Key Updates to Understanding Roles of Childhood Trauma in Overall Health

Abstract

While adverse childhood experiences and trauma, including childhood abuse and neglect, have often been viewed from the lens of psychiatry, their influence on physical health, health behaviors, and factors that moderate health now garner more attention. This article reviews recent literature that has changed clinical and social viewpoints on child abuse and neglect and can be used as a primer to better understand (1) influences of child abuse and neglect on physical illness; (2) critical diagnostic advances relevant to persons who have experienced child abuse and neglect; and (3) ethical, research, and practical questions generated by these new understandings.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Trauma's Roles in HealthIncreasing attention is being paid to the impact of child abuse and neglect on health. The rapidly growing knowledge base on long-term outcomes of those exposed to child abuse and neglect in the form of both trauma and adverse childhood experiences (ACEs), such as childhood economic hardship, 1 neglect, sexual abuse, emotional abuse, discrimination, racism, household dysfunction, exposure to violence, parental mental illness, and parental substance use has warranted this attention. 2 These types of maltreatment have often been viewed only from the lens of psychiatry, but it is now clear that, beyond their impact on mental health, these experiences affect biological mechanisms that influence physical health, 3,4 health behaviors, and other factors that moderate good health, making it a general concern for all of health care and for those invested in improving health outcomes at large. Given these wide-ranging health impacts, health care systems and individual practitioners must be prepared to evaluate childhood maltreatment-related health concerns. Many clinicians feel unprepared to do this sort of work, and it was likely absent from their training. 5 This article aims to review recent core literature that has broadened medicine's understanding of the forms of child abuse and neglect. It also

Patient Abuse, Neglect, and Exploitation: Why Physicians Need to Be Trauma-Informed

“…This is an important distinction because asking about trauma experiences in patients who have symptoms suggestive of trauma can yield a more accurate diagnosis, thereby avoiding misdiagnoses that can lead to mismanagement of symptoms. 32 , 33 Recognizing trauma symptoms is critical in identifying patients who would benefit from evidence-based, trauma-specific treatments. 34 , 35 …”