Childhood adversity

فَذَٰلِكَ ٱلَّذِي يَدُعُّ ٱلۡيَتِيمَ

It is he who pushes aside the orphan

وَلَا تَقۡرَبُواْ مَالَ ٱلۡيَتِيمِ إِلَّا بِٱلَّتِي هِيَ أَحۡسَنُ حَتَّىٰ يَبۡلُغَ أَشُدَّهُۥۚ وَأَوۡفُواْ بِٱلۡعَهۡدِۖ إِنَّ ٱلۡعَهۡدَ كَانَ مَسۡـُٔولࣰ ا

Do not go near the orphan’s property, except with the best [intentions], until he reaches the age of maturity. Honour your pledges: you will be questioned about your pledges

وَلَا تَقۡرَبُواْ مَالَ ٱلۡيَتِيمِ إِلَّا بِٱلَّتِي هِيَ أَحۡسَنُ حَتَّىٰ يَبۡلُغَ أَشُدَّهُۥۚ وَأَوۡفُواْ ٱلۡكَيۡلَ وَٱلۡمِيزَانَ بِٱلۡقِسۡطِۖ لَا نُكَلِّفُ نَفۡسًا إِلَّا وُسۡعَهَاۖ وَإِذَا قُلۡتُمۡ فَٱعۡدِلُواْ وَلَوۡ كَانَ ذَا قُرۡبَىٰۖ وَبِعَهۡدِ ٱللَّهِ أَوۡفُواْۚ ذَٰلِكُمۡ وَصَّىٰكُم بِهِۦ لَعَلَّكُمۡ تَذَكَّرُونَ

Stay well away from the property of orphans, except with the best [intentions], until they come of age; give full measure and weight, according to justice’- We do not burden any soul with more than it can bear- ‘ when you speak, be just, even if it concerns a relative; keep any promises you make in God’s name. This is what He commands you to do, so that you may take heed’

كَلَّاۖ بَل لَّا تُكۡرِمُونَ ٱلۡيَتِيمَ

No indeed! You [people] do not honour orphans

فَأَمَّا ٱلۡيَتِيمَ فَلَا تَقۡهَرۡ

So do not be harsh with the orphan

وَأَمَّا ٱلۡجِدَارُ فَكَانَ لِغُلَٰمَيۡنِ يَتِيمَيۡنِ فِي ٱلۡمَدِينَةِ وَكَانَ تَحۡتَهُۥ كَنزࣱ لَّهُمَا وَكَانَ أَبُوهُمَا صَٰلِحࣰ ا فَأَرَادَ رَبُّكَ أَن يَبۡلُغَآ أَشُدَّهُمَا وَيَسۡتَخۡرِجَا كَنزَهُمَا رَحۡمَةࣰ مِّن رَّبِّكَۚ وَمَا فَعَلۡتُهُۥ عَنۡ أَمۡرِيۚ ذَٰلِكَ تَأۡوِيلُ مَا لَمۡ تَسۡطِع عَّلَيۡهِ صَبۡرࣰ ا

The wall belonged to two young orphans in the town and there was buried treasure beneath it belonging to them. Their father had been a righteous man, so your Lord intended them to reach maturity and then dig up their treasure as a mercy from your Lord. I did not do [these things] of my own accord: these are the explanations for those things you could not bear with patience.’

And do not come anywhere near an orphan’s property except in the fairest manner until he comes of age. And fulfil the covenant should you make a covenant with God or with people in general. Indeed the covenant will be enquired into.

And that you do not approach the property of the orphan save with that approach which is fairer namely the one wherein lie his best interests until he is of age when he is sexually mature. And give full measure and full weight in justice fairly desisting from any fraud. We do not charge any soul beyond its capacity what it can bear in such matters so that if one makes a mistake in a measure or weight and God knows that his intention had been well-meaning then he suffers no blame as is stated in one hadīth. And if you speak to pass a judgement or otherwise then be just by being truthful even if he the person receiving the statement or the one being accused in it should be a kinsman. And fulfil God’s covenant. This is what He has charged you with that perhaps you will remember read tadhakkarūn or tadhkurūn you will be admonished.

No indeed! — a disavowal of this notion in other words honour is not about wealth nor is there any humiliation in poverty rather it has to do with obedience and disobedience respectively; but the disbelievers of Mecca unmindful of this. Rather they do not honour the orphan they do not treat him with kindness despite their wealth or it means that they do not give him what is his due from an inheritance

And come not near to the orphan's property except to improve it, until he attains the age of full strength. And fulfill (every) covenant. Verily, the covenant will be questioned about (34)And give full measure when you measure, and weigh with a balance that is straight. That is good (advantageous) and better in the end (35) The Command to handle the Orphan's Wealth properly and to be Honest in Weights and Measures وَلَا تَقْرَبُوا مَالَ الْيَتِيمِ إِلَّا بِالَّتِي هِيَ أَحْسَنُ حَتَّىٰ يَبْلُغَ أَشُدَّهُ (And come not near to the orphan's property except to improve it, until he attains the age of full strength.) meaning, do not dispose of the orphan's wealth except in a proper manner. وَلَا تَأْكُلُوهَا إِسْرَافًا وَبِدَارًا أَن يَكْبَرُوا ۚ وَمَن كَانَ غَنِيًّا فَلْيَسْتَعْفِفْ ۖ وَمَن كَانَ فَقِيرًا فَلْيَأْكُلْ بِالْمَعْرُوفِ (but consume it [the orphan's property] not wastefully

