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Hicks MR, Smith-Darden J, Johns S, Kernsmith P. Adverse Childhood Experiences Predicting Psychological Distress among Black Youth: Exploring Self-Control as a Moderator. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:859-866. [PMID: 39309350 PMCID: PMC11413298 DOI: 10.1007/s40653-024-00617-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 09/25/2024]
Abstract
Contextual risk factors, such as adverse childhood experiences (ACEs), have a significant impact on the mental health of Black youth. Surprisingly, few studies focus efforts specifically on Black youth. The present study investigates the influence of ACEs on psychological distress among Black youth. Additionally, guided by social cognitive theory, this study highlights emotional self-control as a protective mechanism against the negative consequences of ACEs. Our findings show that ACEs (T1) predicted psychological distress among Black youth a year later (T2). Emotional self-control emerged as a significant buffer of ACEs on the association with psychological distress. Thus, to prevent negative mental health outcomes for Black youth, it is imperative to focus prevention efforts on the crucial risk factors that affect healthy development. By working to increase emotional self-control among Black youth who suffered adverse childhood experiences, negative mental health outcomes over time can be reduced.
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Affiliation(s)
- Megan R. Hicks
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
| | - Joanne Smith-Darden
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
| | - Shantalea Johns
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
| | - Poco Kernsmith
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
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Cross FL, Bares CB, Lucio J, Chartier KG. Adverse Childhood Experiences and Tobacco Use among Latinx Parents in the USA. J Racial Ethn Health Disparities 2024; 11:2294-2303. [PMID: 37490208 DOI: 10.1007/s40615-023-01697-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 07/26/2023]
Abstract
The current study aimed to understand the effects of adverse childhood experiences (ACEs) and cultural factors on Latinx parents' tobacco use. Tobacco use is the leading cause of death among Latinx individuals in the USA, and parental use has long-term secondary harm for children. Thus, it is important to examine cultural protective factors that could prevent Latinx parents and children from the negative health effects of tobacco use. Data came from 2813 18- to 50-year-old Latinx respondents who participated in the Wave 3 of the National Epidemiological Survey on Alcohol and Related Conditions. They reported having children living in their household and had complete data for the variables of interest. In this sample (mean age = 33.5 years, 53.7% female), 16.4% (95%CI = 14.7%, 18.4%) and 7.4% (95%CI = 6.4%, 8.6%) were current and former smokers, respectively. The multivariate multinomial logistic regression analysis showed that experiencing more ACEs categories was associated with increased likelihood of current and former tobacco use compared to never use. Past year discrimination experiences and being US born (2nd and 3rd-generation parents) also increased the likelihood of current use. Differences in risk of current and former tobacco use were found based on respondents' country of origin, with protection against tobacco use found for most countries compared to being from Puerto Rico. Stronger ethnic-racial identity was not protective against tobacco use. Findings show the importance of considering ACEs and cultural factors when designing and implementing tobacco cessation programs for Latinx parents and increasing awareness of the impact of parents' tobacco use on their children.
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Affiliation(s)
| | - Cristina B Bares
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Joel Lucio
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Karen G Chartier
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
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3
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Xu M, Corbeil T, Bochicchio L, Scheer JR, Wall M, Hughes TL. Childhood sexual abuse, adult sexual assault, revictimization, and coping among sexual minority women. CHILD ABUSE & NEGLECT 2024; 151:106721. [PMID: 38479262 PMCID: PMC11104844 DOI: 10.1016/j.chiabu.2024.106721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/11/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Compared with heterosexual women, sexual minority women experience higher rates and greater severity of sexual victimization. Little is known about how childhood sexual abuse (CSA), adult sexual assault (ASA), and revictimization impact coping in this population. Few studies have examined the effects of recency, developmental stage, and revictimization on coping. OBJECTIVE To improve psychosocial outcomes following sexual victimization, it is important to understand whether different patterns of exposure differentially impact coping over time. To do so, we investigated associations between CSA, ASA, and revictimization (both CSA and ASA) and adult sexual minority women's coping strategies. PARTICIPANTS AND SETTING Data are from a longitudinal community-based sample of 513 sexual minority women of diverse ages and races/ethnicities. METHODS Participants reported CSA ( RESULTS High-risk (i.e., genital penetration) CSA and recent ASA were associated with more avoidant coping (compared to no CSA or no ASA). No interaction between CSA and ASA was found, but history of both CSA and ASA had a stronger effect on avoidant coping than no victimization or CSA only. CONCLUSIONS Although sexual revictimization had a stronger impact on coping than CSA or ASA only, we did not find a synergistic effect (i.e., CSA and ASA may have had stacked independent effects). History of ASA was more strongly associated with coping than CSA. Recency of sexual victimization appears especially salient to coping among sexual minority women.
