Evidence Based Guideline
The Effects of Childhood
Stress on Health
Department of Health and Human Services
This course meets the qualifications for 3 hours of continuing education
consisting of reading and taking a post-test on
The Effects of Childhood Stress on Health
Across the Lifespan
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
In this 3 unit course clinicians will be able to:
The ACE Pyramid represents the conceptual framework for the Study. During the time period of the 1980s and early 1990s information about risk factors for disease had been widely researched and merged into public education and prevention programs. However, it was also clear that risk factors, such as smoking, alcohol abuse, and sexual behaviors for many common diseases were not randomly distributed in the population. In fact, it was known that risk factors for many chronic diseases tended to cluster, that is, persons who had one risk factor tended to have one or more others.
Because of this knowledge, the ACE Study was designed to assess what we considered to be “scientific gaps” about the origins of risk factors. These gaps are depicted as the two arrows linking Adverse Childhood Experiences to risk factors that lead to the health and social consequences higher up the pyramid. Specifically, the study was designed to provide data that would help answer the question: “If risk factors for disease, disability, and early mortality are not randomly distributed, what influences precede the adoption or development of them?” By providing information to answer this question, we hoped to provide scientific information that would be useful for the development of new and more effective prevention programs.
The ACE Study takes a whole life perspective, as indicated on the orange arrow leading from conception to death. By working within this framework, the ACE Study began to progressively uncover how childhood stressors (ACE) are strongly related to development and prevalence of risk factors for disease and health and social well-being throughout the lifespan.
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Stress is internal or external influences that disrupt an individual’s normal state of well-being. These influences are capable of affecting health by causing emotional distress and leading to a variety of physiological changes. These changes include increased heart rate, elevated blood pressure, and a dramatic rise in hormone levels.
Toxic stress results from adverse experiences that may be sustained for a long period of time. This type of stress can disrupt early brain development, compro-mise the functioning of important biological systems, and lead to long-term health problems.
Child maltreatment, a source of toxic stress, is a significant public health problem in the United States. An estimated 8,755,000 juvenile victims live in this country. That means that more than 1 of 7 children between the ages of 2 and 17 years have experienced maltreatment. This includes physical abuse, sexual abuse, psychological or emotional abuse, neglect, and custodial interference or family abduction. The perpetrators are family (77%), acquaintances (23%), and strangers (2%).
The Effects of Toxic Stress on Brain Development in Early Childhood
The ability to manage stress is controlled by brain circuits and hormone systems that are activated early in life. When a child feels threatened, hormones are released and they circulate throughout the body. Prolonged exposure to stress hormones can impact the brain and impair functioning in a variety of ways.
• Toxic stress can impair the connection of brain circuits and, in the extreme, result in the development of a smaller brain.
• Brain circuits are especially vulnerable as they are developing during early childhood. Toxic stress can disrupt the development of these circuits. This can cause an individual to develop a low threshold for stress, thereby becoming overly reactive to adverse experiences through-out life.
• High levels of stress hormones, including cortisol, can suppress the body’s immune response. This can leave an individual vulnerable to a variety of infections and chronic health problems.
• Sustained high levels of cortisol can damage the hippocampus, an area of the brain responsible for learning and memory. These cognitive deficits can continue into adulthood.
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