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Book and Media Reviews
August 3, 2011

The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic

Author Affiliations
Author Affiliation: Schools of Medicine and Public Health, University of Illinois at Chicago (carlcbell@pol.net).
JAMA. 2011;306(5):555-556. doi:10.1001/jama.2011.1078

This important book highlights the association between early-life trauma and subsequent physical and mental illness and as such presents a key to the world's optimal public health.

Part 1 does an excellent job of reviewing the history of how human nature includes a strong desire to ignore the public health problem of childhood trauma, which was first publicly identified in the late 1800s. These conversations were destined to be derailed by psychoanalysis' notion of fantasy (remarkably prescient of the current debate surrounding recovered memories and false memories, also discussed in the text). Fortunately, the issue of child abuse and neglect resurfaced in the early 1960s; even then, however, the issue of childhood sexual abuse was underplayed until the late 1980s. The prevalence of early childhood trauma, based on the National Comorbidity Study—Replication, shows that nearly 40% of adults in the general population report having at least 1 event by age 13 years, with 20% of men and 25% of women reporting having directly experienced or witnessed violence. Propitiously, in addition to these risk factors, there is a brief mention of psychosocial protective factors. Part 1 also accentuates several longitudinal studies of clinical observations strengthening the epidemiologic research on later outcomes of early trauma.