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Adverse Childhood Experiences and Child Health in Early Adolescence
Open accessAbstract
IMPORTANCE: Child maltreatment and other adverse childhood experiences, especially when recent and ongoing, affect adolescent health. Efforts to intervene and prevent adverse childhood exposures should begin early in life but continue throughout childhood and adolescence. OBJECTIVES: To examine the relationship between previous adverse childhood experiences and somatic concerns and health problems in early adolescence, as well as the role of the timing of adverse exposures. DESIGN: Prospective analysis of the Longitudinal Studies of Child Abuse and Neglect interview and questionnaire data when target children were 4, 6, 8, 12, and 14 years old. SETTING: Children with reported or at risk for maltreatment in the South, East, Midwest, Northwest, and Southwest United States Longitudinal Studies of Child Abuse and Neglect sites. PARTICIPANTS: A total of 933 children who completed an interview at age 14 years, including health outcomes. EXPOSURES: Eight categories of adversity (psychological maltreatment, physical abuse, sexual abuse, neglect, caregiver's substance use/alcohol abuse, caregiver's depressive symptoms, caregiver treated violently, and criminal behavior in the household) experienced during the first 6 years of life, the second 6 years of life, the most recent 2 years, and overall adversity. MAIN OUTCOMES AND MEASURES: Child health problems including poor health, illness requiring a doctor, somatic concerns, and any health problem at age 14 years. RESULTS: More than 90% of the youth had experienced an adverse childhood event by age 14 years. There was a graded relationship between adverse childhood exposures and any health problem, while 2 and 3 or more adverse exposures were associated with somatic concerns. Recent adversity appeared to uniquely predict poor health, somatic concerns, and any health problem. CONCLUSIONS AND RELEVANCE: Childhood adversities, particularly recent adversities, already show an impact on health outcomes by early adolescence. Increased efforts to prevent and mitigate these experiences may improve the health outcome for adolescents and adults.
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“Epidemiological studies have demonstrated that adverse childhood experiences, namely exposures such as neglect, abuse, caregiver mental illness, and family or community violence, predict poorer long-term outcomes across health and social domains.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Outcomes associated with early adversity include higher risk of type 2 diabetes, obesity, ischemic heart disease, cancers, depression, addictions, and premature mortality, as well as social outcomes including unemployment and lower educational attainment [1–8].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [5]
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“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.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [5]
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“In full, ELA-induced changes may mediate epidemiological links to key diseases, including, among others, obesity, dyslipidemia, type 2 diabetes, atherosclerosis, asthma, thromboembolic events (myocardial infarction, stroke), cancer onset and progression, as well as addictions, psychopathology, and adverse social outcomes [1–6, 18].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [5]
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“Such an approach facilitates the synthesis of complex evidence for application, and is supported by observed dose–response effects linking cumulative early adversity to later outcomes [1, 3, 5], and by the “allostatic load” paradigm exploring pathogenic effects of cumulative all-cause stress [15].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [5]
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Cited by
Sorted by citations
Fox, B., Perez, N. M., Cass, E., Baglivio, M. T., & Epps, N. (2015) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2015.01.011 · Cited by 815
Adverse childhood experiences and life opportunities: shifting the narrative
Metzler, M., Merrick, M. T., Klevens, J., Ports, K. A., & Ford, D. C. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2016.10.021 · Cited by 713
Biological embedding of childhood adversity: from physiological mechanisms to clinical implications
Berens, A. E., Jensen, S. K. G., & Nelson, C. A. (2017) · BMC Medicine · doi:10.1186/s12916-017-0895-4 · Cited by 657
“Such an approach facilitates the synthesis of complex evidence for application, and is supported by observed dose–response effects linking cumulative early adversity to later outcomes [1, 3, 5], and by the “allostatic load” paradigm exploring pathogenic effects of cumulative all-cause stress [15].”
BackgroundAdverse childhood experiences and behavioral problems in middle childhood
Hunt, T. K. A., Slack, K. S., & Berger, L. M. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2016.11.005 · Cited by 535
Systematic review of pediatric health outcomes associated with childhood adversity
Oh, D. L., Jerman, P., Marques, S. S., Koita, K., Purewal, S. K., Harris, N. B., & Bucci, M. (2018) · BMC Pediatrics · doi:10.1186/s12887-018-1037-7 · Cited by 471
Metadata
- Authors
- Flaherty, E. G., Thompson, R., Dubowitz, H., Harvey, E. M., English, D. J., Proctor, L. J., & Runyan, D. K.
- Affiliations
- Northwestern University (US)
- Juvenile Protective Association (US)
- University of Maryland, Baltimore (US)
- University of North Carolina at Chapel Hill (US)
- University of Washington (US)
- Harvard University (US)
- University of Colorado Anschutz (US)
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2013-07-01
- Volume
- 167
- Issue
- 7
- Pages
- 622
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- PMC
- PMC3732117
- OpenAlex
- W2110442242
- Cited by
- 353
- References
- 60
- Citations by year
- 2026: 12 · 2025: 23 · 2024: 28 · 2023: 35 · 2022: 39 · 2021: 54 · 2020: 36 · 2019: 30 · 2018: 29 · 2017: 23 · 2016: 18 · 2015: 15 · 2014: 5 · 2013: 5
- FWCI
- 15.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA031189, K01DA021674)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Keywords
- adverse childhood experiences, child abuse, early adolescence, adolescent health, somatic symptoms, physical abuse, sexual abuse, neglect, caregiver depression, domestic violence, child abuse prevention
- MeSH terms
- Adolescent, Child, Child Abuse, Child, Preschool, Female, Health Status, Humans, Longitudinal Studies, Male, Prospective Studies, Risk Factors, Time Factors, United States, Child of Impaired Parents, Caregivers
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