Study: People With Neurological Conditions Often Experienced Childhood Trauma

A young child in shadow sitting alone in a hallway.


Key Takeaways

  • New research has shown that adults with neurological conditions are more likely to have a history of childhood trauma, suggesting that there's a link between "toxic stress" and physical and mental health later in life.
  • Childhood stress and trauma are often referred to as adverse childhood experiences (ACEs), which can include things like poverty, violence, having an incarcerated parent, or having a caregiver die by suicide.
  • Mental health resources, prevention, and awareness can give children with high ACE scores the tools to help prevent some of the negative effects of trauma.

A recent study from the American Academy of Neurology (AAN) found that many patients being treated for neurological conditions had a history of adverse childhood experiences (ACEs).

The results of the research, which were published in AAN’s journal Neurology: Clinical Practice, provide more evidence on how stress and traumatic events endured in childhood can have a lasting effect on physical and mental wellbeing.

What Are ACEs?

Adverse childhood experiences (ACEs) include things like poverty, experiencing violence, having an incarcerated parent, or having a caregiver die by suicide.

The Study

The researchers gave 198 outpatient adults being seen for neurological symptoms at the University of Pennsylvania the ACE questionnaire as well as screenings for anxiety and depression.

When they looked at the results of the questionnaire and screenings, the researchers found that 23.7% of the patients had high ACE scores—much higher than those of the general population (12.6%).

The high-scoring patients were being treated for neurological conditions such as stroke, headaches, and epilepsy. The researchers also noted that these patients had higher:

  • Rates of emergency room visits and hospitalizations
  • Rates of co-existing medical and/or psychiatric risk factors
  • Anxiety and depression scores

Adys Mendizabal, MD, a neurologist with the University of California Los Angeles and an author of the study, tells Verywell that researchers are becoming more aware of how ACEs affect health.

Mendizabal was prompted to undertake the study because they had observed that a lot of patients who were getting a neurological consultation had a history of trauma. Having "noticed a bit of an association," Mendizabal says that they "wanted to look into it.”

ACEs and Long-Term Health

Research has shown that the environment that a child grows up in influences their development into an adult.

For example, in the mid-1990s, Kaiser Permanente conducted a trail-blazing study that showed abuse and dysfunction in a child's home was linked to risk factors for several leading causes of death in adults.

The researchers developed a questionnaire that asked adults about specific adverse events or experiences that they had endured as children, including:

  • Psychological, physical, or sexual abuse
  • Violence against mother
  • Household substance abuse, mental illness, suicide attempts
  • Incarcerated family members 

The participants that had experienced four or more adverse events in childhood had a higher risk of developing lifestyle factors and habits as adults that contributed to poor health outcomes, such as:

  • Alcoholism/Smoking
  • Drug abuse
  • Suicide attempts
  • Depression
  • Obesity
  • Sexually transmitted diseases
  • Physical inactivity

Toxic Stress

Children who experience one or two of these adverse events for a short time usually recover and grow up without experiencing lasting harmful effects. However, children who live in dysfunctional households for long periods—especially during the early years of development—experience "toxic stress."

Ryan Matlow, PhD

The burden of chronic stress and complex trauma in childhood has a large impact emotionally, psychologically, and affects their behavior.

— Ryan Matlow, PhD

Long-term exposure to high "doses" of stress (chronic toxic stress) triggers the body to produce high levels of the stress hormone cortisol.

When a person has elevated cortisol levels for a long time, it can contribute to health conditions such as:

  • Diabetes
  • Chronic obstructive pulmonary disease (COPD)
  • Cardiovascular disease
  • Stroke
  • Cancer
  • Post-traumatic stress disorder (PTSD)

Brain Changes

Research has also shown that exposure to high levels of cortisol over long periods can also change a child's brain chemistry. These changes can contribute to learning delays, behavioral difficulties, and mood disorders, which can place kids at risk for academic and social challenges during their school years.

A 2009 study published in the American Journal of Preventive Medicine found that adults with an ACE score of six or more died an average of 20 years earlier than people who did not have a history of ACEs.

“The trends are true,” Ryan Matlow, PhD, child clinical psychologist, Stanford School of Medicine, tells Verywell. “The burden of chronic stress and complex trauma in childhood has a large impact emotionally, psychologically, and affects their behavior.” 

