Mid-life reversibility of early-established biobehavioral risk factors: a research agenda

Objectives: epidemiological evidence links exposure to early life adversities --such as childhood maltreatment-- with impaired health and wellbeing in adulthood. Since these effects are usually unrecognized or untreated in childhood, preventive and remediating interventions in adults are needed. We asked, first, can we validly ascertain childhood adversity through retrospective assessments in adulthood? Second, what dimensions of childhood adversity have consequences for adult health? Third, is there enough plasticity in adult behaviors and neural function in mid-life to allow for interventions? Methods: supported by the National Institute on Aging, the UK Economic and Social and the Biotechnology and Biological Sciences Research Councils, a network of researchers in human and animal development addressed these questions through meetings and literature review. Results: widely-used adult ascertainments of childhood adversity are poorly related to prospective ascertainment A small number of dimensions may adequately distinguish among a range of co-occurring childhood adversities and early childhood periods of sensitivity to environmental influence might be reopened in adulthood to favor preventive interventions. Discussion: prospective animal and human research is clarifying targets for intervention to prevent ill health while subgroups of adults who believe they had adverse childhoods, whether or not that was the case, may require special intervention for effective treatment of established illness.