Felitti VJ, Anda RF, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998
“The ACES Study:” Landmark article reignited study of adverse child experiences (ACEs): emotional, physical, or sexual abuse; neglect; domestic violence; household substance abuse, mentally illness or incarceration. Demonstrated high prevalence of ACEs and dose-response relationship to physical &mental illness, early death.
Teicher MH and Samson JA. Enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry, 2016. FREE FULL TEXT ARTICLE
Highlights: Neuroimaging of child brains finds maltreatment changes brain development and structure. Parental verbal abuse, witnessing violence and sexual abuse target brain regions and pathways that process aversive experience. Structural and functional abnormalities attributed to psychiatric illness may be direct consequence of abuse.
Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006 FREE FULL TEXT ARTICLE
Highlights: Overview of science of toxic stress, development of neuroendocrine-immune network, how function is altered by early life adversity, and how thIs increases vulnerability to disease. Describes challenges and opportunities for preventing toxic stress in contemporary pediatric practice.
Danese, A, Moffitt TE, Harrington H et al. Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease: Depression, Inflammation, and Clustering of Metabolic Risk Markers. Arch Pediatr Adolesc Med. 2009. FREE FULL TEXT ARTICLE
Theall KP, Shirtcliff EA, Dismukes AR, et al. Association between neighborhood violence and biological stress in children. JAMA Pediatr. 2017 FREE FULL TEXT ARTICLE.
To study association between neighborhood violence and biological stress, a study of 85 black children was conducted. Increased liquor/convenience stores, domestic violence, and crime were significantly associated with decrease in mean telomere length, and sustained cortisol levels.
Muzik M, et al. Family Social Support Modifies the Relationships Between Childhood Maltreatment Severity, Economic Adversity and Postpartum Depressive Symptoms. Matern Child Health J. 2017 FREE FULL TEXT ARTICLE.
First study to demonstrate interrelationships between income and social support on resilience to postpartum depressive symptoms (PDS) in childhood trauma-surviving women.
Fong K. Child welfare involvement and contexts of poverty: The role of parental adversities, social networks, and social services. Children and Youth Services Review 2017
Interviews with parents investigated for child maltreatment revealed adversities related to poverty; embeddedness in disadvantaged networks or volatile personal relationships; and need for social services. Suggest need to broadly strengthen supports for families and communities.
Slack K, et al. Introduction to the special issue on the economic causes and consequences of child maltreatment. Children and Youth Services Review 2017 FREE FULL TEXT ARTICLE
In depth exploration of correlation of child maltreatment and community- or state-level poverty rates.
Moffitt T Childhood exposure to violence and lifelong health: Clinical intervention science and stress biology research join forces. Dev Psychopath. 2013 FREE FULL TEXT ARTICLE.
Evidence of stress-sensitive measures of children exposed to violence (inflammatory reactions, telomere erosion, epigenetic methylation, gene expression, neuroimaging, neuropsychological testing) and identified promising interventions.
Giovanelli A, et al. Adverse childhood experiences and adult well-being in a low-income, urban cohort. Pediatrics. 2016. FREE FREE TEXT ARTICLE
1,202 low-income, minority participants in Chicago Longitudinal Study. Those with 4 or more ACEs had significantly reduced likelihood of high school graduation and increased risk for depression, health compromising behaviors, juvenile arrest, and felony charges.
Dale SK, Weber K, Cohen MH, Brody LR. Abuse, nocturnal stress hormones, and coronary heart disease risk among women with HIV. AIDS Care. 2017.
Higher norepinephrine/cortisol ratio was significantly related to higher Coronary Heart Disease (CHD) risk. Recent sexual abuse, physical abuse, and domestic abuse were significantly related to higher CHD risk. This association may involve dysregulation of multiple neurobiological systems.
Rubin LH, …Weber KM, Cohen MH, Martin, EM, et al. Perceived and post-traumatic stress are associated with decreased learning, memory and fluency in HIV-infected women. AIDS 2017.
In the context of HIV, stress and PTSD were negatively associated with performance in learning, memory and fluency. Stress and PTS symptoms are treatment targets to potentially improve cognitive performance particularly when HIV treatment is not optimal.
Goldstein E. Patient preferences for discussing childhood trauma in primary care. Perm J. 2017 FREE FULL TEXT ARTICLE
Patient preferences for discussing traumatic experiences and PTSD with clinicians: most patients agreed they were comfortable being asked about trauma and did not oppose the inclusion of trauma-related information in their medical record.
Selvaraj K, et al. Screening for Toxic Stress Risk Factors at Well-Child Visits. J Pediatr 2018.
Universal screening (2569 families) for toxic stress factors in pediatric primary care improved identification and management of family needs. Screening was feasible and acceptable to families.
Wade R, Shea JA, Rubin D, et al. Adverse childhood experiences of low-income urban youth. Pediatrics. 2014. FREE FULL TEXT ARTICLE
Survey of young adults from low-income urban areas identified experiences not included in the initial ACEs including single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination.
Weinreb L, et al. Screening for childhood trauma in adult primary care patients: a cross-sectional survey. Prim Care Companion J Clin Psychiatry. 2010. FREE FULL TEXT ARTICLE
Describes practices, skills, attitudes, and perceived barriers of family physicians in screening adult patients for childhood sexual or physical abuse. Confidence in screening, perceived role, and knowledge of trauma prevalence were associated with routine and targeted screening.
Kerker BD, Storfer-Isser A, Szilagyi M, et al. Do pediatricians ask about adverse childhood experiences in pediatric primary care? Acad Pediatr. 2016. FREE FULL TEXT ARTICLE
Glowa PT, Olson AL, Johnson DJ. Screening for adverse childhood experiences in a family medicine setting: a feasibility study. J Am Board Fam Med. 2016. FREE FULL TEXT ARTICLE
Leitch L. Action steps using ACEs and trauma-informed care: a resilience model. Health Justice. 2017 FREE FULL TEXT ARTICLE
COMMENT: The ACES study on ACEs and resulting implementation of Trauma-Informed Care (TIC). Recommends TIC should move from gathering ACEs Data to neuroscience-based action with practical skills of self-regulation and self-care in both service providers and clients.