Adverse Childhood Experiences in Tromsø 8

Adverse Childhood Experiences Questionaire (ACE-Q) in the Tromsø Study 8th wave

  •  Child abuse, neglect and unusually stressful or traumatic rearing conditions are common pediatric health problems, we argue that these experiences are key determinants of adult health. 
  •  Including  the Adverse Childhood Experiences-Questionnaire (ACE-Q) to Tromsø8, will position us to examine the prevalence of ACE and its consequences for health in adulthood.
  •  Since ACE is planned included in The children of the Tromsø study and FitFuture, we have an unique opportunity to study intergenerational transference of ACE.

Trauma leads to lifelong illness. We know that adults who endorse  higher numbers of adverse experiences were found to have exponentially higher rates of serious physical health outcomes, high-risk health behaviours, and early illness and mortality. Our research group has already investigated potential traumatic events (PTE) in Tromsø municipality. We found that the experience of PTEs was common among the participants in the Tromsø7 study. Overall, 67% of the participants reported at least one such event during their lifetime; and of them, 35.1% reported that at least one PTE happened during their childhood. This project is focus on adverse childhood experiences (ACE) and is guided by developmental psychopathology and attachment theory with an emphasis on risk and resilience: We argue that a more comprehensive understanding of childhood experiences is needed to inform develepement of somatic and mental health issues in adulthood as well as intergenerational transference of ACEs  from parents to their children. 

Childhood trauma leads to offspring with trauma and the same health risks. There is a risk for intergenerational ACEs that often stems from parents' childhood experiences. When occurring at high levels, early adverse experiences can damage later parental attachment, nurturing, and protective behaviors, producing transgenerational cycles of trauma-spectrum neuropsychiatric illness. Thus, children growing up in families with high ACE exposure levels can expect to have much higher rates of psychiatric, addictive and medical diseases that impair parental skills needed for protecting offspring from these same illness-risks. We aim to examine the prevalence of adverse childhood experiences (ACE) in Tromsø muncipality and assess its impact on psychiatric, addictive and medical diseases. We also aim to examine the intergenerational migration of ACE by utilizing coupling to The children of Tromsø study (CoTS) and FitFutures. The main hypothesis of the proposal is that the greater the number of developmental traumas experienced in childhood, the greater the number of illnesses as adults, even after controlling for high-risk health behaviours.

Research strategy/design. ACE-Q a 10-item scale used to correlate childhood maltreatment and adverse rearing contexts with adult health outcomes. ACE-Q is a brief rating scale designed and first published by Felitti in 1998 and has provided substantial epidemiological evidence concerning the link between adverse childhood experiences and adult mental and physical illnesses. ACE is utilized in a broad variety of epidemiological studies of mental health, substance disorders, and medical conditions that high ACE-Q scores are linked with, while highlighting the diverse populations and more specific scientific applications the ACE-Q instrument has been implemented for. The ACE-Q has helped characterize exposure to ACEs as a core public health challenge of remarkable scope in terms of the diversity and severity of adult brain and body diseases that ACEs link with. A current review conclude that ACE-Q shed light on the emerging neuroscience characterizing causal neurodevelopmental interlinkages between ACEs, adult age mental illness, addictions and ultimately, a wide scope of multi-organ diseases. The unique database in the Tromsø study allow us to examine the consequences of ACE across a broad range of Health related factors and diseases. It also allow us track individual trajectories for those who participated in more than one wave. Utilizing ACE-Q in T8 will establish an extraordinary database, not only because it is a representative sample of a Norwegian population but also because of the range of factors that can be included. If ACE-Q is included in T8, it is likely that the Tromsø Study will contribute to the knowledge on why adverse childhood experiences translates into poor adulthood health and higher mortality. Despite growing evidence,  it is needed to inform how does ACE affect mental health trajectories in adulthood. Furthermore, little attention has focused on how parents' own childhood experiences, adverse or positive, may influence the transmission of ACEs across generations. 

Potential for impact. ACE in TS8 can be relevant to cardiovascular disease, stroke, cancer, diabetes, medically unexplained physical symptoms, birth complications, drug/alcohol addiction, health care use, mortality, education level, intergenerational transference of health problems. Persons with high ACE exposure is a vulnerable group, and it would be important contribution from the Tromsø study to contribute to supplementation of knowledge to reduce and if possible to neutralize the adverse effects of ACE late in life. Utilizing ACE-Q in T8, will allow us to consider how ACE can inform future directions and applications needed for advancing behavioral healthcare and research as a core component of public health. The addition of ACE measures in FitFutures and The children of Tromsø Study allow us to examine intergenerational migration of ACE.



Geir F Lorem (Principal investigator)
Jens Thimm (Principal investigator)
Kamilla Rognmo (Principal investigator)
Catharina Elisabeth Arfwedson Wang (Principal investigator)
Kjersti Lillevoll (Principal investigator)