Cumulative childhood stress and autoimmune diseases in adults
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OBJECTIVE: To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. METHODS: Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). RESULTS: Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with >or=2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05). CONCLUSIONS: Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.
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Early-life stress could increase the risk of a range of health problems, including autoimmune disease, cardiovascular disease, depression, diabetes, and hypertension, which can persist into adulthood.
“Mounting evidence has also shown that early-life stress could increase the risk of a range of health problems (e.g., autoimmune disease, cardiovascular disease, depression, diabetes, hypertension), which can persist into adulthood [28,29,30].”
From Biological Embedding of Early-Life Adversity and a Scoping Review of the Evidence for Intergenerational Epigenetic Transmission of Stress and Trauma in Humans (2023) · cites this paper as [29]
The Introduction (page unavailable) describes long-term risks from childhood stress, including mental illness and ischemic heart disease, and the Conclusions report autoimmune-disease hospitalizations decades later. The Methods include insulin-dependent diabetes among the autoimmune diseases studied, but the paper does not establish a risk for diabetes generally; the passages found do not address hypertension. (LLM, conf=0.86)
Experimental — accuracy not yet measuredChildhood trauma is associated with increased risk of cardiovascular disease, autoimmune disease, gastrointestinal symptoms, poor dental health, obesity, and type 2 diabetes.
“Physically, childhood trauma has been associated with increased risk of cardiovascular disease (6), autoimmune disease (7), gastrointestinal symptoms (8), poor dental health (9), obesity, and type 2 diabetes (10).”
From Epigenetic Modifications in Stress Response Genes Associated With Childhood Trauma (2019) · cites this paper as [7]
Retrospective reporting is subject to recall bias and possible underreporting, particularly when participants are asked to report on violence they experienced many years in the past.
“retrospective reporting is subject to recall bias and possible underreporting, particularly when participants are asked to report on violence they experienced many years in the past”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Dube et al., 2009
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- Authors
- Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Dube, Shanta R.
- Venue
- Psychosomatic Medicine
- Published
- 2009-02
- Volume
- 71
- Issue
- 2
- Pages
- 243-250
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC3318917
- OpenAlex
- W2074821083
- Cited by
- 820
- References
- 60
- Citations by year
- 2026: 25 · 2025: 39 · 2024: 55 · 2023: 46 · 2022: 66 · 2021: 63 · 2020: 119 · 2019: 44 · 2018: 57 · 2017: 41 · 2016: 29 · 2015: 52 · 2014: 34 · 2013: 40 · 2012: 56
- FWCI
- 39.19
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL087033)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- adverse childhood experiences, autoimmune disease, cumulative stress, hospitalization, rheumatoid arthritis, myasthenia gravis, idiopathic myocarditis, autoimmune hemolytic anemia, early life stress, immunopathology
- MeSH terms
- Adult, Anemia, Hemolytic, Autoimmune, Autoimmune Diseases, California, Child, Child Abuse, Disease Susceptibility, Divorce, Female, Hospitalization, Humans, Inflammation, Lymphokines, Male, Middle Aged, Myocarditis, Surveys and Questionnaires, Rheumatic Diseases, Stress, Psychological, Cohort Studies, Domestic Violence, Th1 Cells, Th2 Cells, Adult Children
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