Child Maltreatment and Adverse Childhood Experiences

Child maltreatment and adverse childhood experiences (ACEs) encompass a spectrum of harmful exposures before the age of 18, including physical, emotional and sexual abuse, neglect, and household dysfunction such as domestic violence or caregiver substance misuse. These experiences are highly prevalent worldwide and show a dose–response relationship with a range of poor outcomes across the life course. In the short term, exposed children display impaired cognitive development, attachment difficulties and emotional dysregulation. Over the long term, ACEs are linked to elevated risks of depression, anxiety, cardiovascular and metabolic disease, substance misuse and premature mortality. Emerging evidence on biological embedding highlights disruption of neuroendocrine stress systems, chronic inflammation and alterations in brain structure and connectivity. Furthermore, maltreatment effects can span generations through epigenetic and psychosocial pathways, underlining the need for interventions that both prevent early adversity and mitigate its lifelong consequences. A growing consensus advocates for routine screening, trauma-informed care and cross-sectoral policies to create nurturing environments that bolster resilience and reduce the public health and economic burdens of maltreatment.

Research from Nature Portfolio

Recent studies have constructed normative models of structural brain development to characterise the long-term neurobiological imprint of early adversity. In a longitudinal cohort followed into early adulthood, widespread region-specific volume changes were identified in prefrontal, limbic and association cortices. These morphometric deviations were stable across independent samples and predictive at the individual level of future anxiety symptoms. The work underscores the value of personalised neurodevelopmental benchmarks in distinguishing typical variation from adversity-related alterations, and highlights how persistent brain-structure differences may inform risk stratification and targeted prevention strategies.

Child Maltreatment and Adverse Childhood Experiences publication trend

The graph below shows the total number of articles in child maltreatment and adverse childhood experiences across all publications each year (not limited to Nature Index journals).

Technical terms

Adverse childhood experiences (ACEs): Cumulative exposure to abuse, neglect or household dysfunction before age 18 that elevates risk for adverse health and social outcomes.

Objective maltreatment: Instances of abuse or neglect verified by external documentation such as court or protective-services records.

Subjective maltreatment: Self-reported experiences of abuse or neglect, typically collected via retrospective questionnaires.

Normative brain development model: A statistical framework describing typical trajectories of brain structure, against which individual deviations due to adversity are measured.

Population attributable fraction (PAF): The proportion of incidence of a health outcome in a population that can be linked to a specific exposure.

References

1. Objective and subjective experiences of childhood maltreatment and their relationships with cognitive deficits: a cohort study in the USA. The Lancet Psychiatry (2024).
2. Intergenerational transmission of the effects of maternal exposure to childhood maltreatment in the USA: a retrospective cohort study. The Lancet Public Health (2023).
3. A stable and replicable neural signature of lifespan adversity in the adult brain. Nature Neuroscience (2023).
4. Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. The Lancet Public Health (2019).
5. Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Medicine (2017).