"And come not near to the orphan's property, except to improve it, until he (or she) attains the age of full strength; and give full measure and full weight with justice." – We burden not any person, but that which he can bear – "And whenever you speak, say the truth even if a near relative is concerned, and fulfill the covenant of Allah. This He commands you, that you may remember. (152) The Prohibition of Consuming the Orphan's Property Ata' bin As-Sa'ib said that Sa'id bin Jubayr said that Ibn 'Abbas said, "When Allah revealed, وَلَا تَقْرَبُوا مَالَ الْيَتِيمِ إِلَّا بِالَّتِي هِيَ أَحْسَنُ (And come not near to the orphan's property, except to improve it.) and, إِنَّ الَّذِينَ يَأْكُلُونَ أَمْوَالَ الْيَتَامَىٰ ظُلْمًا (Verily, those who unjustly eat up the property of orphans.)[4:10] those who were guardians of orphans separated their food from the orphans' food and their dri

As for man, when his Lord tries him by giving him honor and bounties, then he says: "My Lord has honored me. (15)But when He tries him by straitening his means of life, he says: "My Lord has humiliated me! (16)But no! But you treat not the orphans with kindness and generosity (17)And urge not one another on the feeding of the Miskin (18)And you devour the Turath – devouring with greed (19)And you love wealth with love Jamma (20) Wealth and Poverty are both a Test and Honor or Disgrace for the Servant Allah refutes man in his belief that if Allah gives Him abundant provisions to test him with it, it is out of His honor for him. But this is not the case, rather it is a trial and a test, as Allah says, أَيَحْسَبُونَ أَنَّمَا نُمِدُّهُم بِهِ مِن مَّالٍ وَبَنِينَ - نُسَارِعُ لَهُمْ فِي الْخَيْرَاتِ ۚ بَل لَّا يَشْعُرُونَ (Do they think that in wealth and children with which We enlarge the

أَخْبَرَنَا أَحْمَدُ بْنُ سُلَيْمَانَ، قَالَ حَدَّثَنَا أَبُو نُعَيْمٍ، قَالَ حَدَّثَنَا دَاوُدُ بْنُ قَيْسٍ، عَنْ عَمْرِو بْنِ شُعَيْبٍ، عَنْ أَبِيهِ، عَنْ جَدِّهِ، قَالَ سُئِلَ رَسُولُ اللَّهِ صلى الله عليه وسلم عَنِ الْعَقِيقَةِ فَقَالَ ‏"‏ لاَ يُحِبُّ اللَّهُ عَزَّ وَجَلَّ الْعُقُوقَ ‏"‏ ‏.‏ وَكَأَنَّهُ كَرِهَ الاِسْمَ قَالَ لِرَسُولِ اللَّهِ صلى الله عليه وسلم إِنَّمَا نَسْأَلُكَ أَحَدُنَا يُولَدُ لَهُ ‏.‏ قَالَ ‏"‏ مَنْ أَحَبَّ أَنْ يَنْسُكَ عَنْ وَلَدِهِ فَلْيَنْسُكْ عَنْهُ عَنِ الْغُلاَمِ شَاتَانِ مُكَافَأَتَانِ وَعَنِ الْجَارِيَةِ شَاةٌ ‏"‏ ‏.‏ قَالَ دَاوُدُ سَأَلْتُ زَيْدَ بْنَ أَسْلَمَ عَنِ الْمُكَافَأَتَانِ قَالَ الشَّاتَانِ الْمُشَبَّهَتَانِ تُذْبَحَانِ جَمِيعًا ‏.‏

It was narrated from 'Amr bin Shuaib, from his fahther, that his grandfather said:"The messenger of Allah was asked about the 'Aqiqah and he said: "Allah, the mighty and sublime, does not like Al-Uquq' as if he disliked the word (Al-Aqiqah). He said to the Messenger of Allah: 'But one of us may offer a sacrifice when a child is born to him.' He said: 'Whoever wants to offer a sacrifice for his child, let him do so, for a boy; two sheep, Mukafaatan, (of equal age), and for a girl, one.' (One of the narrators) Dawud said: 'I asked Ziad bin Aslam about the word Mukafaatan and he said: 'Two similar sheep that are slaughtered together

أَخْبَرَنَا الْحُسَيْنُ بْنُ حُرَيْثٍ، قَالَ حَدَّثَنَا الْفَضْلُ، عَنِ الْحُسَيْنِ بْنِ وَاقِدٍ، عَنْ عَبْدِ اللَّهِ بْنِ بُرَيْدَةَ، عَنْ أَبِيهِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم عَقَّ عَنِ الْحَسَنِ وَالْحُسَيْنِ ‏.‏

