Adverse Childhood Experiences (ACEs) in 252 Board-Certified Plastic Surgeons: Prevalences, ACE Clustering, and Effects on Adult Health and Behaviors, Including Self-Defined Depression, Work Addiction, and Burnout

Background: The CDC/Kaiser Adverse Childhood Experiences (ACE) study documented that ACEs predict adult health and self-harming behaviors. ACEs have been documented in physicians and are higher in physicians treated for problematic behavior. Plastic surgeons have never been assayed.

Objectives: Might ACE prevalences in plastic surgeons predict their adult health and/or behavior?

Methods: A total of 252 ABPS-certified plastic surgeons (72% men, 28% women) completed the 10-question CDC/Kaiser ACE survey by deidentified email. Data were collected on adult health and behaviors previously associated with ACEs in the literature.

Results: In total 42% of plastic surgeons had 1 or more ACEs; 9.9% had 4 or more. Emotional abuse was 2 times higher than the control CDC/Kaiser population, although other ACEs were lower. Gender differences existed: female surgeons suffered more sexual abuse (17% vs 8%), physical neglect (7% vs 1%), violence against their mothers (7% vs 2%), and self-defined burnout (32% vs 17%). ACEs occurred in clusters. Total ACEs predicted autoimmune disorders, chronic pain/fatigue, self-defined depression, irritable bowel, antidepressant/anxiolytic use, alcohol abuse, >3 marriages, >10 sexual partners, sex and work addiction, eating disorders, and self-defined burnout (all P < .020). Emotional abuse predicted alcohol abuse. Sexual abuse predicted sex addiction. Emotional neglect predicted autoimmune disease, antidepressant/anxiolytic use, eating disorder, and work addiction. Physical neglect predicted chronic fatigue/chronic pain, depression, and burnout (all P < .001 or less).

Conclusions: Adverse childhood experiences occurred in 42% of our 252-member plastic surgeon cohort and predicted 13 adult illnesses and self-harming behaviors that can impair surgeons’ lives and performances. This may facilitate their recognition and treatment.