Strong, graded relationships between exposure to childhood traumatic stressors and numerous negative health behaviors and outcomes, healthcare utilization, and overall health status inspired the question of whether these adverse childhood experiences (ACEs) are associated with premature death during adulthood.
This study aims to determine whether ACEs are associated with an increased risk of premature death during adulthood.
Baseline survey data on health behaviors, health status, and exposure to ACEs were collected from 17,337 adults aged >18 years during 1995-1997. The ACEs included abuse (emotional, physical, sexual); witnessing domestic violence; parental separation or divorce; and growing up in a household where members were mentally ill, substance abusers, or sent to prison. The ACE score (an integer count of the eight categories of ACEs) was used as a measure of cumulative exposure to traumatic stress during childhood. Deaths were identified during follow-up assessments (between baseline appointment date and December 31, 2006) using mortality records obtained from a search of the National Death Index. Expected years of life lost (YLL) and years of potential life lost (YPLL) were computed using standard methods. The relative risk of death from all causes at age < or =65 years and at age < or =75 years was estimated across the number of categories of ACEs using multivariable-adjusted Cox proportional hazards regression. Analysis was conducted during January-February 2009.
Overall, 1539 people died during follow-up; the crude death rate was 91.0 per 1000; the age-adjusted rate was 54.7 per 1000. People with six or more ACEs died nearly 20 years earlier on average than those without ACEs (60.6 years, 95% CI=56.2, 65.1, vs 79.1 years, 95% CI=78.4, 79.9). Average YLL per death was nearly three times greater among people with six or more ACEs (25.2 years) than those without ACEs (9.2 years). Roughly one third (n=526) of those who died during follow-up were aged < or =75 years at the time of death, accounting for 4792 YPLL. After multivariable adjustment, adults with six or more ACEs were 1.7 (95% CI=1.06, 2.83) times more likely to die when aged < or =75 years and 2.4 (95% CI=1.30, 4.39) times more likely to die when aged < or =65 years.
ACEs are associated with an increased risk of premature death, although a graded increase in the risk of premature death was not observed across the number of categories of ACEs. The increase in risk was only partly explained by documented ACE-related health and social problems, suggesting other possible mechanisms by which ACEs may contribute to premature death.
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"Exposure to adverse childhood experiences (ACEs) such as child abuse and neglect impact a child's socioemotional development (Toth & Manly, 2011). Research has demonstrated a clear relationship between ACEs and a variety of health behaviors and outcomes in adulthood, including premature mortality (Brown et al., 2009), alcoholism (Dube et al., 2001), drug abuse, depression (Chapman et al., 2004), suicide, heart disease, obesity (Williamson, Thompson, Anda, Dietz, & Felitti, 2002), cancer, and chronic lung disease, among others (Felitti et al., 1998). However, more immediate effects that focus on the relationship between ACEs and behavioral health among early childhood samples is limited (Burke, Hellman, Scott, Weems, & Carrion, 2011). "
") und körperliche Erkrankungen dar (Felitti et al., 1998) und ist mit einem niedrigen sozioökonomischen Status assoziiert (Zielinski, 2009). Danach starben Erwachsene mit sechs oder mehr kritischen Kindheitserfahrungen im Schnitt 20 Jahre früher als Menschen ohne diese Erfahrungen (Brown et al., 2009). "
"Early life stress (ELS) is the exposure to childhood events that challenge a child's emotional and physical well-being, exceeding their ability to cope with the events (Gunnar and Quevedo, 2007; Pechtel and Pizzagalli, 2010). Some of these stressors can include abuse, neglect, social deprivation, or household dysfunction (Brown et al., 2009). Further, although acute instances of stress can activate the body's stress response resources in a beneficial manner, high and especially chronic levels of stress can perturb typical brain development (Pechtel and Pizzagalli, 2010). "
[Show abstract][Hide abstract] ABSTRACT: Executive control (EC) generally refers to the regulation of mental activity. It plays a crucial role in complex cognition, and EC skills predict high-level abilities including language processing, memory, and problem solving, as well as practically relevant outcomes such as scholastic achievement. EC develops relatively late in ontogeny, and many sub-groups of developmental populations demonstrate an exaggeratedly poor ability to control cognition even alongside the normal protracted growth of EC skills. Given the value of EC to human performance, researchers have sought means to improve it through targeted training; indeed, accumulating evidence suggests that regulatory processes are malleable through experience and practice. Nonetheless, there is a need to understand both whether specific populations might particularly benefit from training, and what cortical mechanisms engage during performance of the tasks used in the training protocols. This contribution has two parts: in Part I, we review EC development and intervention work in select populations. Although promising, the mixed results in this early field make it difficult to draw strong conclusions. To guide future studies, in Part II, we discuss training studies that have included a neuroimaging component - a relatively new enterprise that also has not yet yielded a consistent pattern of results post-training, preventing broad conclusions. We therefore suggest that recent developments in neuroimaging (e.g., multivariate and connectivity approaches) may be useful to advance our understanding of the neural mechanisms underlying the malleability of EC and brain plasticity. In conjunction with behavioral data, these methods may further inform our understanding of the brain-behavior relationship and the extent to which EC is dynamic and malleable, guiding the development of future, targeted interventions to promote executive functioning in both healthy and atypical populations.