It was narrated from 'Abdullah bin Buraidah, from his father, that:the Messenger of Allah offered the 'Aqiqah for Al-Hasan and Al-Husain

حَدَّثَنَا أَحْمَدُ بْنُ مَنِيعٍ، حَدَّثَنَا إِسْمَاعِيلُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا عَلِيُّ بْنُ زَيْدٍ، عَنْ سَعِيدِ بْنِ الْمُسَيَّبِ، عَنْ عَلِيِّ بْنِ أَبِي طَالِبٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِنَّ اللَّهَ حَرَّمَ مِنَ الرَّضَاعِ مَا حَرَّمَ مِنَ النَّسَبِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ عَائِشَةَ وَابْنِ عَبَّاسٍ وَأُمِّ حَبِيبَةَ ‏.‏ قَالَ أَبُو عِيسَى حَدِيثُ عَلِيٍّ حَسَنٌ صَحِيحٌ ‏.‏

Ali (bin Abi Talib) narrated that The Messenger of Allah said:“Indeed Allah has made unlawful through suckling whatever He made unlawful through lineage.”

حَدَّثَنَا بُنْدَارٌ، حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ الْقَطَّانُ، حَدَّثَنَا مَالِكٌ، ح وَحَدَّثَنَا إِسْحَاقُ بْنُ مُوسَى الأَنْصَارِيُّ، قَالَ حَدَّثَنَا مَعْنٌ، قَالَ حَدَّثَنَا مَالِكٌ، عَنْ عَبْدِ اللَّهِ بْنِ دِينَارٍ، عَنْ سُلَيْمَانَ بْنِ يَسَارٍ، عَنْ عُرْوَةَ بْنِ الزُّبَيْرِ، عَنْ عَائِشَةَ، قَالَتْ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِنَّ اللَّهَ حَرَّمَ مِنَ الرَّضَاعَةِ مَا حَرَّمَ مِنَ الْوِلاَدَةِ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ وَالْعَمَلُ عَلَى هَذَا عِنْدَ أَهْلِ الْعِلْمِ مِنْ أَصْحَابِ النَّبِيِّ صلى الله عليه وسلم وَغَيْرِهِمْ لاَ نَعْلَمُ بَيْنَهُمْ فِي ذَلِكَ اخْتِلاَفًا ‏.‏

Aishah narrated that the Messenger of Allah said:“Indeed Allah has made unlawful through suckling whatever He made unlawful through birth.”

حَدَّثَنَا يَحْيَى بْنُ يَحْيَى، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنْ عَبْدِ اللَّهِ بْنِ أَبِي بَكْرٍ، عَنْ عَمْرَةَ، أَنَّ عَائِشَةَ، أَخْبَرَتْهَا أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم كَانَ عِنْدَهَا وَإِنَّهَا سَمِعَتْ صَوْتَ رَجُلٍ يَسْتَأْذِنُ فِي بَيْتِ حَفْصَةَ ‏.‏ قَالَتْ عَائِشَةُ فَقُلْتُ يَا رَسُولَ اللَّهِ هَذَا رَجُلٌ يَسْتَأْذِنُ فِي بَيْتِكَ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏"‏ أُرَاهُ فُلاَنًا ‏"‏ ‏.‏ لِعَمِّ حَفْصَةَ مِنَ الرَّضَاعَةِ ‏.‏ فَقَالَتْ عَائِشَةُ يَا رَسُولَ اللَّهِ لَوْ كَانَ فُلاَنٌ حَيًّا - لِعَمِّهَا مِنَ الرَّضَاعَةِ - دَخَلَ عَلَىَّ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏"‏ نَعَمْ إِنَّ الرَّضَاعَةَ تُحَرِّمُ مَا تُحَرِّمُ الْوِلاَدَةُ ‏"‏ ‏.‏

A'isha (Allah be pleased with her) reported tha Allah's Messenger (ﷺ) was with her and she heard the voice of a person seeking permission to enter the house of Hafsa. 'A'isha (Allah he pleased with her) said:Allah's Messenger, he is the person who seeks permission to enter your house, whereupon Allah's Messenger (ﷺ) said: I think he is so and so (uncle of Hafsa by reason of fosterage). 'A'isha said: Messenger of Allah, if so and so (her uncle by reason of fosterage) were alive, could he enter my house? Allah's Messenger (ﷺ) said: Yes. Fosterage makes unlawful what consanguinity makes unlawful

حَدَّثَنَا يَحْيَى بْنُ يَحْيَى، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنِ ابْنِ شِهَابٍ، عَنْ عُرْوَةَ بْنِ الزُّبَيْرِ، عَنْ عَائِشَةَ، أَنَّهَا أَخْبَرَتْهُ أَنَّ أَفْلَحَ - أَخَا أَبِي الْقُعَيْسِ - جَاءَ يَسْتَأْذِنُ عَلَيْهَا وَهُوَ عَمُّهَا مِنَ الرَّضَاعَةِ بَعْدَ أَنْ أُنْزِلَ الْحِجَابُ قَالَتْ فَأَبَيْتُ أَنْ آذَنَ لَهُ فَلَمَّا جَاءَ رَسُولُ اللَّهِ صلى الله عليه وسلم أَخْبَرْتُهُ بِالَّذِي صَنَعْتُ فَأَمَرَنِي أَنْ آذَنَ لَهُ عَلَىَّ ‏.‏

