Featured Research

from universities, journals, and other organizations

Shedding light on the long shadow of childhood adversity

Date:
April 30, 2013
Source:
American Medical Association (AMA)
Summary:
Childhood adversity can lead to chronic physical and mental disability in adult life and have an effect on the next generation, underscoring the importance of research, practice and policy in addressing this issue, according to a new article.

Childhood adversity can lead to chronic physical and mental disability in adult life and have an effect on the next generation, underscoring the importance of research, practice and policy in addressing this issue.
Credit: Pixel Memoirs / Fotolia

Childhood adversity can lead to chronic physical and mental disability in adult life and have an effect on the next generation, underscoring the importance of research, practice and policy in addressing this issue, according to a Viewpoint in the May 1 issue of JAMA, a theme issue on child health.

David A. Brent, M.D., of the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, presented the Viewpoint at a JAMA media briefing.

Dr. Brent and co-author Michael Silverstein, M.D., M.P.H., of the Boston University School of Medi-cine, write that early child adversity, defined as child maltreatment, exposure to domestic violence, or living with a household member with serious mental illness, has been linked to myriad chronic conditions associated with premature death: smoking, substance abuse, obesity, cardiovascular disease, depression, and attempted suicide. They add that causal pathways between early adversity and these multiple outcomes are thought to be mediated by changes in stress responsivity, and that animal models have demonstrated that these effects are transmitted from parent to child through epigenetic (the effect of environment on gene expression) mechanisms. "While the pathways by which adversity exerts its effects have not been as elegantly elaborated in humans, it is posited that these epigenetic changes can contribute to immune dysfunction, insulin resistance, and cognitive difficulties that in turn lead to risky behavior and predispose to emotional lability [instability] and depression."

"The good news is that, if detected early enough, the impact of family adversity on child health outcomes can be reversed, or at least attenuated. For example, if maternal depression is treated to remission, the patients' children show symptomatic and functional gains. Economic interventions that provide local employment and move parents out of poverty have been shown to be temporally related to a decreased risk for behavioral disorders in the children of the assisted families. Earlier foster placement can, to some extent, reverse the deleterious neurobiological and cognitive effects of extreme deprivation in infancy."

The authors write that these findings about early adversity and its sequelae have important implications for research, practice, and policy. With regard to research, a better understanding of the biological mechanisms by which early adversity exerts its effects, "definition of the critical periods when such effects are particularly deleterious, and identification of effective approaches to their remediation or prevention are warranted. In addition, the shared roots of leading causes of worldwide disability (such as cardiometabolic disease and depression) suggest opportunities for synergy, because interventions that would prevent the development of these conditions would have a substantial effect on public health worldwide."

"For clinicians, given the potent and long-reaching effects of family adversity on health outcomes, knowledge can be empowering. Physicians must be taught about the effects of adversity, how to detect it, and what steps to take once identified. Screening, referral, and monitoring of the presence of adversity and its effects early in the child's life may prevent or attenuate the destructive multigenerational effects of dysfunctional parenting that occur as a consequence of untreated psychiatric disorder," they write.

The authors add that physicians must also be advocates for social policies that can help families achieve what all parents want -- a secure environment for their children to develop into competent adults. "Home visitation programs for at-risk families of infants have been shown to have long-term positive effects on physical and mental health, education, employment, and family stability. Access to quality preschool education can help to buffer the deleterious effects of poverty."

"The economic cost -- in excess health care utilization, nonresponse to treatment, incarceration, loss of employment, decrease in productivity, and disability -- weighs heavily on families burdened with adversity but ultimately is borne by society as a whole. In the drive to improve quality of health care and contain costs, the huge price tag to society of early adversity cannot be neglected. Through research, clinical care, and advocacy, physicians can shine a light on the dark shadow of adversity and diminish its reach from generation to generation. Society can either invest in combating the effect of adversity on families now, or pay later."


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. David A. Brent, Michael Silverstein. Shedding Light on the Long Shadow of Childhood Adversity. JAMA, 2013 DOI: 10.1001/jama.2013.4220

Cite This Page:

American Medical Association (AMA). "Shedding light on the long shadow of childhood adversity." ScienceDaily. ScienceDaily, 30 April 2013. <www.sciencedaily.com/releases/2013/04/130430105729.htm>.
American Medical Association (AMA). (2013, April 30). Shedding light on the long shadow of childhood adversity. ScienceDaily. Retrieved September 21, 2014 from www.sciencedaily.com/releases/2013/04/130430105729.htm
American Medical Association (AMA). "Shedding light on the long shadow of childhood adversity." ScienceDaily. www.sciencedaily.com/releases/2013/04/130430105729.htm (accessed September 21, 2014).

Share This



More Health & Medicine News

Sunday, September 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com
Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins