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Launch Fallout 4's launcher, go to Options, select "Ultra" preset. Close the launcher
Relaunch Fallout 4, see if anything has changed. If it appears resolved, go ahead and play with settings a bit in the Launcher to optimize your experience how you want.
My HBAO+ and SSAO has become bugged like what you describe before, and this fixes it most of the time.
I will add, the beginning of the game is particularly bad with Ambient Occlusion, so wait until you're in the wasteland proper before really trying to fix it.