Coyne: Stop using the Adverse Childhood Experiences Checklist to make claims about trauma causing physical and mental health problems

Cheshire

Cheshire

Senior Member (Voting Rights)
by James C Coyne November 15, 2017

Witness claims based on research with the ACE that migraines are caused by sexual abuse and that psychotherapy addressing that abuse should be first line treatment. Or claims that childhood trauma is as strong a risk factor for psychosis and schizophrenia as smoking is for lung cancer [* ] and so psychotherapy is equivalent to medication in its effects. Or claims that myalgic encephalomyelitis, formerly known as chronic fatigue syndrome, is caused by childhood trauma and the psychological treatments can be recommended as the treatment of choice. These claims share a speculative, vague neo-cryptic pseudopsychoanalytic set of assumptions that is seldom articulated or explicitly confronted with evidence. Authors typically leap from claims about childhood trauma causing later problems to non sequitur claims about the efficacy of psychological intervention that are not borne out in actually examining effects observed in randomized controlled trials.
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https://www.coyneoftherealm.com/blo...a-causing-physical-and-mental-health-problems
 
Seems that this blog was prompted by the FINE trial's Richard Bentall's use of it:

*Richard Bentall commonly interprets summed ACE scores in peer reviewed articles [ ] as having a traditional dose-response association with mental health outcomes, and therefore as representing a modifiable causal factor in psychosis. In books and in social media, his claims become simply absurd.
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i would like to know of any believable research in the area by actually-scientifically-oriented researchers. is there any?

does prolonged stress during childhood -- or adulthood -- increase the probability of health issues, and if so, which ones specifically? feel free to define "stress" narrowly. lack of touching, misopathy, scapegoating by family or in school, etc.

i realize there are potential obstacles such as recall bias and so on. i am not referring to psycho-woowoo, or even the least anti-scientific of "behavioral" thinking. i don't buy into a mystical and conflated nosology of non-disease "psyche" "illnesses". i am just wondering if it is possible to make good conclusions, preferably with plausible pathophysiology [cortisol, inflammation, etc.]. what can we say with reasonable confidence, if anything?
 
meandthecat said:
Universities once taught Astrology now they teach Psychology, both seem to have a problem with rigor and the scientific method. Garbage in, garbage out but whole industries exist to polish it up and call it gold
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Is this a free education that is funded by taxpayers?

There are so many problems in this world that need attention. Seems like a waste of an education that could be better spent by getting a degree in something that actually helps people (instead of using it to harm people).

So sad. As you said, GIGO.
 
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ACE is a " buzz" phrase which is filtering into many aspects of health and life. Adverse effects will no doubt affect some people more than others - it will be dependent on individual situations and the support available. There is no doubt that prolonged stress presses epigenetic buttons, and that a body hardwired to fight or flight will have a suppressed immune system which increases the potential for chronic illness- this does not mean it is guaranteed.
 
Amw66 said:
There is no doubt that prolonged stress presses epigenetic buttons, and that a body hardwired to fight or flight will have a suppressed immune system which increases the potential for chronic illness- this does not mean it is guaranteed.
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Some people thrive under stress, some don’t do so well. I don’t agree that prolonged stress will suppress everyones immune system. I don’t agree we are all hard wired for fight or flight. And looking thru epigenetic glasses alone is just one way to interpret health/illness.
 
I would agree that some thrive ( there are those who seem to continually run on adrenaline and love it) and that we are not all wired for fight or flight - but we can become so via prolonged stress - and those epigenetic switches are inheritable ( in rodents anyway)
I do have a friend who does not have CFS/ME, but who has had a lifetime of illnesses, some serious longterm stress experience, is constantly on edge and has recently found COMT gene expression which accounts for a great deal for her.
 
I just checked Coyne's twitter feed, and it seems he is getting criticism for this bit on twitter.

