CLASSIC Articles

Felitti VJ, Anda RF, et al.  Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.  Am J Prev Med. 1998  <>  Landmark article reignited study of adverse child experiences (ACEs):  emotional, physical, or sexual abuse; neglect; domestic violence; household substance abuse, mental illness, incarceration.  Demonstrated high prevalence of ACEs and dose-response relationship of adversity to physical & mental illness, early death.

Teicher MH and Samson JA.  Enduring neurobiological effects of childhood abuse and neglect.  J Child Psychol Psychiatry.  2016.  Neuroimaging finds child maltreatment (parental verbal abuse, witnessing violence, sexual abuse and more) changes brain development and structure.  Psychiatric illness may be the direct consequence of abuse.

Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006   Science of toxic stress, development of neuroendocrine-immune network, how function is altered by early life adversity, increased vulnerability to disease.  Describes challenges and opportunities for preventing toxic stress in contemporary pediatric practice.

More Articles

• Jiminez ME, et.al.  Adverse Experience in Early Childhood and Kindergarten Outcomes.  Pediatrics 2016.  
• Danese, A, Moffitt TE, Harrington H et al.  Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease: Depression, Inflammation, and Clustering of Metabolic Risk Markers.  Arch Pediatr Adolesc Med. 2009.