addiction treatment work and, 180
future vision, 223–25
gun-violence victims and, 118–20
health problems by age (overview), 142–43
hormones and, 70–72
overmedicalization criticism, 179
poverty and health problems link (summary), 7–8
as risk factor (overview), xiv–xvi
as taboo subject, 170–71
toxic stress response and, 54–55
ACE/health problems link establishment
difficulties with (summary), 13
misconception on behavior/risk link and, 40–41
See also ACE Study (Felitti/Anda); specific individuals
ACE patient Diego
abuse, 4–5
through the years/health and adversity, 198–205
ACE patient Donna, 31–32, 34–35
ACE patient Jack, 140–42
ACE patient Lila
treatment, 149–50
ACE patient Patty, 32–35, 41, 75
ACE patient Tiny, 79–81
ACE patient Trinity, 61, 62, 63–64
ACE patients Nia/Charlene
Child Protective Services (CPS), 78
postpartum depression, 78–79
ACE patients twins/brothers witnessing violence, 5
ACE questionnaire, 227
at CYW, 229
ACE screening
criticism/labeling of children, 176–79
importance of, 177–78
practice guidelines and, 153
situation (2008), 98–99
supplemental categories/findings, 148–49
teen screening, 148
universalizing, 152–54
criticism, 40
dose-response relationship, 40
explaining “how” and, 42
Felitti’s obesity clinic patients and, 31–35
power of, 39
purpose of, 36
reasons not widely known, 40–42
See also Anda, Robert; Felitti, Vincent
ACE treatment
adults and, 167–68
ADEM (acute disseminated encephalomyelitis), 22–24, 25
ADHD (attention deficit hyperactivity disorder)
treatment, 65
underlying biology, 60
Adverse Childhood Experiences. See ACE
aging and telomeres, 86–90
Alzheimer’s disease, 69
American Journal of Preventative Medicine, 30
amygdala
See also ACE Study (Felitti/Anda)
asthma and ACEs, 4, 5, 6, 9, 10, 27, 39, 61, 73, 99, 139, 142, 143, 181, 201
autoimmune disease
See also specific diseases
Baldwin, James, 9
Basedow, Karl Adolph van, 63
Basedow’s disease, 63
Bayview
Burke Harris witnessing drug deal, 117–18
expansion, 126
situation before opening, 10
team-based care, 138–39
See also Center for Youth Wellness (CYW)
Bayview Child Health Center patients
ACE scores, 58–59
complex situations, 138–39
health problems overview, 6
need for data, 115
pediatric obesity programs and, 108–11
See also specific patients; specific treatments
bilirubin. See jaundice and newborns
Black Infant Health Program (BIH), 189–90, 195
Blackburn, Elizabeth, 86–87
brain and neurological system
toxic stress and, 66–70
See also neuroplasticity; specific components
brain-derived neurotrophic factor (BDNF), 110
bubonic plague (Black Death), 11, 208
Burke, Basil, 17–18
Burke, Evan
description/personality, 216
mother’s schizophrenia and, 215–16
sister (Nadine), 220–21
Burke Harris, Nadine
brother’s stroke and, 213–16
loss of son (Ziggy Harris), 219–21
stress response to witnessing shooting, 45–47
Burke, Louis, 216
Burke, Sarah, xi–xiv, 213–15, 221
California Pacific Medical Center (CPMC), 8–9, 14
Canada, Geoff, 132
cancer
collaboration on childhood cancers, 206–7
meditation’s effects, 112
treatment comparison to toxic stress, 207–8
Cantor, Pamela
children’s 9/11 effects and, 182–84
See also Turnaround for Children
husband (Nick) and ACEs, 169–70
realization of toxic stress in son, 166
treatment for husband, 166–67
video on verbal/emotional abuse and, 165
Carrion, Victor
Centennial Medal, Institute of Jamaica, 17
Center for Youth Wellness (CYW)
ACE questionnaire, 229
Burke Harris position, 126–27
community supporters, 133–34
description of rooms, 197–98
hearing on, 133–34
planning, 122–25
team-based care, 138
See also Bayview Child Health Center
Centers for Disease Control and Prevention (CDC), 36, 152
child-parent psychotherapy (CPP). See CPP (child-parent psychotherapy)
Clarke, Whitney
Cocalis, Rachel, 127
Community Health Assessment for San Francisco (2004), 8, 25
corticosteroids studies on tadpoles (Hayes lab), 15, 18–21, 22
cortisol
cognition/mood and, 51
daily pattern, 52–53
development, 20–22
hippocampus and, 58
meditation and, 112
short-term/long-term stressors and, 21–22
CPP (child-parent psychotherapy)
critical period of development, 144–45
Diagnostic and Statistical Manual of Mental Disorders, 60
Doll, Mary Lou, 136–37
dopamine, 69
Dowd, Denise, 119–20
education and schools
ACE-screening resistance, 181–82
See also Turnaround for Children
environment and genetics, 82–83
epigenetics description, 82–83
epigenetic regulation
DNA methylation, 84
early detection of problems and, 90
histone modification, 84
processes responsible for, 83
toxic stress and lifelong health and, 83–84
exercise
amount/balance, 110–11
benefits overview, 108–11
obesity programs, 31–35
See also ACE Study (Felitti/Anda)
fight or flight response, 49, 50
See also stress response
Fraiberg, Selma, 101
Gates, Robert, 157
Gates Foundation, 189
