The impact of childhood adversity, including abuse and neglect, on adult health

Exposure to serious adverse experiences in childhood, including physical, sexual and emotional abuse and neglect is very common. Many good studies suggest that abuse (physical or sexual abuse, or witnessing violence in the home) occurs to about 1 in 3 children. Exposure to a broader range of adversities that include things like growing up in a home where adults have addictions or mental illness or are engaged in criminal activity occurs in about half of children (maybe even more). Vincent Felitti and his colleagues have demonstrated just how strongly exposure to childhood adversity is linked to adult health (see the the link in the sidebar about their ACE study). It is an enormous public health problem that gets too little attention, and the reason that we wrote Damaged.

  • Maunder RG, Peladeau N, Savage D, Lancee WJ. The prevalence of childhood adversity among healthcare workers and its relationship to adult life events, distress and impairment. Child Abuse & Neglect. 34:114-123, 2010.
  • Maunder RG, Halpern J, Schwartz B, Gurevich M. Symptoms and responses to critical incidents in paramedics who have experienced childhood abuse and neglect. Emergency Medicine Journal. 29:222-227, 2012.
  • R Caplan, S Hart, M Silverberg, R Maunder, J Stempak. Attachment, childhood abuse, and IBD-related quality of life and disease activity outcomes. Inflammatory Bowel Diseases. 2014 May.
  • Maunder RG, Hunter JJ, Atkinson L, Steiner M, Wazana A, Fleming AS, Moss E, Gaudreau H, Meaney MJ, Levitan RD. An attachment-based model of the relationship between childhood adversity and somatization in children and adults. Psychosomatic medicine. 2017 Jun 1;79(5):506-13.
  • Le TL, Levitan RD, Mann RE, Maunder RG. Childhood Adversity and Hazardous Drinking: The Mediating Role of Attachment Insecurity. Subst Use Misuse. 2018 Jan 15:1-12.
  • Bekele T, Collins E, Maunder R, Gardner S, Rueda S, Globerman J, Le T, Hunter J, Benoit A, Rourke S and The OHTN Cohort Study Team, Childhood Adversities and Physical and Mental Health Outcomes in Adults Living with HIV: Findings from the Ontario HIV Treatment Network Cohort Study, AIDS Research and Treatment, vol. 2018, Article ID 2187232, 17 pages, 2018. doi:10.1155/2018/2187232 Get free open access pdf here.
  • RG Maunder, L Wiesenfeld, A Lawson, JJ Hunter. The relationship between childhood adversity and clinical complexity in psychiatric outpatients. Journal of Interpersonal Violence, 2019, DOI: 10.1177/0886260519865968
  • RG Maunder, DW Tannenbaum, JA Permaul, C Haber, M Mitri, D Costantini, JJ Hunter. The prevalence and clinical correlates of adverse childhood experiences in primary care patients with cardiometabolic disease or risk factors. BMC Cardiovascular Disorders, 19(1): 1-10, 2019, DOI: 10.1186/s12872-019-01277-3. Get free open access pdf here.
  • RG Maunder, JJ Hunter, DW Tannenbaum, TL Le, C Lay. Physicians’ Knowledge and Practices Regarding Screening Adult Patients for Adverse Childhood Experiences. BMC Health Services Research 2020 Apr 15;20(1):314. doi: 10.1186/s12913-020-05124-6. Get free open access pdf here.
  • LC Godoy, C Frankfurter, M Cooper, C Lay, R Maunder, ME Farkouh. Association of adverse childhood experiences and cardiovascular disease later in life. JAMA Cardiology. doi:10.1001/jamacardio.2020.6050   Published online December 2, 2020
  • TL Le, R Geist, E Bearss, RG Maunder. Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety. Child Abuse & Neglect,120, 2021,105216, https://doi.org/10.1016/j.chiabu.2021.105216. Get free open access article here.
  • T Paulson, B Perrin, R Maunder and RT Muller. Toward a Trauma-Informed Approach to Evidence Law: Witness Credibility and Reliability, Canadian Bar Review, 101(3); 496-545; 2023. Get free open access article here.