Biological embedding of childhood adversity: from physiological mechanisms to clinical implications

• Published in: BMC medicine Vol. 15; no. 1; p. 135
• Main Authors: Berens, Anne E, Jensen, Sarah K G, Nelson, 3rd, Charles A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20-07-2017; BioMed Central; BMC
• Subjects: Adult; Adults; Adverse childhood experiences; Advocacy; Aggression; Animals; Brain development; Caregivers; Child; Child abuse & neglect; Child Abuse - prevention & control; Child Abuse - psychology; Children; Children & youth; Coronary artery disease; Diabetes mellitus; Disease prevention; Disease Susceptibility - psychology; Embedded systems; Embedding; Epidemiology; Epigenetics; Exposure; Gene expression; Health aspects; Health promotion; Health risks; Heart diseases; Humans; Illnesses; Intervention; Mechanics; Mental depression; Mental disorders; Mental health care; Metabolism; Molecular modelling; Neural networks; Pediatrics; Physiology; Primary care; Public health; Researchers; Review; Reviews; Social disparities; Socioeconomic factors; Stress; Violence; Adverse childhood experiences; Health promotion; Primary care; Stress; Brain development; Social disparities
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-017-0895-4

Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses. Additional work has shed light on the potential molecular mechanisms by which early adversity becomes "biologically embedded" in altered physiology across body systems. This review surveys evidence on such mechanisms and calls on researchers, clinicians, policymakers, and other practitioners to act upon evidence.
Childhood psychosocial adversity has wide-ranging effects on neural, endocrine, immune, and metabolic physiology. Molecular mechanisms broadly implicate disruption of central neural networks, neuroendocrine stress dysregulation, and chronic inflammation, among other changes. Physiological disruption predisposes individuals to common diseases across the life course.
Reviewed evidence has important implications for clinical practice, biomedical research, and work across other sectors relevant to public health and child wellbeing. Warranted changes include increased clinical screening for exposures among children and adults, scale-up of effective interventions, policy advocacy, and ongoing research to develop new evidence-based response strategies.