Q&A: How Trauma Affects Physical Health

A sad young woman.

Imagine a young person on the street, shaking from fear or hunger. Or one of his classmates lying awake because he's worried about violence in the home. The physical effects of trauma can be seen in almost any survivor, but until recently, they had never been quantified.

Last year, Dr. Stacy Drury of the Tulane University School of Medicine co-authored a study that looked at the length of young people’s telomeres, a sort of “shoelace cap” at the end of every cell that acts as a marker of aging. In Drury’s words, telomeres act as “a kind of a clock that tells your body how old each cell is. And as your cell gets older, the telomere gets shorter, and once it gets to a certain shortness, it tells your cell to 'Stop growing up. It’s..time to stop dividing and die.'"

Youth with a history of violence in the home and other traumatic experiences, Drury and her colleagues found, had shorter telomeres than their peers. In other words, the cells of traumatized youth were older than their years.

[Read the abstract of Drury's article, “The Association of Telomere Length With Family Violence and Disruption,” in our library.]

What does it mean for a young person’s cells to age too soon? We spoke with Dr. Drury to learn more.

NCFY: How does this study challenge the way we look at the effects of trauma?

Dr. Drury: As child psychiatrists, trauma—both inside and outside the family—is something we’ve [considered] very important in terms of mental health. But being able to track these biological changes in kids has huge implications and really establishes this link between trauma and regular physical health. [There are] biological impacts happening much sooner than anyone thinks and therefore the interventions and prevention efforts need to start much sooner than anyone would think.

Potentially, these untreated effects and the mental illness associated with them can make people more likely to have depression or anxiety, but [they also] really influence cardiovascular health, obesity, their chance of diabetes, and many other health risks. It isn’t that they’ll maybe have health problems when they grow up. It’s that they’re growing up with a negative health trajectory that has lifelong implications.

[Learn how physical health can improve well-being.]

NCFY: Who is most at risk for these adverse effects?

Dr. Drury: What we saw that was most concerning was that it wasn’t just one risk factor. It was the combined impact of seeing a family member get hurt, having a family member commit suicide, and witnessing community violence. Those were all independent predictors [of telomere-shortening trauma], but the biggest risk is when you have more than one.

[Read more about trauma-informed care.]

NCFY: How can these findings inform the way we treat and assist youth?

Dr. Drury: This paper says that the family structure is important. If you’re thinking about a child getting help, it’s not just about getting them treatment, but also focusing on creating a safer and more protective environment in the home. If you just give a child therapy, that may not [provide] enough biological protection. You really have to think about building safety within the family.

This is also something that pediatricians need to pay attention to. If a child is obese, trauma isn’t just causing mental health problems. It’s related to physical health problems. That’s something that entire systems of care need to pay more attention to. Getting children back on playgrounds, getting them into safe community centers, getting them to exercise and work on healthy diets. For high-risk kids with a lot of trauma and family violence, these kinds of interventions may have a much broader impact than many people think. 

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