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Psychosocial Environment

Common Stressors

Stress, much like beauty, is in the eye of the beholder. What is stressful for one person may not be for another. However, there are some events and environments which typically cause stress:1

  • Changes to family: marriage, pregnancy, death, divorce, a new child
  • Work environment: job change, job loss, promotion, work overload, conflict at work, business failure, employee strike
  • Living environment: new house, relocation to a new community, loss of a home, neighborhood crime
  • Physical environment or conditions: noise, pollution, traffic, violence, illness, disability, injury, pain, cold, heat, lack of sleep, hunger, malnutrition, natural disaster, unsafe surroundings, physical abuse or neglect
  • Economic environment: poverty, escalating bills, unanticipated expenses, theft
  • Social environment: isolation, family or peer demands, forced separation (such as from military service, prison, abandonment or conflict), grief, emotional abuse or neglect, legal entanglements, bullying, difficult roommates or neighbors

vt. 把 ...

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9. Add Personality

BuzzFeed News将“假新闻”定义为已经被验证“100%是假的”,并且列出了96家喜欢传播这些虚假信息的网站。
This includes McKinsey, the consultancy that kick-started its secretive leadership election process in October with a gathering of more than 500 senior partners at the Grosvenor House Hotel in London. The next stage involves the firm’s 550 senior partners voting on a shortlist of candidates to replace Dominic Barton — the incumbent since 2009 — in January, followed by a run-off between the two most popular candidates in February.
5. Gay Marriage

Our psychosocial environment includes our responses to stressors in our lives, from temporary ones such as a traffic jam to major stressors such as war, homelessness or major disease. Our relationships with family members, friends, colleagues and other individuals and groups with whom we interact in our communities are an important part of this environment. These can impact our capacity to deal with stressors. Nurturing, supportive relationships allow us to better access all our innate resources to respond to stress in positive ways.2

family support

 

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凭借创新性的信用评级技术,4年前创办的陆金所已经发展成为行业的领头羊。
2021届哈佛待入学新生的脸书官方主页提醒学生,“如果新生在诚信、成熟度或道德品质方面存在问题,那么校方保留针对恶劣情况取消学生入学资格的权利。
前“以色列小姐”盖尔·加朵在2015全球十大美女榜中居第六位。她是服装品牌“卡斯特罗”的首席模特。加朵因饰演《速度与激情》系列电影里的吉泽尔· 姬赛儿一角而闻名于世。

Stress and the Body's Response

Our bodies, families, communities and lives are embedded in a complex network of systems. The degree of support in the environment can shape a person’s resilience. Likewise, an environment that is stressful can foster disease. The conditions of a person’s social and psychological environment—those in which they are born, grow, live, work and age—are known as the social determinants of health. These conditions are shaped by the distribution of money, power and resources at global, national and local levels.3

Risks for Stress: Riskscapes

A riskscape, or landscape of risks, captures the overlapping threats to health occurring in a physical location that increase risk for disease.4 An example of overlapping risks can be seen in impoverished neighborhoods,5 which often experience many of the stressors listed above simultaneously. We discuss poverty in more detail on our Socioeconomic Environment page.

Minority status, age and gender further interact to increase risk for disease.6 Individuals experience additional adversity when they live amid wealth and affluence but do not share those resources.7

Colliding Neutron Stars
这只漂亮的伯曼猫在Ins上有超过128000名粉丝,而且它还是拉格菲尔德众多设计的灵感。
中国外汇储备出现史无前例的下跌,已经引发市场担心:如果资本外流持续下去,而央行继续捍卫汇率,外储可能迅速蒸发。多数分析师相信,中国央行将被迫缩减干预力度,以免外汇储备进一步枯竭。

Stressful Environments and the Social Ecological Model of Health

The rise of chronic disease is a complex and growing problem for public health in the US.8 Stress, particularly exposure to long-term chronic stress, is associated with the majority of chronic health conditions.9

