Integrating and Synthesizing Adversity and Resilience Knowledge and Action: The ICARE Model

Overview

Journal Am Psychol

Publisher American Psychological Association

Specialty Psychology

Date 2021 Mar 18

PMID 33734789

Citations 13

Authors

Jennifer Hays-Grudo

Amanda Sheffield Morris

Lana Beasley

Lucia Ciciolla

Karina Shreffler

Julie Croff

Affiliations

Soon will be listed here.

Abstract

This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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References

Slopen N, Kubzansky L, McLaughlin K, Koenen K . Childhood adversity and inflammatory processes in youth: a prospective study. Psychoneuroendocrinology. 2012; 38(2):188-200. PMC: 3632283. DOI: 10.1016/j.psyneuen.2012.05.013. View

Wade Jr R, Shea J, Rubin D, Wood J . Adverse childhood experiences of low-income urban youth. Pediatrics. 2014; 134(1):e13-20. DOI: 10.1542/peds.2013-2475. View

Steinberg L, Lamborn S, Dornbusch S, Darling N . Impact of parenting practices on adolescent achievement: authoritative parenting, school involvement, and encouragement to succeed. Child Dev. 1992; 63(5):1266-81. DOI: 10.1111/j.1467-8624.1992.tb01694.x. View

Fareri D, Tottenham N . Effects of early life stress on amygdala and striatal development. Dev Cogn Neurosci. 2016; 19:233-47. PMC: 4912892. DOI: 10.1016/j.dcn.2016.04.005. View

Anderson L, Shinn C, Fullilove M, Scrimshaw S, Fielding J, Normand J . The effectiveness of early childhood development programs. A systematic review. Am J Prev Med. 2003; 24(3 Suppl):32-46. DOI: 10.1016/s0749-3797(02)00655-4. View

McEwen B . Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998; 840:33-44. DOI: 10.1111/j.1749-6632.1998.tb09546.x. View

Bethell C, Newacheck P, Hawes E, Halfon N . Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience. Health Aff (Millwood). 2014; 33(12):2106-15. DOI: 10.1377/hlthaff.2014.0914. View

Clarkson Freeman P . Prevalence and relationship between adverse childhood experiences and child behavior among young children. Infant Ment Health J. 2015; 35(6):544-54. DOI: 10.1002/imhj.21460. View

Cutrona C, Wallace G, Wesner K . Neighborhood Characteristics and Depression: An Examination of Stress Processes. Curr Dir Psychol Sci. 2008; 15(4):188-192. PMC: 2186297. DOI: 10.1111/j.1467-8721.2006.00433.x. View

10.

Cloitre M, Petkova E, Wang J, Lu Lassell F . An examination of the influence of a sequential treatment on the course and impact of dissociation among women with PTSD related to childhood abuse. Depress Anxiety. 2012; 29(8):709-17. DOI: 10.1002/da.21920. View

11.

Hertzman C . Putting the concept of biological embedding in historical perspective. Proc Natl Acad Sci U S A. 2012; 109 Suppl 2:17160-7. PMC: 3477385. DOI: 10.1073/pnas.1202203109. View

12.

Burdette A, Hill T . An examination of processes linking perceived neighborhood disorder and obesity. Soc Sci Med. 2008; 67(1):38-46. DOI: 10.1016/j.socscimed.2008.03.029. View

13.

Oberlander T, Weinberg J, Papsdorf M, Grunau R, Misri S, Devlin A . Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses. Epigenetics. 2008; 3(2):97-106. DOI: 10.4161/epi.3.2.6034. View

14.

Franke H . Toxic Stress: Effects, Prevention and Treatment. Children (Basel). 2016; 1(3):390-402. PMC: 4928741. DOI: 10.3390/children1030390. View

15.

Yamaoka Y, Bard D . Positive Parenting Matters in the Face of Early Adversity. Am J Prev Med. 2019; 56(4):530-539. PMC: 10954083. DOI: 10.1016/j.amepre.2018.11.018. View

16.

Perroud N, Paoloni-Giacobino A, Prada P, Olie E, Salzmann A, Nicastro R . Increased methylation of glucocorticoid receptor gene (NR3C1) in adults with a history of childhood maltreatment: a link with the severity and type of trauma. Transl Psychiatry. 2012; 1:e59. PMC: 3309499. DOI: 10.1038/tp.2011.60. View

17.

Strathearn L, Mertens C, Mayes L, Rutherford H, Rajhans P, Xu G . Pathways Relating the Neurobiology of Attachment to Drug Addiction. Front Psychiatry. 2019; 10:737. PMC: 6857543. DOI: 10.3389/fpsyt.2019.00737. View

18.

Bruce J, Gunnar M, Pears K, Fisher P . Early adverse care, stress neurobiology, and prevention science: lessons learned. Prev Sci. 2013; 14(3):247-56. PMC: 3633628. DOI: 10.1007/s11121-012-0354-6. View

19.

Deater-Deckard K . Family matters: Intergenerational and interpersonal processes of executive function and attentive behavior. Curr Dir Psychol Sci. 2014; 23(3):230-236. PMC: 4153697. DOI: 10.1177/0963721414531597. View

20.

Masten A . Global perspectives on resilience in children and youth. Child Dev. 2013; 85(1):6-20. DOI: 10.1111/cdev.12205. View