Gene-environment interplay and the biology of misfortune
|
|
|
- Cora Logan
- 5 years ago
- Views:
Transcription
1 Gene-environment interplay and the biology of misfortune The Jill Joseph Lecture Children s National Medical Center W. Thomas Boyce Departments of Pediatrics and Psychiatry University of California, San Francisco
2
3
4 A life of almost shameful good fortune A gratifying and productive professional career Stable 43-year marriage Two thriving children, two grandchildren Few or no disturbances of health
5 A life of almost shameful good fortune A gratifying and productive professional career Stable 43-year marriage Two thriving children, two grandchildren Few or no disturbances of health A life of disappointment and affliction Disabling chronic disease at age 11 Diagnosis of schizophrenia by age 20 Unplanned pregnancy; delivery of a disabled child Suicide at 53 years of age
6 Why? How?
7 Why some get sick and others do not? The origins of our differences? TWIN HUMAN MYSTERIES
8 Why some get sick and others do not? The origins of our differences? TWIN HUMAN MYSTERIES
9 A STORY IN THREE PARTS:
10 A STORY IN THREE PARTS: 1. Early, socially stratified exposures to adversity become biologically embedded over time, affecting developmental and disease risk over the entire life course.
11 A STORY IN THREE PARTS: 1. Early, socially stratified exposures to adversity become biologically embedded over time, affecting developmental and disease risk over the entire life course. 2. Such risk is highly variable from child to child and is influenced by even the most proximate, immediate experiences of social subordination.
12 A STORY IN THREE PARTS: 1. Early, socially stratified exposures to adversity become biologically embedded over time, affecting developmental and disease risk over the entire life course. 2. Such risk is highly variable from child to child and is influenced by even the most proximate, immediate experiences of social subordination. 3. Genes and social environments operate together to produce these powerful developmental effects.
13 (Chen et al, 2002) Social partitioning of child health and development
14 (Chen et al, 2002) Social partitioning of child health and development % with emotional or behavioral problems (CDC, MMWR; May 6, 2011)
15 (Chen et al, 2002) Social partitioning of child health and development % with emotional or behavioral problems (CDC, MMWR; May 6, 2011) Poorer children sustain higher rates of acute and chronic, physical and mental disorders, school failure and delinquency Not simply an effect of poverty Graded, linear association, with higher rates of disorder at every step of the SES gradient SES is the single most powerful determinant of health outcomes
16
17 Toxins Diet Health care Housing Violence Parenting Adversity and stress
18 Socioeconomic partitioning of stressors and adversities Evans & English, 2002
19 75 60 Socioeconomic partitioning of stressors and adversities Poverty Middle Income Evans & English, Density Housing problems Noise Family turmoil Violence
20 75 60 Socioeconomic partitioning of stressors and adversities Poverty Middle Income Evans & English, Density Housing problems Noise Family turmoil Violence
21 Childhood maltreatment predicts adult inflammation (Danese et al: PNAS, 2007)
22 Childhood experiences of adversity/trauma predict leading causes of adult mortality (Felitti et al, 1998)
23 Population attributable risk for psychiatric disorders by exposures to childhood adversities (N=6,483) (McLaughlin et al: Arch Gen Psychiatry, 2012) All adversities All disorders Fear subclass Distress subclass Behavior subclass Substance abuse subclass Population attributable risk
24 Population attributable risk for psychiatric disorders by exposures to childhood adversities (N=6,483) (McLaughlin et al: Arch Gen Psychiatry, 2012) All adversities All disorders Fear subclass Distress subclass Behavior subclass Substance abuse subclass Population attributable risk Population attributable risk = Ie - Iu i.e., the reduction in incidence that would be observed if the population were entirely unexposed, compared with its current (actual) exposure pattern
25 Population attributable risk for psychiatric disorders by exposures to childhood adversities (N=6,483) (McLaughlin et al: Arch Gen Psychiatry, 2012) All adversities All disorders Fear subclass nearly 30% of adolescent psychopathology attributable to childhood adversities Distress subclass Behavior subclass Substance abuse subclass Population attributable risk Population attributable risk = Ie - Iu i.e., the reduction in incidence that would be observed if the population were entirely unexposed, compared with its current (actual) exposure pattern
26 Pervasive differences in the experiences of everyday life
27 Program for International Student Assessment (PISA)
28 Program for International Student Assessment (PISA) NLSCY, Cycle 4
29 Program for International Student Assessment (PISA) NLSCY, Cycle 4 Chapman et al (2004) J Aff Disorders
30 Program for International Student Assessment (PISA) NLSCY, Cycle 4 Chapman et al (2004) J Aff Disorders Weber et al (2008) BMC Psychiatry
31 Program for International Student Assessment (PISA) NLSCY, Cycle 4 Stressful, disadvantaged environments have highly variable effects on developmental and health outcomes Chapman et al (2004) J Aff Disorders Weber et al (2008) BMC Psychiatry
