top of page

Wisdom from the Fields of Neuroscience, Epigenetics, ACEs & Resilience (NEAR Science)

By Whitney Marris, LCSW, CTIPP's Director of Practice & System Transformation

CTIPPGuideNEARscience
.pdf
Download PDF • 3.73MB

Making Sense of Critical NEAR Terms & Concepts in Context


The dynamic field of NEAR (Neuroscience, Epigenetics, Adverse Childhood Experiences [ACEs], and Resilience) science illuminates our evolving understanding of individual and collective experiences related to trauma and resilience. This knowledge is a crucial backdrop and provides an important context for community capacity-building and change initiatives.

It is not expected or necessary for change makers to hold such a deep understanding of NEAR science that they could earn a Ph.D., operate on a brain, code a sequence of DNA, or anything of the sort.


Having said that, developing a foundational grasp of NEAR science is valuable as this frame equips individuals, groups, and communities with knowledge and insights that provide a holistic, evidence-informed perspective, fostering informed decision-making and enriching the impacts of their work to transform intergenerational health and well-being (Porter et al., 2016).


NEUROSCIENCE


Neuroscience relates to the understanding of the nervous system and brain, including (Posakony, 2020):

  • Discovering the role of emotions in relation to memory and the brain. For example:

    • The brain stem is the most primitive part of the brain, playing a role in regulating basic life functions like breathing, heart rate, and digestion. The brain stem is involved in the autonomic nervous system (ANS), which controls involuntary functions, including one’s automatic response to stress and trauma, preparing the body to navigate exposure to threat through the activation of the fight, flight, freeze, fawn, and/or faint/flop responses (these reactions—the “5 Fs”—are explored in greater depth below).

    • The amygdala plays a central role in processing and regulating emotional responses and is involved in the formation of emotional memories and the perception of emotionally charged stimuli. With repeated exposure to stress, adversity, and/or trauma, and without adequate reparative action following such exposures, the amygdala can become hyperactive, leading to heightened emotional responses. As a protective temporary response to extreme threats, the amygdala can “go offline,” influencing emotional processing and integration.

    • The prefrontal cortex is responsible for higher-order cognitive functions like decision-making, planning, impulse control, and emotional regulation. This part of our brain acts like an “emotional thermostat,” helping us engage in reasoned, balanced, and modulated reactions, as well as to understand the potential consequences of our actions. The prefrontal cortex also helps us relate to others, access and demonstrate empathy, build connections with others, and navigate healthy relationships, as well as adapt to new situations and learn from our experiences.

  • Recognizing humankind's capacity available through neuroplasticity

    • Neuroplasticity is the brain’s ability to adapt, change, and reorganize itself toward healing over time. Positive experiences, relationships, and therapeutic interventions can promote healthy neuroplasticity, aiding in trauma recovery and contributing to post-traumatic growth.

Image sourced from Dr. Arielle Schwartz

  • Comprehending the general functions and roles of neurotransmitters

    • Neurotransmitters are chemical messengers that communicate between brain cells. You may have heard of some of these examples:

      • Serotonin influences mood and emotions and contributes to a sense of well-being. Imbalances in serotonin levels are associated with mood disorders, anxiety, and difficulties in emotional regulation.

      • Dopamine affects motivation, pleasure, and reward. Dopamine dysregulation is linked to issues such as difficulty experiencing pleasure (anhedonia) and impulsivity, which are not uncommon experiences among people who have experienced trauma.

      • GABA (Gamma-Aminobutyric Acid) acts as an inhibitory neurotransmitter, meaning it has calming impacts on neural activity and the nervous system. Trauma can lead to imbalances in GABA levels, contributing to heightened anxiety and difficulties in relaxation.

      • Glutamate acts as an excitatory neurotransmitter, promoting neural activity. Elevated glutamate levels are associated with hyperactivity in the nervous system, contributing to symptoms like hypervigilance among people with lived experience.

      • Norepinephrine (noradrenaline) is released in stress or danger, preparing the body to respond to a perceived threat. In traumatic situations, there can be a dysregulation in the release of norepinephrine, contributing to hypervigilance, hyperarousal, and a more extreme stress/trauma response. Norepinephrine is also involved in memory consolidation, especially in emotionally charged situations, and can contribute to a person experiencing a vivid recollection of traumatic events.