A'isha (Allah be pleased with her) reported that Aflah, the brother of Abu'l-Qu'ais, who was her uncle by reason of fosterage, came, and asked her permission (to enter the house) after seclusion (Hijab) was instituted. I refused to admit him. When Allah's Messenger (ﷺ) came, I informed him what I had done. He commanded me to grant him permission (as the brother of her foster-father was also her uncle)

قال الله تعالى إن الذين يأكلون أموال اليتامى ظلما إنما يأكلون في بطونهم نارا وسيصلون سعيرا النساء وقال تعالى ولا تقربوا مال اليتيم إلا بالتي هي أحسن الانعام وقال تعالى ويسألونك عن اليتامى قل إصلاح لهم خير وإن تخالطوهم فإخوانكم والله يعلم المفسد من المصلح البقرة

الفائدة العاشرة أن يتمكن من الإيثار والتصدق بما فضل من الأطعمة على اليتامى والمساكين فيكون يوم القيامة في ظل صدقته + حديث كل امرئ في ظل صدقته أخرجه الحاكم من حديث عقبة بن عامر وقد تقدم + كما ورد به الخبر فما يأكله كان خزانته الكنيف وما يتصدق به كان خزانته فضل الله تعالى فليس للعبد من ماله إلا ما تصدق فأبقى أو أكل فأفنى أو لبس فأبلى فالتصدق بفضلات الطعام أولى من التخمة والشبع وكان الحسن رحمة الله عليه إذا تلا قوله تعالى إنا عرضنا الأمانة على السموات والأرض والجبال فأبين أن يحملنها وأشفقن منها وحملها الإنسان إنه كان ظلوما جهولا قال عرضها على السموات السبع الطباق والطرائق التي زينها بالنجوم وحملة العرش العظيم فقال لها سبحانه وتعالى هل تحملين الأمانة بما فيها قالت وما فيها قال إن أحسنت جوزيت وإن أسأت عوقبت فقالت لا ثم عرضها كذلك على الأرض فأبت ثم عرضها على الجبال الشوامخ الصلاب الصعاب فقال لها هل تحملين الأمانة بما فيها قالت وما فيها فذكر الجزاء والعقوبة فقالت لا ثم عرضها على الإنسان فحملها

جحيفة قال جاء رجل إلى النبي صلى الله عليه وسلم يشكو جاره فقال له اطرح متاعك في الطريق قال فجعل الناس يمرون به فيلعنونه فجاء إلى النبي صلى الله عليه وسلم فقال يا رسول الله ما لقيت من الناس قال وما لقيت قال يلعنوني قال فقد لعنك الله قبل الناس قال يا رسول الله فإني لا أعود وخرجه أبو داود بمعناه من حديث أبي هريرة ولم يذكر فيه فقد لعنك الله قبل الناس وخرج الخرائطي من حديث أم سلمة قالت دخلت شاة لجارة لنا فأخذت قرصة لنا فقمت إليها فأخذتها من بين لحييها فقال رسول الله صلى الله عليه وسلم إنه لا قليل من أذى الجار فأما إكرام الجار والإحسان إليه فمأمور به وقد قال الله تعالى واعبدوا الله ولا تشركوا به شيئا وبالوالدين إحسانا وبذي القربى واليتامى والمساكين والجار ذي القربى والجار الجنب والصاحب بالجنب وابن السبيل وما ملكت أيمانكم إن الله لا يحب من كان مختالا فخورا النساء فجمع الله تعالى في هذه الآية بين ذكر حقه على العبد وحقوق العباد على العباد أيضا وجعل العباد الذين أمر بالإحسان إليهم خمسة أنواع أحدها

وقد أخبرنا النبي صلى الله عليه و آله و سلم عن صاحب الشملة التي غلها من المغنم انها تشتعل نارا في قبره هذا وله فيها حق فكيف بمن ظلم غيره ما لا حق له فيه فعذاب القبر عن معاصي القلب و العين و الاذن و الفم و اللسان و البطن و الفرج و اليد و الرجل و البدن كله فالنمام و الكذاب و المغتاب و شاهد الزور و قاذف المحصن و الموضع في الفتنة و الداعي إلى البدعة و القائل على الله و رسوله مالا علم له به والمجازف في كلامه وآكل الربا آكل أموال اليتامى وآكل السحت من الرشوة و البرطيل و نحوهما وآكل مال أخيه المسلم بغير حق أو مال المعاهد و شارب المسكر وآكل لقمة الشجرة الملعونة والزاني واللوطي والسارق والخائن والغادر والمخادع والماكر وآخذ الربا ومعطيه وكاتبه وشاهداه والمحلل والمحلل له و المحتال على إسقاط فرائض الله وارتكاب محارمه ومؤذي المسلمين ومتتبع عوراتهم والحاكم بغير ما أنزل الله والمفتي بغير ما شرعه الله والمعين على الاثم و العدوان وقاتل النفس التي حرم الله والملحد في حرم الله والمعطل لحقائق أسماء الله وصفا

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وثلاثة في البطن: شرب الخمر، وأكل مال اليتيم ظلما، وأكل الربا.