32 Variability in developmental outcomes by adversity and SES Noise?
33 Variability in developmental outcomes by adversity and SES Noise? or music?
34
35
36 Hypothalamic-pituitary-adrenocortical system
37 Hypothalamic-pituitary-adrenocortical system Locus coeruleus-autonomic system
38 Hypothalamic-pituitary-adrenocortical system Adrenocortical and autonomic reactivity to standardized laboratory stressors Salivary cortisol response Impedance cardiography: fight or flight response Broad and reliable individual variability in magnitude and patterns of response Locus coeruleus-autonomic system
39 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
40 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT Presyndromal psychopathology Low Low ANS Reactivity High ANS Reactivity High Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
41 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT Presyndromal psychopathology Low Low ANS Reactivity High ANS Reactivity High Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
42 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT Presyndromal psychopathology Low Low ANS Reactivity High ANS Reactivity High Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
43 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT Presyndromal psychopathology Low Low ANS Reactivity High ANS Reactivity High Maskrosbarn (Sw): dandelion child Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
44 INTERACTIVE EFFECTS OF ANS REACTIVITY AND FAMILY CONFLICT Presyndromal psychopathology Low Low ANS Reactivity High ANS Reactivity High Orkidebarn: orchid child Maskrosbarn (Sw): dandelion child Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
45 Presyndromal psychopathology Low Neophobic, shy, and reactive children with sensory Low ANS Reactivity High ANS Reactivity sensitivities High Orkidebarn: orchid child Maskrosbarn (Sw): dandelion child Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
46 Presyndromal psychopathology Low Neophobic, shy, and reactive children with sensory Low ANS Reactivity High ANS Reactivity DIFFERENTIAL NEUROBIOLOGICAL SUSCEPTIBILITY TO SOCIAL CONTEXT sensitivities High Orkidebarn: orchid child Maskrosbarn (Sw): dandelion child Family Conflict OBRADOVIĆ J, BOYCE WT ET AL: DEV PSYCHOPATHOL, 2011
47
48 Violent injuries (per 100K subject-hours) High reactivity Low reactivity 0 Low stress year Confinement year Boyce & Suomi, 1998
49 Violent injuries (per 100K subject-hours) High reactivity Low reactivity 0 Low stress year Confinement year Boyce & Suomi, 1998
50 Violent injuries (per 100K subject-hours) High reactivity Low reactivity 0 Low stress year Confinement year Boyce & Suomi, 1998
51 Fall Chronic Daily Cortisol Level (Std) Bush, Adler & Boyce, 2012 BDNF Val66Met polymorphism BDNF Met carrier BDNF Val/Val SD +1 SD Family Income
52 Fall Chronic Daily Cortisol Level (Std) Bush, Adler & Boyce, 2012 BDNF Val66Met polymorphism BDNF Met carrier BDNF Val/Val SD +1 SD Family Income
53 Ellis, Essex & Boyce, Low warmth, low SNS reactivity High warmth, low SNS reactivity Low warmth, high SNS reactivity High warmth, high SNS reactivity Tanner Stage Age in Years, Centered on 12.5
54 Ellis, Essex & Boyce, Low warmth, low SNS reactivity High warmth, low SNS reactivity Low warmth, high SNS reactivity High warmth, high SNS reactivity Tanner Stage Age in Years, Centered on 12.5
55 Ellis, Essex & Boyce, Low warmth, low SNS reactivity High warmth, low SNS reactivity Low warmth, high SNS reactivity High warmth, high SNS reactivity Tanner Stage Age in Years, Centered on 12.5
56 Ellis, Essex & Boyce, Low warmth, low SNS reactivity High warmth, low SNS reactivity Low warmth, high SNS reactivity High warmth, high SNS reactivity Tanner Stage Age in Years, Centered on 12.5
57 Ellis, Essex & Boyce, Low warmth, low SNS reactivity High warmth, low SNS reactivity Low warmth, high SNS reactivity High warmth, high SNS reactivity Tanner Stage Age in Years, Centered on 12.5
58 DIFFERENTIAL NEUROBIOLOGICAL SUSCEPTIBILITY TO SOCIAL CONTEXT
59 Society Behavior DIFFERENTIAL NEUROBIOLOGICAL SUSCEPTIBILITY TO SOCIAL CONTEXT Brain Circuitry/ synapse Genome/ epigenome
60 SES, stress and oral health Dental caries = single most common chronic disease of childhood Strong SES and racial disparities Known etiologic factors: lead exposure, tobacco smoke, diet, and access to fluoridated water Oral bacteria Strep mutans and Lactobacillus acidophilus Leading account of disparities: neglect of children s dental hygiene by low SES parents
61
62
63 T1 T2 T3
64 T1 T2 T3
65 T1 T2 T3
66 T1 T2 T3
67 T1 T2 T3 Deciduous teeth as a stress biomarker in young children?
68 enamel dentin crown pulp chamber root gumcanal supporting ligament root accessory canal root end opening T1 T2 T3 Deciduous teeth as a stress biomarker in young children?
69 enamel dentin crown pulp chamber root gumcanal supporting ligament root accessory canal root end opening T1 T2 T3 Deciduous teeth as a stress biomarker in young children?
70 Sociobiological effects on childhood dental caries (Boyce et al, 2010) SES Dental caries
71 Sociobiological effects on childhood dental caries (Boyce et al, 2010) SES Cariogenic bacteria Dental caries
72 Sociobiological effects on childhood dental caries (Boyce et al, 2010) SES Financial stress Cariogenic bacteria HPA activation Dental microanatomy Dental caries
73 Sociobiological effects on childhood dental caries (Boyce et al, 2010) SES Financial stress Cariogenic bacteria Bacteria x Cortisol HPA activation Dental microanatomy Dental caries
74 Sociobiological effects on childhood dental caries (Boyce et al, 2010) Oral health disparities related to two interacting pathways: Cariogenic Earlier and more bacteria intensive exposure to an agent of SES disease among Dental Bacteria low SES x Cortisol children caries More family adversity resulting in greater Dental HPA activation, cortisol secretion, and microanatomic microanatomy vulnerability Financial stress HPA activation
75 Beyond the visible, surface forces driving socioeconomic health disparities
76 Beyond the visible, surface forces driving socioeconomic health disparities Toxins Diet Health care Housing Violence Parenting Adversity and stress
77 Beyond the visible, surface forces driving socioeconomic health disparities Toxins Diet Health care Housing Violence Parenting Adversity and stress Might there be deeper, less visible currents of social inequality?