Social Ecological Model of Health

The Social Ecological Model of Health Promotion (SEM) describes how our psychosocial experiences are nested inside layers that influence health and well-being:10

  • individual
  • interpersonal (familial)
  • communal (neighborhood)
  • societal

The Human Stress Response System

This response system is evolutionarily old and has been shaped by the environmental experiences of thousands of preceding generations. Through millennia of adverse environmental challenges, adaptations and collective evolution, humans have developed a sophisticated stress response system.11

The physical stress response is a complex network of coordinated physical and behavioral activations from the endocrine and nervous systems:12

When a threat is perceived, the hypothalamus activates the sympathetic nervous system (the "fight or flight" response) by sending signals through the autonomic nerves to the adrenal glands. The adrenal glands pump the hormone epinephrine—also known as adrenaline—into the bloodstream, causing several physiological changes:13
  • 1、超级自信。邦德的超级自信让他不仅更加性感,而且工作更出色。与理性和客观相比,多一些自信往往收获更多(自负时人人感觉都不错)。无论男女都不喜欢谦逊的人。邦德有着实干家的品质:作为特种部队成员,他与普通人不同,具有非凡的自信(又称“自欺性提高”),并且情绪更稳定、更富弹性。
  • 辟谣!《中美贸易战停火!止战!》系新华社2018年5月20日旧闻
  • 从几乎所有单项指标看,巴黎高等商学院都没有排在首位,但它整体表现强劲。该学院学生毕业3年后的年薪为9.3万美元,位居第五;性价比以及毕业生国际流动性位居第三。该学院还在目标实现率方面并列第一(93%)。
  • 1-2月房产营业税增20.2% 多地区商品房销售回暖
  • 电商并非“黄金地” LED企业做好取舍是关键
  • It has been speculated by varying sources that with MGM back up and running, Sony Entertainment, the company that distributed the last two 007 adventures Casino Royale and Quantum of Solace, will announce their take over of the franchise. Deadline, on the other hand, tend to believe that James Bond 23 may go to Paramount, as they have a very close relationship with Spyglass and are currently working with them to produce Star Trek 2.
    在美国许多人居住的大面积地区之中,只有东部在2014年记录到低于平均气温的温度,这与西部的异常高温形成了鲜明对比。有专家认为,造成美国这些极端温度的天气模式是温室气体排放的间接后果,但这个观点尚有待证明。

When the initial surge of epinephrine subsides, the hypothalamus activates the 1月燕郊房价环比上涨5.23% 专家:是否可持续待观察, signaling the release of cortisol to keep the sympathetic nervous system engaged.

When the threat passes, the parasympathetic nervous system (the "rest and digest" function) calms the body and returns it to a pre-threat state.

PsychosocialHPA

Click to zoom

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The SEM is particularly useful in allowing researchers to study stressors from the micro scale (cellular) to the macro scale (social policy), positioning their work in the larger social ecological context.14 Layers are labeled with their corresponding social determinants of health.

PsychosocialSEMModelLWalker

雷曼股份:LED产业和体育产业双不误

Policies that affect economic and social determinants (top level) can decrease access to income and education, and have powerful effects on neighborhood stressors.15

These policies shape disparities in local environments (second level)16 such as poverty, pollution, crime rates and political power.

Daily opportunities (third level) create or suppress nurturing environments and govern the frequency and intensity of daily hassles (discrimination and microaggressions).17

These layers affect our daily behaviors and patterns (fourth level) and daily interactions.

As these pressures funnel down from the political to the community to the individual, they become observational cues (fifth level) that the environment is threatening, unpredictable or uncontrollable and thus stressful.18

Upon activation, the brain sends signals to the body to mount a stress response.19

stressed child

石材行业洗牌 人造石降成本

Allostasis: The Body’s Stress Response

When the brain interprets a threat, it sends a cascading signal through the body that causes a stress response, known casually as "fight or flight" and more formally as an allostatic response.20 See The Human Stress Response System at right for more detail.

