Children's Mental Health and the Life Course Model: A Virtual Workshop Series Proceedings of a Workshop (2020) / Chapter Skim
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3 Developmental Origins of Children's Mental Health Disorders
3 Developmental Origins of Children's Mental Health Disorders
Pages 13-26
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From page 13... ...
Dunn, assistant professor at the Harvard Medical School and Massachusetts General Hospital, who made a case for identifying sensitive periods in development linked to greater risk for depression and other brain health challenges among children and adolescents and how using shed teeth could possibly do so (Davis et al., 2020)
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Additionally, Figure 3-1 The 10 defined adverse childhood experiences. SOURCE: Robert Wood Johnson Foundation, 2013.
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. In addition to these physical effects on living conditions for people in lower socioeconomic statuses, she said, people in these conditions often have more psycho-social risk factors and worse relationships with family members and their community.
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STRESS PATHWAYS IN THE BRAIN AND IMPACTS ON DEVELOPMENT While the linkages seem to be clear and increasingly well established between stressful environments and child development, Kim also expanded on why childhood adversity leads to negative mental health outcomes and the things that happen in the body such as the development of stress pathways in the brain and the neurobiological mechanisms that affect a person across their life course. Overview of Biological Mechanisms Stress and adversity affect development in the brain, Kim said, namely in the amygdala and the prefrontal cortex, which are the signature brain regions involved in emotional and self-regulation.
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Research has found that maternal anxiety, inflammation, and the presence of cortisol during pregnancy are associated with altered amygdala and prefrontal cortex functionality in newborn babies. Additionally, maternal depression during pregnancy has been associated with decreased amygdala functional connectivity with the prefrontal cortex in newborns (Posner et al., 2016)
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Long-Term Impacts into Adulthood Childhood is a sensitive period of development, Kim said, and research now shows that exposure to socioeconomic disadvantages during childhood is associated with poor health outcomes in adult life. Cohen and colleagues found that socioeconomic status exposures during childhood can be predictors of all-cause mortality, as well as specifically cardiovascular mortality and morbidity (Cohen et al., 2010)
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In the same participants that displayed lower levels of prefrontal cortex activation, a higher brain activity pattern was observed in the amygdala, which could be responsible for their ineffective regulation of emotions. Additionally, the study found an association between lower prefrontal cortex activity and exposure to multiple stressors from ages 9 to 17 years old, Kim explained.
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The allostatic load model says that the wear and tear on the body from chronic stress causes negative disruptions of brain structure and function that are precursors of later impairments in learning and behavior, resulting in chronic physical and mental illnesses (McEwen, 2012)
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Finally, the sensitive period model suggests intervention during or shortly before sensitive periods of development. These sensitive periods constitute windows of vulnerability in which the risk of depression is more acute, but conversely they can also be windows of opportunity where protective factors might be
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. What life course theoretical models best explain the relationship between exposure to childhood adversity and psychopathology symptoms: recency, accumulation, or sensitive periods?
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Using Teeth as a Biomarker To address the limitations of current measures of childhood adversity and potentially provide new information, Dunn posed this question: "Can children's shed teeth serve as a biomarker of ACE exposure? " She referenced a conceptual model exploring the use of this strategy to prevent mental illness by targeting interventions during sensitive periods of children's development (Davis et al., 2020)
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While the associations between exposure, health, and brain development are becoming clear, the research identifying the types of interventions that are most successful and the populations in which they work best is unfortunately much less uncertain, Kim said. Current neuro-imaging literature lacks the depth sufficient enough to distinguish between cultural differences and provide specific brain evidence for different racial or ethnic groups.
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The unique challenges of both cultural and poverty differences are understudied, Kim said, and should be better understood. While neuro-imaging literature has successfully contributed to identifying mechanisms that link stressful experience and maternal health outcomes as well as those that link sensitive, region-specific developmental periods to adversity exposure, further research could help identify risk factors related to culture and demographics, as well as factors that may protect children from risk.
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