A long-term study of 1,420 people finds that childhood trauma is more commonplace than is often assumed, and that its effects upon the transition to adulthood and adult functioning are not only confined to post-traumatic stress symptoms and depression but are more broadly based.

These conclusions were reported November 9, 2018 by a team led by 2009 BBRF Young Investigator William E. Copeland, Ph.D., of the Vermont Center for Children, Youth and Families at the University of Vermont. He and his colleagues are part of The Great Smoky Mountain Study, a study of children in 11 mainly rural counties in North Carolina.

Beginning in 1993 and continuing through 2015, the study annually observed 1,420 children, selected randomly from a group of 12,000 local children, through age 16, and again when they reached ages 19, 21, 25 and 30. Results are based on analysis of over 11,000 individual interviews. The sample was designed to over-represent frequently overlooked rural and Native American communities.

One striking perspective emerging from the study is that “it is a myth to believe that childhood trauma is a rare experience that only affects few,” the researchers say. Rather, their population sample suggests, “it is a normative experience—it affects the majority of children at some point.” A surprising 60 percent of those in the study were exposed to at least one trauma by age 16. Over 30 percent were exposed to multiple traumatic events.

“Trauma” for the purpose of the study included violent events (violent death of a loved one, physical abuse or harm, war or terrorism, captivity); sexual trauma; witnessing a trauma that caused or could have caused death or severe injury; learning about a traumatic event involving a loved one; and other traumas such as diagnosis with a serious illness, serious injury, or fire.

“Our study suggested that childhood trauma casts a long and wide-ranging shadow,” the researchers say, associated with elevated risk for many adult psychiatric disorders affecting many “important domains of functioning,” with impacts in the form of diminished health, financial and academic success, and social life.

The impact of trauma across the lifespan has been noted in many past studies. The newly reported study, appearing on the website of the Journal of the American Medical Association (JAMA), differed because it followed children from year to year. Prior studies relied upon memory-based reports of childhood events made by participants during their adulthood, which tend to be less accurate. The new study also statistically compensated for the presence of other childhood factors that often co-occur with childhood trauma such as poverty and family instability or dysfunction.

The researchers say their results are consistent with an “accumulation” model of trauma that assigns increased lifetime risk of psychosocial impact with each additional traumatic exposure during childhood. While they do not shed light on the question of which children are more likely to experience trauma, the team hopes the results will inform public policy, via “interventions or policies that broadly target this largely preventable cluster of childhood experiences.”

The research team included: E. Jane Costello, Ph.D., 2009 Ruane Prizewinner and 2007 BBRF Distinguished Investigator; and Edwin J.C.G. van den Oord, Ph.D., 2002 BBRF Independent Investigator.