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Affiliation(s)
- Mariah Xu
- Columbia University, School of Nursing, United States of America.
| | - Thomas Corbeil
- Columbia University, Department of Psychiatry, United States of America
| | | | - Jillian R Scheer
- Syracuse University, Department of Psychology, United States of America
| | - Melanie Wall
- Columbia University, Department of Psychiatry, United States of America
| | - Tonda L Hughes
- Columbia University, School of Nursing, United States of America
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Bochicchio L, Porsch L, Zollweg S, Matthews AK, Hughes TL. Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:764-794. [PMID: 37070743 PMCID: PMC10582204 DOI: 10.1177/15248380231162973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.
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Affiliation(s)
| | - Lauren Porsch
- Columbia University School of Nursing, New York, NY, USA
| | - Sarah Zollweg
- Columbia University School of Nursing, New York, NY, USA
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Compton AB, Panlilio CC, Humphreys KL. What's the matter with ACEs? Recommendations for considering early adversity in educational contexts. CHILD ABUSE & NEGLECT 2023; 142:106073. [PMID: 36774310 PMCID: PMC10293056 DOI: 10.1016/j.chiabu.2023.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, some trauma-informed education practices use "ACE scores," a number that represents the sum of endorsed items from a survey derived from the Adverse Childhood Experiences (ACEs) study in 1998. We caution that the survey provides limited information within education, and such scores have limited utility for designing and delivering individualized intervention to support students who have experienced adversity. OBJECTIVE We sought to illustrate why ACEs are not well-suited for use in trauma-informed education, provide definitions for adversity-related terms from which a broader and common understanding of adversity can stem, and provide recommendations for integration of adversity-informed approaches to the educational context. METHODS We compiled definitions of adversity-related constructs and made recommendations based on review of relevant research from the fields of psychology and education. RESULTS Rather than tailoring educational practices to specific children based on the "traumatic" events they experience, we recommend educators focus their efforts on building supportive classrooms geared toward supporting students with best practices drawn from the Science of Learning, and with the understanding that early adversity can influence heterogeneous trajectories in student development and behavior. In addition, further research on educational practices, including the use of a shared language for describing and defining adversity-related experiences, are the concrete steps needed to better support a goal of adversity-informed education.
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Scheer JR, Wall MM, Veldhuis CB, Ford JV, Cascalheira CJ, Helminen EC, Shaw TJ, Jaipuriyar V, Zaso MJ, Hughes TL. Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8286-8315. [PMID: 36843440 PMCID: PMC10238679 DOI: 10.1177/08862605231153886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women's (SMW's) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW (Mage = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW's differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW's increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.
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Affiliation(s)
| | - Melanie M. Wall
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University School of Nursing, Center for Sexual and Gender Minority Health Research, New York, NY, USA
| | - Cindy B. Veldhuis
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Cory J. Cascalheira
- Syracuse University, Syracuse, NY, USA
- New Mexico State University, Las Cruces, NM, USA
| | - Emily C. Helminen
- Syracuse University, Syracuse, NY, USA
- Rochester Institute of Technology, Rochester, NY, USA
| | - Thomas J Shaw
- Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | | | - Tonda L. Hughes
- Columbia University, New York, NY, USA
- Columbia University School of Nursing, Center for Sexual and Gender Minority Health Research, New York, NY, USA
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Reed-Fitzke K, LeardMann CA, Wojciak AS, Ferraro AJ, Hamilton A, Duncan JM, Rull RP. Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support. J Affect Disord 2023; 325:721-731. [PMID: 36627058 DOI: 10.1016/j.jad.2023.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Previous research indicates an association between adverse childhood experiences (ACES) and health outcomes; however, most of these studies rely on variable-centered techniques. This study implemented a person-centered approach to provide a more nuanced understanding of these relations. METHODS The sample consisted of 3611 male Marines who completed two surveys, one prior to service and another during or after service. A series of latent class analyses were conducted to identify homogenous subgroups, using ACE categories as indicators. Hierarchical regressions were conducted to examine the relationships between classes, deployment experiences, depression and PTSD, and social support problems. RESULTS Five classes were identified: Low Adversity (48.8 %), Low Adversity - Parental Separation (PS; 33.1 %), Elevated Adversity (7.0 %), Moderate Adversity - Violence/Safety (5.7 %), and Moderate Adversity - Parental Loss (PL; 5.4 %). Several classes were associated with outcomes; in reference to Low Adversity, Moderate Adversity - PL was associated with depression and PTSD, Elevated Adversity was associated with PTSD and social support problems, and Low Adversity - PS was associated with social support problems. Experiencing moderate to high combat appeared to modify the associations between Moderate Adversity - PL and depression and PTSD. LIMITATIONS Study sample was limited to U.S. Marines; ACEs indicators were limited to specific categories, not allowing for a full range of potential childhood traumatic experiences. CONCLUSIONS Findings suggest a nuanced connection between ACEs and mental health; using specific patterns of ACEs, particularly multifaceted indicators of adversity that are inclusive of parental absence may have more utility than the sheer number of ACEs as an indicator for those who may at a heightened risk for mental health concerns.
