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The link between childhood adversity and late-life mental health: evidence for the influence of early-life experiences or illusory correlations?

Published online by Cambridge University Press:  15 February 2017

Tracy D. Vannorsdall
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Cynthia A. Munro
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Corresponding

Extract

Adverse childhood experiences (ACEs) reflect stressful or traumatic early life events such as abuse, neglect, and significant household challenges. These experiences are increasingly appreciated as factors that exert influence on physical and mental functioning throughout the lifespan. Numerous studies have demonstrated dose–response relationships between the number of ACEs reported and negative health outcomes in adulthood (Anda et al., 2006). At the same time, evidence points to the role of ACEs in the development of heightened biological reactivity to stress that may serve to increase vulnerability to the development of mental and substance use disorders (e.g., Heim et al., 2010). Furthermore, the existence of sex differences in both stress reactivity and the prevalence of various forms of psychopathology in adulthood (Doom et al., 2013) raises the question of whether men and women are differentially vulnerable to the health risks posed by ACEs. Much of the work concerning ACEs has focused on outcomes as they present in middle adulthood, which may not generalize to later life, as there may be cohort effects in the prevalence of (or likelihood of reporting) ACEs. Studies finding that the newly old report greater numbers of ACEs than their more senior counterparts imply that rates of ACEs are increasing over time and may be contributing to the development of mental and substance abuse disorders (MSUDs) in the growing population of aging adults, and make a case for better understanding these associations in later life.

Type
Commentary
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Anda, R. F. et al. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neurosciences, 256, 174186. doi: 10.1007/s00406-005-0624-4.CrossRefGoogle ScholarPubMed
Choi, N. G., DiNitto, D. M., Marti, N. and Choi, B. Y. (2016). Association of adverse childhood experiences with lifetime mental and substance use disorders among men and women aged 50+ years. International Psychogeriatrics, pp. 1–14. doi: 10.1017/S1041610216001800 Google Scholar
Doom, J. R., Cicchetti, D., Rogosch, F. A. and Dackis, M. N. (2013). Child maltreatment and gender interactions as predictors of differential neuroendocrine profiles. Psychoneuroendocrinology, 38, 14421454. doi: 10.1016/j.psyneuen.2012.12.019 CrossRefGoogle ScholarPubMed
Heim, C., Shugart, M., Craighead, W. and Nemeroff, C. B. (2010). Neurobiological and psychiatric consequences of child abuse and neglect. Developmental Psychobiology, 52, 671690. doi: 10.1002/dev.20494 CrossRefGoogle ScholarPubMed
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