Every year, more than 1 million children are exposed to sexual
or physical abuse or neglect in the United States.1 Childhood
physical or sexual abuse is associated with adult health
problems, including somatic symptoms and medical symptoms, such
as heart disease, psychological problems, and substance abuse;
for many variables, this association is as strong as for
patients who are currently experiencing abuse.2 Women with a
history of sexual abuse report depression onset earlier in life
and appear to engage in more harmful and self-defeating coping
strategies.3 Furthermore, a powerful graded relationship exists
between adverse childhood experiences and risk of attempted
suicide across the life span.4 Individuals who experience early
life stress (ELS) are at increased risk for pathophysiological
changes in the CNS that increase their vulnerability to stress
later in life, which predisposes them to mental and physical
disorders. Thus, genetically susceptible individuals are at
increased risk for stress-related d