Expert Commentary

Childhood stress and the risk for adult chronic disease

A study by Harvard University and the University of California, San Francisco focuses on the correlation between mental health and the risk for heart-related diseases

Heart disease is the single leading cause of death in the United States, with nearly one in four Americans dying from heart-related chronic illnesses each year, according to the U.S. Centers for Disease Control and Prevention. While much is known about how nutrition and lifestyle factors — for example, poor diet and lack of exercise — are related to heart health, comparatively less is known about its links with psychological factors, like emotions. Researchers have begun to explore and substantiate the relationship between mental health and chronic disease, with increasing attention on how early in life these relationships begin to appear.

In a study published in the October 2015 issue of the Journal of the American College of Cardiology, researchers from the Harvard T.H. Chan School of Public Health and University of California San Francisco Medical School looked at the correlation between mental health and the risk for heart-related diseases. In “Psychological Distress Across the Life Course and Cardiometabolic Risk,” the authors discuss data from a sample of more than 6,500 people in a group known as the 1958 British Birth Cohort. All participants were born in England, Scotland and Wales during the same week in 1958 and information about them — including health data — was collected at various points in their lives. This study is unique because the researchers were able to assess psychological distress at multiple time points from age 7 to age 45. This allowed them to compare distress experienced only in adulthood to distress experienced only in childhood and also to distress persisting from childhood into adulthood.

For the purposes of this study, psychological distress is defined using mental health symptoms, including depression and anxiety. Cardiometabolic disease risk was assessed using information on nine known biological indicators of heart disease, including cholesterol and blood pressure.

The study’s findings include:

  • Just over half of the sample reported experiencing psychological distress at some point in their lives.
  • Nearly eleven percent (10.7 percent) of the sample reported distress in both childhood and adulthood. Just over a quarter (25.1 percent) of the sample reported distress in childhood only, and 15 percent reported distress in adulthood only. The authors conclude that psychological distress “at any point in the life course is associated with higher cardiometabolic risk.”
  • Fewer male participants (9 percent) of the sample reported distress in both childhood and adulthood than female participants (13 percent).
  • Participants who reported only childhood distress, only adult distress or persistent distress all were found to have a significantly higher risk of heart disease at age 45 compared to those who reported no distress at any time during their lives.

This is the first study to suggest a heightened risk for chronic diseases by individuals who experience distress in childhood, even when distress was not experienced in adulthood. These findings question the idea that biological damage sustained early in life can be fully reversed if distress is alleviated, suggesting that childhood may be a period of particular vulnerability with respect to the future chronic disease. Ultimately, the authors conclude that these findings highlight a greater need to address children’s emotional development as a part of early chronic disease prevention efforts.

Related research: A 2010 report from the National Scientific Council on the Developing Child and the National Forum on Early Childhood Policy and Programs, “The Foundations of Lifelong Health Are Built in Early Childhood,” explains how the earliest years lay the groundwork for lifelong health. A May 2013 report from the Centers for Disease Control and Prevention, “Mental Health Surveillance Among Children – United States, 2005-2011,” provides a survey of relevant statistics for the psychological health of young people. In a 2013 study, “Internalizing and Externalizing Behaviors Predict Elevated Inflammatory Markers in Childhood,” the authors find that children’s behavior problems are significantly associated with markers for adult chronic disease.

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