  • Being able to determine how to intervene to support resilience and recovery across the lifespan based on what is observed individually and/or collectively

  • Understanding the basics of various brain states with an emphasis on the possible protective stress/trauma/survival responses that may emerge in the face of stress, challenge, or change, sometimes referred to as the “5 Fs.”

    • Fight: some of us may express a courageous resolve to engage in vigilant action to protect ourselves by confronting adversity with strength and/or asserting (or re-asserting) our power, dominance, and/or control

    • Flight: some of us may lean toward an elegant inclination toward protective withdrawal, characterized by our nervous systems making a wise and discerning survival-based choice to protect ourselves by stepping back and seeking safety to escape danger or threat

    • Freeze: some of us may embrace stillness and observation when confronted with perceived or actual danger, bringing us to pause and disconnect from overwhelming feelings of pain or danger to prevent further stress and find safety

    • Fawn: some of us may demonstrate adaptive cooperation and appeasement to keep ourselves safe, instinctively making efforts to cooperate, defuse conflict, or otherwise appease others to navigate circumstances that pose a threat to our well-being

    • Faint/Flop: some of us may “shut down,” experiencing a momentary loss of connection or consciousness and thus providing our brains and bodies with a reprieve from overwhelming stressors or threats, especially when we feel that there is no possible chance we will be able to win a fight, make a convincing plea, hide, or flee to access safety


The “5 Fs” are sometimes understood/depicted across a spectrum of hyperarousal to hyperarousal, as depicted below.

EPIGENETICS


Epigenetics describes how the body’s genes are expressed and adapt to behaviors, experiences, and environments across the life course and, as research has revealed, transgenerationally (Yehuda & Lehrner, 2018).


It is critical for advocates and activists to note that one’s DNA is not necessarily their destiny, as there are many factors (e.g., stress levels, exposure to environmental toxins, diet, etc.) that influence gene expression, well-being, and resiliency along the life course. It might be useful to conceptualize epigenetics as something like the “director’s cut” of a person’s genetic script. That is, while a person’s DNA may represent the script of a movie, epigenetics can be thought of as the added annotations that determine what parts are highlighted, enhanced, muted, or skipped.


Importantly, while unresolved trauma can and often does impact gene expression, the field of epigenetics also provides a realistic foundation for hope by revealing that epigenetic changes can be reversible. That means that making lifestyle, relational, and environmental changes that are connected to resiliency, strengths, skills, and the capacity to heal and grow can help “edit” these marks beneficially that also can be passed on from one generation to the next (Posakony, 2020).


There is evidence that communities that adopt a trauma-informed approach can see the positive impacts cascade through the lives of community members in ways that produce changes in genetic expression that contribute to generational healing and recovery (Danielson & Saxena, 2019).


Community and systems change has the potential to support future generations with a disposition toward empathy, resiliency, strength, social competency, reflective awareness, and citizenship, all of which contribute to more empowered, meaningful ways of thinking, knowing, being, doing, and relating than are available to trauma-impacted communities that do not undergo change efforts through this type of framework (Ungar, 2021).

Image sourced from Adobe Stock


ADVERSE CHILDHOOD EXPERIENCES


Adverse childhood experiences (ACEs) refer to certain indicators of significant stressors and challenges encountered within families, communities, and systems that, when experienced in the first eighteen years of life, particularly with compounding and/or intersectional experiences, can powerfully shape physical, psychological, social, spiritual, emotional, and behavioral health and well-being.


Together, the now-famous original ACEs study, along with the expanded Philadelphia ACE study, shone a spotlight on the powerful and indelible impacts of adverse childhood experiences across the life course.


And yet, it is important to note that the ACE questionnaire was originally designed as a public health instrument that aims to capture trends at a broader population level; that is, the ACE questionnaire itself was not crafted to predict the individualized life trajectory of any specific person.


When thinking about ACEs in an individual context, it is important that something like the ACE questionnaire is utilized as a tool for understanding–such as helping to explain how certain responses or behaviors have served as adaptive and informing possible reparative action and recovery pathways–rather than as a crystal ball defining the entire narrative of a person’s life.


