By: Katie Davis

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Hundreds of studies across multiple disciplines have uncovered a common finding: exposure to childhood adversity is a powerful predictor of poor mental health throughout the life course. Since the introduction 20 years ago of the Adverse Childhood Experiences (ACE) Study, research on childhood adversity has continued to gain prominence. Today, childhood adversity is the focus of filmsbooks, and popular science coverage geared towards the general public. 

But while childhood adversity continues to be a popular topic of conversation within the scientific community and beyond, there are still a few important challenges to this field of research. For example, what is childhood adversity? And how do we measure it? Making sense of current (and future) findings will require that we better define, capture, and refine what we really mean when we talk about childhood adversity.

Defining it. What is childhood adversity?

Broadly, “childhood adversity” has been used to describe a host of experiences that can cause serious or chronic stress during childhood. These adverse experiences can vary from exposure to threatening or traumatic conditions in the environment (e.g, sexual or physical abuse, natural disasters) to a lack of healthy environmental inputs (e.g., poverty, neglect). 

However, as some have pointed out, researchers may not be aligned in how they define childhood adversity. Without a shared understanding of what childhood adversity is (and is not), it will be difficult to compare findings across studies.

Capturing it: How can we measure childhood adversity?

Even when researchers agree on the definition of childhood adversity, they face the practical challenge of how to measure it. One of the biggest obstacles to measuring childhood adversity relates to whether to rely on prospective reports of adversity (i.e., reports that are collected as the child grows up) versus retrospective reports (i.e., reports that are collected from memory after the child is an adult). 

Unfortunately, neither measure is perfect. Prospective reports tend to come from children’s parents, who may be hesitant to disclose their children’s exposure to certain types of adversities, such as abuse or neglect. In comparison, adults’ retrospective reports of adversities experienced in childhood may be flawed due to errors in memory. Objective reports, such as data collected from children’s health records, may address some of these problems, but still may not accurately capture some types of adversity, such as abuse.

Refining it: Which features of childhood adversity are most potent?

To understand the effects of childhood adversity, we need to understand the specific features of adversity that are most harmful. Does exposure to physical abuse confer the same psychological risks as neglect? What about exposure to physical abuse in early childhood versus adolescence? 

In the Dunn Lab, our research has focused on understanding how type and timing of adverse experiences can have a particularly strong effect on risk for mental health problems, so that we and others can continue to refine the ways we study childhood adversity and ultimately intervene to offset its negative consequences.

Where to go from here?

So how can we as researchers sidestep these potential pitfalls and continue to make meaningful gains in the study of childhood adversity? We have three suggestions to start:

  1.  Say what you mean. Researchers, clinicians, and others involved in childhood development need to come to a consensus about a definition of childhood adversity––some potential shared definitions have already been proposed. In the meantime, scientists studying childhood adversity should be clear about the definition they used, so that conclusions can be more easily drawn across studies.
     
  2.  Push for more precise measures. Childhood adversity isn’t just skin deep: adverse experiences can change a person’s biology, leaving behind biological memories of such experiences. Studies on inflammatory markers and epigenetic profiles are exploring new objective measures to capture both the occurrence and consequences of adversity exposure. Meanwhile, researcher using prospective and retrospective reports should weigh the pros and cons of each––and, when possible, use convergent measures.
     
  3.  Dig into the details. Once we know what we mean when we talk about childhood adversity and have a strategy for how to measure it, we can then dive deeply into exploring which adversities are most harmful, and when.

Addressing each of these steps will make for not just better science, but also better interventions––interventions that are targeted at clearly defined and accurately assessed adversities, and that are timed to have the greatest possible impact.

To learn more about childhood adversity and its effects on development, check out:

Harvard’s Center on the Developing Child
Administration for Children & Families

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