Ninth International Conference on Health, Wellness & Society

Abstract

Chronic disease is common in adults and has implications for general health, quality of life, and mortality. The literature posits a causal relationship between childhood psychological trauma and both the development and poor outcomes of chronic disease in adulthood. To optimize chronic disease management and work towards prevention, an understanding of the relational mechanisms is key. Two primary pathways of how childhood trauma leads to chronic disease in adulthood have been posited. In the first pathway, adverse childhood experiences lead to coping behaviors such as smoking, alcohol use, poor food choices, and sedentary lifestyle. These behaviours then become the mechanism of biomedical damage and the development of chronic disease. In the second pathway, experiencing trauma activates the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, and the inflammatory response. Having these systems hyper-activated early in life causes permanent changes and primes these systems to over-respond to stressors, leading to chronic disease. While these pathways are helpful, they are incomplete in that they overemphasize Cartesian dualism and the separation of physical, psychological, and social health. Using biopsychosocial and trauma-informed approaches as theoretical foundations, we will present a parsimonious model of the complex relationship between childhood trauma and chronic disease in adulthood. Adoption of this model into practice has implications for people with chronic disease, healthcare providers, and health care systems for managing and preventing chronic disease.