How Are Adverse Childhood Experiences Related to Mental and Physical Health in Later Life

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Based on the landmark study “Adverse Childhood Experience Study” (and/or other studies), discuss the empirical evidence regarding the effects of childhood abuse and neglect on adult mental and physical health.

Research has shown that certain health problems increase with the amount of ACEs (Adverse Childhood Experiences) the individual reports. Continuous stress arising from ACEs, causes neurobiological changes in the brain, resulting in impairment of the normal development of multiple brain structures and functions that are associated with a range of mental and physical health problems. In addition to this other maladaptive behaviours that arise from abuse may also contribute to behaviours that exacerbate or precipitate the health problems to be discussed (Anda et al, 2006).

Consistent stress results in dysregulation of the Hypothalamic Pituitary and Adrenal axis (HPA axis) and related systems having adverse effects on the brain. The inhibitory mechanism that allows cortisol levels return back to normal does not develop properly. Having a low stress threshold and high stress levels from a young age generates diminished resilience in overcoming stressful situations in later life. CRF (corticotrophin releasing factor) is released during the stress response and influences many of the brain systems that are related to the health issues found in ACE sufferers (Anda et al, 2006 :Chartier 2007).

Victims of ACE have been found to have an increased risk of developing anxiety disorders as CRH regulates anxiogenic and anxiolytic pathways (Anda et al, 2006 ) Dysregualtion of the HPA is linked to having low serotonin and high dopamine levels: this combination results in hyper-vigilance, and contributes to anxiety disorders. Overactive limbic system are also thought to contribute to anxiety disorders as they regulate emotions and the fear response (Hulme,2011).

Decreased levels of serotonin in prefrontal cortex are thought to affect executive function and judgement which may explain why ACE sufferer are prone to maladaptive coping behaviours such as somatization, substance abuse, self-harm, suicidal behaviours (Kendler, Kuhn, Vittum, Prescott & Riley, 2005) While these also arise from parental practices, they have a physiological basis. Development of affective disorders (i.e. depression and anxiety) can be attributed to chronic stress contributing to the dysregulation of serotonin, a known cause of depression and related mood disorders. Expectedly persons who experienced four or more categories of ACE, compared to those who had experienced none, had 4-to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempts; a 2- to 4-fold increase in smoking (Edwards, Anda, Fellitti & Dube, 2004).

Several brain abnormalities contribute to increased incidence of substance abuse and their related health risks in ACE sufferers. Animal studies have found that early life stressors lead to increased levels on norepinephrine in the brain (Anda et al , 2006). As alcohol and heroin are known to decrease activity in the locus coerulus and hence norepinephrine, those who have experienced ACE are more likely to use these substances as a relief from the PTSD like symptoms that norepinephrine causes (Bremner & Vermetten, 2001: Anda et al , 200).

High HPA activity during childhood and denial of developmentally appropriate experience results in general hindrances on brain development and thus learning capacity. ACE sufferers have decreased myelination and neuronal activity, synaptic connectivity, smaller hypothalamus and corpus callosum contributing to sub -optimal learning and further developmental outcomes (Perry and Pollard, 1998).

Abnormally high levels of dopamine that arise from high cortisol levels coupled with a decrease in hypothalamic volume has been thought to contribute to difficulties with learning, memory and attention (Kendall-Tackett,...
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