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

296 Citations (Scopus)

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 - Feb 2009
Externally publishedYes

Fingerprint

Autoimmune Diseases
Hospitalization
Autoimmune Hemolytic Anemia
Domestic Violence
Divorce
Health Maintenance Organizations
Myasthenia Gravis
Sex Offenses
Myocarditis
Rheumatic Diseases
Psychological Stress
Substance-Related Disorders
Rheumatoid Arthritis
Cohort Studies
Retrospective Studies

Keywords

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

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

Cite this

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

Cumulative childhood stress and autoimmune diseases in adults. / Dube, Shanta R.; Fairweather, DeLisa; Pearson, William S.; Felitti, Vincent J.; Anda, Robert F.; Croft, Janet B.

In: Psychosomatic Medicine, Vol. 71, No. 2, 02.2009, p. 243-250.

Research output: Contribution to journalArticle

Dube, SR, Fairweather, D, Pearson, WS, Felitti, VJ, Anda, RF & Croft, JB 2009, 'Cumulative childhood stress and autoimmune diseases in adults', Psychosomatic Medicine, vol. 71, no. 2, pp. 243-250. https://doi.org/10.1097/PSY.0b013e3181907888
Dube, Shanta R. ; Fairweather, DeLisa ; Pearson, William S. ; Felitti, Vincent J. ; Anda, Robert F. ; Croft, Janet B. / Cumulative childhood stress and autoimmune diseases in adults. In: Psychosomatic Medicine. 2009 ; Vol. 71, No. 2. pp. 243-250.
@article{1ff38c3e5df64819aebc330d4431f91b,
title = "Cumulative childhood stress and autoimmune diseases in adults",
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.",
keywords = "Autoimmune diseases, Childhood abuse, Inflammatory response, Stress, Traumatic stress",
author = "Dube, {Shanta R.} and DeLisa Fairweather and Pearson, {William S.} and Felitti, {Vincent J.} and Anda, {Robert F.} and Croft, {Janet B.}",
year = "2009",
month = "2",
doi = "10.1097/PSY.0b013e3181907888",
language = "English (US)",
volume = "71",
pages = "243--250",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Cumulative childhood stress and autoimmune diseases in adults

AU - Dube, Shanta R.

AU - Fairweather, DeLisa

AU - Pearson, William S.

AU - Felitti, Vincent J.

AU - Anda, Robert F.

AU - Croft, Janet B.

PY - 2009/2

Y1 - 2009/2

N2 - 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.

AB - 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.

KW - Autoimmune diseases

KW - Childhood abuse

KW - Inflammatory response

KW - Stress

KW - Traumatic stress

UR - http://www.scopus.com/inward/record.url?scp=65649111156&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65649111156&partnerID=8YFLogxK

U2 - 10.1097/PSY.0b013e3181907888

DO - 10.1097/PSY.0b013e3181907888

M3 - Article

C2 - 19188532

AN - SCOPUS:65649111156

VL - 71

SP - 243

EP - 250

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 2

ER -