Practitioner Review: Twenty years of research with adverse childhood experience scores – Advantages, disadvantages and applications to practice

Journal of Child Psychology and Psychiatry, Journal Year: 2019, Volume and Issue: 61(2), P. 116 - 130

Published: Oct. 14, 2019

Adverse childhood experience (ACE) scores have become a common approach for considering adversities and are highly influential in public policy clinical practice. Their use is also controversial. Other ways of measuring adversity - examining single adversities, or using theoretically empirically driven methods might advantages over ACE scores.In this narrative review we critique the conceptualisation measurement ACEs research, practice, health discourse.The score has limitations simplicity: its simplicity facilitates wide-ranging applications policy, settings but risks over-simplistic communication risk/causality, determinism stigma. The other focussing on limited because tend to co-occur. Researchers rapidly accruing datasets facilitate new theoretical empirical approaches work at an early stage, e.g. weighting including severity, frequency, duration timing. More research needed establish what should be included as ACE, how individual weighted, cluster, implications these findings policy. New conceptualising that incorporate knowledge, while maintaining some current questionnaire, could helpful clinicians, practitioners, patients public.Although welcome focus ACEs, more critical view their conceptualisation, measurement, application practice urgently needed.

Language: Английский

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The Value of Dimensional Models of Early Experience: Thinking Clearly About Concepts and Categories

Perspectives on Psychological Science, Journal Year: 2021, Volume and Issue: 16(6), P. 1463 - 1472

Published: Sept. 7, 2021

We review the three prevailing approaches—specificity, cumulative risk, and dimensional models—to conceptualizing developmental consequences of early-life adversity address fundamental problems with characterization these frameworks in a recent Perspectives on Psychological Science piece by Smith Pollak. respond to concerns raised Pollak about models early experience highlight value for studying adversity. Basic dimensions proposed existing include threat/harshness, deprivation, unpredictability. These identify core that cut across categorical exposures have been focus specificity risk approaches (e.g., abuse, institutional rearing, chronic poverty); delineate aspects are likely influence brain behavioral development; afford hypotheses adaptive maladaptive responses different adversity; articulate specific mechanisms through which exert their influences, experience-driven plasticity within an evolutionary-developmental framework. In doing so, advance falsifiable hypotheses, grounded neurodevelopmental evolutionary principles, supported accumulating evidence provide fertile ground empirical studies

Language: Английский

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Why and how does early adversity influence development? Toward an integrated model of dimensions of environmental experience

Development and Psychopathology, Journal Year: 2022, Volume and Issue: 34(2), P. 447 - 471

Published: March 14, 2022

Abstract Two extant frameworks – the harshness-unpredictability model and threat-deprivation attempt to explain which dimensions of adversity have distinct influences on development. These models address, respectively, why, based a history natural selection, development operates way it does across range environmental contexts, how neural mechanisms that underlie plasticity learning in response experiences influence brain Building these frameworks, we advance an integrated experience, focusing threat-based forms harshness, deprivation-based unpredictability. This makes clear why are inextricable and, together, essential understanding environment matter. Core integrative concepts include directedness learning, multiple levels developmental adaptation environment, tradeoffs between adaptive maladaptive responses adversity. The proposes proximal distal cues as well unpredictability those cues, calibrate both immediate rearing environments broader ecological current future. We highlight actionable directions for research needed investigate experience.

Language: Английский

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Early life stress and brain function: Activity and connectivity associated with processing emotion and reward

NeuroImage, Journal Year: 2019, Volume and Issue: 209, P. 116493 - 116493

Published: Dec. 27, 2019

Investigating the developmental sequelae of early life stress has provided researchers opportunity to examine adaptive responses extreme environments. A large body work established mechanisms by which stressful experiences childhood poverty, maltreatment, and institutional care can impact brain distributed systems body. These are reviewed briefly lay foundation upon current neuroimaging literature been built. More recently, cognitive neuroscientists have identified a number effects adversity, including differential behavior function. Among most consistent these findings differences in processing emotion reward-related information. The neural correlates processing, particularly frontolimbic functional connectivity, well studied samples with results indicating accelerated maturation following adversity. Reward received less attention, but here evidence suggests deficit reward sensitivity. It is as yet unknown whether emotion-regulation circuits comes at cost delayed development other systems, notably system. This review addresses that investigated identifying important next steps study function

Language: Английский

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Differential Associations of Deprivation and Threat With Cognitive Control and Fear Conditioning in Early Childhood

Frontiers in Behavioral Neuroscience, Journal Year: 2019, Volume and Issue: 13

Published: May 8, 2019

Early-life adversity (ELA) is strongly associated with risk for psychopathology. Within adversity, deprivation and threat may lead to psychopathology through different intermediary pathways. Specifically, deprivation, defined as the absence of expected cognitive social inputs, lower performance on complex tasks whereas threatening experiences, presence experiences that reflect harm child, are atypical fear learning emotional processes. However, distinct associations behavioral outcomes have not been examined in early childhood. The present study examines how Children 4-7 years old (N=63) completed assessing control conditioning; were assessed using child interview parent questionnaires. Regression analyses performed including scores controls age, gender IQ. Because this first time these variables childhood, interactions age also examined. Deprivation, but was worse task. Threat, interacted predict learning. Young children who experienced high levels showed evidence measured by differential skin conductance response even at earliest measured. In contrast, exposed threat, emerged only older ages. higher blunted reactivity amplitude reinforced stimuli regardless age. Results suggest influences Future work should examine neural mechanisms underlying changes link increased negative exposure, such

