Perspectives on Integrating Biological Assessments to Address the Health Effects of Childhood Adversities.

Abstract: A majority of adults in the United States (US) report a range of stressful and potentially traumatic childhood experiences (e.g., physical or sexual abuse, witnessing violence, neglect). Such adversities are associated with a range of mental (e.g., anxiety, mood, and behavioral difficulties) and physical (e.g., cardiovascular illnesses, diabetes, asthma) health problems. Increasingly, precision medicine approaches seek to prevent and treat such multifinal downstream health problems by identifying common etiological pathways (e.g., inflammation and immune pathways) and candidate biomarkers to target interventions. In this context, we review the rationale for continued research to identify biomarkers of childhood adversity. Building on the bioecological theory, we emphasize that individual neurobiological profiles develop within multiple ecological levels (individual, family, neighborhood, macrosocial) that confer both risk and protective factors that can attenuate or amplify biological effects of childhood adversity. Given the limited data on adversity-associated biomarkers for children and adolescents, we discuss future recommendations for research, implications for clinical care, and ethical considerations. Preventing childhood adversity and supporting adversity- and trauma-informed systemic intervention approaches remains our primary recommendation. We highlight the continued need to consider both biomarkers of risk and protective factors across ecological levels in future research.