In healthy doses and supportive environments, this response is tempered and can foster learning.21 In adversarial environments the allostatic response can manifest as chest pain, heart palpitations, headaches, dysphagia (difficulty swallowing), intestinal cramping, anxiety, panic, immobility, frustration, muscle tension and inflammation.22

These reactions can be exhausting and imprint a strong memory of fear on the brain.23 Fortunately, a feedback system in the brain is capable of stopping the stress response. 24 Terminating the stress response and restoring the body to pre-stress response states is important to protecting the body’s long-term health.25

Programming the Stress Response

When early-life experiences signal that the environment is unpredictable, threatening or uncontrollable, the stress response system may be reprogrammed, becoming blunted,26 or may be programmed to be sensitized and thus more responsive.

Responsivity is informed by the number of steroid receptors available during stress termination.27 The feedback system in the brain—cells in the hippocampus—have glucocorticoid receptors that, once filled, signal the termination of the stress response. When there are fewer glucocorticoid receptors in these cells, it takes a higher circulating quantity of cortisol to terminate the stress response.

The number of receptors available in the feedback system is dependent on how many proteins are produced in that cell. This is determined by the availability of the receptor gene to be transcribed into proteins. Stress signals, such as cortisol, circulating in maternal blood during pregnancy, can epigenetically alter the glucocorticoid receptor gene to be permanently downregulated, causing fewer receptor proteins to be produced.28

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How our bodies respond to stress varies across the population,29 determined by genetic predisposition30 and previous experiences including exposure to maternal stress signals before birth31 The typical responsivity can be modified by genetic predisposition32 but is generally neither amplified nor repressed.33 This neutral programming is optimal in moderately stressful environment where life is not overly threatening nor consistently safe. Over an individual’s life, neutral programming is optimal in balancing the risk for internal burnout from repetitive stress burden and survival in adverse environments long enough to maximize periods for mating and parenting.34

Chronic Stress and Disease: Weathering

With repeated exposure to stressors, the HPA axis activation is sustained, and stress signals continue to flood the body. This sustained activation delays the onset of restorative repair and pushes the body into pre-disease states.35 Chronic stress acts on the cardiovascular, metabolic, neuroendocrine and immune systems:36

  • Fudan University and Peking University, two prestigious comprehensive universities in China, were ranked fourth and sixth on the salary ranking, while the remaining of the top 20 were dominated by finance/economics and science/technology schools.
    单词complex 联想记忆:
  • The prince said authorities could recover as much as $100 billion in settlements.
    欧洲工商管理学院(Insead)领衔2017年英国《金融时报》全球MBA百强榜。这是这所拥有多个校区的国际商学院连续第二年高居榜首,去年该学院首次摘得桂冠。
    This means war: Christopher Nolan's second film not set in the present (or future) is an epic tableau about the rescue of hundreds of thousands of troops from the French coast. Tom Hardy, Mark Rylance, Kenneth Branagh, Cillian Murphy and, er, Harry Styles, star. Think Saving Private Ryan, but saltier.
    As institutions are brought under dictatorial control, the opposition is driven into rebellion or acquiescence.
    1、超级自信。邦德的超级自信让他不仅更加性感,而且工作更出色。与理性和客观相比,多一些自信往往收获更多(自负时人人感觉都不错)。无论男女都不喜欢谦逊的人。邦德有着实干家的品质:作为特种部队成员,他与普通人不同,具有非凡的自信(又称“自欺性提高”),并且情绪更稳定、更富弹性。

Over time, stress deteriorates health and resilience. This process is referred to as weathering.37 Just as a flag that weathers many storms begins to fray, so too does the body when it experiences harsh environments of social inequity.38 The health outcomes are mental illness, chronic disease morbidity and premature death.39 In short, stress causes physical changes that impact our health and functioning.