78 African cichlid fish maintain severe hierarchical organization in which only dominant males have reproductive access to females
79 African cichlid fish maintain severe hierarchical organization in which only dominant males have reproductive access to females Rats in subordination paradigm show proinflammatory shifts in cytokine signaling pathways
80 African cichlid fish maintain severe hierarchical organization in which only dominant males have reproductive access to females Rats in subordination paradigm show proinflammatory shifts in cytokine signaling pathways Primate species form stable, linearly transitive social hierarchies Subordinate positions: upregulated adrenocortical function, impaired immune competence, decreased resistance to disease
81 African cichlid fish maintain severe hierarchical organization in which only dominant males have reproductive access to females Rats in subordination paradigm show proinflammatory shifts in cytokine signaling pathways Primate species form stable, linearly transitive social hierarchies Subordinate positions: upregulated adrenocortical function, impaired immune competence, decreased resistance to disease Young children form social orders within weeks of entering new social groups Are subordinate positions in early peer hierarchies associated with greater stress, exaggerated reactivity, and excessive, stress-related morbidity?
82 Naturalistic measures of dominance/ subordination behavior
83 Naturalistic measures of dominance/ subordination behavior Social dominance: a pattern of repeated encounters in which the outcome consistently favors the same dyad member
84 Naturalistic measures of dominance/ subordination behavior Social dominance: a pattern of repeated encounters in which the outcome consistently favors the same dyad member Dominance observations: critical event and scan sampling over 3-5 weeks
85 Naturalistic measures of dominance/ subordination behavior Social dominance: a pattern of repeated encounters in which the outcome consistently favors the same dyad member Dominance observations: critical event and scan sampling over 3-5 weeks Behaviors: physical attack, imitation, directing, threat, relational aggression
86 Naturalistic measures of dominance/ subordination behavior Social dominance: a pattern of repeated encounters in which the outcome consistently favors the same dyad member = Dominance observations: critical event and scan sampling over 3-5 weeks = Behaviors: physical attack, imitation, directing, threat, relational aggression
87
88 338 kindergarten children; 29 public school classrooms
89 338 kindergarten children; 29 public school classrooms Depression,8Ina5en6on,8Peer8rela6onships,8Academic8competence! Boys Girls 2 1 0!1! !1!2 Social8Posi6on8(Low8to8High) Depression Ina5en6on Peer8rela6onships Academic8competence
90 Subordinate children sustain higher rates of depression and inattention, poorer peer relationships and academic competence Boys > girls 338 kindergarten children; 29 public school classrooms Depression,8Ina5en6on,8Peer8rela6onships,8Academic8competence! Boys Girls 2 1 0!1! !1!2 Social8Posi6on8(Low8to8High) Depression Ina5en6on Peer8rela6onships Academic8competence
91 Subordinate children sustain higher rates of depression and inattention, poorer peer relationships and academic competence Boys > girls 338 kindergarten children; 29 public school classrooms Depression,8Ina5en6on,8Peer8rela6onships,8Academic8competence! Boys Girls 2 1 0!1! !1!2 Social8Posi6on8(Low8to8High) Depression Ina5en6on Peer8rela6onships Academic8competence
92 Powerful, stress-related effects of social subordination and marginality, at both the societal and small group level.
93 Powerful, stress-related effects of social subordination and marginality, at both the societal and small group level. Effects that can be mitigated by more egalitarian, empathic policies and practices.
94 Developmental calibration of neurobiological circuitry: How does it happen?
95 Developmental calibration of neurobiological circuitry: How does it happen? Same species of buckeye butterfly Polyphenism driven by temperature and length of daylight A conditional adaptation involving differential epigenetic regulation of genes determining wing coloration and pattern
96
97 Environmental exposures
98 Environmental exposures
99 Environmental exposures Epigenetic marks as the physical nexus between genes and environments
100 N = 570 Wisconsin Study of Families and Work N = 109 Infancy Preschool Parental stressors Epigenetic profiling of buccal epithelial cells
101 Epigenetic vestiges of early parental stressors Essex, Boyce et al: Child Dev, 2013
102 Epigenetic vestiges of early parental stressors Mothers stressors in infancy more related to differences in methylation for both girls and boys Essex, Boyce et al: Child Dev, 2013
103 Epigenetic vestiges of early parental stressors Mothers stressors in infancy more related to differences in methylation for both girls and boys Fathers stressors in preschool associated with demethylation differences, primarily for girls Essex, Boyce et al: Child Dev, 2013
104 Epigenetic vestiges of early parental stressors Mothers stressors in infancy more related to differences in methylation for both girls and boys Fathers stressors in preschool associated with demethylation differences, primarily for girls Pattern of association consistent with known developmental time course of parental influence Essex, Boyce et al: Child Dev, 2013
105
106
107
108
109 Adaptive phenotype Maladaptive phenotype
110
111 A STORY IN THREE PARTS: 1. Early, socially stratified exposures to adversity become biologically embedded over time, affecting developmental and disease risk over the entire life course. 2. Such risk is highly variable from child to child and is influenced by even the most proximate, immediate experiences of social subordination. 3. Genes and social environments operate together to produce these powerful developmental effects.
112 Why? How?
113 Why? How? Unshared family environment; i.e., raised in different families Sibling differences in genomic risk Birth order or gender Complex, epigenetic interaction between allelic variation and family environment
114 8 year old patient with chronic abdominal pain
115 8 year old patient with chronic abdominal pain I am sick of this messy life. Always the same. Everyone makes fun of me. No one recognizes my potential. I am serious. Tim Kreschmer, secondary school student Posted on the internet the night prior to a shooting rampage that killed 15 people
116 Occupy Wall Street 8 year old patient with chronic abdominal pain I am sick of this messy life. Always the same. Everyone makes fun of me. No one recognizes my potential. I am serious. Tim Kreschmer, secondary school student Posted on the internet the night prior to a shooting rampage that killed 15 people
117 Social stratification Subordination Stress and adversity Inequality in life chances
118 Social stratification Subordination Stress and adversity Inequality in life chances A selfish and boundless thirst for power and material prosperity (Pope Francis, in address to U.N. General Assembly)
119 Social stratification Subordination Stress and adversity Inequality in life chances A selfish and boundless thirst for power and material prosperity (Pope Francis, in address to U.N. General Assembly) Social relationships are important!
