The process by which individuals' previous experiences and environments systematically alter their health and functioning across the life span. 

Biological Embedding

Adverse health effects of toxic stress during childhood can include:
- Maladaptive coping skills 
- Poor stress management 
- Unhealthy lifestyles
- Mental illness
- Physical disease

Adverse Health Effects of Toxic Stress

The toxic stress response affects the neuroendocrine-immune network, and that response leads to a prolonged and abnormal cortisol response. The resultant immune dysregulation increases the risk of infections in children. The toxic stress response is believed to play a role in the pathophysiology of depressive disorders, behavioral dysregulation, PTSD, and psychosis. 

Toxic Stress Response

Resilience is the ability to properly adapt to adversity despite the conditions. It is dynamic and plays a large role in a toxic stress response. Factors that predict resilience in children experiencing adversity include a solid relationship between the child and parent, child and teacher, adequate social support, and parent's sense of efficacy. Focusing on early interventions to strengthen resilience factors may help to minimize a toxic stress response. 

Resilience in Toxic Stress

Factors believed to increase vulnerability to early toxic stress include a child's increased sensitivity to both psychological and physiologic stress with decreased resources for social and psychological support to help with stress coping skills. Other sources of vulnerability may include poor social support, abusive parenting, developmental delays, and maladaptive behaviors in response to adversity. 

Vulnerability in Toxic Stress

A child risks maladaptive stress responses when exposed to childhood adversity and toxic stress. The first several years of life are sensitive periods of time for increased neuroplasticity, after which it begins to wane. If primary preventive measures are implemented during the early, sensitive windows of development, appropriate stress responses to adversity may result. Screening is a means to identify those children who would benefit from both preventive measures and, if need be, therapeutic interventions.

Screening for Toxic Stress

Toxic stress occurs when a child has underwent a traumatic event for so long that the body fails to recover fully. This type of stress is considered "toxic," because of its high correlations with modified gene expression, increased allostatic load, and issues with cognitive and social-emotional development.

University of Illinois at Chicago

Children who have experienced at least one ACE are at more of a risk for:
- Toxic stress
- Increased risk for mental illness
- Increased suicidal ideation and attempts
- Increased risk for chronic physical health problems 

Consequences of Adverse Childhood Experiences (ACEs)

- Positive
- Tolerable
- Toxic
- Physiological
- Cognitive
- Behavioral

Types of Stress Responses

Barnes, A. J., Anthony, B. J., Karatekin, C., Lingras, K. A., Mercado, R., & Thompson, L. A. (2020). Identifying adverse childhood experiences in pediatrics to prevent chronic health conditions. Pediatric research, 87(2), 362–370. https://doi.org/10.1038/s41390-019-0613-3

Identifying Adverse Childhood Experiences in Pediatrics to Prevent Chronic Health Conditions

Toxic Stress

Adverse childhood experiences are correlated with chronic mental health and addiction problems such as depression, posttraumatic stress disorder (PTSD), and substance abuse. In multiple studies, ACEs were significantly associated with negative mental health outcomes such as depression and substance dependence with a mediating variable of mood and anxiety disorders. 

Adverse Childhood Experiences' (ACEs) can increase risk for developing a mental illness

Several studies have found a direct correlation between ACEs and suicide attempts, as well as the preoccupation with the idea of suicide. A nationwide study found that both physical and sexual abuse during childhood (in addition to seeing domestic violence) greatly influenced suicide attempts. The researchers inferred that preventing ACE in this studied population would've reduced suicide attempts by 50% for women and 33% for men.

Adverse Childhood Experiences (ACEs) can increase suicidal ideation and attempts

Adverse childhood experiences has been associated with several physical health problems such as cardiovascular disease, chronic lung disease, autoimmune disease, headaches, sleep disturbances, obesity, and early death.

Adverse Childhood Experiences (ACEs) can increase risk for chronic physical health problems 

-Unhealthy coping mechanisms
-Difficulty Coping
-Neurodevelopment issues & behavioral conditions


 Mental Health Issues as a result of ACEs

- Accelerated heart rate
- Headaches
- Gastrointestinal problems

Types of Physiological Stress Responses

- Difficulty concentrating
- Difficulty with decision-making

Types of Cognitive Stress Response

- Drinking alcohol
- Smoking
- Taking actions to eliminate cause of stress

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