A Systematic Review of Trials to Improve Child Outcomes Associated With Adverse Childhood Experiences.: Context: The purpose of this systematic literature review was to summarize current evidence from RCTs for the efficacy of interventions involving pediatric health care to prevent poor outcomes associated with adverse childhood experiences measured in childhood (C-ACEs). Evidence acquisition: On January 18, 2018, investigators searched PubMed, PsycInfo, SocIndex, Web of Science, Cochrane, and reference lists for English language RCTs involving pediatric health care and published between January 1

Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis.: Background: The Center for Disease Control (CDC) and Kaiser Permanente developed the Adverse Childhood Experiences (ACE) scale to identify negative experiences in childhood. The goal of this study is to systematically review outcomes associated with the ACEs in the CDC-Kaiser ACE scale to understand the diversity of outcomes associated with this scale. Methods: The authors conducted a search of English language articles published through September 30, 2016 using OVID Medline®; Ovid Medline® Dail

Adverse Childhood Experiences and Executive Function Difficulties in Children: A Systematic Review.: Background: The relationship between adverse childhood experiences (ACEs) and detrimental mental health outcomes has been increasingly explored within scientific literature since the original ACE study was published by Felitti et al. (1998). Given that deficits in executive functions (EF) are prominent in most forms of psychopathology across the lifespan, there is utility in considering how ACEs relate to EF outcomes. Objective: To consolidate the research to date on the relationship between ACE

Stress, epigenetics and depression: A systematic review.: Environmental stressors, such as childhood maltreatment, have been recognized to contribute to the development of depression. Growing evidence suggests that epigenetic changes are a key mechanism by which stressors interact with the genome leading to stable changes in DNA structure, gene expression, and behaviour. The current review aimed to evaluate the relationship between stress-associated epigenetic changes and depression. Human studies were identified via systematic searching of PubMed/Medl

Adverse childhood experiences and allostatic load: A systematic review.: Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences associated with an increased lifetime risk of negative health outcomes. The Allostatic Load (AL) is a measure of multisystem dysregulation, resulted by chronic stress. We systematically reviewed the English language literature on the association between ACEs and AL to identify the clinical risk profile, with the exclusion of reviews and preclinical studies. Searches covered the publication period up to the 1st of Feb

Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews.: Background: Adverse Childhood Experiences (ACEs) such as abuse, neglect or household adversity may have a range of serious negative impacts. There is a need to understand what interventions are effective to improve outcomes for people who have experienced ACEs. Methods: Systematic review of systematic reviews. We searched 18 database sources from 2007 to 2018 for systematic reviews of effectiveness data on people who experienced ACEs aged 3-18, on any intervention and any outcome except incidenc

Early Adverse Experiences and the Developing Brain.

Children exposed to various forms of adversity early in life are at increased risk for a broad range of developmental difficulties, affecting both cognitive and emotional adjustment. We review a growing body of evidence suggesting that exposure to adverse circumstances affects the developing brain in ways that increase risk for a myriad of problems. We focus on two forms of adversity, one in which children are exposed to childhood maltreatment in family environments, and another in which children are exposed to extreme psychosocial deprivation in contexts of institutional rearing. We discuss ways in which each of these experiences represent violations of species-expected caregiving conditions, thereby imposing challenges to the developing brain. We also review emerging data pointing to the effectiveness of early intervention in remediating neurodevelopmental consequences associated with …

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Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect.

In the past two decades, much evidence has accumulated unequivocally demonstrating that child abuse and neglect is associated with a marked increase in risk for major psychiatric disorders (major depression, bipolar disorder, post-traumatic stress disorder [PTSD], substance and alcohol abuse, and others) and medical disorders (cardiovascular disease, diabetes, irritable bowel syndrome, asthma, and others). Moreover, the course of psychiatric disorders in individuals exposed to childhood maltreatment is more severe. Recently, the biological substrates underlying this diathesis to medical and psychiatric morbidity have been studied. This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associ…

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Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and …

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The role of adverse childhood experiences in cardiovascular disease risk: a review with emphasis on plausible mechanisms.

Childhood adversity, characterized by abuse, neglect, and household dysfunction, is a problem that exerts a significant impact on individuals, families, and society. Growing evidence suggests that adverse childhood experiences (ACEs) are associated with health decline in adulthood, including cardiovascular disease (CVD). In the current review, we first provide an overview of the association between ACEs and CVD risk, with updates on the latest epidemiological evidence. Second, we briefly review plausible pathways by which ACEs could influence CVD risk, including traditional risk factors and novel mechanisms. Finally, we highlight the potential implications of ACEs in clinical and public health. Information gleaned from this review should help physicians and researchers in better understanding potential long-term consequences of ACEs and considering adapting current strategies in treatmen…

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Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes.

