Is This About My Childhood? — Part One

How Early Experiences Affect the Way We Feel, Think, and Relate to Others

Most of us can draw a line between what happened to us in childhood and where we are right now. We can do this with our emotional and psychological patterns, our culture and beliefs, behaviors, what we like or dislike.

Drawing this chronological line between our childhood and now helps us ground ourselves in a story that makes sense.

Even though we can do this over and over, in my experience, most people actually underestimate how much influence their childhood had on them. We often see the very first layer of causes and effects, and miss out on much of the nuance and the subtleties of that influence.

For example, many people with phobias (such as a fear of spiders) can very clearly recall a time when they started being afraid. I’ve met people who can detail the events so thoroughly, you’d think it happened last week.

Then, compare this with a person who gets angry waiting to be called in by a nurse at the Emergency Department. Some people can, unfortunately, lash out with aggression and violence towards the staff when they see themselves being “skipped in line”. This person can even explain to you, a week or a month later, that they understand why people need to be selected in a particular order of severity. Yet, they could not stop the anger from taking over at that moment.

Not many people would think about this person’s childhood as the basis of their reaction. However, it’s very likely that their reaction did, in fact, stem from what happened to them in their early life. The details are likely to be different: They may have been skipped over a lot due to parents that favoured their siblings; or they may have had many instances of ridicule that left them susceptible to the feelings of shame that come with being overlooked; or they may have learned that violence (verbal or physical) is the best (or only) way of getting what you want from others.

There is no way of knowing with certainty how the person came to react this way, unless we sit down and talk to them. But, as you can see, there are so many subtle ways that our childhood can affect us as adults.

To help people see the connection more clearly, I’ve decided to write a few posts explaining this concept and some of the research behind it. While the amount of research on this topic has been immense, finding a clear and simple source explaining this can be a bit of a mess.

My hope is to show that if we want to understand ourselves, truly, we need to understand how our childhood experiences influenced us: our story, our patterns, our reactions, etc.

If we want to change, we need to be able to see how we came to be who we are, first and foremost.

If you’ve had 4 or more adverse events, you’re probably a smoker.

This title is intentionally sensational. No, it’s not accurate, nor is it true. And yes, I am twisting the author’s words.

You are, however, twice as likely to be a smoker according to the Adverse Childhood Experiences study, conducted in 1998 by Felitti and colleagues¹. In fact, they found that the more adverse events one experienced, the higher their “likelihood of smoking by the age of 14, chronic smoking as adults, and the presence of smoking-related diseases.”

We can’t talk about the link between childhood and adult mental health without talking about the ACEs study. It’s the seminal study on the link between events of abuse or dysfunction, and health outcomes for adults. The experiences they studies included various forms of abuse and neglect, such as abuse, household substance use, violence between parents, etc.

This study revolutionized the field’s understanding of the impact childhood experiences have on us. Well, revolutionized the field of medicine, perhaps, as the field of psychology and mental health was quite aware of this link for a long while.

As important as this study was, the most important idea that they came up with isn’t just studying the impact of the adverse events on people. What was unique about this study is that they looked into how events that happened in long ago, could impact future outcomes for adults. In other words, the links they found between these experiences and outcomes (such as smoking or alcohol addiction, higher rates of heart disease, cancer, and obesity), are important because they correlate so strongly into adulthood. Even more so, they showed that multiple types of adverse events correlated with worse outcomes. This would be echoed by future studies, discussing the impact of cumulative risk².

Adult mental health risk is particularly high with ACEs

This pattern continues to hold with more recent studies, like the one by Hughes and colleagues from 2017, which showed that the link is strong when examining over 200,000 participants across 37 studies³. The strongest associations were with sexual risk-taking, mental ill health, problematic alcohol use, problematic drug use, interpersonal violence, and self-directed violence.