The misuse of ACE scores bears several potential adverse consequences, such as (Tebes et al., 2019; Weems et al., 2021

  • Oversimplifying of the complex and multifaceted nature of trauma and its impacts—reducing intricate and varied lived experiences to a single score neglects this complexity

  • Stigmatization, othering, and labeling of individuals based on their ACE score—this can perpetuate negative stereotypes and result in the resiliency, adaptivity, and strengths that people possess being overlooked and unacknowledged

  • Predictive misconceptions—assuming that a high ACE score predicts an inevitably negative life trajectory is a potentially harmful misconception that overlooks the concept of multifinality, defined by McLaughlin (2016) as “the process by which the same risk and/or protective factors may ultimately lead to different developmental outcomes”

  • Neglect of protective factors—focusing solely on ACE scores may lead to overlooking protective factors, strengths, gifts, and resources that contribute to resiliency, undermining efforts people have the capacity to experience self-healing and post-traumatic growth

  • Inadequate individualization of interventions — assuming a “one-size-fits-all approach” based on ACE scores can cause inadequately tailored interventions, ignoring that personalized approaches are essential in trauma recovery

  • Ethical concerns—when ACE scores are placed on a person’s health records as a defining factor, particularly without a clear explanation of what that means and obtaining informed consent, confidentiality and other ethical concerns come to light, particularly given the stigma that still surrounds experiences of trauma and adversity

  • Impact on self-perception—people may internalize a negative narrative based on their ACE score, particularly if poor outcomes are heavily emphasized, as this may reduce one’s self-efficacy and sense of hope to experience positive change

  • Cultural insensitivity—cultural factors may lead to misinterpretation of people’s lived experiences when ACE scores are examined in isolation

It is also noteworthy that, beyond what has been widely accepted as being under the original ACEs umbrella based on what appears in the most widely known and -used ACE questionnaire, there are additional forms of developmental adversity—“exposure during childhood or adolescence to environmental circumstances that are likely to require significant psychological, social, or neurobiological adaptation by an average child and that represent a deviation from the expectable environment”—that are important to consider in devising and implanting plans for trauma-informed community change work (McLaughlin, 2016).


Such examples may include experiencing discrimination or racism, being bullied, experiencing migration or displacement, witnessing war, enduring extreme poverty, being exposed to community violence or deteriorating built environments, or becoming involved in the foster system (Philadelphia ACE Project, n.d.; Posakony, 2020).


Further explorations, such as Smart Start’s (n.d.) “Healthy & Resilient Communities” frameworks, have further expanded this exploration by including adverse climate experiences (e.g., hurricanes, wildfires, droughts, and so forth) as well as “atrocious cultural experiences” (e.g., having a legacy of trauma through a macro and socio-historical lens, such as slavery, genocide, colonization, segregation, family separation, and so forth). These conditions and experiences demand contextual consideration in addressing community change.

Image sourced from SmartStart.org


Individuals, communities, and systems impacted by adversity can also undergo profound transformation through which resilience and post-traumatic growth ultimately emerge.


While the ACEs framework illuminates the negative impacts of certain stressors on individual and collective well-being, the concept of Protective and Compensatory Experiences (PACEs; sometimes colloquially referred to as Positive Childhood Experiences) offers a vital counterbalance to consider when holistically exploring the NEAR framework.


PACEs encompass a variety of factors, including (Sheffield Morris & Hays-Grudo):

  • Supportive relationships

    • Unconditional love from a parent/caregiver

    • Having and spending time with a best friend(s)

    • Volunteering in the community/helping others

    • Being part of a group

    • Having a mentor outside of the family

  • Enriching resources

    • Living in a safe home where needs are met

    • Getting a quality education/having opportunities to learn

    • Having and engaging in a hobby

    • Being physically active

    • Having fair rules and routines

Similarly to how ACEs often cumulatively contribute to negative effects across the life course, PACEs have been demonstrated to protect against the risk of adverse impacts following stress, challenge, change, and adversity in early life.


In addition to serving as a buffer for exposure to trauma, PACEs also have been connected to positive outcomes related to mental health and well-being in adulthood.


More specifically, there is evidence that the right-fit combination of resources and relationships falling under the PACEs umbrella contributes to optimal neurological development, engagement in health-supporting behaviors, strong social, emotional, and cognitive functioning, as well as longevity and lifelong health (Sheffield Morris & Hays-Grudo). For example, positive parenting, social support, and a sense of belonging in one’s early years are associated with the development of qualities such as empathy, self-regulation skills, and social skills in one’s adult years.