120 Social stratification Subordination Stress and adversity Inequality in life chances A selfish and boundless thirst for power and material prosperity (Pope Francis, in address to U.N. General Assembly) Social relationships are important!
121 Nancy Adler, Abbey Alkon, Ron Barr, Loïc Belingard, Pam Den Besten, Nicki Bush, Nicole Catherine, Bruce Ellis, Tanya Erb, Marilyn Essex, John Featherstone, Clyde Hertzman, Young Shin Kim, Mark Kishiyama, Mike Kobor, Stephanie Lam, Amani Nuru-Jeter, Tim Oberlander, Doug Jutte, Amani Nuru-Jeter, Jelena Obradović, Khaled Sarsour, Margaret Sheridan, Juliet Stamper, Anat Zaidman, the MacArthur Foundation Research Network on Psychopathology and Development, the National Institute of Mental Health, the National Institute of Child Health and Human Development, the WT Grant Foundation, the Robert Wood Johnson Foundation Health & Society Scholars Program, the University of British Columbia, the UBC Human Early Learning Partnership, and the Experience-Based Brain and Biological Development Program of the Canadian Institute For Advanced Research, and the Child and Family Research Institute.
122 DUPREE M: LEADERSHIP IS AN ART, 1989
123 SHE HAS TO BE ABLE TO CONNECT YOUR VOICE TO YOUR TOUCH DUPREE M: LEADERSHIP IS AN ART, 1989
Epigenetic Variation in Human Health and Disease
Epigenetic Variation in Human Health and Disease Michael S. Kobor Centre for Molecular Medicine and Therapeutics Department of Medical Genetics University of British Columbia www.cmmt.ubc.ca Understanding
Abbey Alkon, RN, PNP, MPH, PhD Professor, University of California, San Francisco School of Nursing Lecture at ZHAW Zurich University of Applied
Abbey Alkon, RN, PNP, MPH, PhD Professor, University of California, San Francisco School of Nursing Lecture at ZHAW Zurich University of Applied Sciences Institute of Nursing, School of Health Professions
TAKING ON TRAUMA: Developmental and Educational Implications of Toxic Stress
TAKING ON TRAUMA: Developmental and Educational Implications of Toxic Stress Heather C Forkey, M.D. RTSC Making a Difference Conference November 10, 2015 Disclosure slide I have no actual or potential
What nurses need to know about Trauma-Informed Care
What nurses need to know about Trauma-Informed Care Define trauma-informed care Identify how to assess for trauma Tap in to resources for these patients and their families Kaiser Permanente,1995-1997
Roots of Adult Disease Traced to Early Childhood Adversity
Contact: Millicent Lawton Center on the Developing Child millicent_lawton@harvard.edu (617) 496-0429 Roots of Adult Disease Traced to Early Childhood Adversity Early childhood programs could prevent chronic
The Resilient Revolution takes on
The Resilient Revolution takes on Attachment, Adverse Childhood Experiences(ACEs) and Neuroscience A Tale of Pathologies? Dr Derek Blincow Blackpool 2018 Grand Theory in Adversity and Child Development
Why do people use drugs? Why do so many people use drugs? What should we do?
Why do people use drugs? Why do so many people use drugs? What should we do? David Labby MD PhD Health Share of Oregon -- May 17, 2018 Learning Objectives 1. To increase understanding of societal determinants
Attending to the Whole Population
Attending to the Whole Population a population health roundtable June 29, 2016 WHO definition of health Health is a state of complete physical, mental and social well-being and not merely the absence
How does adversity in childhood get under the skin
How does adversity in childhood get under the skin What can we learn from neuroscience and epigenetics? Eamon McCrory Professor of Developmental Neuroscience & Psychopathology, UCL Consultant Clinical
Trauma and Stress: Neurobiology and the Impact on Development
Trauma and Stress: Neurobiology and the Impact on Development https://www.cbsnews.com/news/oprah winfrey treatingchildhood trauma ELIZABETH REEVE MD HEALTHPARTNERS MEDICAL GROUP Why is This Topic Important?
Limits of Understanding. by Paul Klee ( )
Limits of Understanding by Paul Klee (1879-1940) When I approach a child, he inspires in me two sentiments; tenderness for what he is, and respect for what he may become. --Louis Pasteur-- March Madness
1/30/2018. Risk factors: substance exposure. MY LAB S RESEARCH: Risk factors: Toxicants (BPA)
Risk factors: substance exposure Cocaine Exposure Cannabis Exposure Tobacco Exposure Roussotte F, Soderberg L, et al. 2012. J Neurodev Disorders. 4:22. Marround HE, Tiemeier H, et al. 2016. Biological
Learning objectives: 2/21/18. Children s Research Triangle Wendy Kovacs Cortes, Ph.D., LMFT
Wendy Kovacs Cortes, Ph.D., LMFT Learning objectives: Biological and relational components of intergenerational trauma. Epigenetics and ACES. How relational trauma is transmitted intergenerationally. How
5/12/2016. Adverse Childhood Experiences and the Impact of Toxic Stress/Trauma 50,000
Adverse Childhood Experiences and the Impact of Toxic Stress/Trauma 1875 50,000 1 358 FTE Top Referral Sources COMMUNITY WELL-BEING CHILD WELL-BEING FINANCIAL STABILITY RECOVERY Reduces Need for Services
Course Catalog. Early Intervention, Treatment, and Management of Substance Use Disorders
Course Catalog To take a course, visit our website at https://www.mindfulceus.com - You can link directly to a course by visiting https://www.mindfulceus.com/course/id where ID is the ID number listed
Week 2: Disorders of Childhood
Week 2: Disorders of Childhood What are neurodevelopmental disorders? A group of conditions with onset in the developmental period Disorders of the brain The disorders manifest early in development, often
Early Childhood Caries (ECC) KEVIN ZIMMERMAN DMD
Early Childhood Caries (ECC) KEVIN ZIMMERMAN DMD What Is Early Childhood Caries? Early Childhood Caries (ECC) is a transmissible infectious process that affects children younger than age 6 and results
