Identifying and Preventing Adverse Childhood Experiences

Jones, Christopher M.; Merrick, Melissa T.; Houry, Debra

doi:10.1001/jama.2019.18499

Cited by 126 publications

(96 citation statements)

References 7 publications

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“…International health surveillance and initiatives that promote preventative measures on a practitioner level are paramount to address this destructive trend [19]. Said initiatives are beginning to appear in an attempt to address the important implications ACEs have on chronic disease as an adult.…”

Section: Aces and Implications On International Health Securitymentioning

confidence: 99%

The Relationship of Adulthood Chronic Disease and Adverse Childhood Experiences (ACEs): Implications Regarding Prevention and Promotion in International Health

Holter¹,

Marchionni²,

Bhatt³

2021

Contemporary Developments and Perspectives in International Health Security - Volume 1

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Several studies, including the innovative 1998 ACE Study by CDC-Kaiser Permanente, have assessed the association among adulthood chronic disease and the prevalence of maladaptive, health-harming behaviors including: excessive alcohol use, tobacco use, physical inactivity, psychiatric illness including suicidal ideation or attempts, promiscuous sexual behavior (>50 sex partners), history of STI/STD and severe obesity (obesity (BMI > 35 kg/m 2)), subsequent to an individual's exposure to adverse childhood experiences (ACEs). Individuals that have encountered numerous instances of ACEs are almost twice as likely to die before the age of 75, demonstrating a dose-dependent relationship between the instances of ACEs and an increased morbidity/mortality in regard to chronic disease. This excerpt examines the contribution of ACEs to chronic disease and the consequential maladaptive behavior to said adversity, the consequential physiologic and biomolecular changes explained by the Biological Embedding of Childhood Adversity Model in addition to the implications of recounted ACEs on international health security in regard to concepts like conflict, displacement and food insecurity. The apparent association among adulthood chronic disease and ACEs demand changes that promote preventative processes as a means to address the implications these interconnections have on international health.

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Section: Aces and Implications On International Health Securitymentioning

confidence: 99%

The Relationship of Adulthood Chronic Disease and Adverse Childhood Experiences (ACEs): Implications Regarding Prevention and Promotion in International Health

Holter¹,

Marchionni²,

Bhatt³

2021

Contemporary Developments and Perspectives in International Health Security - Volume 1

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“…These previous studies are informative, however the majority of them examined individual aspects or a limited number of ACEs. It is known that the risk of negative outcomes associated with adverse experiences is more pronounced in individuals who experience multiple ACEs [3,16,17]. Presently, there is a paucity of knowledge on the cumulative effects of ACEs on childhood obesity.…”

Section: Introductionmentioning

confidence: 99%

Association between cumulative exposure to adverse childhood experiences and childhood obesity

2020

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Background Exposure to adverse childhood experiences (ACEs) is associated with many childhood diseases and poor health outcomes in adulthood. However, the association with childhood obesity is inconsistent. We investigated the association between reported cumulative ACE score and body mass index (BMI) in a large sample of patients at a single institution. Methods This cross-sectional study included children aged 2-20 years that were screened in a general pediatrics clinic for ACEs utilizing the Center for Youth Wellness ACEs questionnaire between July 2017 and July 2018. Overall ACE score was categorized as 'no exposure' (score = 0), 'low exposure' (score = 1), and 'high exposure' (score� 2). BMI was categorized as overweight/obese (BMI percentile � 85) or non-obese (BMI percentile < 85). The association between ACEs score and obesity was determined using univariate and multivariable logistic regression. Results Of the 948 patients included in the study, 30% (n = 314) were overweight/obese and 53% (n = 504) had no ACE exposure, 19% (n = 179) had low ACE exposure, and 28% (n = 265) had high ACE exposure. High ACE exposure was associated with increased odds of obesity (OR = 1.47, 95%CI = 1.07-2.03, p = 0.026). However, after adjusting for age, race/ethnicity, insurance type, and birth weight, the association attenuated and was null (OR = 1.01, 95% CI = 0.70-1.46, p = 0.97).