Item 3: There is so much ambiguity in endorsments of (ostensible) sexual abuse.Maybe it was a positive, liberating experience.
This is a crucial item and discussions of the ACE often assume that it is endorsed and represents a traumatic experience:

Did an adult or person at least 5 years older than you ever…

Touch or fondle you or have you touch their body in a sexual way?

or

Try to or actually have oral, anal, or vaginal sex with you?
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Note that this is a complex item for which endorsement could be on the basis of a single instance of an adult or person at least 5 years older touching or fondling the respondent. What if the “perpetrator” is the 20 year old boyfriend or girlfriend of a 14 year old?

Are we willing to treat as equivalent “Touch or fondle you” and “having anal sex” in all instances?

Arguably, the event which construed as trauma could actually be quite positive, as in the respondent forming a secure attachment with a somewhat older, but nonetheless appropriate partner. All that is unconventional is not traumatic. What if the respondent and “perpetrator” were in a deeply intimate relationship or already married?

The research that attempts to link endorsement of such an item to lasting mental and physical health problems is remarkably contradictory and inconsistent
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I've always been a bit puritanical on age differences and teenage sex, 18/16 seemed a creepy gap to me, but this does seem like a needless mess in a blog about the ACE. I wouldn't move from talk of a 'positive, liberating experience' to talking about a twenty year old having sexual contact with a fourteen year-old. The questionnaire is about experiences under 18, so the point could have been made with a 17/22 divide. I'm not saying everyone who had sexual contact with an older person when they were a teen was necessarily harmed by it, but the idea of a twenty-year old sexually 'liberating' a fourteen year old isn't that appealing.
 
Here in the US we still have States that don’t require a minimum age for marriage. A friend of mine got married at 16, but had to travel out of state where it was legal. Her husband was more than 6 years her senior. So in her case, she was not sexually traumatized. They remained married for 34 years.

I think Coyne had the right concept about the flaws of ACE, but choose a very poor example. Maybe he could consider hiring a proof reader to catch his occasional faux pas?
 
Samuel said:
i would like to know of any believable research in the area by actually-scientifically-oriented researchers. is there any?

does prolonged stress during childhood -- or adulthood -- increase the probability of health issues, and if so, which ones specifically? feel free to define "stress" narrowly. lack of touching, misopathy, scapegoating by family or in school, etc.

i realize there are potential obstacles such as recall bias and so on. i am not referring to psycho-woowoo, or even the least anti-scientific of "behavioral" thinking. i don't buy into a mystical and conflated nosology of non-disease "psyche" "illnesses". i am just wondering if it is possible to make good conclusions, preferably with plausible pathophysiology [cortisol, inflammation, etc.]. what can we say with reasonable confidence, if anything?
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I think some of the idea behind the longitudinal studies where they follow families and their health for decades gives a better picture because its not retrospective and biased by looking for bad events when people are ill.

But it is very hard to get over the huge number of potential factors and the lack of ways to control for them. Especially the ones that haven't been thought of.
 
IMO it’s a combo of genetics and the environment. I don’t subscribe to the “childhood/teen abuse” psychological theory. In their skewed line of logic, then their would be a different impact, for a risk factor of getting a chronic disease if the victim was 18 vs 20.... and if the abuser was 5 years older vs 4 years older. It’s all just such utter nonsense.

IMO, I think we may be genetically vulnerable to getting ME, but multiple factors need to be triggering it. I feel it needs to be a perfect storm scenario.

But back to Coyne, hope this is a wake up call for him to rethink his social media presence, and how to best communicate his theories.
 
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BurnA said:
Coyne is really getting hit hard over this on twitter:
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This is what Elon Musk learned about social media; he has 15M Twitter followers. (Maybe Coyne could take note that after mistakes are made, lessons can be learned).

"I find one learns lessons in the course of life," he begins with a wry half-smile. "And one lesson I've learned is, don't tweet on Ambien. That's on the record: Tweeting on Ambien is unwise. You may regret it."

http://www.rollingstone.com/culture...ans-for-outer-space-cars-finding-love-w511747
 
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