The frequency, duration, intensity, source, target and proximity of stressors influence the extent of the stress response. The duration of response can increase an individual’s risk for physical and mental burnout. Stressors that are higher intensity or longer duration carry a high internal burden (allostatic load).40 Over time this internal pressure forces body systems to adapt in ways that foster pre-disease states.41

In weathering, each body system adapts to this internal pressure through secondary changes:42

Dysregulation in these areas  can cause these secondary changes.43   With chronic stress, such changes increase the risk for these conditions:44
  • Cardiopulmonary system
  • Metabolism
  • Mental functioning
  • Autoimmune response
  • Aging
  • Increased startle response
  • Anxiety and vigilance
  • 专家:本轮房价周期已见顶 部分城市将回调
  • Glucose sensitivity
  • Immune suppression
  • 社保新政平稳落地 企业减负红利显现

Stress-induced Gene Expression

Physiologic shifts following stressful exposures occur in large part through hormone-activated gene expression.45 When cortisol is released by the adrenal glands into the blood stream, it targets glucocorticoid responsive genes in tissues distributed throughout the body,46 including the central nervous system, metabolism, immune, cardiovascular, endocrine and renal systems.47

Within each cell nucleus, the steroid hormone binds with its receptor, and this complex binds to a stretch of DNA called a hormone response element.48 This binding activates gene expression to shift the physiologic activity of the target cell. In this way, stressful experiences, mediated through the allostatic response, have an epigenetic effect on the body.

See our Gene-Environment Interaction page for further explanation.

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Through this process, chronic stress responses cause weathering on the body, eroding health status.49 As years turn into decades, the physiologic changes (such as hypertension, metabolic disorder or anxiety) may become irreversible, often increasing co-morbidities, potentially increasing maladaptive coping mechanisms (such as social aversion, drug and alcohol dependence) and decreasing life expectancy.50

Through these mechanisms social structures can get under the skin, alter our bodies and cause disease. The loss of productivity and financial burden of systemic disease further erodes family and community resilience, especially when the chronic stress starts in childhood.51

Disadvantaged Populations

Lower social classes experience longer durations of chronic stress, such as lengthy unemployment or institutionalized discrimination. Those with less power experience barriers to achievement of life goals, such as high costs of educational programs or lack of childcare options, inadequate recognition and rewards for personal qualification (such as gender pay differences) or for invested effort in the workplace. In the US and other White-majority countries, minorities and women in these environments are exposed to more chronic stressors than their White male counterparts due to differential expectations resulting in role strain and interpersonal conflict.52

Both the sources and frequency of stressors are not distributed equally in society, with heavier burdens borne by those with less advantage.53 These systems of inequity create differences in health outcomes, known as health disparities.54

Stressful Environments and the Developing Child

Stress Effects on Brain Development

n. 情报,情报工作,情报
Rogers, unhappy with the turn of events, decided to leave the show after the first three seasons. The breach of contract led to a multi-million dollar lawsuit. Ironically, Wayne Rogers had never signed his contract to begin with (he had a problem with a morals clause). The lawsuit was thrown out. You could say Rogers got the last laugh, but since M·A·S·H went on for eight more seasons and Rogers' never reached the same career success again, the last laugh might be a relative concept.
n. 失业,失业人数
These documentaries use the standard tools — archival footage, talking-head interviews, carefully selected musical cues — to write history in the present tense. In the era of Black Lives Matter, the stories of the Black Panthers and the jazz singer and activist Nina Simone could hardly be more relevant. Mr. Nelson and Ms. Garbus tell them beautifully.
It shifts your kid's weight to your shoulders and core instead of your back.
In dollar terms, imports plunged 18.8 per cent last month to $114.19, from a 7.6 per cent drop in January and versus an expected drop of 3.6 per cent.
他说:“比如说,如果他们拖延从韩国进口的海关流程并采取对韩国商品的其他报复举措,韩国政府对此将无能为力。”

These exposures increased amygdala function, which enhances fear, anxiety, and emotional dysfunction, while it decreased prefrontal cortex function, which participates in regulating and terminating the stress response.55

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Our stress system responds to environmental conditions even before birth56 and is especially sensitive early in development.57 Glucocorticoid receptors are found in most fetal tissue and in the placenta, suggesting they are capable of responding to high maternal cortisol. Early-life experiences shape our stress response and therefore the impact stress has on our health over the life course.