Identifying ACEs Early

As the medical community becomes more aware of how trauma can shape a child’s future physical and mental wellbeing, experts are developing processes to identify and support children with high ACE scores before the negative health consequences can develop. 

For example, many doctor's offices are starting to screen patients using the ACE Quiz assessment, which can help them identify children at high risk and provide early interventions and resources.

According to the Center for Disease Control and Prevention (CDC), highly effective interventions and prevention tools include:

  • Strengthening a family's financial security
  • Resources on giving young kids a good start with school
  • Connecting children with caring adults and activities
  • Therapy and mental health support
  • Supporting and educating parents on positive parenting tactics

Normalizing Mental Health

In the last couple of years—and especially after a year of lockdown during the COVID-19 pandemic—Americans have experienced an attitude shift toward mental health awareness and the negative downstream effects that it can cause if left untreated.

Ryan Matlow, PhD

Establishing safety, encouraging storytelling, and creating an exposure narrative are the core components of supporting children with childhood trauma.

— Ryan Matlow, PhD

Mental health is now being recognized as a public health emergency, and governments and organizations are prioritizing initiatives in policy creation and making resources accessible to everyone.

Normalizing mental health can also help prevent the negative outcomes of childhood trauma and children with high ACE scores.

“An impactful intervention for children with a history of complex trauma would be to normalize the negative emotions we feel as natural,” says Matlow. “And combine this with the psycho/educational piece and skill-building to support them.”

In 2019, the American Psychological Association (APA) reported that 87% of Americans believe that having mental health challenges is nothing to be ashamed of.

In a culture that has systematically undervalued and stigmatized the importance of mental health resources and the effects that they can have on our long-term health, we are beginning to see progress.

What Can We Do?

Awareness and prevention are key for helping children and adults who have experienced childhood trauma become more resilient and counteract the risk factors and health conditions that can show up later in life.

Adopting a trauma-informed care mindset is a starting point for getting schools, government systems, healthcare facilities, and organizations to change how they communicate with people who may have a history of childhood trauma.

What Is Trauma-Informed Care?

Trauma-informed care is an approach to talking about trauma. Rather than asking someone, What is wrong with you?” trauma-informed care asks, “What happened to you?"

“It doesn’t take a professional to help a child with the skills and tools to build resilience,” says Matlow. “Establishing safety, encouraging storytelling, and creating an exposure narrative are the core components of supporting children with childhood trauma.”

Taking steps to normalize these conversations—including the realization that negative emotions are part of being human—can help communities shift toward being more mental health-centered. 

We can normalize the mental health conversation in our daily lives by:

  • Digging deeper in our conversations with friends and family
  • Speak openly if we are struggling with negative emotions
  • Politely point out if someone says something about mental health that is stigmatizing or incorrect
  • Become educated on trauma-informed care and how to change our language around mental health

What This Means For You

Experiencing trauma and chronic stress in childhood may contribute to poor physical and mental health in adulthood. However, early identification of adverse childhood experiences (ACEs) and providing children with support can help prevent these negative outcomes.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mendizabal A, Nathan C, Khankhanian P, et al. Adverse childhood experiences in patients with neurologic disease. Neurology: Clinical Practice. doi:10.1212/CPJ.0000000000001134

  2. Centers for Disease Control and Prevention. ACEs: Risk and Protective Factors.

  3. Felitti V, Anda R, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine. doi:10.1016/S0749-3797(98)00017-8

  4. Nationwide Children's Hospital. Toxic stress: How the body's response can harm a child's development.

  5. State of California Department of Healthcare Services. The science of ACEs and Toxic Stress.

  6. Brown D, Anda R, Tiemeier H, et al. Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine. doi:10.1016/j.amepre.2009.06.021

  7. Center for Disease Control and Prevention. Help youth at risk for ACEs.

  8. Radfar A, Ferreira M, Sosa J, et al. Emergent crisis of COVID-19 pandemic: Mental health challenges and opportunities. Frontiers in Psychiatry. doi:10.3389/fpsyt.2021.631008

  9. American Psychological Association. Survey: Americans becoming more open about mental health.

  10. Center for Health Care Strategies, Trauma-Informed Care Implementation Resource Center. What Is Trauma-Informed Care?.

By Amy Isler, RN, MSN, CSN
Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.