Mechanisms Underlying the Association Between Early-Life Adversity and Physical Health: Charting a Course for the Future

Abstract

Early life adversities (ELA) are associated with subsequent pervasive alterations across a wide range of neurobiological systems and psychosocial factors that contribute to accelerated onset of health problems and diseases. In this article, we provide an integrated perspective on recent developments in research on ELA, based on the articles published in this Special Issue of Psychosomatic Medicine. We focus on: (1) the distinction between specific versus general aspects of ELA in terms of the nature of exposure (e.g., physical and sexual abuse, emotional abuse or neglect, relative socioeconomic deprivation), biological and behavioral correlates of ELA, and differences across diseases; (2) the importance of timing in the critical phases of exposure to ELA; and (3) adaptive versus dysfunctional responses to ELA and their consequences for biological and behavioral risk factors for adverse health outcomes. This article concludes with outlining important new targets for research in this area, including the neurobiology of affect as mechanism linking ELA to adverse health outcomes, and the need for large-scale longitudinal investigations of multi-system processes relevant to ELA in diverse samples, starting prenatally, continuing to late adolescence, and with long-term follow-up assessments that enable evaluation of incident disease outcomes.

Exposure to traumatic events in childhood predicts cortisol production among high risk pregnant women

“…This high prevalence is of public health concern, because early life exposure to traumatic events can have profound and lifelong consequences (Perry, Pollard, Blakley, Baker, & Vigilante, 1995). Broadly, adults with a history of childhood trauma are at elevated risk for a range of physical and mental health problems, including dysregulation of immune, cardiovascular, and endocrine systems (Baumeister, Akhtar, Ciufolini, Pariante, & Mondelli, 2016; Bush, Lane, & McLaughlin, 2016; Roy, Janal, & Roy, 2010; Teicher et al, 2003), and heightened risk for psychopathology (Heim & Nemeroff, 2001). Childhood exposure to trauma has implications not only for health across the lifespan, but also for the next generation (Narayan, Bucio, Rivera, & Lieberman, 2016).…”

Power of the Positive: Childhood Assets and Future Cardiometabolic Health

“…Kubzansky and co-workers 11 have previously demonstrated in the 1958 National Child Development Study that childhood psychological distress (internalizing and externalizing symptoms at ages 7-16 years) is associated with cardiometabolic risk and that it accounted for 37% of the association between social disadvantage and adult cardiometabolic risk. 12 In other samples, mental health and social relationships appeared to mediate associations between early-life adversity and physical health outcomes, 3 providing additional evidence of their preceding role. Yet analytic findings in a representative sample of US adolescents suggest that heart disease precedes any mental disorder.…”

“…In this issue of Pediatrics, Qureshi et al 1 provide a much-needed focus on positive psychological assets in childhood (rather than the more welldocumented focus on childhood adversity) 2 and the relationship with subsequent cardiometabolic health. The examination of protective and resilience-enhancing factors is a largely unmet research priority, 2,3 and each of the 4 domains examined reveal empirical potential for investment. For example, the literature demonstrating the role of early-childhood executive function (or self-regulation) in obesity risk is substantial.…”

Capability and adversity: reframing the “causes of the causes” for mental health

“…Extending the scope of ACEs to include discrimination, exposure to community violence and poverty evokes a complex ecosystem of influences and interdependencies. It seems likely that different kinds of adverse experiences will have different effects, which themselves will be influenced by critical periods for child development, and the impact of protective or mitigating factors (Bush et al, 2016;McLaughlin and Sheridan, 2016).…”