California 2,287, % Greater Bay Area 393, % Greater Bay Area adults 18 years and older, 2007
Mental Health Whites were more likely to report taking prescription medicines for emotional/mental health issues than the county as a whole. There are many possible indicators for mental health and mental
Safety Individual Choice - Empowerment
Safety Individual Choice - Empowerment Diane M. Gruen-Kidd, LCSW Department for Behavioral Health, Developmental and Intellectual Disabilities Diane.Gruen-Kidd@ky.gov Please Be Aware There are parts of
Workshop ACEs. Adverse Childhood Experiences and how knowing about them can inform our (clinical) practice
Workshop ACEs Adverse Childhood Experiences and how knowing about them can inform our (clinical) practice! Dr Sara Ketteley Consultant Psychiatrist at Great Chapel Street Adverse Childhood Experiences
Child-Parent Psychotherapy Research Fact Sheet OVERVIEW
Child-Parent Psychotherapy Research Fact Sheet OVERVIEW Child-Parent Psychotherapy (CPP) is an intervention model for children aged 0-5 who have experienced traumatic events and/or are experiencing mental
DRAFT THE HIGH COST OF ADVERSE CHILDHOOD EXPERIENCES
THE HIGH COST OF ADVERSE CHILDHOOD EXPERIENCES 2007 Family Policy Council Please do not reproduce in part or in full without permission BRAIN RESEARCH See for example: Teicher, M et al. Neurobiological
Neil W Boris, MD Irving Harris Training Director, Florida State University Center for Prevention and Early Intervention Policy
Neil W Boris, MD Irving Harris Training Director, Florida State University Center for Prevention and Early Intervention Policy Professor (Public Health and Medicine), Researcher Focus on Early Childhood
University of British Columbia (Vancouver, British Columbia) Doctor of Philosophy in Psychology
HANNAH M. C. SCHREIER T HE PENNSYLVANIA STATE UNIVERSITY w D EPARTMENT OF BIOBEHAVIORAL H EALTH 219 BIOBEHAVIORAL H EALTH BUILDING w UNIVERSITY PARK, PA w 16802 P HONE: 814.863.5767 w EMAIL: hannah.schreier@psu.edu
Department of Psychiatry/ Pediatrics, University of California, San Francisco
Published on Bush Lab (http://bushlab.ucsf.edu) Home > CTRP-Health CTRP-Health The CTRP-Health study at the UCSF Child Trauma Research Program (CTRP) investigates the effects of clinical intervention on
WHATEVER IT TAKES! UNDERSTANDING ADVERSE CHILD EXPERIENCES. Nadine Burke Harris, MD, MPH CEO, Center for Youth Wellness March 1, 2013
WHATEVER IT TAKES! UNDERSTANDING ADVERSE CHILD EXPERIENCES Nadine Burke Harris, MD, MPH CEO, Center for Youth Wellness March 1, 2013 Effect of ACEs on Health, Learning & Behavior Background Brief overview
Early Life Roots of Health. Ann Bullock, MD Director Division of Diabetes Treatment and Prevention Indian Health Service
Early Life Roots of Health Ann Bullock, MD Director Division of Diabetes Treatment and Prevention Indian Health Service What Happens Early Affects the Rest of Our Lives many adult diseases should be viewed
Trauma and Development: An Integrated Best Practice Approach
Trauma and Development: An Integrated Best Practice Approach ATTACH Conference- September 27, 2015 Kathy Ryan, Ph.D., LCSW Clinical Coordinator, Circle Preschool Program, GRSCAN, Richmond, VA Denise Powers,
The Magnitude of the Solution. Building Self-Healing Communities
The Magnitude of the Solution Building Self-Healing Communities Beyond Resilience Flourish To Flourish: To Prosper with Sustained, Continuous, Steady, Strong Growing Well Bing & Miriam Webster Dictionaries
Wonder Girls to Wonder Women: Lessons Learned from a Longitudinal Study of Girls with ADHD
Wonder Girls to Wonder Women: Lessons Learned from a Longitudinal Study of Girls with ADHD Christine Zalecki, Ph.D. Associate Clinical Professor, UC San Francisco Director, Berkeley Girls with ADHD Longitudinal
Like a footprint in wet cement Understanding Adverse Childhood Experience Research. The agenda 1/13/2015
Like a footprint in wet cement Understanding Adverse Childhood Experience Research Victor I. Vieth Senior Director & Founder National Child Protection Training System Gundersen Health System The agenda
Module 2 Understanding the Science of Brain Development
September 2013 Module 2 Understanding the Science of Brain Development Participants will: Module 2 Learning Objectives Understand the impact of the prenatal period on the developing brain including the
Adverse Childhood Experiences Predictor s of Future Health In my end is my beginning T.S. Eliot Four quartets
Adverse Childhood Experiences Predictor s of Future Health In my end is my beginning T.S. Eliot Four quartets Steve Wolfe, M.D. Professor Emeritus University of Iowa Department of Family Medicine Learning
Adverse Childhood Experiences. Dr Michael Smith, Associate Medical Director, Mental Health & Addictions, NHS Greater Glasgow & Clyde
Adverse Childhood Experiences Dr Michael Smith, Associate Medical Director, Mental Health & Addictions, NHS Greater Glasgow & Clyde A story of Childhood Adversity Some ACE science ACE reduction in practice
Demographics HD 300 Child Abuse & Neglect
Demographics HD 300 Child & Neglect Unit 10 Sexual (Intra-Familial) Sexual abuse cuts across all socioeconomic levels. Offenders are usually male (97%). Victims are usually female (77%). 1 in 4 molested
The Relationship of Adverse Childhood Experiences to Adult Health Status
The Relationship of Adverse Childhood Experiences to Adult Health Status Presentation to MCAH Committee December2, 21 Edwin Ferran Director of Learning and Innovation Community Action Partnership of Sonoma
ORAL HEALTH OF GEORGIA S CHILDREN Results from the 2006 Georgia Head Start Oral Health Survey
ORAL HEALTH OF GEORGIA S CHILDREN Results from the 26 Georgia Head Start Oral Health Survey Introduction Oral health is an essential component of health throughout life. Poor oral health and untreated
Section C. Intrinsic and Extrinsic Influences on Infant and Early Childhood Regulatory Development
