Department of Science, Technology and Society (STS), School of Social Sciences and Technology, Technical University of Munich, Arcisstr. 21, 80333, Munich, Germany.
Department of Economics and Policy, School of Management, Technical University of Munich, Arcisstr. 21, 80333, Munich, Germany.
Hist Philos Life Sci. 2024 Oct 29;46(4):33. doi: 10.1007/s40656-024-00629-3.
Adverse childhood experiences (ACEs) have become a topic of public and scientific attention. ACEs denote a range of negative experiences in early life, from sexual abuse to emotional neglect, that are thought to impact health over the life course. The term was coined in the CDC-Kaiser ACE Study, an epidemiological study that surveyed 17,421 adults about ACEs and correlated the responses with participants' current health records. Shortly after the study was published in 1998, the US CDC deemed ACEs an important public health target; however, it is only recently that ACEs feature prominently in scientific and public discourses. We contend that this rise in popularity is linked to the adoption of epigenetic explanations for how ACEs affect health. Based on a literature analysis, we trace the evolution of explanatory frameworks for ACEs-from coping behaviors to allostatic load to epigenetics-and analyze how each of these explanations not only reconsiders the mechanisms by which ACEs affect health, but also who should be held responsible for addressing ACEs and how. Epigenetics provides distinctly different discursive possibilities than previous frameworks: firstly, it offers one distinct molecular mechanism for how ACEs work, lending "molecular credibility" to epidemiological findings; secondly, it raises the possibility of reversing the negative effects of ACEs on the biological level. This epigenetic articulation makes ACEs attractive for new actors in science and society. Particularly, it facilitates novel interdisciplinary collaborations and attracts actors in health advocacy who are interested in non-deterministic readings of ACEs that counteract stigma and support positive health interventions and healing.
不良的童年经历（ACEs）已经成为公众和科学界关注的话题。ACEs 表示早期生活中一系列的负面经历，从性虐待到情感忽视，这些经历被认为会影响整个生命周期的健康。这个术语是在疾病预防控制中心-凯撒 ACE 研究中创造的，这是一项对 17421 名成年人进行 ACEs 调查并将反应与参与者当前健康记录相关联的流行病学研究。该研究于 1998 年发表后不久，美国疾病预防控制中心将 ACEs 视为一个重要的公共卫生目标；然而，直到最近，ACEs 才在科学和公众话语中占据重要地位。我们认为，这种流行度的上升与采用表观遗传学解释 ACEs 如何影响健康有关。基于文献分析，我们追溯了 ACEs 解释框架的演变——从应对行为到适应负荷到表观遗传学——并分析了这些解释中的每一个如何不仅重新考虑了 ACEs 影响健康的机制，还重新考虑了谁应该负责解决 ACEs 以及如何解决。表观遗传学提供了与以前框架截然不同的话语可能性：首先，它为 ACEs 如何发挥作用提供了一个独特的分子机制，为流行病学发现提供了“分子可信度”；其次，它提出了在生物学水平上逆转 ACEs 负面影响的可能性。这种表观遗传学的表述使 ACEs 对科学和社会中的新参与者具有吸引力。特别是，它促进了新的跨学科合作，并吸引了健康宣传者中的参与者，他们对 ACEs 的非决定论解读感兴趣，这种解读可以对抗污名化，并支持积极的健康干预和治疗。
