Early childhood adversity — such as maltreatment, exposure to domestic violence, or living with another person with serious mental illness — may carry heavy consequences from generation to generation, according to a recent report published in JAMA.
A dysfunctional childhood is linked to several conditions associated with premature death, including smoking, substance abuse, obesity, cardiovascular disease, depression, and attempted suicide.
According to the researchers, early childhood adversity changes stress responsivity, potentially leading to these negative outcomes.
“The good news is that, if detected early enough, the impact of family adversity on child health outcomes can be reversed, or at least attenuated. For example, if maternal depression is treated to remission, the patients’ children show symptomatic and functional gains,” said David A. Brent, M.D., of the University of Pittsburgh School of Medicine and co-author Michael Silverstein, M.D., M.P.H., of the Boston University School of Medicine..
“Economic interventions that provide local employment and move parents out of poverty have been shown to be temporally related to a decreased risk for behavioral disorders in the children of the assisted families.
Earlier foster placement can, to some extent, reverse the deleterious neurobiological and cognitive effects of extreme deprivation in infancy,” they said.
The authors add that physicians should be taught about the effects of adversity, how to detect it, and what steps to take once identified.
Screening, referral, and monitoring may prevent or ease the destructive multigenerational effects of dysfunctional parenting that occur as a consequence of an untreated psychiatric disorder.
Physicians must be advocates for social policies that can help families achieve what all parents want — a secure environment for their children to develop into competent adults, said the authors.
“Home visitation programs for at-risk families of infants have been shown to have long-term positive effects on physical and mental health, education, employment, and family stability. Access to quality preschool education can help to buffer the deleterious effects of poverty,” they said.
“The economic cost — in excess health care utilization, nonresponse to treatment, incarceration, loss of employment, decrease in productivity, and disability — weighs heavily on families burdened with adversity but ultimately is borne by society as a whole.
“In the drive to improve quality of health care and contain costs, the huge price tag to society of early adversity cannot be neglected,” said the authors.