Objective: Childhood maltreatment increases risk for psychopathology. For some highly prevalent disorders (major depression, substance abuse, anxiety disorders, and posttraumatic stress disorder) a substantial subset of individuals have a history of maltreatment and a substantial subset do not. The authors examined the evidence to assess whether those with a history of maltreatment represent a clinically and biologically distinct subtype. Method: The authors reviewed the literature on maltreatment as a risk factor for these disorders and on the clinical differences between individuals with and without a history of maltreatment who share the same diagnoses. Neurobiological findings in maltreated individuals were reviewed and compared with findings reported for these disorders. Results: Maltreated individuals with depressive, anxiety, and substance use disorders have an earlier age at onse…

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Biological memory of childhood maltreatment: current knowledge and recommendations for future research.

Child maltreatment (CM) not only has detrimental and lifelong psychological consequences, but also can lead to lasting alterations in core physiological systems--a biological memory of CM. Furthermore, some of these alterations might even be transmitted to the next generation. This article describes current knowledge about the effects of CM on the stress system (i.e., the hypothalamus-pituitary-adrenal axis), on cellular aging (i.e., telomere length and telomerase activity), and on the immune system. Furthermore, we want to initiate research on the question of transmission of the described physiological alterations subsequent to CM to the next generation--possibly through epigenetic imprinting. As diverse neurobiological factors and epigenetics are closely linked, these different research fields should join forces to gain a deeper understanding of the biological determinants and sequelae…

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Trauma in early childhood: empirical evidence and clinical implications.

Children in the birth to 5 age range are disproportionately exposed to traumatic events relative to older children, but they are underrepresented in the trauma research literature as well as in the development and implementation of effective clinical treatments and in public policy initiatives to protect maltreated children. Children from ethnic minority groups and those living in poverty are particularly affected. This paper discusses the urgent need to address the needs of traumatized young children and their families through systematic research, clinical, and public policy initiatives, with specific attention to underserved groups. The paper reviews research findings on early childhood maltreatment and trauma, including the role of parental functioning, the intergenerational transmission of trauma and psychopathology, and protective contextual factors in young children's response to t…

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Research review: the neurobiology and genetics of maltreatment and adversity.

The neurobiological mechanisms by which childhood maltreatment heightens vulnerability to psychopathology remain poorly understood. It is likely that a complex interaction between environmental experiences (including poor caregiving) and an individual's genetic make-up influence neurobiological development across infancy and childhood, which in turn sets the stage for a child's psychological and emotional development. This review provides a concise synopsis of those studies investigating the neurobiological and genetic factors associated with childhood maltreatment and adversity. We first provide an overview of the neuroendocrine findings, drawing from animal and human studies. These studies indicate an association between early adversity and atypical development of the hypothalamic-pituitary-adrenal (HPA) axis stress response, which can predispose to psychiatric vulnerability in adultho…

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An observational study of Internet behaviours for adolescent females following sexual abuse.

Child sexual abuse (CSA) is associated with revictimization and sexual risk-taking behaviours. The Internet has increased the opportunities for teens to access sexually explicit imagery and has provided new avenues for victimization and exploitation. Online URL activity and offline psychosocial factors were assessed for 460 females aged 12-16 (CSA = 156; comparisons = 304) with sexual behaviours and Internet-initiated victimization assessed 2 years later. Females who experienced CSA did not use more pornography than comparisons but were at increased odds of being cyberbullied (odds ratio = 2.84, 95% confidence interval = 1.67-4.81). These females were also more likely to be represented in a high-risk latent profile characterized by heightened URL activity coupled with problematic psychosocial factors, which showed increased odds of being cyberbullied, receiving online sexual solicitation…

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Comparing intra and extra-familial child sexual abuse in a forensic context.

Background: Child sexual abuse continues to be a problem aggravated by difficulty of detection. The aim of this study was to compare intra-familial (IF) and extra-familial (EF) child sexual abuse cases in search of differential variables that may allow for better intervention and prevention. Method: A sample of 221 forensic/legal cases (44.8% IF and 55.2% EF) dealing with children between 3 and 18 years of age (75% female) was analysed. Results: IF sexual abuse was significantly more likely to occur more than once (p = .000; OR = 6.353), with greater delay in its revelation (>1 year OR = 8.132), and with younger victims (9.05 vs. 11.45; p = .000). Intellectual disability was more prevalent among EF victims (p = .017; OR = 3.053). There was a higher proportion of reconstructed families, more legal records, and more histories of domestic violence among IF sexual abuse families. Even among …

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The process of coping with domestic violence in adult survivors of childhood sexual abuse.

Research suggests that the use of disengaged or avoidant strategies to cope with interpersonal violence contributes to the development of depressive symptoms and other psychological difficulties. Survivors of childhood sexual abuse (CSA) who are exposed to subsequent episodes of abuse may be more likely to rely on disengaged coping strategies, placing them at elevated risk of psychological symptomatology. In this study, we explored the interrelationships between coping, depression, and self-esteem in an ethnically diverse sample of domestic violence survivors (N = 219) with and without a history of CSA. As predicted, CSA survivors (n = 86) reported significantly greater use of disengaged coping strategies (wishful thinking, self-criticism, and social withdrawal) than non-CSA survivors (n = 133). As hypothesized, both a CSA history and the use of disengaged coping significantly predicted …

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Psychosocial Stressors and Telomere Length: A Current Review of the Science.