Image sourced from Oklahoma State University


In addition to PACEs, when considering buffering ACEs it is useful to examine additional community-level protective factors demonstrated to build community resilience, disrupt intergenerational trauma cycles, and mitigate the deleterious impacts of ACEs on adult functioning and well-being.


Positive individual and collective experiences and outcomes become more likely to be realized in communities in which (CDC, n.d.):

  • All people have access to medical care and mental health services

  • There is equitable access to safe, stable housing

  • Nurturing, safe, affordable childcare is available and accessible

  • High-quality preschool is accessible to community members

  • Safe, engaging afterschool programming and activities are available for local students to participate in

  • Families have access to economic and financial help

  • Local work opportunities prioritize family-friendly policies

  • Strong cross-sector, cross-system community partnerships exist and leveraged

  • Community members feel connected to each other

  • Local culture is characterized by civic engagement and meaningful participation among community members

See CTIPP’s Guide to Trauma-Informed Community Change for further information about community context and conditions to support well-being.

Ensuring that PACEs and other protective factors at the individual, family, community, and systems level are illuminated in conversations about ACEs and, more broadly, the NEAR science framework helps shine a spotlight on the promise of healthier individual and collective experiences and outcomes and serves as fuel to motivate more people to mobilize around the system transformation needed to bring a healthier, flourishing future to fruition.


RESILIENCE


Resilience describes the capacity to adapt to, prevent, or mitigate the impacts of an adverse event or traumatic experience and recover through survival, adaptability, evolution, and growth despite ongoing stress, challenge, and change (Ellis & Dietz, 2017). Resilience can be conceptualized as both a quality of individuals and of collective groups and communities.


While the nature and degree of resilience may vary from individual to individual, from group to group, and from community to community, it is vital to recognize that resilience is a universal quality, and within each and every one of us is a remarkable inherent capacity for resiliency.


Like a sturdy foundation, resilience forms the bedrock of our psychological and emotional well-being, supporting us in recovering from setbacks, learning from our experiences, and forging ahead with newfound meaning and strengths. This reflects the remarkable capacity of the human spirit to endure and overcome.


We all have innate resilience, and thus, resiliency may be thought of as something we may exercise and also that can be strengthened. Recognizing and nurturing the intrinsic resilience each person, community, and system possesses is essential to fully embrace the potential for growth and positive transformation.


In an individual context, at a high level, characteristics and factors that are vital to enhancing and mobilizing resilience include (National Child Traumatic Stress Network, n.d.; Neff & McGhee, 2010; Nugent et al., 2014; Pennington, n.d.):

  • Realistic optimism and hope

  • Cognitive flexibility (i.e., the ability of a person’s mind to adapt and switch between different tasks, thoughts, or strategies)

  • Active coping skills (e.g., reframing the meaning of problems, seeking information, reaching for social support/help from others, etc.)

  • Insight and self-awareness

  • Connection to a sense of meaning in one’s life (e.g., spiritual beliefs, cultural context, connections with others, goals, dreams, core values, etc.)

  • Access to resources to help buffer negative consequences of exposure to stress, adversity, and trauma in daily life

  • Feeling safe at home and in the community

  • Future-oriented, solution-focused thinking

  • Physical well-being and healthy habits

  • Positive self-image, sense of self-worth, and self-compassion

  • Supportive social network

Image sourced from Boise State University


When working in a community context, it is important to conceptualize communities as unique, living, self-organizing systems.


Indicators of contextual community resilience, particularly in the context of implementing and sustaining trauma-informed change, include factors like (Ellis & Dietz, 2017; Feldman, 2021; Norris et al., 2008; Pfefferbaum, 2014; Posakony, 2020):

  • Mutuality and social reciprocity

  • Training on community competence to support activities related to civic engagement, self-management, and collective empowerment for community engagement and self-advocacy

  • High communication and information-sharing, including (but not limited to) the bidirectional transfer of knowledge and communication between residents between community members, organizations/agencies that support the community, and policy-/decision-makers who serve the community

  • Social capital (i.e., networks for community members to tap into for social support)

  • Community resources

  • The ability to sustain economic development

  • Community co-care and collaboration

  • Common language and understanding of trauma and NEAR science


Putting it All Together to Inform Trauma-Informed Transformation


Implementing trauma-informed and allied change efforts works most effectively when education about and consideration for the NEAR framework is integrated throughout the planning, implementation, and sustainment of efforts toward transformation.