genetics and environment, 82–83
development and acceptance, 208–10
medical and public-health response, 210
Ghaly, Mark, 123–24
gonadal dysfunction, 70–71
Graves, Robert, 63
Graves’ disease, 63–64
growth failure
See also specific ACE patients
gun-violence victims, 119–20
Guthrie, Robert
son (John) and mental disability, 135–36
Guttmacher, Alan, 175
Harlem Children’s Zone, 132
Harris, Kamala
positions, 118–19
prevention of health and social problems, 120–22
Hayes, Tyrone and Hayes lab, 15, 18–21, 22
Hellman, Julia, 124
hippocampus
HIV/AIDS
zip codes and, 8
homeostasis, 21
hormones
function, 19
Hayes lab studies, 19
neuroplasticity and, 146
sleep and, 103
stress response and, 70–72
See also specific hormones
Hospital Council of Northern and Central California
conversation after (Marjorie), 97–98
description, 91
hyperthyroidism, 63–64
hypothalamic-pituitary-adrenal (HPA) axis, 49, 50, 102, 112, 169
hypothyroidism, 24
immune system
breastfeeding and, 74
infants and children and, 73–74
inflammation and, 73
sleep and, 103
inflammation
ACEs and, 74
autoimmune diseases and, 74
balance and, 110–11
cytokines and, 110
immune system and, 73
meditation and, 112
integrated medicine, 168
Janus, Kathleen Kelly
Bayview Clinic/CYW and, 156
dinners with women leaders and, 156–57
bilirubin and, 150
description, 150
treatment, 150–51
Johnson, Jenee, 189–91, 192, 193, 195
Kaiser Permanente, San Diego, members, 36–37, 39
Kaposi’s sarcoma, 60–61
Karlén, Jerker, 73
Kawachi, Ichiro, 25
King, Martin Luther, 190
Kram, Gabriel, 113–14
Legend, John, 125
Lieberman, Alicia
Lister, Joseph, 209
locus coeruleus
aggressive behavior and, 68
prefrontal cortex and, 67–68
sleep and, 68
LSD, 113
Mannix, Nancy and ACE screening, 177, 179–81, 188–89, 210
Marley, Bob, 17
Meaney, Michael, 81, 82, 84–85, 206
See also rat mothers and pups study
meditation
health benefits, 111–12
mindfulness and, 112–15
miasma theory of disease, 11–12, 208–9
Mind Body Awareness (MBA) Project, 112–13
mindfulness, 112–15
Moss, Adam, 149
National Crittenton Foundation, 176, 177–78
neuroplasticity, 145–46
New Yorker, 132
newborn screenings
See also specific issues
Neylan, Thomas, 89
9/11 effects, 183–85
obesity (adult)
Felitti’s programs, 31–35
high-risk communities and, 25
obesity (pediatric)
O’Donovan, Aoife, 89
Pai-Espinosa, Jeanette
background, 176
Palo Alto community, 90–91
Pediatric Oncology Group (POG), 206–7
phenylketonuria (PKU) disease
positive stress response, 54
posttraumatic stress disorder (PTSD), 47, 89
Precision Public Health Summit
Burke Harris response to tension, 193–94
overview, 189–94
researcher-community tension, 190–91
prefrontal cortex
functions and location, 67–68
Puterman, Eli, 88–89
race
Arno and sons, 191–92
comparing to humans, 85–86
dose-response pattern and, 81–82
serotonin/stress response and, 84
switching pups, 85
Renschler, Todd
Lieberman and, 101–2
revolution
ACE treatment in the future, 223–25
See also germ theory
Rice, Condoleezza, 157
Romanian orphanages and orphans, 67
sensitive period of development, 145
Sheridan, Sue
Cal (son) and jaundice, 150–51
Singer, Monica, 127
Sister J. and CYW opposition, 129–31, 132
sleep
biological importance, 102–3
infants of depressed moms, 102
locus coeruleus and, 68
meditation and, 112
smell and miasma theory, 208–9
standing orders, 23–24, 25, 26
stress hormones
development and, 20–22
sleep and, 102–3
See also corticosteroids studies on tadpoles; specific hormones
bear encounter example, 49–52
feedback inhibition and, 51
hormones and, 70–72
immune system and, 51
main players overview, 49
superhuman strength stories and, 48
types, 54–55
stress response buffer
need to enhance, 211
preventing dysregulation, 53
See also Caroline’s story; rat mothers and pups study
stress response, maladaptive (dysregulated)
disruption of feedback inhibition, 53
immune system and, 65
PTSD, 47
stroke
signs, xiii
sympatho-adrenomedullary (SAM) axis, 49, 50, 51, 102
tadpoles and corticosteroids studies (Hayes lab), 15, 18–21, 22
talk therapy, 27
TED Talk, Burke Harris, 157–58, 175
telomeres
aging and, 86–90
damage, 87–88
description, 86–87
environment and genetics, 87–90
Tipping Point Community, 123–24, 125–26
tolerable stress response, 54
toxic stress response
See also ACE
ACEs and, 182–89
adult ACE training and, 185–86
background, 182
chronic adversity and stress and, 183–85
discipline strategy and, 186
9/11’s effects on children and, 183–85
need for understanding, 181–82
resilience and grit and, 187
safety and stability and, 185
solutions approach, 186–88
test scores and, 186–88
ventral tegmental area (VTA), 67, 69–70
White House and Burke Harris, 175, 189
Williams, Cynthia, 139–40
Williamson, David, 36
women leader dinners
ACEs discussion, 157–59
Burke Harris joining, 156–57
See also Caroline’s story
Zamarra, John, 111