Journal
AMERICAN PSYCHOLOGIST
Volume 76, Issue 2, Pages 203-215Publisher
AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/amp0000766
Keywords
adverse childhood experiences (ACEs); protective and compensatory experiences (PACEs); adversity; resilience; biobehavioral adaptations to stress
Categories
Funding
- National Institute of General Medical Sciences of the National Institutes of Health [P20GM109097]
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The ICARE model suggests that adverse childhood experiences lead to biological and behavioral adaptations that affect cognitive, social, and emotional development, which may be passed down to future generations through genetic and behavioral pathways. Research highlights the importance of protective relationships and environmental resources in mitigating the effects of ACEs.
This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions.
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