Can Family Secrets Make You Sick?

I work in a US urban charter school that's in danger of losing its charter because it fails financially and academically.

75% of its students are growing up without regular contact with their fathers, 25% without their mothers, and more than 10% are designated homeless (this means they've moved more than 4 times in a year; the state defines this designation).

The teachers are close with the students; we hear stories that tell us who has a really hard childhood. I can emphatically tell you that the harder the student's life is, the more misbehavior they exhibit and the more unhealthy they appear. By "appear" I mean weight, smell, visible grime, cuts and burns, these sorts of things.

Here is a list of signs of child abuse:

http://www.safehorizon.org/page/10-signs-of-child-abuse-58.h...

Here are signs you might not see as abuse when you come across them: thumb-sucking, fear of going home, body odor.

Each of those is easy to criticize or fix: "Get that thumb out of your mouth." "What do you mean you don't want to go home and watch [TV show they've mentioned]?" "[behind their backs] so-and-so stinks."

(put a ":)" after each of those criticisms to see how they could be jokes or a caring statements, depending on tone. Still, they don't go far enough in addressing the underlying problem)

Those criticisms identify the wrong signifier for their sign. The signifier is not sheer childishness (in the case of thumbsucking), but a coping mechanism for abuse.

> "An association doesn't necessarily mean that one thing causes the other thing," says Floud.

Does anyone else get tired of seeing this all the time? It feels like the standard, pat response nowadays of a smart person to basically any association whatever. Of course ice cream sales in the summer don't cause murders, but in turn, I seriously doubt anyone is saying that sexual assault somehow physiologically deforms breast tissue directly leading to carcinoma.

Look, I know very little about medicine, I don't even know that much about statistics. But wouldn't the idea be more like these traumas could stress the body in some way that makes some of its subsystems perform in a degraded manner, which over time develops into illness? As I say, I'm out of my depth here. But that sort of response is starting to strike me as irksomely glib.

A lot of the data in the ACE study is actually pretty dodgy -- what people are comfortable admitting to changes over time, and also people forget things as they get older. So comparing responses from a 70-year-old to responses from a 30-year-old about things that happened in their childhood is kind of apples and oranges. I still think it's an important study and worth talking about, but I'm not sure I really believe that, say, people are 5x more likely to commit suicide or 4.5x more likely to get an STD than they were 20 years earlier.

> Cancer, addiction, diabetes and stroke (just to name a few) occurred more often among people with high ACE scores.

Pretty major known confounding here. Family-based, adoption, twin, GCTA or GWAS studies usually find low effects from shared environment but high heritability or specific hits, especially for addiction & diabetes (stroke and cancer are less well known but still plenty of GWAS hits for those too). And this is true of various aspects of bad parenting like physical abuse as well.

> She thinks doctors and patients should take care not to overinterpret an ACE score — it's not a crystal ball that predicts health or illness.

It's also a hell of a lot more depressing if true. We can fix biological issues a hell of a lot more easily than we can convince people to not be so shitty to each other.

Smartphone with no plan for when you have Wi-Fi, prepaid phone for when you don't.

That's how we do it. Best of both worlds.

Notice how the lone medical expert represented was skeptical of the findings.

That's because among serious psychologists and those who study genetics, the view advocated here is pretty much exactly wrong: your childhood experiences have almost no effect on the adult you become.

The public and the media tend to believe otherwise, and regularly put out stories like this one, perpetuating the myth. But it's just not true.

We've known for years that the genes you inherit from your parents are far more important than whatever parenting they do. Adopted siblings raised in the same household grow up to be no more similar than strangers plucked off the street. And identical twins raised apart grow up to be ridiculously similar -- almost creepily so -- despite having no shared environment. When you run the correlations, genes turn up as a large factor in every single measurable outcome (education level, income, IQ, height, weight, personality, choice of college major, and so on), whereas shared environment -- where you grew up, how your parents raised you, your socioeconomic status -- begins as a moderate impact while you are a child and then slowly disappears in your teens, until at age 25, your IQ and personality have basically nothing to do with whether your parents read to you at night or spanked you or talked to you or ignored you completely, or what siblings you grew up with, or what house you grew up in, or what town you grew up in.

(Coincidentally, ACE is a relevant acronym here, but it stands for something different than from what it does in the article. Additive genetics, Common environment, and unique Environment are the components of the outcome of twin studies. Common environment is the factor of your parents and household, and unique environment is every other environmental factor. http://en.wikipedia.org/wiki/Twin_study#Methods)

Now, there is a small caveat to the above. If you were severely abused as child that can impact you later, but it truly has to be severe abuse. To lower a child's IQ, you'd have to really starve them or deprive them of key nutrients -- but this pretty much never happens in the US. A diet of only McDonald's is more than sufficient to prevent this kind of stunting. Likewise, the sexual or physical abuse would have to be pretty extreme to impact you later -- much more than this story let on.

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So, the real story behind this NPR piece is that people with bad parents often grow up to have problems not because of bad parenting, but because their bad parents happened to pass them bad genes. In other words, the common cause was that both the child and the parents had bad genes. You should never trust a study about parenting or the effects of the environment if it doesn't take genes into account.

And this is where people get uncomfortable, because no one wants to believe that something you're born with, something you cannot change, is so important to who you are. The "truth" about the effects of genes and your environment does not fit in well with mainstream ideals of equality of opportunity and free will. Thus, the impact of genes are routinely downplayed everywhere you look, and environmental effects are raised up, like in this piece. There is broad, systemic bias at work, making the world out to be the way we want it, rather than the way it really is.

But we do ourselves a profound disservice in this (often unintentional) act of twisting the truth to fit our ideals. It causes grief when we blame fat people for being lazy or lacking self control, when in reality their obesity is largely a product of their genes and the modern phenomenon of cheap and tasty food. We praise smart kids with lucky genes who get A's, while putting down their less bright peers, even if they worked harder, because they only managed to get C's. We love beautiful people, but shun their less appealing peers.

So I ask you: Where is the compassion for those with unlucky genes? Where is the support for those who don't have the talent to live out the American Dream? Why is it that no one knows or cares about genetic luck -- probably the greatest source of inequality and unfairness in our world?

Alternative Hypothesis (and there are many): People of a lower-socioeconomic demographic both have greater chances of a poor upbringing as well as poor health as they get older.

Lot of confounding variables you need to correct for here.

"Well, my God, this is the second incest case I've seen in [then] 23 years of practice"

I don't believe this. Either the doc has deliberately kept his eyes shut or hasn't spent much time talking to patients. Incest, a term wide than but inclusive of most 'child abuse', is far more widespread than laypersons realize. Docs see it regularly and geneticists debate the ethics of tests any test which might reveal family secrets.

http://blogs.nature.com/spoonful/2011/02/qa_the_insidious_an...