Indeed, the research shows a very strong link with mental health difficulties in adulthood (a fact most psychotherapists are not surprised by). Here are some of the findings on the connection between adult mental health and childhood experiences:

• The presence of ACEs raised the odds of developing Depression, Anxiety, and Suicidality by two times⁴.
• ACEs increased risk for problematic drug use, interpersonal violence, and self-directed violence³.
• Increased risk of adult mood, anxiety, behavioural, and substance disorders⁵.
• Increased likelihood of adolescent dating violence (being physically harmed, or physically harming someone else, in a dating relationship)⁶.
• Increased likelihood of adult sexual revictimization (being sexually assaulted or otherwise sexually victimized again later in life)⁷.
• Linked with obsessive-compulsive symptoms (OCD)⁸, ADHD⁹, and worse clinical outcomes in bipolar disorder¹⁰.
• Increased likelihood and severity of substance-use disorder in adolescence and adulthood¹¹.

These effects are particularly terrifying when we consider that a large majority of children grow up with more than one factor. When we think about how much this can affect people as they grow up, we realize that there can never be enough consideration of it.

In the next article, we’ll continue exploring how these all fit together. We’ll talk about what happens when children grow up with multiple risk factors, some of the problems with how these studies measure adversity, and why adversity isn’t a terminal diagnosis.

Give me something worth investigating

I keep a running list of mental-health topics to research and write about. If there is a question you think is worth investigating, send it to me.

You can reach me through LinkedIn, Facebook, or the Contact page on my website. I love hearing from you!

References

(1) Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8

(2) Evans, G. W., Li, D., & Whipple, S. S. (2013). Cumulative risk and child development. Psychological Bulletin, 139(6), 1342–1396. https://doi.org/10.1037/a0031808

(3) Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4

(4) Sahle, B. W., Reavley, N. J., Li, W., Morgan, A. J., Yap, M. B. H., Reupert, A., & Jorm, A. F. (2022). The association between adverse childhood experiences and common mental disorders and suicidality: An umbrella review of systematic reviews and meta-analyses. European Child & Adolescent Psychiatry, 31, 1489–1499. https://doi.org/10.1007/s00787-021-01745-2

(5) Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., Aguilar-Gaxiola, S., Alhamzawi, A. O., Alonso, J., Angermeyer, M., Benjet, C., Bromet, E., Chatterji, S., de Girolamo, G., Demyttenaere, K., Fayyad, J., Florescu, S., Gal, G., Gureje, O., … Williams, D. R. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British Journal of Psychiatry, 197(5), 378–385. https://doi.org/10.1192/bjp.bp.110.080499

(6) Miller, E., Breslau, J., Chung, W.-J. J., Green, J. G., McLaughlin, K. A., & Kessler, R. C. (2011). Adverse childhood experiences and risk of physical violence in adolescent dating relationships. Journal of Epidemiology & Community Health, 65(11), 1006–1013. https://doi.org/10.1136/jech.2009.105429

(7) Ports, K. A., Ford, D. C., & Merrick, M. T. (2016). Adverse childhood experiences and sexual victimization in adulthood. Child Abuse & Neglect, 51, 313–322. https://doi.org/10.1016/j.chiabu.2015.08.017

(8) Ou, W., Li, Z., Zheng, Q., Chen, W., Liu, J., Liu, B., & Zhang, Y. (2021). Association between childhood maltreatment and symptoms of obsessive-compulsive disorder: A meta-analysis. Frontiers in Psychiatry, 11, Article 612586. https://doi.org/10.3389/fpsyt.2020.612586

(9) Zhang, N., Gao, M., Yu, J., Zhang, Q., Wang, W., Zhou, C., Liu, L., Sun, T., Liao, X., & Wang, J. (2022). Understanding the association between adverse childhood experiences and subsequent attention deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies. Brain and Behavior, 12, Article e2748. https://doi.org/10.1002/brb3.2748

(10) Agnew-Blais, J., & Danese, A. (2016). Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: A systematic review and meta-analysis. The Lancet Psychiatry, 3(4), 342–349. https://doi.org/10.1016/S2215-0366(15)00544-1

(11) Leza, L., Siria, S., López-Goñi, J. J., & Fernández-Montalvo, J. (2021). Adverse childhood experiences (ACEs) and substance use disorder (SUD): A scoping review. Drug and Alcohol Dependence, 221, Article 108563. https://doi.org/10.1016/j.drugalcdep.2021.108563