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Mechanisms Underlying the Association Between Early-Life Adversity and Physical Health: Charting a Course for the Future

Bush, Nicole R. PhD; Lane, Richard D. MD, PhD; McLaughlin, Katie A. PhD

doi: 10.1097/PSY.0000000000000421

ABSTRACT Early-life adversities (ELA) are associated with subsequent pervasive alterations across a wide range of neurobiological systems and psychosocial factors that contribute to accelerated onset of health problems and diseases. In this article, we provide an integrated perspective on recent developments in research on ELA, based on the articles published in this Special Issue of Psychosomatic Medicine. We focus on the following: 1) the distinction between specific versus general aspects of ELA with regard to the nature of exposure (e.g., physical and sexual abuse, emotional abuse or neglect, relative socioeconomic deprivation), biological and behavioral correlates of ELA, and differences across diseases; 2) the importance of timing in the critical phases of exposure to ELA; and 3) adaptive versus dysfunctional responses to ELA and their consequences for biological and behavioral risk factors for adverse health outcomes. This article concludes with outlining important new targets for research in this area, including the neurobiology of affect as a mechanism linking ELA to adverse health outcomes, and the need for large-scale longitudinal investigations of multisystem processes relevant to ELA in diverse samples, starting prenatally, continuing to late adolescence, and with long-term follow-up assessments that enable evaluation of incident disease outcomes.

From the Departments of Psychiatry and Pediatrics, University of California San Francisco, Division of Developmental Medicine, Center for Health and Community (Bush), San Francisco, California; Departments of Psychiatry, Psychology and Neuroscience (Lane), University of Arizona, Tucson, Arizona; Department of Psychology (McLaughlin), University of Washington, Seattle, Washington.

The authors of this editorial served as Guest Editors for this special issue of Psychosomatic Medicine.

Address correspondence and reprint requests to Nicole R. Bush, PhD, UCSF, Center for Health and Community, 3333 California St, Suite 465, San Francisco, CA 94118. E-mail:

Copyright © 2016 by American Psychosomatic Society
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