An abundance of research has implicated socioeconomic disadvantage as a major risk factor for increased rates of morbidity and mortality worldwide. While advances in science, medicine, and technology have enabled a positive trend in health outcomes over the previous two decades, individuals of lower socioeconomic status have experienced negligible improvements in health and longevity. Furthermore, individuals of lower socioeconomic status face higher risks of mental health disorders than their higher socioeconomic status counterparts. In order to improve methods of intervention, it is important to understand how the roots of these issues are cultivated during childhood.
Socioeconomic status is operationalized in multiple ways, including objective measures at both the household and neighborhood levels such as income, education, occupation, employment status, and single-parent status, as well as subjective measures such as perceived social status. This work explores the relationships between exposure to childhood socioeconomic disadvantage and the development of psychopathology. It reviews the literature for impacts of lower socioeconomic status during childhood on both internalizing (mood and anxiety) and externalizing (behavioral and substance use) disorders. Overall, mental health disorders constitute a significant proportion of the worldwide health burden, affecting one in four adults across the global population, including one in five adults and one in two adolescents in the United States. These staggering prevalence rates illuminate the importance of better understanding the mechanisms by which mental health illnesses emerge.
Childhood exposure to socioeconomic deprivation has been identified as a robust contributing factor to the increased risk of psychopathology development. Exposure to socioeconomic disadvantage increases the risk for mood disorders such as major depressive disorder, dysthymic disorder, bipolar I and II disorder, cyclothymic disorder; anxiety disorders such as generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias; behavioral disorders such as oppositional defiant disorder, conduct disorder, antisocial personality disorder, and attention-deficit/hyperactivity disorder; and substance use disorders such as alcohol and tobacco use. These conditions can disrupt normal growth and development; cause significant impairment in social, academic, and occupational environments; and create tremendous distress in important areas of daily functioning.
An ecobiodevelopmental model reveals how the interplay of biological factors, such as genetic inheritance and physiological adaptations/disruptions, with ecological factors, such as the social and physical environment, occurs continuously across the entire life span from the prenatal period through infancy, childhood, adolescence, and adulthood to drive development and the evolution of individual health and disease. Application of this approach helps to explain how genetic predispositions interact with exposure to poverty to cultivate an environment more prone to adverse childhood experiences. Adverse childhood experiences are stressors occurring prior to the age of 18 that can be threatening or harmful emotionally or physically, which can include traumatic or potentially traumatic experiences such as neglect and abuse. Examples include socioeconomic hardship, racial/ethnic discrimination, parental death, separation from parents, divorce, neighborhood violence, parental mental illness, abuse, neglect, parental substance abuse, violence and criminality in the home, and life-threatening physical illness.
Adverse childhood experiences promote toxic stress, which occurs from distressing situations high in magnitude, duration, or frequency without protective, buffering adult relationships to help the child cope. Toxic stress is characterized by an overloading of the body’s normal physiologic response mechanisms, which can have adverse long-term consequences through brain circuitry alterations and physiologic disruptions of the hypothalamic-pituitary-adrenocortical axis occurring during sensitive, critical periods of development. Toxic stress-induced alterations can occur in brain regions such as the hippocampus, amygdala, and prefrontal cortex, which are important in mood control, anxiety, stress coping, decision-making, and self-regulation. Self-regulation is a critical mediator in the link between childhood deprivation and subsequent psychopathology, as deficits in self-regulation increases the risk of both internalizing and externalizing disorders. In summation, the ecobiodevelopmental model is a multi-disciplinary approach that integrates developmental science constructs of toxic stress and self-regulation with ecology, neuroscience, and life course sciences to supply promising explanations for the underlying mechanisms linking childhood poverty to mental illnesses.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/38597 |
| Date | 09 October 2019 |
| Creators | Desai, Nisarg |
| Contributors | Offner, Gwynneth, Davies, Theresa A. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NonCommercial-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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