Children and Stress
The new science on chronically harsh and conflict-ridden households.
Posted Wednesday, Aug. 11, 2010, at 10:06 AM
You work and work to provide for your kids, and that puts you under a lot of stress. Job insecurity, maybe some mortgage problems, and other common afflictions of the times only increase the pressure. You find yourself taking it out on your family—the kids, your spouse, the cat, any unfortunate who gets in your way. When you're home and not obsessively checking your e-mail, you lose your temper, you snap and yell and brood, you run alternately too hot (angry and aggressive, spoiling for a fight) and too cold (withdrawn and distant, a forbidding stone-face). You'll admit that you're hard to be around, but look, life is tough and you're knocking yourself out without much in the way of thanks or respite to make enough money to feed and house the kids, and that's what matters most, right?
Well, yes and no. Providing for children's basic material needs is essential—it would be silly to argue otherwise. But a chronically harsh, conflict-ridden, chaotic household environment can do psychological damage and related physical damage that undercuts the good effects of whatever you're doing to provide for children's basic needs. What researchers are finding out about the effect of early stress on children's long-term health may well cause you to rethink your priorities. So far, the developing body of research in this area tells us at least this much:
Before we discuss the research and its implications, we want to underscore a couple of points. First, don't misread what follows as an incitement to panic because you argue with your spouse or yell at your kids now and then. Most people with spouses or kids do that. We're talking about sustained, ongoing stress, not the usual ups and downs of family life. Second, what follows is not an attack on strict parenting. From the point of view of the science, a lot of order or not so much order can both be OK or not OK, depending on what else is going on in a household.
Psychologists have known for decades that children exposed to harsh environments are at increased risk for all sorts of negative psychological consequences. The social, emotional, behavioral, and cognitive damage piles up over the short and long terms. Children who are abused are more likely to have higher rates of alcohol and drug abuse, anxiety, depression, stress disorder, eating and sleep disorders, hyperactivity, impairments in thinking, suicidal behavior and self-harm, poor relationships with others, and low self-esteem. They are more likely to do poorly in school, be kept behind in grade level, and go less far in their education.
We also know that not everybody who was abused will show the same outcomes. Subtle variations in genes, for instance, help regulate chemical reactions in the body—the activity of hormones and neurotransmitters—when it responds to stressful events like abuse. A particular set of stressors may overactivate one child's system, leading to depression, but affect another child to a much lesser degree.
We've also learned more in recent years about how harsh environments in childhood can increase the risk for physical illness and early death. This isn't limited to the immediate physical effects of abuse: the brain and abdominal injuries, bruises and welts, burns and scalds, fractures, lacerations. Set those aside for the moment, although we realize that's a lot to set aside: The widespread tendency around the world to ignore, cover up, or misidentify the causes of children's deaths makes it hard to arrive at defensible numbers, but a World Health Organization study of violence estimated that approximately 57,000 children in the world per year suffer fatal abuse , with the greatest risk for children who are 4 or younger.
When the vast majority of abused children who survive the immediate abuse grow up, they are at increased risk for cancer, chronic lung disease, heart and liver disease, reproductive health problems, sexual dysfunction, and sexually transmitted diseases. Among the many studies in support of this conclusion is the Adverse Childhood Experience Study, an ongoing project that has examined the medical histories of approximately 17,000 adults to determine that those who had been exposed to neglect, abuse, or family violence as children were 1½ to 2 times more likely to die prematurely, have heart disease, or suffer autoimmune disorders.
It's important, however, not to confine this discussion to situations that answer to the legal definition of child abuse. We need that legal definition so we can track patterns and so government can decide when to intervene in family life, but psychologists are coming to see a great deal of harm resulting from mistreatment of children that does not rise to the extreme levels that qualify legally as abuse. Harsh and chaotic early environments that are not labeled as physically abusive do increase the risk of adverse psychological consequences.
Here's where the science is producing fresh news. Recent work in this area points to three main conclusions.
First, less-extreme harsh environments still lead to physical health problems. Children don't have to be abused in a strict legal sense to suffer lasting harm.
Alan E. Kazdin, who was president of the American Psychological Association in 2008, is John M. Musser professor of psychology and child psychiatry at Yale University and director of Yale's Parenting Center and Child Conduct Clinic.
Carlo Rotella is director of American studies at Boston College.
Illustration by Alex Eben Meyer.