Last week, in the joint annual convention of the Philippine Society of Hypertension and Philippine Lipid Society, I attended an interesting panel discussion on childhood factors that could lead to heart problems in adulthood.
Dr. Bernadette Madrid, head of Child Protection Unit of the Philippine General Hospital, talked about the impact of adverse childhood experiences (ACEs) on both physical and mental health in adulthood.
She cited a landmark paper on this frequently unrecognized problem—the Adverse Childhood Experiences (ACE) Study. It is the largest study done on the social effects of childhood experiences throughout the life span of 17,421 participants.
ACEs are any toxic or traumatic experiences before age 18, which can have a lasting imprint on one’s health. They may include domestic violence; sexual, physical, or verbal abuse; being with someone in the home who is chronically depressed or mentally ill; absence of or physical and emotional neglect by one or both biological parents.
Based on one study cited by Dr. Madrid, around two of three children experience physical violence, six of 10 experience psychological violence, and 17 percent experience sexual violence.
Two out of three also experience bullying of any form or have witnessed psychological violence at home; and four out of 10 suffer cyber violence.
Early pregnancy, suicide
In a local study published in the Child Abuse and Neglect journal in 2010 on the impact of ACEs on health risk behaviors, it was shown that children and adolescents who were sexually abused were 12 times more likely to engage in early sex, nine times more likely to have early pregnancy, and five times more likely to commit suicide.
Furthermore, the study—authored by Dr. Madrid and colleagues, Dr. Laurie Ramiro and Dr. David Brown— showed that children who felt unloved were twice as likely to smoke, use illicit drugs, have early sex and multiple sex partners; and five times more likely to commit suicide. The more the number of ACEs experienced, the higher the risk of suicidal tendencies in adulthood.
Interestingly, ACE also correlated with the risk of developing illnesses in adulthood, including bronchitis or emphysema, heart diseases, cancers, diabetes, and mental health problems.
Brain development
Scientists have established that adverse early experiences could affect the development of the brain structure that shapes the way people learn, think and behave for the rest of their lives.
It is said that ACEs are not like footprints in the sand. They’re more like footprints in cement because they’re long-lasting.
Dr. Madrid clarified that high-risk adolescent and adult behaviors may not be the primary problem, but may likely be their compensatory mechanism, in reaction to their ACEs, which they have never acknowledged to anyone. It’s their coping mechanism to feel safe or just better, explained Dr. Madrid.
She emphasized that the magnitude of the ACE problem is so great that primary prevention is ultimately the only realistic solution.
Every family, particularly the parents, must make an effort to ensure a favorable environment for their children, free of any toxic or traumatic ACE.
This is not to say that children have to be overprotected and shielded from all forms of stressful situations, emphasized the panel of experts composed of Dr. Emma Llanto of the Asian Hospital and Medical Center, and Dr. Queena Lee-Chua, professor at the Ateneo de Manila University and Inquirer columnist.
The experts said that children should be allowed to fail sometimes, and to encounter challenges, but not to the point of traumatizing them emotionally and mentally that could leave indelible scars in their minds.