It is vital to institutionalize this knowledge within programs, policies, protocols, and practices among community organizations, entities, businesses, and agencies, as well as among the general population, to enhance individual and collective potential and capacity to contribute meaningfully to change (Müller & McKenney, 2020).


This is interconnected with education. Simply put, we cannot know what we do not know until we know it. In CTIPP’s work and national and international engagement, it is not uncommon for people to refer to learning about NEAR science as a “lightbulb moment” for them. Once we can contextualize trauma responses as understandable, automatic, protective, and adaptive, we have more capacity to move away from pathologizing, blaming, and shaming and move toward engaging with greater empathy, compassion, and intentionality in our daily lives.


Education on NEAR science also helps reduce stigma and normalize experiences of trauma on a broader, more collective scale, which is particularly critical given the evidence that experiencing trauma is normative—that is, more people endorse having experienced trauma than not.


This understanding becoming institutionalized in our communities, systems, and structures is a critical aspect of coming together across currently siloed sectors, isolated disciplines, polarized political parties, and other socially constructed manners of difference to co-create supportive environments that bring us toward a more resilient, healthy future that we all can get behind. The NEAR frame enables us to better recognize that what works for one person or community might not necessarily work for another, thus unlocking possibilities that connect more with an abundance mindset and anchor in collaboration rather than competition.


To help more people, groups, communities, and systems stand empowered to act with greater intentionality to work toward responding to trauma and preventing re-traumatization, it is important that we increase access to accurate, evidence-informed information about what helps and what hurts. NEAR science provides a rich, accessible frame (despite the multisyllabic components that can be intimidating on their face!) to support trauma-informed, healing-centered action and change at individual and collective levels.


Some‌ initial ideas of NEAR-based activities that individuals, communities, organizations, and systems may consider implementing to raise consciousness that can translate to informed decision-making and action toward transformation include (Sege et al., 2017; Social Current, n.d.):

  • Structure opportunities for reflection on NEAR-related components into community capacity-building and change efforts

  • Integrate NEAR science principles into programming to ensure that services professionals are equipped with this knowledge and that community-based supports are aligned with trauma-informed practices

  • Launch a community or social media awareness campaign to bring awareness to NEAR science and the impacts of trauma to reduce stigma, foster empathy, spur action, and encourage people to support one another

  • Provide opportunities to hone knowledge and skills for transformational leadership to support community members with lived experience in informing and‌ leading change efforts

  • Implement NEAR-based regular evaluation processes and feedback mechanisms that engage voices of lived experience to assess the effectiveness of trauma-informed change initiatives as well as the alignment with evolving needs of the community

  • Encourage and support self- and collective-care practices that align with NEAR science

  • Work with policymakers to understand the NEAR framework to substantiate allocating funding to trauma-impacted communities and increasing access to science-aligned promising practices

  • Support efforts to utilize a NEAR frame with community planners, leaders, and other decision-makers to scale the prevention continuum to ensure sustainability and resiliency to future threats of harm, as well as to design physical and emotional spaces demonstrated to enhance well-being and support flourishing

  • Host workshops, seminars, and other events to foster a shared understanding and promote a collective commitment to trauma-informed practices

  • Provide education and training on NEAR science to the entire community—not “just” to clinical-focused professionals, academics, or those who provide direct services

    • Remember: knowledge is power! Self-understanding and other-understanding are both critical components of coming together to mobilize the wisdom of NEAR to create and sustain broad, significant change.

