Rejoinder to Kraav, Tolmunen, Kauhanen, and Lehto Letter to the Editor

Abstract

The results of the Kraav et al. study are particularly encouraging in an era when there is so much concern about non-replications in science (Open Science Collaboration, 2015). This replication is even more notable because these new findings represent a complex set of relationships that extend the work of Osborn and Widom (2019) and similarly presents findings that contradict previous research. Replications of findings that challenge existing assumptions are important and warrant serious attention. The authors found that documented records of ACEs were associated with the elevated levels of CRP that remained significant even controlling for smoking, alcohol use, and depression, whereas retrospective self-reports were not. These findings are similar to our study (Osborn & Widom, 2019) despite a number of differences between the two studies. First, Osborn and Widom compared the results of retrospective self-reports of childhood physical and sexual abuse and neglect with child protective agency (official) reports of childhood physical and sexual abuse and neglect for the same time period. Kraav et al. compared nurses' reports at the time and retrospective reports based on different indicators of adverse childhood experiences, that is, they defined ACES as childhood experiences of poverty, paternal alcohol problems, or parental divorce that might be considered more subtle forms of adverse childhood experiences than childhood maltreatment. Second, they examined the consequences in a substantially longer follow-up period of a group of older middle-age men. Third, the participants were from a different country (Finland) and more homogeneous racially so that the sample was all white Caucasian males, whereas the Osborn and Widom study included males, females, Blacks, and Whites. Fourth, although blood was collected in both studies, there were vast differences between the protocols for blood collection. In the Finnish study, blood tests were conducted during baseline investigations (1984-1986) when the participants (mean age 50.9) were requested to fast overnight, abstain from smoking for 12 h, and avoid alcohol use for 3 days before obtaining blood samples. This was not a possibility with the Osborn and Widom study. Because of these differences, the similarity of the findings is even more striking. The documented ACES in the Finnish study were retrieved from school health records from nurses' reports based on the 'health and behavior of pupils, home visits and familiarity with the family backgrounds and home conditions of the pupils'. The authors noted that nurses could have missed milder cases and only recorded a case when an ACE was brought to their attention. Although this is a real possibility, the documentation of the childhood experiences is the critical factor given that it predicts this long-term health consequence. Furthermore, this potential limitation has been expressed in relation to the Osborn and Widom study where child protective agency records may have missed milder cases. But as these findings show, relia...

Letter to the Editor: Response to “Purchasing Under the Influence of Alcohol” and Related Issues in Taiwan

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