A growing literature suggests that exposure to adverse social conditions may accelerate biological aging, offering one mechanism through which adversity may increase risk for age-related disease. As one of the most extensively studied biological markers of aging, telomere length (TL) provides a valuable tool to understand potential influences of social adversity on the aging process. Indeed, a sizeable literature now links a wide range of stressors to TL across the life span. The aim of this article is to review and evaluate this extant literature with a focus on studies that investigate psychosocial stress exposures and experiences in early life and adulthood. We conclude by outlining potential biological and behavioral mechanisms through which psychosocial stress may influence TL, and we discuss directions for future research in this area.

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Early-Life Adversity and Physical and Emotional Health Across the Lifespan: A Neuroimmune Network Hypothesis.

Children who experience chronic stressors are vulnerable to emotional and physical health problems across the lifespan. This phenomenon raises questions for scientists and clinicians alike. How does adversity get under the skin of the developing child? Through what mechanisms does it confer vulnerability to a heterogeneous set of mental and physical illnesses? And how does it instantiate risk across different life stages, engendering vulnerability to conditions that develop shortly after stressor exposure-like depression-and conditions that manifest decades later, like heart disease? Although answers to these questions have started to emerge, research has typically focused on single diseases or organ systems. To understand the plethora of health problems associated with childhood adversity, we argue that the field needs a second generation of research that recognizes multidirectional tra…

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Rethinking Compassion Fatigue Through the Lens of Professional Identity: The Case of Child-Protection Workers.

Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then art…

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Biological Embedding of Early-Life Adversity and a Scoping Review of the Evidence for Intergenerational Epigenetic Transmission of Stress and Trauma in Humans.

Severe or chronic stress and trauma can have a detrimental impact on health. Evidence suggests that early-life adversity can become biologically embedded and has the potential to influence health outcomes decades later. Epigenetics is one mechanism that has been implicated in these long-lasting effects. Observational studies in humans indicate that the effects of stress could even persist across generations, although whether or not epigenetic mechanisms are involved remains under debate. Here, we provide an overview of studies in animals and humans that demonstrate the effects of early-life stress on DNA methylation, one of the most widely studied epigenetic mechanisms, and summarize findings from animal models demonstrating the involvement of epigenetics in the transmission of stress across generations. We then describe the results of a scoping review to determine the extent to which th…

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Outcomes and outputs affiliated with Children's Advocacy Centers in the United States: A scoping review.

Background: The Children's Advocacy Center (CAC) model is the predominant multidisciplinary model that responds to child sexual abuse (CSA) in the United States (US). While the CAC model has made important contributions in case coordination and referrals for specialty services, little is known about child- or family-oriented outcomes. Objective: Explore the trends and gaps involving outcome and output measures affiliated with CACs in the US. Participants & setting: A scoping review of the literature was conducted on English language articles published between 1985-2019 that involved CACs and children less than 18 years of age. Methods: An electronic database search using the terms "Children's Advocacy Center(s)," "Child Advocacy Center(s)," and "CAC(s)" identified titles and abstracts. Data from articles selected for full text review were evaluated by a multidisciplinary team using a mix…

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Epigenetics: A Missing Link Between Early Life Stress and Depression.

Exposure to early life stress (ELS) represents a major risk factor for the development of psychiatric disorders, including depression. The susceptibility associated with ELS may result from persistent changes in gene transcription, which can occur through epigenetic mechanisms, such as DNA methylation, histone modifications, and microRNA expression. Animal models and reports in humans described that negative stimuli can alter the neurodevelopment of an individual, affecting their behavior and cognitive development. It is currently hypothesized that levels of environmental adversity in this early developmental period are able to shape the experience-dependent maturation of stress-regulating pathways leading to long-lasting alterations in stress responsivity during adulthood. Here, we review key findings from animal and clinical studies examining the effects of prenatal and postnatal envir…

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Early life stress and brain function: Activity and connectivity associated with processing emotion and reward.

Investigating the developmental sequelae of early life stress has provided researchers the opportunity to examine adaptive responses to extreme environments. A large body of work has established mechanisms by which the stressful experiences of childhood poverty, maltreatment, and institutional care can impact the brain and the distributed stress systems of the body. These mechanisms are reviewed briefly to lay the foundation upon which the current neuroimaging literature has been built. More recently, developmental cognitive neuroscientists have identified a number of the effects of early adversity, including differential behavior and brain function. Among the most consistent of these findings are differences in the processing of emotion and reward-related information. The neural correlates of emotion processing, particularly frontolimbic functional connectivity, have been well studied i…

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Accelerated aging in bipolar disorder: A comprehensive review of molecular findings and their clinical implications.