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“…Depression is a major health concern in the United States with a prevalence of 7% of all adults or 13% of all adolescents (age12-17) in 2017 [1,2]. Those who experience severe early life stress (ELS) or adverse childhood events (ACE) have increased risk for the development of depression, suicide ideation and suicide attempts later in life [3][4][5][6]. 61% of the US population have experienced at least 1 ACE, and16% have experienced 4 or more, putting a significant population at increased risk for developing mood-disorders later in life [3].…”

Section: Introductionmentioning

confidence: 99%

“…Those who experience severe early life stress (ELS) or adverse childhood events (ACE) have increased risk for the development of depression, suicide ideation and suicide attempts later in life [3][4][5][6]. 61% of the US population have experienced at least 1 ACE, and16% have experienced 4 or more, putting a significant population at increased risk for developing mood-disorders later in life [3]. In order to better understand the interaction of ELS/ACE and increased susceptibility to development of a mooddisorder (such as anxiety or depression) we use a preclinical rodent model of severe childhood neglect -maternal deprivation (MD).…”

Section: Introductionmentioning

confidence: 99%

Early life stress dysregulates kappa opioid receptor signaling within the lateral habenula

Simmons

Shepard

Gouty

et al. 2020

Preprint

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The lateral habenula (LHb) is an epithalamic brain region associated with value-based decision making and stress evasion through its modulation of dopamine (DA)-mediated reward circuitry. Specifically, increased activity of the LHb is associated with drug addiction, schizophrenia and stress-related disorders such as depression, anxiety and posttraumatic stress disorder. Dynorphin (Dyn)/Kappa opioid receptor (KOR) signaling is a mediator of stress response in reward circuitry. Previously, we have shown that maternal deprivation (MD), a severe early life stress, increases LHb intrinsic excitability while blunting the response of LHb neurons to extra hypothalamic corticotropin-releasing factor (CRF) signaling, another stress mediator. CRF pathways also interact with Dyn/KOR signaling. Surprisingly, there has been little study of direct KOR regulation of the LHb despite its distinct role in stress, reward and aversion processing. To test the functional role of Dyn-KOR signaling in the LHb, we utilized ex-vivo electrophysiology combined with pharmacological tools in rat LHb slices. We show that activation of KORs by a KOR agonist (U50,488) exerts differential effects on the excitability of two distinct subpopulations of LHb neurons that differ in their expression of hyperpolarization-activated cation currents (HCN, Ih). Specifically, KOR stimulation increases neuronal excitability in LHb neurons with large Ih currents (Ih+) while decreases neuronal excitability in small/negative Ih (Ih-) neurons. Additionally, we found that an intact fast-synaptic transmission is required for the effects of U50,488 on the excitability of both Ih- and Ih+ LHb neuronal subpopulations. Consistently, KOR activation also altered both glutamatergic and GABAergic synaptic transmission. While stimulation of presynaptic KORs uniformly suppressed glutamate release onto LHb neurons, we found that U50, 488 either increased or decreased GABA release. We also found that MD significantly increased immunolabeled Dyn (the endogenous KOR agonist) labeling in neuronal fibers in LHb while significantly decreased mRNA levels of KORs in LHb tissues compared to those from non-maternally deprived (non-MD) control rats. While total p38 MAPK (a downstream signaling pathway driven by KOR activation) expression was elevated in the LHb of MD rats compared to non-MD controls, we found that application of KOR-specific agonist, U50,488, onto LHb slices was still able to alter phosphorylated p38 MAPK (ph-p38) expression in MD rats similar to non-MD controls. Moreover, we found that the U50,488-mediated increase in LHb neuronal firing observed in non-MD rats was absent following MD. Altogether, this is the first demonstration of the existence of the functional Dyn/KOR signaling in the LHb that can be modulated in response to severe early life stressors such as MD.

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Identifying and Preventing Adverse Childhood Experiences

Cited by 126 publications

References 7 publications

The Relationship of Adulthood Chronic Disease and Adverse Childhood Experiences (ACEs): Implications Regarding Prevention and Promotion in International Health

The Relationship of Adulthood Chronic Disease and Adverse Childhood Experiences (ACEs): Implications Regarding Prevention and Promotion in International Health

Association between cumulative exposure to adverse childhood experiences and childhood obesity

Early life stress dysregulates kappa opioid receptor signaling within the lateral habenula

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