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Contents. Acknowledgments About the Author
Contents Preface Acknowledgments About the Author xvii xviii xix PART I: Understanding Aggression 1 1. Media Violence: History and Key Issues 2 Concerns About Media Violence Throughout History 3 Evaluating
RELATIONSHIP BETWEEN CHILDHOOD POVERTY AND DEPRESSION AND ANXIETY. A Quantitative Analysis. Tyra Smith
RELATIONSHIP BETWEEN CHILDHOOD POVERTY AND DEPRESSION AND ANXIETY A Quantitative Analysis By Tyra Smith Introduction Being a child living in poverty has many effects on a child s emotional, social, and
TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT:
TRAUMA AND TOXIC STRESS IN THE PEDIATRIC PATIENT: How to Appreciate, Assess and Address Heather C. Forkey, M.D. Foster Children Evaluation Service (FaCES) UMass Children s Medical Center Worcester MA Disclosure
Both Sides of the Desk: Trauma-Informed Services in the Child Support Program
Both Sides of the Desk: Trauma-Informed Services in the Child Support Program Rebecca Sharp, MPA, LMSW Katie Morgan, SC IV-D Director Both Sides of the Desk: Trauma-Informed Services in the Child Support
MEDICAL ASPECTS OF TRAUMA
MEDICAL ASPECTS OF TRAUMA Toxic Stress and Health Heather C. Forkey, M.D. Foster Children Evaluation Service (FaCES) UMass Children s Medical Center Worcester MA Disclosure slide I have no actual or potential
on Brain Development Infant brain development
Effects of Child Abuse and Neglect on Brain Development Jodi Flick, LCSW, ACSW Family and Children s Resource Program Jordan Institute for Families UNC-Chapel Hill School of Social Work joflick@email.unc.edu
Understanding Adverse Childhood Experiences. Building Self-Healing Communities
Understanding Adverse Childhood Experiences Building Self-Healing Communities Robert Anda, MD, MS Co-Founder ACE Interface 2013 www.aceinterface.com Building Self-Healing Communities Health Care Child
THE URBAN CHILD INSTITUTE
THE URBAN CHILD INSTITUTE 8 BRAIN DEVELOPMENT The first years of life are a vital period for early brain development. 9 Decades of research show that the environment of a child s earliest years can have
Correlation of Early Childhood Caries Risk and Obesity in Preschool Age Children Via Salivary Testing
Correlation of Early Childhood Caries Risk and Obesity in Preschool Age Children Via Salivary Testing Dr. Francisco Ramos-Gomez (UCLA) and Dr. R.S. Jones (U. Minn) with Dr. Wendy Slusser, Venice Family
Therese s Family of Origin Issues. Protective Factors. Trauma and Addicted Family Systems: A Multi-dimensional Perspective
Trauma and Addicted Family Systems: A Multi-dimensional Perspective with Claudia Black, MSW, Ph.D. and Shelley Uram, M.D. Senior Fellows The Meadows Protective Factors Had a special relationship with an
GENERAL PROFILE OF PEDIATRICS
GENERAL PROFILE OF PEDIATRICS HUANG Guo-ying, M.D. ( 黄国英教授 ) Professor, Department of Pediatrics Shanghai Medical College Fudan University gyhuang@shmu.edu.cn Requirements in this lesson To be familiar
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
COLLEGE OF EDUCATION DEPARTMENT OF SPECIAL EDUCATION, REHABILITATION AND SCHOOL PSYCHOLOGY CALIFORNIA STATE UNIVERSITY, SACRAMENTO School Psychology Diagnostic Clinic 6000 J Street Sacramento, California
5/2/2017. By Pamela Pepper PMH, CNS, BC. DSM-5 Growth and Development
By Pamela Pepper PMH, CNS, BC DSM-5 Growth and Development The idea that diagnosis is based on subjective criteria and that those criteria should fall neatly into a set of categories is not sustainable,
What s the Diagnosis? A Developmental Perspective
What s the Diagnosis? A Developmental Perspective Larry Pezor, MD Medical Director Eastern Shore Psychological Services Staff Child Psychiatrist Adventist HealthCare Behavioral Health & Wellness Services,
47361 Developmental Psychopathology University of Massachuestts Lowell Dr. Doreen Arcus
Mental Retardation Mash & Wolfe Powerpoint Historical Perspectives on Mental Retardation Historically, prevailing sentiment was ignorance and mistreatment Degeneracy theory (1800 s) saw MR as regression
The Effects of Maternal Alcohol Use and Smoking on Children s Mental Health: Evidence from the National Longitudinal Survey of Children and Youth
1 The Effects of Maternal Alcohol Use and Smoking on Children s Mental Health: Evidence from the National Longitudinal Survey of Children and Youth Madeleine Benjamin, MA Policy Research, Economics and
Society for Prevention Research 2018 Call for Papers Author Abstract Submission Questions. Research Foci
Society for Prevention Research 2018 Call for Papers Author Abstract Submission Questions Research Foci Please select your Research Foci. (Select all that apply) Academic Achievement ADHD Addiction Aging
Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder
Mental Health Problems in Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Presenter: Date: Jacqueline Pei, R. Psych., PhD Carmen Rasmussen, PhD May 5, 2009 The FASD Learning
Surviving and Thriving: Trauma and Resilience
Guiding our community s children through life s critical moments with trauma-informed mental health and child development services. Surviving and Thriving: Trauma and Resilience John Richardson-Lauve,
SAMPLE OF LITERATURE REVIEW FOR PSYCHOLOGY CAPSTONE PROJECT
Abstract In the past one decade, there has been an increased concern about children being exposed to various traumatic events and violence. Most of them end up developing the post-traumatic stress disorder
Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV
Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV Milton L. Wainberg, M.D. Associate Clinical Professor of Psychiatry College of Physicians and Surgeons Columbia University mlw35@columbia.edu
Mobilizing a Community to Address the Impact of Childhood Trauma.