A person’s individual responsiveness to stress signals can shape brain development.58 Highly responsive individuals demonstrate better learning and health outcomes in supportive environments and worse health outcomes in high adversity environments.59 Supportive environments foster better mental and social learning, increase memory and improve decision-making; in such environments, children have adequate time for stress response termination and are generally characterized by openness to information.

In negative environments, however, high responsivity magnifies the body’s response to intense or chronic stressors, increasing the risk for weathering over the life span. Highly responsive individuals can become hypersensitive to social feedback and psychological manipulation, both capable of detracting individuals from achieving goals.60 This increases the risk for future stressful experiences, further increasing the risk for weathering.

cycle of stress and performance

Stress responsivity shapes the intensity of weathering and has implications for later adult health outcomes.61 Responsivity biased toward either under- or over-reactivity can predispose children to adult disease.62 For example, overexposure to maternal stress hormones before birth can restrict birth weight and predispose the developing child to hypertension later in life.63 Effects of parental stress, such as reduced opportunities for bonding and distant parent-child relationships, significantly increase the risk up to fourfold for a child to experience anxiety, depression, diabetes and heart disease as an adult.64 Higher prenatal glucocorticoid exposure is directly associated with higher circulating glucocorticoids in adulthood, and both are associated with increased hypertension and hyperglycemia and changes in adult behaviors.65

Investigating Brain Changes

We rely heavily on animal models to understand early-life stress programming because sampling a core of living human brain is not an option. However, we do have direct human associations: the brains of suicide completers show epigenetic changes in the glucocorticoid receptor gene66 as well as methylation changes in other important genes that inform the intensity of the stress response.67

Newborns of mothers with depressive symptoms during pregnancy also demonstrated increased methylation of the GR gene in umbilical cord blood cells. As three-month-old infants, these children had higher levels of salivary cortisol.68

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Brain Changes

With exposure to chronic stress, the brain changes shape, reducing connections that support nuanced cognitive function, self-regulation and memory; this process is less reversible as a child ages. Through these changes, chronic stress increases the likelihood of aggression, vigilance and anxiety.69 Because an individual suffering from these changes and conditions is handicapped in becoming a nurturing parent (although many people do overcome adversity and become terrific parents), the effects of stress can be self-perpetuating down generations. Through stress biasing, the social determinants can become multigenerational stimulants of chronic disease.70

To the individual, there is a cost for high responsivity. Early life stressors that reshape the brain affect hippocampal and amygdala development that can affect a child’s transition into adolescence. Chronic early stress impacting social learning may predispose teens to depression and substance abuse, both feeding into adult chronic diseases.71 This is a vicious cycle of early childhood adversity. The stress that parents experience can have direct influences on a child’s biological capacity in responding to future stressful situations.72 The parent-child relationship, in utero and through development, provides experiential information that programs stress responsivity.

Telomere Changes

Telomeres are structures on the ends of chromosomes that protect and stabilize chromosomes. They are essential for avoiding cellular dysfunction. Telomere length is reduced with age, smoking and stress, and shorter telomeres can impair health.73

Telomere length in specific blood cells is viewed as a biomarker for cellular aging that is closely associated with age-related and chronic diseases.74 This biomarker may reflect population-level weathering in communities. For example, a study of nine-year-old boys found that adverse environments shaped by low income, low maternal education, unstable family structure and harsh parenting were associated with a 19 percent shortening of white blood cell telomeres as compared to a cohort in more nurturing environments. These boys physically aged faster than their chronical age would suggest. Children with the most sensitivity (highest responsivity) to stress showed the longest telomeres in advantaged environments and the shortest in disadvantaged environments.75

Resilience

Resilience, the capacity to recover quickly from difficulties, is a characteristic of both individuals and communities. Parental bonding is a resilience factor, protecting children from the adverse effects of poverty on emotional and cognitive development.76

Community resilience is difficult to define and measure; the US Department of Health & Human Services defines it as "the ability of a community to use its assets to strengthen public health and healthcare systems and to improve the community’s physical, behavioral, and social health to withstand, adapt to, and recover from adversity".77   A resilient community is one that is socially connected, takes collective action, and has access to necessary resources.

