Athena Chow

Athena is a DPhil student in Experimental Psychology at the Oxford laboratory of Risk and Resilience, Genes & Environment Research. She obtained a Bachelor of Science in Psychology from University College London (UCL) and then continued researching the early risk factors for joint trajectories of bullying victimisation and perpetration in the UCL C-MAP Lab. Her interests include developmental psychopathology, longitudinal research methods, and life course epidemiology. Specifically, she is interested in investigating the early risk and protective factors for psychopathology in children and young people, and how scientific evidence can be applied to inform early interventions aimed at reducing social inequalities in childhood.

Description of proposed research
Adverse childhood experiences (ACEs) constitute a public health crisis. Children who experience ACEs are at higher risk for psychopathology, chronic health diseases, and substance abuse later on in life (Felitti et al., 1998). Across Europe, the annual health costs attributable to ACEs are estimated at $581 billion, with over 75% of costs arising from individuals with two or more ACEs (Bellis et al., 2019). Evidently, there is a pressing need to improve the life chances of children exposed to adversities and relieve the public health burden of ACEs.

Although research has established robust associations between ACEs and risk for psychopathology, the traditional cumulative risk approach is limited. By summing ACEs as a risk score, the cumulative risk approach implicitly assumes that all ACEs impact development via the same mechanism despite their heterogeneity in type, severity, and frequency.

The Dimensional Model of Adversity and Psychopathology (DMAP; McLaughlin, Sheridan, & Lambert, 2014) conceptualises childhood adversities under the distinct dimensions of threat and deprivation. During sensitive developmental periods, the brain is particularly malleable to biological disruptions as it is maximally plastic and experience-dependent (Fox et al., 2010). DMAP proposes specific neurobiological pathways for how threat (e.g., abuse, violence) and deprivation (e.g., poverty, neglect) during the early years become biologically embedded to impact risk for psychopathology (e.g., depression, anxiety) later on. Research has shown that childhood threat exposure adapts the neural systems underlying fear learning to display poor emotion regulation, heightened reactivity to negative stimuli, and difficulties distinguishing threat versus safety cues (McLaughlin et al., 2016). In terms of childhood deprivation, the lack of caregiver stimulation adapts neural systems to a less complex environment, such that children who experience early deprivation display deficits in executive function and working memory (Tibu et al., 2016).

Nevertheless, there are research gaps that need to be addressed. First, as previous DMAP studies largely relied on small cross-sectional samples from the US (e.g., Machlin et al., 2019; McLaughlin et al., 2016; Sheridan et al., 2017), there is a need for longitudinal research to link threat and deprivation ACEs in early childhood with psychopathology outcomes in later development. Second, bullying needs to be included as an ACE under the DMAP dimension of threat as there is substantial evidence that childhood bullying exposure directly contributes to psychopathology above genetic and shared environmental factors (Singham et al., 2017). Indeed, recent research found that including peer victimisation with the original 10-item ACE scale significantly improved prediction of mental health symptoms (Finkelhor et al., 2015). Third, protective factors which can buffer children from the adverse developmental consequences of ACEs need to be identified to inform social policies and interventions aimed at reducing social inequalities. In order to understand how to foster resilience, research must first understand how particular protective factors can compensate for ACE-related deficits or mitigate the impact of ACEs on risk for psychopathology.

To address these research gaps, the proposed research will apply the DMAP framework on representative UK birth cohorts, include bullying as an ACE under the threat dimension, and examine a range of protective factors. Using data from longitudinal birth cohort studies, the proposed research will investigate how neurobiological mechanisms and protective factors interact to influence the impact of ACEs on risk for psychopathology, with a particular focus on children’s emotion regulation and executive function as the underlying mechanisms. For example, amongst children who experienced ACEs, those with protective factors (e.g., social support, high socioeconomic status) may display better emotion regulation and executive function, as well as lower risk for psychopathology than their counterparts. Essentially, the proposed research aims to understand the multifinality of ACEs by exploring how children with similar ACE histories end up with varying psychopathology outcomes as a result of the interplay between multiple levels of biopsychosocial factors across development.

Findings from the proposed research will contribute to the goal of the Leverhulme Trust Biopsychosocial Doctoral Scholarship Programme to reduce social inequalities in early childhood by informing early interventions on how to mitigate and prevent the adverse developmental consequences of ACEs. The research will generate clinically useful knowledge (e.g., specific neurobiological mechanisms to be targeted and protective factors to be implemented during the early years) that can foster resilience, refine evidence-based interventions for at-risk children, and provide vulnerable children with sufficient support.

Athena Chow is supervised by Professor Lucy Bowes.