Mobilizing a Community to Address the Impact of Childhood Trauma 1 Teri Barilla Is coordinator of the Walla Walla County Community Network, part of the Washington State Family Policy Council system. Building
Social Determinants of Child Mental Health
Social Determinants of Child Mental Health October 13 th, 2018 Douglas Russell, MD Adolescent and Child Psychiatrist PAL Consultant Seattle Children's Hospital Disclosures No financial disclosures We will
Trauma Informed Practice
Trauma Informed Practice 10 th Shared Learning in Clinical Practice Symposium Dr Kath Moores Senior Clinical Psychologist Outer South Community Mental Health Service Karyn O Keefe Lived Experience Educator
The Brain on Stress. How the social environment gets under the skin (Biological embedding over the lifecourse) Bruce S. McEwen, Ph.D.
The Brain on Stress How the social environment gets under the skin (Biological embedding over the lifecourse) Bruce S. McEwen, Ph.D. Alfred E. Mirsky Professor Head, Harold and Margaret Milliken Hatch
Dr. Delphine Collin-Vézina, Ph.D.
Interview Presentation Tier 2 Canada Research Chair Position School of Social Work McGill University Dr. Delphine Collin-Vézina, Ph.D. Career Path Academic Studies and Research Realizations Applied research
Institutional Abuse: Untying the Gordian Knot. Dr Julian Parmegiani MB BS FRANZCP September 2018
Institutional Abuse: Untying the Gordian Knot Dr Julian Parmegiani MB BS FRANZCP September 2018 Out of Home Care Current Statistics Heritability of Psychiatric Disorders Talk Outline The effects of trauma
Neurobiology of Kindness
Maggie Bennington Davis MD Creating a Safe Place Neurobiology Kindness WHAT S THE BIG DEAL ABOUT TRAUMA? When When people people are are exposed exposed to to trauma, trauma, violence, violence, overwhelming
Intervening with Young Children in the Child Welfare System: Multidimensional Treatment Foster Care for Preschoolers (MTFC-P)
Stress, Neurodevelopment, and Programs that Promote the Well-Being of Children and Families: Early Childhood March 14 th, 2012 Intervening with Young Children in the Child Welfare System: Multidimensional
Epigenetics, Stress and the Brain. Epigenetics. The Epigenome. Stress 9/19/12
Epigenetics, Stress and the Brain Epigenetics Andrew Z. Fire and Craig C. Mello won the Nobel prize in Medicine and Physiology in 2006 for their discovery of "RNA interference gene silencing by double-stranded
Adolescence. Adolescence: The Power of the Developmental History. Human Development and Learning. Stephen E. Brock, Ph.D.
EDS 248 Stephen E. Brock, Ph.D.,NCSP : The Power of the Developmental History Susan, CA: 15-6, Grade: 10, L 1 : English Referring concerns Poor school attendance Poor grades (failing all but one class)
SEA-FHR-1. Life-Course. Promoting Health throughout the. Department of Family Health and Research Regional Office for South-East Asia
SEA-FHR-1 Promoting Health throughout the Life-Course Department of Family Health and Research Regional Office for South-East Asia the health and development of neonates, children and adolescents
Molly Faulkner, PhD, CNP, LISW UNM, Dept of Psychiatry and Behavioral Sciences Div of Community Behavioral Health
Molly Faulkner, PhD, CNP, LISW UNM, Dept of Psychiatry and Behavioral Sciences Div of Community Behavioral Health What is anxiety? What causes anxiety? When is anxiety a problem? What is the size of the
Clinical Relevance of Biological Alterations in PTSD. Rachel Yehuda, PhD Mount Sinai School of Medicine New York, NY
Clinical Relevance of Biological Alterations in PTSD Rachel Yehuda, PhD Mount Sinai School of Medicine New York, NY New developments in PTSD Conceptual shift New findings of prevalence, longitudinal course,
LOUISIANA MEDICAID PROGRAM ISSUED: 04/13/10 REPLACED: 03/01/93 CHAPTER 13: MENTAL HEALTH CLINICS SECTION13.1: SERVICES PAGE(S) 9 SERVICES
SERVICES The clinic services covered under the program are defined as those preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services that are furnished to an outpatient by or
Adverse Childhood Experiences, Behavioral Health and the Connection to Asthma in School Age Children
Adverse Childhood Experiences, Behavioral Health and the Connection to Asthma in School Age Children Elliott Attisha DO FAAP Henry Ford Health System Childhood Asthma Most Common Chronic Disease of Childhood
Socioeconomic Status and the Development of Executive Function
EXECUTIVE FUNCTIONS Socioeconomic Status and the Development of Executive Function Cayce J. Hook, BA, Gwendolyn M. Lawson, BA, Martha J. Farah, PhD University of Pennsylvania, USA January 2013 Introduction
TRAUMA-INFORMED CARE. Mary Mueller, LMSW Michigan Department of Health and Human Services
TRAUMA-INFORMED CARE Mary Mueller, LMSW Michigan Department of Health and Human Services Agenda Describe trauma, its impact and prevalence Discuss trauma-informed approaches in family planning services
Unique Experience of the World
Unique Experience of the World Preparing for Anticipated World Dangerous BIOLOGY OF STRESS CHARACTERISTICS Brawn over Brains Focused: Fight, Flight or Freeze OUTCOME Individual & species survive the worst
Key Issues in Child Welfare: Behavioral Health (abridged elearning Storyboard)
Key Issues in Child Welfare: Behavioral Health (abridged elearning Storyboard) We ve covered the key issues of substance use disorders and intimate partner violence. Let s talk now about behavioral health.