Substantial risks to community health and well-being lie within community adversities such as climate change, urbanization and disparities. In the context of a natural or manmade disaster, increasing community resilience includes better preparedness and disaster planning, promoting community systems, and reducing threats to health. These are some steps communities and public health can take to build resilience:78

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  • 北京积分落户申报首日 系统登录顺利
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    syn=same,drome一次流出-一次流出相同症状-综合症状syn=same;drome=drone(n 雄蜂;v 嗡嗡作声)-同样的症状嗡嗡的过来-综合症状
  • 家居电商3岁 经营模式仍在探路
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

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  • THE AMERICANS (FX, Jan. 28) Season 3 of this terrific blend of Cold War spy thriller and family drama begins with Washington’s K.G.B. contingent feeling the weight of the Soviet war in Afghanistan. Frank Langella joins the cast as the new handler for the show’s husband-and-wife agents, replacing Margo Martindale’s Claudia. (Making its premiere eight days later: NBC’s “Allegiance,” about Russian spies embedded in the United States. Huh.)
    第二场比赛将于10月8日在上海的梅赛德斯-奔驰文化中心举行。
  • 8、苹果发布会
    支持:洛杉矶影评人协会将其评为最佳影片。
  • 单词galaxy 联想记忆:
    单词campaign 联想记忆:
    黄金市场可能会对美元以及美国加息的前景着迷。但还有一个因素正在逼近:金矿供应下降。
  • 3. 凯特?阿普顿
    Roles With Bite
  • Research in Southern California children found that living in a high-stress home is associated with more susceptibility to the negative effects of air pollution on the lungs.80  
  • In a study of children from birth to age seven, children who experienced high levels of air pollution in utero had lower IQ scores than those not exposed, but only when their mothers experienced material hardship.81

Selected Sources of Stress and Impacts on Health

Psychosocial risk factors for disease include family conflict, neighborhood violence, work stress and social discrimination; these factors can hinder mental and physical health.82

Domestic and Intimate Partner Violence

Global Domestic and Intimate Partner Violence

Globally, most data available is on intimate partner violence and sexual assault against women. An estimated 35 percent of women worldwide have experienced intimate partner violence over their lifetimes. Violence rates range from 71 percent of all women in Ethiopia to 15 percent of all women in Japan. Worldwide, up to 38 percent of all murders of women are committed by their partners.83

Domestic and Intimate Partner Violence: United States

Domestic violence includes violence from spouses, partners, parents, children, siblings or relatives. Three-quarters of incidents occur against women.84 In fact, it is estimated that a US woman is assaulted or beaten every nine seconds.85

Types of Domestic Violence.86

  • Rape
  • Sexual assault
  • Robbery
  • Intimate partner assault

Most violence occurs around the home (77 percent),87 and 19 percent of all violent incidents include the use of a weapon.88

The 房主过户前坐地起价要涨80万 称大不了双倍返定金 shows that between 2003 and 2012, domestic violence accounted for 21 percent of all violent victimizations in the US, with 70 percent of those from intimate partner violence (IPV).89

graph of violent relationships

data from Truman and Morgan90

Preventing Violence in Relationships

Research in high-income areas indicates school-based programs can help prevent relationship violence among young people.91

Costs. Intimate partner violence accounted for $4 billion annually in 1995 in health care services and an additional $900 million in lost productivity.92 When these amounts are updated to 2003 figures, $8.3 billion in annual expenses are estimated, a combination of higher medical costs ($5.8 billion) and lost productivity ($2.5 billion).93

Health outcomes of intimate partner violence. In addition to death and injury (bruising, flesh wounds, fractures, brain injury and headaches), the cardiovascular, gastrointestinal, immune, and endocrine systems are impacted from violence-induced stress, as discussed above.

