Adverse Childhood Experiences & Disability in US Adults

PM R, 2014 · DOI: 10.1016/j.pmrj.2014.01.013 · Published: August 1, 2014

Simple Explanation

This study investigated the connection between negative experiences in childhood and disabilities in adulthood. Adverse Childhood Experiences (ACEs) include abuse and family problems before the age of 18. Researchers looked at data from over 81,000 adults, examining how many ACEs they reported and whether they had any disabilities. They found a strong link: the more ACEs a person had, the more likely they were to report a disability. This connection remained even after considering other health conditions, suggesting that childhood adversity has a lasting impact on adult health and function. The study highlights the importance of addressing childhood trauma to improve long-term well-being.

Study Duration

2 years

Participants

81,184 non-institutionalized US adults

Evidence Level

Cross-sectional state-population-based survey

Key Findings

1
Over half (57%) of participants reported at least one adverse childhood experience category and 23.2% reported disability.
2
The odds of disability increased in a graded fashion with ACE count.
3
Compared to those with no ACEs, the odds of disability was highest in those experiencing both abuse and family dysfunction (2.6), followed by those experiencing abuse only (1.9) and then family dysfunction only (1.3).

Research Summary

This study examined the relationship between adverse childhood experiences (ACEs) and self-reported disabilities in adulthood using data from a large, multi-state population-based survey. The findings revealed a strong, graded association between the number of ACEs and the likelihood of reporting a disability, even after adjusting for demographic factors and chronic health conditions. The study emphasizes the importance of recognizing the impact of childhood adversity on disability and suggests that increased awareness among clinicians, researchers, and policymakers is crucial for improving the lives of those affected.

Practical Implications

Clinical Practice

Rehabilitation clinicians should consider the impact of ACEs on patients' functional recovery and incorporate trauma-informed care into their practice.

Research

Further research is needed to identify mediating factors and high-risk groups to design targeted interventions that address the long-term effects of childhood adversity.

Policy

Policymakers should prioritize primary prevention of child abuse and promote policies that support families and create safe, nurturing environments for children.

Study Limitations

1
The BRFSS is limited to those in the community with telephones, potentially underestimating the prevalence of abuse and disability.
2
The study is cross-sectional, making it difficult to establish causality between ACEs and disability.
3
The BRFSS measures are broad and may not capture the full complexity of childhood adversity or disability.

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