The epigenetic impact of adverse childhood experiences through the lens of personalized medicine

Sheldon Levy, John Muench

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Over the last two decades, there has been increasing evidence that adverse childhood experiences (ACEs; e.g., physical, emotional and sexual abuse; household member substance misuse; incarceration; mental illness; parental divorce; or witnessing intimate partner violence) before age 18 contribute to the development of disease in adults, including mental illness, cancer, heart disease and diseases of the endocrine system [1,2]. Although there is evidence that ACEs can result in epigenetic changes, leading to increased susceptibility to illness [3], the relative strength of each of the various ACEs in this association has not been well delineated. However, there is some evidence that sexual, physical and emotional abuse has the greatest impact on inflammatory markers [4]. Despite the known impact of ACEs on individual health and treatment outcomes, this understanding has yet to be incorporated into standard medical practice. Many clinicians do not know of the strong association between ACEs and disease, many are worried that they might upset or trigger anxiety in their patient by asking and many feel they do not have the tools to help patients with high ACE scores. We offer evidence that suggests that ACEs are an important aspect of how individuals respond to both disease and treatment. In addition, we suggest that this information as well as information about resiliency can be useful in risk assessment.We further suggest that the ACE information of individuals participating in clinical trials would be helpful in determining the efficacy of various treatment approaches and intensities, with the goal of creating truly personalized medical treatment.

Original languageEnglish (US)
Pages (from-to)425-429
Number of pages5
Issue number8
StatePublished - Apr 2022


  • childhood adversity
  • personalized medicine
  • social epigenetics

ASJC Scopus subject areas

  • Genetics
  • Cancer Research


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