Health Consequences of Intimate Partner Violence94

Health conditions 

Asthma

Infections

Circulatory conditions

Cardiovascular disease

Fibromyalgia

Irritable bowel syndrome

Chronic pain

家纺三巨头摩擦频繁 行业竞争白热化

Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

厨电新营销:年轻化 多元化 娱乐化

Delayed prenatal care
Preterm delivery

Low birth weight babies

Perinatal deaths

Unintended pregnancies

Psychological conditions

Anxiety

Depression

PTSD

Antisocial behavior

Suicidal behavior in females

Low self-esteem

Inability to trust

Fear of intimacy

Emotional detachment

Sleep disturbances

Flashbacks

Social impacts

Restricted access to services

四川广元:“力信佳建材”等25批次钢材质量差

Isolation from social networks

Homelessness

Health behaviors

High-risk sexual behaviors

Harmful substance abuse

统计局:1-2月份经济运行总体平稳

Overuse of health services

Child Abuse and Neglect

The CDC provides some 2014 facts on child maltreatment (either abuse or neglect) in the US:95

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The CDC estimates total lifetime costs of child maltreatment at $124 billion annually.:96

Youth Violence

Any violence—including being a victim, offender or witness—in early childhood extending into young adulthood is considered youth violence. The US CDC provides some important US statistics to consider:97

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Inspire strategies

World Health Organization with CDC and other global partners created INSPIRE, a technical package of seven evidence-based strategies to end violence against children. Click to open the Inspire infographic from the WHO website.

Risk factors for youth violence:98

  • A history of violence
  • Substance abuse
  • Delinquent behaviors
  • Poor family functioning
  • Poor grades in school
  • Community poverty

Adverse Childhood Experiences

PsychosocialCDCACEpyramid

graphic from the CDC;99 click to zoom

Adverse childhood experiences—ACEs—were first identified in the late 1990s. The risk for violence, victimization, and disease outcomes are heavily impacted by early childhood experiences. As shown at right, adverse childhood experiences can set children on an arduous path that increases risk for poor health behaviors, disease, disability, social problems and early death outcomes.100

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Examples of Adverse Childhood Experiences

Abuse

  • Emotional
  • Physical
  • Sexual

Household challenges

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  • Household substance abuse
  • 90后流行“租生活”
  • Parental separation or divorce
  • Criminal household member

Neglect

  • Emotional
  • Physical

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  • Alcoholism / alcohol abuse
  • 广东南沙首批人才公寓开放申请
  • Depression
  • Fetal death
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Financial stress
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  • Sexually transmitted diseases
  • Suicide attempts
  • Smoking
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

Neighborhood Violence

Living in a neighborhood that experiences high levels of violence can have a devastating impact on people’s long-term mental and physical health.  People who live in neighborhoods with high rates of violence suffer from trauma-related illnesses such as post-traumatic stress disorder (PTSD), at higher rates.101

child memorial in a poor neighborhood

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Exposure to neighborhood violence is especially harmful for children—it has been shown to impair children’s cognitive abilities and academic performance, and potentially contribute to inattentive and compulsive behaviors.102

Other health outcomes are associated with negative characteristics of residential settings including fewer cancer screenings, cardiovascular disease, and the outcomes of violence discussed above. The risk or resilience of a community can directly affect the prevalence of child maltreatment.103

A 2015 review of national and international studies in urban areas found these associations. More research is needed in rural areas to understand if these factors are generalizable:104

  • In the US community unemployment rate, per capita income, poverty rate and educational status were associated with intimate partner violence.
  • Internationally, though lacking representation from Europe or the Middle East, intimate partner violence was associated with community norms, community attitudes towards women, women’s literacy, education, and murder rates. Women’s empowerment is also shown to be protective against IPV.
  • Households with higher proportions of children were also associated with an increased risk of IPV.
  • Community characteristics such as lower collective efficacy, social cohesion, higher perceived neighborhood disorder, and general social disorganization are associated with an increase of IPV. Although crime and violence rates themselves have mixed results with association to IPV, higher levels of perceived violence and worry about violence are associated with IPV.

