Training Medical Students, Residents to Address Toxic Stress

Whereas, we define toxic stress as non-normative adverse childhood experiences (ACEs) in the absence of socioemotional buffering, which has been associated with changes in brain structure and function, epigenetic alterations, and a chronically activated stress response system; and



Whereas, toxic stress during childhood has been associated with long-term health outcomes, including substance abuse, depression, anxiety, suicide attempts, intimate partner violence, sexually transmitted diseases, COPD, liver disease, and ischemic heart disease1, 2; and



Whereas, fostering resilience and supporting strong parent (or caregiver)-child relationships has been shown to potentially mitigate the effects of adverse childhood experiences and the toxic stress response; and



Whereas, current medical training includes minimal to no education on defining toxic stress, identifying families in clinic potentially affected by toxic stress, supporting parent-child relationships, or connecting families to community-based resources; therefore be it



RESOLVED, that the AAP issue a policy statement or other formal communication emphasizing the importance of toxic stress education in medical school and pediatric residency training; and be it further



RESOLVED, that the AAP include tools related to toxic stress prevention, resilience, and adverse childhood experiences in the Bright Futures Handbook.



FISCAL NOTE:



REFER TO: 2017 Annual Leadership Forum



LEAD AUTHOR: Ryan Hassan, MD



CO-AUTHOR: Sarah Maxwell



CO-AUTHOR: Maya Ragavan, MD