
        Importance of neglect for childhood aggression.
        Pediatrics. 2008; 121: 725-731
        View in Article
        • Kaplow J.B.
        • Widom C.S.
        • Kaplow J.B.
        • Widom C.S.
        Age of onset of child maltreatment predicts long-term mental health outcomes.
        J Abnorm Psychol. 2007; 116: 176-187
        View in Article
        • Runyan D.K.
        • Curtis P.A.
        • Hunter W.M.
        • et al.
        Longscan: a consortium for longitudinal studies of maltreatment and the life course of children.
        Aggression Violent Behav. 1998; 3: 275
        View in Article
        • Runyan D.K.
        • Hunter W.M.
        • Socolar R.R.
        • et al.
        Children who prosper in unfavorable environments: the relationship to social capital.
        Pediatrics. 1998; (10112–10018)
        View in Article
        • Sameroff A.J.
        • Seifer R.
        • Barocas R.
        • et al.
        Intelligence quotient scores of 4-year-old children: social-environmental risk factors.
        Pediatrics. 1987; 79: 343-350
        View in Article
        • Zolotor A.J.
        • Runyan D.K.
        • Zolotor A.J.
        • Runyan D.K.
        Social capital, family violence, and neglect.
        Pediatrics. 2006; 117: e1124-e1131
        View in Article
        • English D.J.
        • Upadhyaya M.P.
        • Litrownik A.J.
        • et al.
        Maltreatment's wake: the relationship of maltreatment dimensions to child outcomes.
        Child Abuse Negl. 2005; 29: 597-619
        View in Article
        • Hussey J.M.
        • Marshall J.M.
        • English D.J.
        • et al.
        Defining maltreatment according to substantiation: distinction without a difference?.
        Child Abuse Negl. 2005; 29: 479-492
        View in Article
        • English D.J.
        • Bangdiwala S.I.
        • Runyan D.
        The dimensions of maltreatment: introduction.
        Child Abuse Negl. 2005; 29: 441-460
        View in Article
        • Barnett D.
        • Manly J.T.
        • Cicchetti D.
        Defining Child Maltreatment: The Interface Between Policy and Research.
        Ablex, Norwood, NJ1993
        View in Article
        • Turner C.F.
        • Lessler J.T.
        • Gfroerer J.C.
        Survey measurement of drug use: methodological studies.
        Department of Health and Human Services, Washington, DC1992
        View in Article

      20. Hunter HM, Cox CE, Teagle s, el al. measure for Assessment of Functioning and Outcomes in Longitudinal Research on Child Abuse. Volume 2: middle Childhood. Available at: http://www.iprc.unc.edu/ longscan. Accessed December 10, 2008.

        View in Article
        • Radloff L.S.
        The CES-D Scale: a self-report depression scale for research in the general population.
        Appl Psychol Measure. 1977; 1: 385-401
        View in Article
        • Derogatis L.R.
        Brief Symptom Inventory.
        Clinical Psychometric Research, Baltimore, Md1975
        View in Article
        • Derogatis L.R.
        BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual. 4th ed.
        National Computer Systems, Minneapolis, Minn1993
        View in Article
        • Straus M.A.
        Measuring intrafamily conflict and violence: the Conflict Tactics Scale.
        J Marriage Fam. 1979; 41: 75-88
        View in Article
        • Coddington R.D.
        The significance of life events as etiologic factors in the diseases of children. II. A study of a normal population.
        J Psychosom Res. 1972; 16: 205-213
        View in Article
        • Achenbach T.M.
        • Edelbrock C.
        Manual for the Child Behavior Checklist/4-18 and 1991 Profile.
        Departent of Psychiatry, University of Vermont, Burlington, Vt1991
        View in Article

      27. Bloom B, Dey AN, Freeman G. Summary health statistics for US children: National Health Interview Survey, 2005. National Center for Health Statistics. Vital Health Stat; 2006.

        View in Article
        • Offord D.R.
        • Boyle M.H.
        • Szatmari P.
        • et al.
        Ontario Child Health Study. II. Six-month prevalence of disorder and rates of service utilization.
        Arch Gen Psychiatry. 1987; 44: 832-836
        View in Article
        • Anda R.F.
        • Croft J.B.
        • Felitti V.J.
        • et al.
        Adverse childhood experiences and smoking during adolescence and adulthood.
        JAMA. 1999; 282: 1652-1658
        View in Article
        • Dube S.R.
        • Felitti V.J.
        • Dong M.
        • et al.
        Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study.
        Pediatrics. 2003; 111: 564-572
        View in Article
        • Dube S.R.
        • Anda R.F.
        • Felitti V.J.
        • Edwards V.J.
        • Croft J.B.
        Adverse childhood experiences and personal alcohol abuse as an adult.
        Addict Behav. 2002; 27: 713-725
        View in Article
        • Dong M.
        • Giles W.H.
        • Felitti V.J.
        • et al.
        Insights into causal pathways for ischemic heart disease: adverse childhood experiences study.
        Circulation. 2004; 110: 1761-1766
        View in Article
        • Heller S.S.
        • Larrieu J.A.
        • D'Imperio R.
        • Boris N.W.
        Research on resilience to child maltreatment: empirical considerations.
        Child Abuse Negl. 1999; 23: 321-338
        View in Article

      Article Info

      Publication History

      Accepted: November 7, 2008
      Received: August 7, 2008

      Identification

      DOI: https://doi.org/10.1016/j.acap.2008.11.003

      Copyright

      © 2009 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2022 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX