Abstract：
Adverse childhood experiences (ACEs) significantly impact lifelong health and well-being. Despite extensive research, a comprehensive understanding of ACEs\' multifaceted impacts continues to be challenging to achieve. This study synthesizes meta-analytic evidence to provide a comprehensive view of ACEs\' effects, addressing various approaches to conceptualizing ACEs and their diverse outcomes. Employing an umbrella synthesis methodology, this review integrated findings from 99 meta-analyses involving 592 effect sizes. We examined ACEs through specificity, lumping, dimensional, and child maltreatment-centric approaches, assessing their impact across six domains: biological system dysregulation, neuropsychological impairments, physical health complications, mental health conditions, social and behavioral challenges, and criminal justice involvement. The findings reveal a small to moderate overall effect size of ACEs across outcome domains. Specific ACE approaches exhibited varying impact levels, with notable differences in effects on mental health, social/behavioral issues, and criminal justice involvement. When ACEs were aggregated without distinguishing between different types, but with consideration of their cumulative effects, adverse outcomes were significantly exacerbated. The child maltreatment-centric approach consistently demonstrated substantial effects across all evaluated domains. This review underscores the heterogeneity in ACEs\' impacts, influenced by the type of ACE and specific outcomes considered. It highlights the necessity for comprehensive approaches to understanding, preventing, and mitigating the effects of ACEs. These insights are vital for developing targeted interventions and informing policy-making, emphasizing the complexity and varied nature of ACEs\' influence on individual development and societal well-being.
摘要：
不良儿童经历（ACE）显着影响终身健康和福祉。尽管进行了广泛的研究,对ACEs多方面影响的全面理解仍然是一项艰巨的任务。本研究综合了荟萃分析证据，以提供ACEs效应的全面视图，解决概念化ACE及其不同结果的各种方法。采用伞式综合方法，这篇综述整合了99项meta分析的结果,涉及592个效应大小.我们通过特异性检查ACE，集块,dimensional,以儿童虐待为中心的方法，评估它们在六个领域的影响：生物系统失调，神经心理障碍，身体健康并发症，心理健康状况,社会和行为挑战，和刑事司法的参与。研究结果表明，ACEs在结果域中的总体效应大小为小到中等。特定的ACE方法表现出不同的影响水平，对心理健康的影响有显著差异，社会/行为问题，和刑事司法的参与。当ACE在不区分不同类型的情况下聚合时，但是考虑到它们的累积效应，不良结局显著加剧.以儿童虐待为中心的方法在所有评估领域都表现出了实质性的影响。这篇综述强调了ACE影响的异质性，受ACE类型和所考虑的具体结果的影响。它强调了全面理解方法的必要性，预防,减轻ACE的影响。这些见解对于制定有针对性的干预措施和为政策制定提供信息至关重要，强调ACE对个体发展和社会福祉的影响的复杂性和多样性。