References


Centers for Disease Control and Prevention. (n.d.). Risk and protective factors. https://www.cdc.gov/violenceprevention/aces/riskprotectivefactors.html


Danielson, R., & Saxena, D. (2019). Connecting adverse childhood experiences and community health to promote health equity. Social and Personality Psychology Compass, 13(7), 1-13. https://doi-org.gate.lib.buffalo.edu/10.1111/spc3.12486

Ellis, W. R., & Dietz, W. H. (2017). A new framework for addressing adverse childhood and community experiences: The building community resilience model. Academic Pediatrics, 17(7), S86-S93. https://doi-org.gate.lib.buffalo.edu/10.1016/j.acap.2016.12.011


Feldman, R. (2021). Social behavior as a transdiagnostic marker of resilience. Annual Review of Clinical Psychology, 17, 153-180. https://doi.org/10.1146/annurev-clinpsy-081219-102046


McLaughlin, K. A. (2016). Future directions in childhood adversity and youth psychopathology. Journal of Clinical Child and Adolescent Psychology, 45(3), 361-382. https://doi.org/10.1080%2F15374416.2015.1110823


Müller, R., & McKenney, M. (2020). A science of hope? Tracing emergent entanglements between the biology of early life adversity, trauma-informed care, and restorative justice. Science, Technology, & Human Values, 46(6), 1230-1260. https://doi.org/10.1177%2F0162243920974095


Norris, F.H., Stevens, S.P., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150. https://doi.org/10.1007/s10464-007-9156-6


National Child Traumatic Stress Network. (n.d.). Resilience and child traumatic stress. https://www.nctsn.org/sites/default/files/resources/resilience_and_child_traumatic_stress.pdf


Neff, K., & McGhee, P. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9(3), 225-240. http://dx.doi.org/10.1080/15298860902979307


Nugent, N. R., Summer, J. A., & Amstadter, A. B. (2014). Resilience after trauma: From surviving to thriving. European Journal of Psychotraumatology, 5(10), 1-4. https://doi.org/10.3402%2Fejpt.v5.25339


Pennington, A. (n.d.) Resilience trait 1: Insight and emotional intelligence. https://insighttimer.com/blog/resilience-insight-emotional-intelligence/


Pfefferbaum, R.L. (2014). Advancing community resilience to disasters: Considerations for theory, policy, and practice. In A. Farazmand (Ed.), Crisis and emergency management: Theory and practice, pp. 691-708 (Second Edition). CRC Press.


Philadelphia ACE Project. (n.d.). Philadelphia ACE Survey. https://www.philadelphiaaces.org/philadelphia-ace-survey

Porter, L., Martin, K., & Anda, R. (2016). Self-healing communities: A transformational process model for improving intergenerational health. https://www.rwjf.org/en/library/research/2016/06/self-healing-communities.html


Posakony, T. (2020). N.E.A.R. science (Neuroscience, Epigenetics, ACEs, and Resilience): Emerging wisdom. http://www.emergingwisdom.net/n-e-a-r-science-neuroscience-epigenetics-aces-and-resilience/


Sege, R., Bethell, C., Linkenbach, J., Jones, J. A., Klika, B., & Pecora, P. J. (2017). Balancing adverse child experiences with HOPE: New insights into the role of positive experience on child and family development. https://www.social-current.org/wp-content/uploads/2021/10/balancing_aces_with_hope.pdf


Sheffield Morris, A., & Hays-Grudo, J. (2023). Protective and compensatory childhood experiences and their impact on adult mental health. World Psychiatry, 22(1), 150-151.https://doi.org/10.1002%2Fwps.21042


Smart Start. (n.d.). 4 realms of ACEs and resilience. https://www.smartstart.org/resilience-intro/resilience-home/


Social Current. (n.d.). Change in Mind Institute. https://www.social-current.org/engage/change-in-mind-institute


Tebes, J. K., Champine, R. B., Matlin, S. L., & Strambler, M. J. (2019). Population health and trauma-informed practice: Implications for programs, systems, and policies. American Journal of Community Psychology, 64(3-4), 494-508. https://doi.org/10.1002/ajcp.12382


Ungar, M. (Ed.). (2021). Multisystemic resilience: Adaptation and transformation in contexts of change. Oxford University Press. https://doi.org/10.1093/oso/9780190095888.001.0001

Weems, C. F., Russell, J. D., Herringa, R. J., & Carrion, V. G. (2021). Translating the neuroscience of adverse childhood experiences to inform policy and foster population-level resilience. American Psychologist, 76(2), 188-202. https://psycnet.apa.org/doi/10.1037/amp0000780


Yehuda, R., & Lehrner, A. (2018). Intergenerational transmission of trauma effects: Putative role of epigenetic mechanisms. World Psychiatry, 17(3), 243-257. https://doi.org/10.1002%2Fwps.20568

Comentários


bottom of page