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ACEs: Evidence, Gaps, Evaluation and Future Priorities

Published online by Cambridge University Press:  11 April 2019

Andrew Steptoe*
Affiliation:
Department of Behavioural Science and Health, University College London E-mail: [email protected]
Theresa Marteau
Affiliation:
Department of Public Health and Primary Care, University of Cambridge E-mail: [email protected]
Peter Fonagy
Affiliation:
Division of Psychology and Language Sciences, University College London E-mail: [email protected]
Kathryn Abel
Affiliation:
Division of Psychology and Mental Health, University of Manchester E-mail: [email protected]

Abstract

There is strong evidence linking adverse childhood experiences (ACEs) and poor outcomes in adulthood both in terms of mental and physical health. Gaps in both the evidence base and research priorities still exist. These include understanding how to identify and assess risk in children who have experienced ACEs, and also the development and, importantly, the evaluation of interventions. Outstanding gaps include whether there are sensitive periods during childhood, the role of resilience/protective factors, the causal relationships, biological mechanisms and relative risk of ACEs for particular negative outcomes. ACEs affect individual children differently and chronic exposure appears to increase the risk of poor outcomes in adulthood, meaning interventions should also be tailored to the individual children, families and communities. Generally, there needs to be better evaluation of interventions and dissemination of this information to ensure that their use is evidence based. More input from affected communities, clinicians, funding bodies and Government departments is required to identify research priorities and ensure gaps in the evidence base are addressed.

Type
Themed Section: Adverse Childhood Experiences (ACES) – Implications and Challenges
Copyright
© Cambridge University Press 2019 

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