Cumulative childhood stress and autoimmune diseases in adults

Shanta R. Dube, Delisa Fairweather, William S. Pearson, Vincent J. Felitti, Robert F. Anda, Janet B. Croft

Research output: Contribution to journalArticle

316 Scopus citations

Abstract

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 ≥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.

Original languageEnglish (US)
Pages (from-to)243-250
Number of pages8
JournalPsychosomatic Medicine
Volume71
Issue number2
DOIs
StatePublished - Jan 1 2009

Keywords

  • Autoimmune diseases
  • Childhood abuse
  • Inflammatory response
  • Stress
  • Traumatic stress

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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    Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71(2), 243-250. https://doi.org/10.1097/PSY.0b013e3181907888