Study Finds Childhood Trauma Can Worsen Disease Activity for Adults With Lupus

If you’ve long suspected your traumatic childhood impacted your health later in life, a new study published in the journal Arthritis Care & Research found compelling evidence there’s a connection between experiencing childhood trauma or adversity and lupus.

Systemic lupus erythematosus (SLE) is an autoimmune condition that causes your immune system to attack healthy tissues and organs in your body. Because any organ system can be affected, lupus can cause a wide range of symptoms. Common lupus symptoms include chronic pain, fatigue, a butterfly-shaped facial rash and hair loss.

Lupus is believed to be caused by a combination of genetic and environmental factors, commonly referred to as epigenetics. You inherit a risk of developing the condition from your family but its onset and severity is triggered by an environmental factor. Like other autoimmune conditions such as multiple sclerosis (MS), stress is one such environmental trigger that can lead to the onset of lupus and flares later on. The current research looked at just how much childhood stress may be a factor when you have lupus.

To measure the impact of childhood trauma, researchers used adverse childhood experiences (ACE) scores, a now-standard measure of childhood trauma. ACE scores cover 10 domains, including physical, sexual and emotional abuse, losing a parent (divorce, death or otherwise), food and housing instability, and family members with substance use or mental health issues. The higher your ACE score on a scale of one to 10, the more likely your childhood will impact future health outcomes.

Researchers measured the ACE scores of 269 lupus patients in California compared to more than 6,000 people without lupus. Participants were then asked to rate their own well-being and lupus symptoms, which were compared to reports from their doctors. Participants with and without lupus had similar ACE scores (nearly 66% of participants reported at least one adverse event in childhood).

For those with lupus, a higher ACE score correlated with more lupus flares, damage, depression, and lower physical function and quality of life. Participants with more than four ACEs rated the negative impact of lupus as nearly double compared to participants with an ACE score of zero. The impact was also greater in women, older participants, Latinx or African American people, those without college degrees and patients with lupus nephritis (lupus-related kidney inflammation).

The outcome of this study indicates stress carried into adult life from childhood can worsen lupus. Focusing prevention efforts on reducing early childhood adversity and adding in mental health support later in life may be one way to reduce the severity and impact of lupus.

“Our results support the notion that stress in the form of ACEs may be a factor in poor health in systemic lupus, both in disease development and in more severe outcomes,” the study’s lead author, Kimberly DeQuattro, MD, said in a press release. “These findings are a call to action to focus efforts on ACE prevention in childhood, as well as clinical and mental health interventions that foster resilience in adulthood.”