Discrimination

Racism, sexism, and other forms of discrimination exert a negative influence on mental health in a variety of ways. While experiencing discrimination within a person’s community is deeply stressful in and of itself, discrimination can also place certain groups at a higher risk of other adversities (poverty, segregation, unemployment, violence), which can also negatively impact health. Systematic racism, for example, raises exposure of communities of color to social exclusion and economic adversity, thereby placing them at a higher risk of stress, anxiety and chronic disease.105

Work Stress

Many factors in a person’s workplace can have a negative impact on their mental well-being. Factors such as poor work satisfaction, high demand, low job security, harassment and work disorganization can all cause people to feel substantially stressed while on the job. A 2016 investigation found 43 percent of working adults said their job negatively affects their stress levels. Others said their job negatively affects their eating habits (28 percent), sleeping habits (27 percent) and weight (22 percent).106

Behavioral Responses to Stress

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Stress and Addiction

substances often abused

 

同质化严重 智能化并非拯救小家电的万能钥匙

Stress a powerful risk factor for both developing an addiction and relapsing back into addiction.107 Stress affects the reward pathways of the brain, those same pathways involved in stress, in ways that make people especially prone to become addicted to substances such as nicotine, alcohol and drugs.108

Health-supporting Mechanisms

CDC offers healthy ways to cope with stress:109

  • Take a break, even a short one
  • Breathe deeply
  • Exercise
  • Visualize
  • Scan your body for tension
  • Talk to someone
  • Focus on the here and now
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  • Cut out the caffeine
  • Face the problem

What we know about stress and addiction:110

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One reason stress is a such a risk factor for substance abuse is that substance abuse can temporarily reduce anxiety caused by stressful events. As stress levels become chronic, the body responds with dysregulated hormonal states and stress-related behaviors that can produce anxiety. This predisposes an individual to seek substances that temporarily alleviate this stress-induced physical state. After the 9/11 terrorist event in the US, researchers noted a corresponding increase in the sales of various street drugs.111

Those who drink alcohol report that doing so makes them feel relaxed and less stressed. However, using alcohol as a coping mechanism for stress, especially on a regular basis, increases alcohol's harm to the body.

Stress and Antisocial or Violent Behavior

Stressors early in life are heavily associated with aggressive tendencies later in adulthood.112 Universally, childhood maltreatment is a risk factor for conduct disorders, antisocial personality symptoms, and becoming a violent offender. Research has found that abused boys experiencing erratic, coercive and punitive parenting were most at risk of antisocial behaviors later in adulthood, with the earlier the experience the more likely the negative behaviors were. Early child abuse doubles the risk a person will engage in criminal activities later in life.113

Environments That Break the Cycle of Violence114

  • Securing a stable environment
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  • Psychotherapy
  • Promoting positive parenting
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This "cycle of violence" describes the association between experiencing violence during childhood and the increased risk of either becoming violent or being a victim of violence. Although the majority of maltreated do not grow up to abuse others, we do know that one in six maltreated children becomes a violent offender and one in eight sexually abused boys becomes a sex offender.115 Victims of childhood abuse are at an increased risk of abusing their own children. Researchers also have found that up to one in seven children who experienced maltreatment in childhood also experienced abuse by their spouse. Violent experiences can be collective (gang membership), self-directed (harming oneself) or interpersonal (by a parent or other).116


This page's content was created by Lorelei Walker, PhD, and Nancy Hepp, and last revised in September 2016.

CHE invites our partners to submit corrections and clarifications to this page. Please include links to research to support your submissions through the comment form on our Contact page.

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