Constantian Mark B, Zaborek Nick
Aesthet Surg J. 2025 Feb 18;45(3):321-332. doi: 10.1093/asj/sjae214.
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.
Might ACE prevalences in plastic surgeons predict their adult health and/or behavior?
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.
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).
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.
美国疾病控制与预防中心/凯撒医疗机构不良童年经历（ACE）研究表明，不良童年经历可预测成年后的健康状况和自我伤害行为。不良童年经历在医生群体中已有记录，且在因行为问题接受治疗的医生中更为常见。整形外科医生群体尚未进行过相关评估。
整形外科医生的不良童年经历患病率能否预测其成年后的健康状况和/或行为？
共有252名获得美国整形外科委员会（ABPS）认证的整形外科医生（72%为男性，28%为女性）通过匿名电子邮件完成了包含10个问题的美国疾病控制与预防中心/凯撒医疗机构ACE调查问卷。收集了与文献中先前报道的与不良童年经历相关的成年健康状况和行为数据。
总计42%的整形外科医生有1次或更多不良童年经历；9.9%的医生有4次或更多。情感虐待发生率比美国疾病控制与预防中心/凯撒医疗机构对照组人群高出2倍，不过其他不良童年经历发生率较低。存在性别差异：女外科医生遭受性虐待的比例更高（17%对8%）、身体忽视比例更高（7%对1%）、目睹针对母亲的暴力行为比例更高（7%对2%）以及自我定义的职业倦怠比例更高（32%对17%）。不良童年经历呈聚集发生。不良童年经历总数可预测自身免疫性疾病、慢性疼痛/疲劳、自我定义的抑郁、肠易激综合征、使用抗抑郁药/抗焦虑药、酗酒、3次以上婚姻、10个以上性伴侣、性成瘾和工作成瘾、饮食失调以及自我定义的职业倦怠（所有P < .020）。情感虐待可预测酗酒。性虐待可预测性成瘾。情感忽视可预测自身免疫性疾病、使用抗抑郁药/抗焦虑药、饮食失调和工作成瘾。身体忽视可预测慢性疲劳/慢性疼痛、抑郁和职业倦怠（所有P < .001或更低）。
在我们252名整形外科医生队列中，42%的医生有不良童年经历，这些经历可预测13种成年疾病和自我伤害行为，而这些可能会损害外科医生的生活和工作表现。这可能有助于对其进行识别和治疗。
