Table 1 Concepts relating childhood experience to adult outcomes
Definitions | ||
|---|---|---|
Exposure | Adverse childhood Experiences | An epidemiological measure of childhood abuse, neglect, and family dysfunction, which can be assessed in adults using a ten-item Adverse Childhood Experiences (ACE) questionnaire. ACEs include emotional and physical abuse or neglect, sexual abuse, and exposure to household violence or substance misuse. ACE would include most forms of childhood trauma. |
Complex Trauma | A psychological construct that relates childhood traumatic experiences to adult emotions and behaviour. A particular focus on health harming behaviours, and on service responses to those problems. | |
Response | Attachment | A fundamental aspect of human development: infants’ biological instinct to develop a relationship with at least one caregiver for safety and protection. Over time, the “attunement” developed in such relationships helps the child to regulate their feelings and make sense of the world. Secure attachment develops when parents consistently respond to their child’s needs. Patterns of “insecure” attachment include resistant, avoidant and disorganised types. Attachment theory has also been applied to adult relationships. |
Consequences | Allostatic Load | The physiological consequences of chronic exposure to fluctuating or heightened stress, which may lead to physical, behavioural and cognitive effects. |
Toxic stress | Prolonged activation of the body’s stress response, occurring when a child experiences strong, frequent, and/or enduring adversity without the protection of a supportive adult relationship. Such adversity could arise from the burden of longstanding poverty, and the forms of ACE described above. Integrates aspects of both exposure and “resilience” to traumatic experiences. | |