Scared Sick: The Relationship Between Trauma and Disease

Susan E. Craig, Ph.D.craigsus@juno.com

Visit my blog at http://meltdownstomastery.wordpress.com

Child Abuse in the United States

»Trauma is a public health problem estimated to effect 26% of all children in the United States (SAMHSA, 2011).

• Family violence is the #1 cause of childhood trauma.

• Just under five children in the United States die every day as a result of child abuse.

Child Well-being in the United States

»1 in 100 infants each year is born with Fetal Alcohol Syndrome, a preventable cause of mental retardation and learning disabilities.

• ¼ of the children insured by Medco took prescription drugs to manage a chronic disease.

• 13% of children ages eight to fifteen have had a diagnosable mental illness within the last year.

Adult Well-being in the United States

• 26% of adults in the United States over eighteen have a diagnosable mental disorder(NIMH, 2010).

• ¼ of American adults over eighteen meet the criteria for a substance abuse disorder.

• 18% of adults in the United States over eighteen have an anxiety disorder.

What’s the Connection ?

The Adverse Childhood Experiences (ACE) Study

“The most important public health study that you have never heard of.”

ACEs Too HighAdults

Continue to affect adult health and behavior

• Accounts for intergenerational transmission of violence, poverty, and neglect

• Reduces the ability of adults to provide children with a “modulated nervous system to help them regulate their physical and emotional being”.

ACEs Increase Likelihood of Heart Disease*• Emotional abuse 1.7x• Physical abuse 1.5x• Sexual abuse 1.4x• Domestic violence 1.4x• Mental illness 1.4x• Substance abuse 1.3x• Household criminal 1.7x• Emotional neglect 1.3x• Physical neglect 1.4x

Childhood Experiences and Adult Alcoholism

0

2

4

6

8

10

12

14

16

18%

Alc

ohol

ic

ACE Score

0

1

23

4+

Adverse Childhood Experiences andHistory of STD

0

0.5

1

1.5

2

2.5

3

Adj

uste

d O

dds

Rat

io

0 1 2 3 4 or moreACE Score

ACEs Too HighChildren

• Traumatize Children – Overwhelm Their Capacity to Cope• Trauma Alters Brain Development

in Predictable Ways• Changes in Brain Interfere with Academic and

Social Competence, Increase Risk of Disease• Children w/ ACE Score of 4+ are 47 time more likely

than peers to be depressed, 12 times more likely to commit suicide

Trauma and the Brain

“the young mind is as driven to obliterate the chronic pain of loss and rejection as it is to escape physical pain.”

• Survival Brain• Emotional Brain• Logical Brain

Trauma and Children’s Health

»Asthma- Risk more than doubled in predisposed children exposed to marital strife or maternal depression»ADHD – Often associated with low birth

weight and maternal depression• Obesity and chronic inflammation - biomarkers in

blood-C-reactive protein and interleukin-6 that show inflammation in the body.

“They do not want to hear what their children suffer. They’ve made the telling of the suffering itself taboo”

From Possessing the Secret of Joy, Alice Walker

Yet the Silence Continues

From ACE Study Slides: Vincent Felitti

Criminal Justice Problems and Unaddressed Sexual/Physical Abuse

• More than 75% of girls in juvenile justice system Calhoun et al, 1993

• 80% of women in prison and jails Smith, 1998

• 100% of men on death row Freedman, Hemenway, 2000

• Boys who commit violence van der Kolk, 1998

What to Do• Recognize that trauma causes

children to carry RELENTLESS needs for safety and survival into classrooms and everyday experiences.

• The presence of caring adults can restore safety and mitigate effects

• High incidence calls for trauma-sensitive schools

Trauma-sensitive Supports

• Trauma-sensitive Interviews, Case Histories• Collaboration w/ Parents• Collaboration w/Staff• Screening

Trauma-sensitive Supports

• Know How to Manage the “Double Struggle”• Know How to “Find the Fear”• Know How to Collaborate•Work as a Team