Abstract
The early years of life are a critical period for the development of the human brain and the maturation of behavior. The plasticity of the developing nervous system means that experiences during childhood and adolescence have an outsized impact on brain pathways that regulate key functional modalities, including emotional regulation, social cognition, executive function, and affective processing.
Malign environmental factors, such as abuse, neglect, loss, or deprivation—known collectively as adverse childhood experiences (ACEs)—intersect with this inherent developmental vulnerability to alter brain function and even structure in detrimental ways, and are well-documented risk factors for a wide range of somatic (e.g., obesity, diabetes, cardiovascular disease, and asthma) and psychiatric disorders (e.g., mood disorders, anxiety, post traumatic stress disorder, and substance abuse disorders) as well as developmental delays, unhealthy lifestyle choices, and violent or criminal behavior.
The damaging effects of ACEs are especially concerning given the prevalence and pervasiveness of childhood maltreatment. According to the Centers for Disease Control, at least one in seven children will have experienced abuse or neglect in the past year, with those <1 year of age experiencing the highest rate of victimization—a number that is likely to underestimate the true number of abusive incidents (Centers for Disease Control and Prevention, 2022).
Worryingly, although several studies reported a decrease in reports of child abuse during the COVID-19 pandemic, a recent survey suggests a different story took place behind closed doors: 11% of adolescents surveyed reported physical abuse in 2020—more than twice the number reporting such abuse in a 2013 survey—whereas 55% reported emotional abuse, compared with 13.9% in 2013 (Krause et al., 2022). In addition to the long-term injurious effects on health and well-being noted above, abuse and neglect impose a significant lifetime economic burden on victims, their families, and the health care system, estimated at ∼$6 billion (Centers for Disease Control and Prevention, 2022).
Even children and adolescents who escape overt victimization are not immune to the deleterious effects of exposure to violence in their homes or communities. Witnessing domestic violence, for example, has been linked to both near-term behavioral dysfunction, such as increased irritability, sleep disorders, separation anxiety, and developmental delays as well as long-term sequelae that include an increased risk of further victimization as adults as well as engaging in aggressive or violent behavior themselves.
Understanding the long-range consequences of exposure to violence in childhood may not only improve our assessment of and response to the violent behavior of some former victims but can also inform the development of evidence-based treatment and prevention strategies. This special issue of Violence and Gender presents original findings from recent research on the effect of direct or indirect exposure to violence during childhood. Two of these studies focus on mothers who are victims of intimate partner violence and examine the extent and nature of their awareness of their children's exposure to violence in the home and the implications of such exposure for their child's development.
One drawback of many studies of the behavioral consequences of ACEs has been the failure to discriminate between different types of adverse events. A third article in this issue endeavors to address this knowledge gap by using the statistical methodology of latent class analysis to identify specific patterns of exposure to ACEs to quantify the association between these patterns to externalizing behavior problems. The special issue concludes with an insightful commentary on the current state of our understanding of the impact of adverse experiences in childhood by Dr. James Garbarino, one of the pioneering researchers in the field of child maltreatment research.
As we reflect on the set of articles, it may be helpful to consider emerging research on factors influencing the course of aging, and the pathogenesis of neurodegenerative diseases tragically suggests that adversity in early life may cast an even longer shadow than previously believed. Although the majority of research on exposure to ACEs, including the studies featured in this issue, track behavioral outcomes only up to middle age, new studies have reported an association between exposure to ACEs and a decrease in late-life cognitive function, including subjective cognitive decline, symptoms of dementia, and even Alzheimer's disease (Corney et al., 2022; Schickedanz et al., 2022; Terry et al., 2022).
Future research, including longitudinal studies currently underway in multiple forms of dementia, will be needed to shed additional light on the risk ACEs pose to the brain and behavior across the lifespan—and emphasize the importance of developing and implementing effective strategies to prevent and mitigate the occurrence of this significant public health risk. These individual experiences also intersect with risk and protective experiences in complex ways across multiple levels within the social ecology (Lopez et al., 2021). It is our hope that this collection of articles stimulates future research that informs intervention and prevention programming to reduce exposure to ACEs and the public health burden associated with ACEs for children across the life course.