Effect of Early Childhood Adversity on Child Health

Flaherty, Emalee G.; Thompson, Richard; Litrownik, Alan J.; Theodore, Adrea D.; English, Diana J.; Black, Maureen M.; Wike, Traci L.; Whimper, Lakecia; Runyan, Desmond K.; Dubowitz, Howard

doi:10.1001/archpedi.160.12.1232

Cited by 202 publications

(155 citation statements)

References 45 publications

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“…The large body of clinical literature suggesting a causal relationship between psychosocial distress and physical illness (Levine, Covino et al 1996;Katon 2003;Tarrier, Gregg et al 2005;Flaherty, Thompson et al 2006;Heim, Wagner et al 2006;Sareen, Jacobi et al 2006) supports the view that the isolation rearing impairment of wound healing resulted from the associated brain and behavior changes we found. Nonetheless, to firmly establish whether these changes are cause or consequence of this relationship, further investigation is needed.…”

Section: Relation Between Isolation Rearing and Impaired Wound Healingsupporting

confidence: 81%

“…In addition to its detrimental impact on mental health (Kaufman, Plotsky et al 2000;Heim and Nemeroff 2001;Rutter 2002;Schilling, Aseltine et al 2007), psychosocial adversity also detrimentally impacts physical health (Flaherty, Thompson et al 2006;Heim, Wagner et al 2006;Sareen, Jacobi et al 2006). In addition, we and others have shown that patients with psychiatric difficulties have worse medical outcomes (Levine, Covino et al 1996;Katon 2003;Tarrier, Gregg et al 2005) and are at heightened risk for sustaining subsequent physical injuries (Rockwell, Dimsdale et al 1988;Swenson, Dimsdale et al 1991).…”

Section: Introductionmentioning

confidence: 99%

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Isolation rearing impairs wound healing and is associated with increased locomotion and decreased immediate early gene expression in the medial prefrontal cortex of juvenile rats

Levine¹,

Leeder²,

Parekkadan³

et al. 2008

Neuroscience

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In addition to its maladaptive effects on psychiatric function, psychosocial deprivation impairs recovery from physical illness. Previously, we found that psychosocial deprivation, modeled by isolation rearing, depressed immediate early gene (IEG) expression in the medial prefrontal cortex (mPFC) and increased locomotion in the open field test (Levine, Youngs et al. 2007). In the present study, we examined whether similar changes in behavior and gene expression are associated with the maladaptive effects of psychosocial deprivation on physical injury healing. After weaning, anesthetized rats were subjected to a 20% total body surface area third degree burn injury and were subsequently either group or isolation reared. After four weeks of either isolation or group rearing (a period that encompasses rodent childhood and early adolescence), rats were sacrificed, and their healing and gene expression in the mPFC were assessed. Locomotion in the open field test was examined at 3 weeks post burn injury. We found that: 1) gross wound healing was significantly impaired in isolation reared rats compared to group reared rats, 2) locomotion was increased and IEG expression was suppressed for isolation reared rats during burn injury healing, 3) the decreased activity in the open field and increased IEG expression was greater for burn injury healing group reared rats than for uninjured group reared rats, 4) the degree of hyperactivity and IEG suppression was relatively similar between isolation reared rats during burn injury compared to uninjured isolation reared rats, 5) behavioral hyperactivity to novelty (the open

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Section: Relation Between Isolation Rearing and Impaired Wound Healingsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Isolation rearing impairs wound healing and is associated with increased locomotion and decreased immediate early gene expression in the medial prefrontal cortex of juvenile rats

Levine¹,

Leeder²,

Parekkadan³

et al. 2008

Neuroscience

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“…In a parallel fashion, longitudinal studies that document the long-term consequences of childhood adversity indicate that alterations in a child' s ecology can have measurable effects on his or her developmental trajectory, with lifelong consequences for educational achievement, economic productivity, health status, and longevity. [23][24][25][26][27] The EBD framework described in this article presents a new way to think about the underlying biological mechanisms that explain this robust link between early life adversities (ie, the…”

Section: A New Framework For Promoting Healthy Developmentmentioning

confidence: 99%

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

Shonkoff¹,

Siegel²,

Dobbins³

et al. 2012

Pediatrics

3,852

2,375

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Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.

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“…Medically, abuse has been strongly associated with a range of gastroenterological and genitourinary symptoms (7)(8)(9)(10)(11)(12)(13)(14)(15), pain (16), and worse daily functioning due to poor health (17). Abuse has also been associated with a range of mental health outcomes, including depression and post-traumatic stress disorder (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) as well as substance abuse (29).…”

Section: Introductionmentioning

confidence: 99%

An examination of the association of abuse (physical, sexual, or emotional) and female sexual dysfunction: results from the Boston Area Community Health Survey

Lutfey

Link

Litman

et al. 2008

Fertility and Sterility

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Study objective-To examine associations between abuse (physical, sexual, and emotional) in childhood and adolescence/adulthood and sexual activity and dysfunction (FSD) in women.Design-We analyzed data from the Boston Area Community Health (BACH) Survey, a community-based epidemiologic study of urologic and sexual symptoms and risk factors in a racially/ ethnically diverse random sample of women aged 30-79 (N=3,205 women). Setting-Boston Area communityPatients-Participants were community residents.Interventions-Data were observational; no interventions were made.Main outcome measure-Sexual activity and dysfunction rates (FSD) were assessed by means of a validated questionnaire: the Female Sexual Function Index (FSFI).Results-Abuse history was not significantly associated with likelihood of sexual activity. Among those who were sexually active with a partner, a history of each of three types of abuse approximately doubles the risk of FSD. Specifically, childhood emotional (OR 2.13, 95% CI 1.28, 3.56), adult sexual (OR 1.94, 95% CI 1.23, 3.08), and adult emotional abuse (OR 1.86, 95% CI 1.15, 3.01) were all significantly and positively associated with sexual dysfunction (p < .05) after adjusting for covariates (including depression). Analyses of the six FSD domains showed that the relationships were strongest for pain (p = .006) and satisfaction (p < .001).Conclusions-These findings extend previous literature by identifying an association between FSD and multiple types of abuse, even after adjusting for depression.

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Effect of Early Childhood Adversity on Child Health

Abstract: Adverse environmental exposures, including child abuse and other household dysfunction, are associated with poor child health even at an early age, although our data do not support a dose-response relationship.

Cited by 202 publications

References 45 publications

Isolation rearing impairs wound healing and is associated with increased locomotion and decreased immediate early gene expression in the medial prefrontal cortex of juvenile rats

Isolation rearing impairs wound healing and is associated with increased locomotion and decreased immediate early gene expression in the medial prefrontal cortex of juvenile rats

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

An examination of the association of abuse (physical, sexual, or emotional) and female sexual dysfunction: results from the Boston Area Community Health Survey

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