期刊
BMC MEDICINE
卷 15, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12916-017-0895-4
关键词
Adverse childhood experiences; Brain development; Stress; Health promotion; Social disparities; Primary care
资金
- National Institutes of Health [MH078829]
- Bill and Melinda Gates Foundation [OPP1111625]
- The Sackler Scholar Programme in Psychobiology, an initiative of the Sackler Foundation
- Bill and Melinda Gates Foundation [OPP1111625] Funding Source: Bill and Melinda Gates Foundation
Background: 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. Observations: 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. Conclusions: 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.
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