Perinatal Substance Use: Evidence for Current Practice. Karen Clemmer, MCAH Coordinator, Sonoma County
Perinatal Substance Use: Evidence for Current Practice Karen Clemmer, MCAH Coordinator, Sonoma County The impact of perinatal marijuana use on pregnancy outcomes & lactation Learning Objectives Influence
Children, Young People & Trauma
Children, Young People & Trauma 28 th May 2010 Belinda Cooley Lily Lee Workshop Outline Expectations of Workshop Definition of Trauma Attachment and Neurobiology Impact of Trauma Framework for Intervention
The Impact of Adverse Childhood Experiences Across The Life Course
The Impact of Adverse Childhood Experiences Across The Life Course Robert Anda, MD, MS ACE Study Concepts www.robertandamd.com www.cdc.gov/ace www.acestudy.org In the brain, as in the economy, getting
Toxic Stress: The Impact on Young Children and What YOU Can Do!
Toxic Stress: The Impact on Young Children and What YOU Can Do! Betty Rintoul, Ph.D. 1600 Growth of Brain Whole Brain Weight in Grams 1400 1200 1000 800 600 400 200 Conception to Birth Birth to Age 20
Adverse Childhood Experiences
Adverse Childhood Experiences Adam Zolotor, MD, DrPH Associate Professor of Family Medicine University of North Carolina at Chapel Hill Interim President, North Carolina Institute of Medicine Presentation
PERINATAL MENTAL HEALTH: CHILDREN S LONG-TERM OUTCOMES
PERINATAL MENTAL HEALTH: CHILDREN S LONG-TERM OUTCOMES How the South London Child Development Study & work at the Channi Kumar Mother & Baby Unit has informed the need for perinatal mental health services
Teen Suicide 2013 Kmcfarlane 10/3/13
1 2 3 4 5 6 7 Teen Suicide Kevin McFarlane BSN,RN,CEN,EMT University of New Mexico Hospital Suicide The spectrum of suicide Suicide Defined Suicide: Intentionally causing one s own death. Sometimes difficult
Violence Prevention A Strategy for Reducing Health Inequalities
Violence Prevention A Strategy for Reducing Health Inequalities Professor Mark A Bellis Centre for Public Health Liverpool John Moores University WHO Collaborating Centre for Violence Prevention Overview
Trauma History and Extensive Service Use: Strategies for Treatment and Prevention
Trauma History and Extensive Service Use: Strategies for Treatment and Prevention February 15, 2017 Introduction: Framing the Issue David Shern, Ph.D. Senior Public Health Advisor NASMHPD February 15,
Trauma and Resiliency Building. Champaign County Community Coalition 14 February 2018 Trauma & Resiliency Building Working Group
Trauma and Resiliency Building Champaign County Community Coalition 14 February 2018 Trauma & Resiliency Building Working Group History of the Working Group What is Trauma SAMSHA s definition Event(s)
Depression in Women Etiology & Management Strategies Diana E. Ramos, MD,MPH
Depression in Women Etiology & Management Strategies Diana E. Ramos, MD,MPH Associate Clinical Professor, Keck University of Southern California Medical Director, Reproductive Health, Los Angeles County
Toward Trauma-Informed Home Visiting: Addressing Depression and Social Support
Toward Trauma-Informed Home Visiting: Addressing Depression and Social Support Robert T. Ammerman, PhD 1,2 Alonzo T. Folger, PhD 1,2 1 Cincinnati Children s Hospital Medical Center, University of Cincinnati
Raising Awareness: Trauma-Informed Practices
Raising Awareness: Trauma-Informed Practices Presented by Michele A. Carmichael Director IL-AWARE Principal Consultant for Behavioral Health Supports in Schools Illinois State Board of Education Intentions:
The Effects of Trauma. And How to Facilitate Recovery!
The Effects of Trauma And How to Facilitate Recovery! Adverse Childhood Experiences (ACEs). 17,000 Surveyed 63% experienced at least 1 of the following categories: 11% experienced emotional abuse. 28%
3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose
A module within the 8 hour Responding to Crisis Course Our purpose 1 What is mental Illness Definition of Mental Illness A syndrome characterized by clinically significant disturbance in an individual
CROSS SECTOR INDUCTION AND ORIENTATION Alice Springs. 27 March 2014
CROSS SECTOR INDUCTION AND ORIENTATION Alice Springs 27 March 2014 Numbers of NT Sexual Abuse Notifications and Substantiations 2008-09 to 2012-13 1400 1200 1227 1000 872 821 Notifications 800 666 Substantiations
Exposure to Childhood Adversities and Psychiatric Disorders
Exposure to Childhood Adversities and Psychiatric Disorders Cristiane S. Duarte, PhD, MPH Lambert Associate Professor of Child Psychiatry Division of Child and Adolescent Psychiatry Columbia University
PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW
PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW WHAT IS TRAUMA? Severe neglect, loss, and/or witnessing
Relaxation and Stress Management Through Meditation. Dennis Abreu AM LCSW
Relaxation and Stress Management Through Meditation Dennis Abreu AM LCSW OBJECTIVES Early Childhood Suspension and Expulsion What is Stress Effects of stress on Central Nervous System Effects of Stress
2/19/2015. The Adverse Childhood Experiences (ACE) Study. Learning Objectives. The Adverse Childhood Experiences (ACE) Study.
/9/5 Learning Objectives The Adverse Childhood Experiences (ACE) Study Participants of this training will: Recognize and identify adverse childhood events Describe three results of the ACE Study Explain
PREMATURE PRIMARY TOOTH LOSS
Disclaimer This movie is an educational resource only and should not be used to manage your dental health. All decisions about the management of premature primary tooth loss must be made in conjunction
A. The Broad Continuum of Attention Problems
A. The Broad Continuum of Attention Problems 3 Facts Sheets: (1) Developmental Variations (2) Problems (3) Disorders The American Academy of Pediatrics has produced a manual for primary care providers