The Lifelong Effects of Early Childhood Adversity and Toxic Stress
Top Cited Papers
- 1 January 2012
- journal article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 129 (1), e232-e246
- https://doi.org/10.1542/peds.2011-2663
Abstract
Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.Keywords
This publication has 86 references indexed in Scilit:
- Current concepts on the role of inflammation in COPD and lung cancerCurrent Opinion in Pharmacology, 2009
- Secular Changes in Mortality Disparities in New York City: A ReexaminationJournal of Urban Health, 2009
- Health Disparities Across the LifespanJAMA, 2009
- Lasting Epigenetic Influence of Early-Life Adversity on the BDNF GeneBiological Psychiatry, 2009
- Chemokines in the immunopathogenesis of hepatitis C infectionJournal of Hepatology, 2008
- Uninsured Children and Adolescents With Insured ParentsJAMA, 2008
- Elevated Inflammation Levels in Depressed Adults With a History of Childhood MaltreatmentArchives of General Psychiatry, 2008
- The social environment and the epigenomeEnvironmental and Molecular Mutagenesis, 2007
- Stress and inflammation in exacerbations of asthmaBrain, Behavior, and Immunity, 2007
- The Darwinian concept of stress: benefits of allostasis and costs of allostatic load and the trade-offs in health and diseaseNeuroscience & Biobehavioral Reviews, 2005