Language: Английский

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Adverse Childhood Experiences and Executive Function Difficulties in Children: A Systematic Review

Child Abuse & Neglect, Journal Year: 2020, Volume and Issue: 106, P. 104485 - 104485

Published: May 8, 2020

Language: Английский

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Association of Childhood Adversity With Morbidity and Mortality in US Adults

JAMA Pediatrics, Journal Year: 2021, Volume and Issue: 175(12), P. 1269 - 1269

Published: Oct. 5, 2021

Childhood adversity (CA) is a powerful determinant of long-term physical and mental health that associated with elevated risk for chronic disease psychopathology. However, the degree to which CA contributes mortality as preventable driver ill-health death unknown.To estimate contribution behaviors, including smoking sedentary behavior, well annual attributable in US through influences on leading causes (eg, cardiovascular disease).For this systematic review, PsycINFO MEDLINE databases were searched November 15, 2019. The publications from inception (1806 PsycINFO, 1946 MEDLINE) Meta-analyses associations between morbidity outcomes included. population fraction (PAF) was calculated these along estimated prevalence CA. PAF then applied number deaths each cause are Additionally, incidence behaviors derive cases Exposure 1 or more experiences before age 18 years analyzed, abuse, neglect, family violence, economic adversity.A total 19 meta-analyses 20 654 832 participants reviewed. accounted approximately 439 072 annually US, 15% 2019 (2 854 838 deaths), (including heart disease, cancer, suicide). In addition, millions unhealthy markers, than 22 million sexually transmitted infections, 21 illicit drug use, inflammation, 10 inactivity. greatest proportion suicide attempts up 38% 33%, respectively.The results review suggest contributor may be considered mortality. prevention intervention pathways link should critical public priority.

Language: Английский

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The effects of early life adversity on children’s mental health and cognitive functioning

Translational Psychiatry, Journal Year: 2022, Volume and Issue: 12(1)

Published: June 10, 2022

Emerging evidence suggests that partially distinct mechanisms may underlie the association between different dimensions of early life adversity (ELA) and psychopathology in children adolescents. While there is minimal types ELA are associated with specific outcomes, unique cognitive socioemotional consequences increase transdiagnostic risk mental health problems across internalizing externalizing spectra. The current review provides an overview recent findings examining (e.g., language, executive function), attention bias, emotion regulation), correlates along threat/harshness, deprivation, unpredictability. We underscore similarities differences connecting to particular identify gaps future directions help clarify inconsistencies literature. This focuses on childhood adolescence, periods exquisite neurobiological change sensitivity environment. utility dimensional models better understanding mechanistic pathways towards expression discussed, supporting value such developmental sequelae ELA. Integration existing focused psychiatric classification biobehavioral advance our etiology, phenomenology, treatment difficulties youth.

Language: Английский

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Poverty and self-regulation: Connecting psychosocial processes, neurobiology, and the risk for psychopathology

Comprehensive Psychiatry, Journal Year: 2018, Volume and Issue: 90, P. 52 - 64

Published: Dec. 21, 2018

In the United States, over 40% of youth under age 18 live at or near federal poverty line. Several decades research have established clear links between exposure to child and development psychopathology, yet mechanisms that convey this risk remain unclear. We review in developmental science other allied disciplines identify self-regulation as a critical factor may influence psychopathology after poverty. then connect work with neurobiological an effort further inform these associations. propose starting framework focused on neural correlates self-regulation, discuss recent relating alterations brain regions related self-regulation. close by highlighting important considerations for future poverty/socioeconomic status, neurobiology, risks negative mental health outcomes.

Language: Английский

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Influences of early‐life stress on frontolimbic circuitry: Harnessing a dimensional approach to elucidate the effects of heterogeneity in stress exposure

Developmental Psychobiology, Journal Year: 2020, Volume and Issue: 63(2), P. 153 - 172

Published: March 29, 2020

Abstract Early‐life stress confers profound and lasting risk for developing cognitive, social, emotional, physical health problems. The effects of on the brain contribute to this risk, with frontolimbic circuitry particularly susceptible early experiences, possibly due its innervation glucocorticoid receptors timing circuit maturation. To date, majority studies have employed a categorical approach, comparing stress‐exposed versus non‐stress‐exposed youth. However, there is vast heterogeneity in nature exposure outcomes. Recent forays into understanding psychobiological dimensional approach focused experiential, environmental, temporal factors that influence association between subsequent vulnerability. This review highlights empirical findings inform circuitry. We identify timing, type, severity, controllability, predictability stress, degree which caregiver involved, as specific features may play substantial role differential propose framework these development partially determine how influences and, ultimately, mental health.

Language: Английский

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