Bipolar disorder (BD) has been associated with clinical signs of accelerated aging, which potentially underlies its association with several age-related medical conditions, such as hypertension, metabolic imbalances, dementia, and cancer. This paper aims to comprehensively review evidence of biological aging in BD and explore findings and controversies related to common biological clocks in patients, including telomere length, DNA methylation, mitochondrial DNA copy number, inflammation, and oxidative stress. Our results suggest a complex interplay between biological markers and a potential key role of environmental factors, such as childhood trauma and psychological stress, in determining premature aging in patients. Moreover, given its multifactorial nature, our summary evidences the need for further studies incorporating clinical evidence with biomarkers of accelerated aging in BD. Re…

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The impact of early life stress on the central oxytocin system and susceptibility for drug addiction: Applicability of oxytocin as a pharmacotherapy.

Early life trauma is strongly associated with an increased vulnerability to abuse illicit drugs and the impairment of neural development. This includes alterations to the development of the oxytocin system, which plays a pivotal role in the regulation of social behaviours and emotion. Dysregulation of this important system also contributes to increased susceptibility to develop drug addiction. In this review, we provide an overview of the animal models of early life stress that are widely used, and discuss the impact that early life stress has on drug-taking behaviour in adolescence and adulthood in both sexes. We link this to the changes that early life stress has on the endogenous oxytocin system, and how exogenously administered oxytocin may help to re-establish functioning of the system, and in turn, reduce drug-taking behaviour.

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The Role of Early Life Stress in HPA Axis and Anxiety.

Substantial evidence from various studies suggests a preeminent role for early adverse experiences in the development of psychopathology. The most recent studies reviewed here suggest that early life stressors are associated with an increased risk for anxiety disorders in adulthood. Early life stress predisposes individuals to develop a number of psychiatric syndromes, particularly affective disorders, including anxiety disorders, and is therefore a significant health problem. This review examines the emerging literature on the relationship between stress, hypothalamic-pituitary-adrenal (HPA) axis function, and generalized anxiety disorder (GAD), panic disorder, and phobias and the role of early life stress as an important risk factor for HPA axis dysfunction. The most consistent findings in the literature show increased activity of the HPA axis in depression associated with hypercortiso…

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Examining the Association Between Adverse Childhood Experiences and Lifetime History of Head or Neck Injury and Concussion in Children From the United States.

Objective: Our objective was to determine whether there is an association between adverse childhood experiences (ACEs) and lifetime history of early childhood mild head or neck injury and concussion in a nationally representative US cohort. Setting and design: This is a cross-sectional study using data from the Adolescent Brain Cognitive Development (ABCD) Study (data release 3.0), a prospective investigation of child brain development and health. Participants: There were 11 878 children aged 9 or 10 years at baseline, recruited from 21 school-based sites in the United States. After excluding children with missing questionnaires for the primary exposure variable and children with severe brain injuries involving more than 30-minute loss of consciousness, the final sample size was 11 230 children. Measures: The primary exposure variable was ACEs. We measured eight ACEs: sexual abuse, physi…

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Adverse childhood experiences, associated stressors and comorbidities in children and youth with fetal alcohol spectrum disorder across the justice and child protection settings in Western Australia.

Background: Individuals with Fetal Alcohol Spectrum Disorder (FASD) are at risk of having adverse childhood experiences (ACEs), especially those with child protection and/or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study (1) explored the ACEs and associated stressors in individuals with FASD; (2) investigated the association between ACEs and negative outcomes, i.e., justice/child protection system involvement; and (3) examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders. Methods: Data were collected retrospectively via file review from diagnostic clinics in Western Australia. Life adversity was coded using a standardised ACEs questionnaire. A total of 211 participants (72% males) with FASD w…

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Adverse childhood experiences and adult inflammation: Single adversity, cumulative risk and latent class approaches.

Background: Adverse childhood experiences (ACEs) have long been known to be related to poorer health across the life course. Previous studies typically relied on cumulative risk scores or individual adversities measured through retrospective self-reports. However, these approaches have important limitations. Cumulative risk scores assume equal weighting of adversities and the single adversity approach ignores the high probability that adversities co-occur. In contrast, latent class analysis (LCA) offers an alternative approach to operationalise ACEs that respects the clustering of adversities and may identify specific patterns of ACEs important for health outcomes. Furthermore, prospective and retrospective reports of ACEs show poor agreement. Therefore, it is important to compare findings based on prospective and retrospective measures in the same individuals. Despite an increasing numb…

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Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents.

Background: Since the COVID-19 outbreak at the end of 2019, it has evolved into a global pandemic with tremendous mental health impact besides the threats to people's physical health. Objective: The aims were to examine whether exposure to COVID-19 predicts elevated levels of anxiety and post-traumatic stress symptoms and whether pre-pandemic maltreatment experiences exacerbate this impact on mental health in adolescents. Participants and setting: The survey was conducted online from February 8 st to February 27th, 2020, and the questionnaires were distributed and retrieved through a web-based platform. This study includes a total of 6196 subjects, aged range from 11 to 18 years old. Methods: Several multivariable linear regressions were used to analyse the data. Results: The largest variance in PTSS and anxiety problems was explained by ACEs, with more pre-pandemic maltreatment experien…

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