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Affiliation(s)
| | - Cynthia A LeardMann
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA; Leidos, San Diego, CA, USA
| | | | | | | | | | - Rudolph P Rull
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA
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López G, Yeater EA, Veldhuis CB, Venner KL, Verney SP, Hughes TL. Sexual Assault, Psychological Distress, and Protective Factors in a Community Sample of Black, Latinx, and White Lesbian and Bisexual Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1239-NP1260. [PMID: 35459411 PMCID: PMC10201544 DOI: 10.1177/08862605221090570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Intersectionality and minority stress frameworks were used to guide examination and comparisons of psychological distress (depression, anxiety, posttraumatic stress disorder symptoms) and protective factors (religiosity, spirituality, social support) among 673 Black, Latinx, and White lesbian and bisexual women with and without histories of sexual assault. Participants were from Wave 3 of the 21-year longitudinal Chicago Health and Life Experiences of Women (CHLEW) study. More than one-third (38%) of participants reported having experienced adolescent or adult sexual assault (i.e., rape or another form of sexual assault) since age 14. Confirmatory factor analysis, structural equation modeling, and multivariate analyses of covariance were used to analyze the data. Results revealed that levels of religiosity/spirituality and psychological distress varied by race/ethnicity and by sexual identity (i.e., Black lesbian, Black bisexual, Latinx lesbian, Latinx bisexual, White lesbian, White bisexual). Black lesbian women reported the highest level of religiosity/spirituality whereas White lesbian women reported the lowest level. White bisexual women reported the highest level of psychological distress whereas White lesbian women reported the lowest level. We found no significant differences in reports of sexual assault or in social support (i.e., significant other, family, friend, and total social support). However, White lesbian women had higher friend, significant other, and total social support relative to the other five groups of women with minoritized/marginalized sexual identities. Future work should examine whether religiosity, spirituality, and social support serve as protective factors that can be incorporated into mental health treatment for lesbian and bisexual who have experienced sexual assault to reduce psychological distress.
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Affiliation(s)
- Gabriela López
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | | | - Cindy B. Veldhuis
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY, USA
| | - Kamilla L. Venner
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Steven P. Verney
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY, USA
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Hawn SE, Hawrilenko M, McDowell Y, Campbell S, Garcia NM, Simpson TL. An in-depth look at latent classes of DSM-5 psychiatric comorbidity among individuals with PTSD: Clinical indicators and treatment utilization. J Clin Psychol 2022; 78:2214-2244. [PMID: 35973077 PMCID: PMC9561047 DOI: 10.1002/jclp.23429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 04/25/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is associated with high comorbidity rates across the full range of psychiatric disorders. However, little is known about how psychiatric comorbidity manifests among people with PTSD, particularly with regard to concurrent diagnoses. METHOD Latent class analysis (LCA) was used to characterize discrete classes of PTSD comorbidity using past year DSM-5 diagnostic standards among a large nationally representative epidemiologic sample of U.S. adults. Follow-up analyses compared participant characteristics across latent classes. RESULTS The LCA was best characterized by five classes: low comorbidity, distress-fear, distress-externalizing, mania-fear-externalizing, and mania-externalizing. Excluding the low comorbidity class, proportions of borderline and schizotypal personality disorder were high across classes. CONCLUSION Participant characteristics across classes of past year PTSD comorbidity are explored through the lens of case conceptualization and treatment planning utility.
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Affiliation(s)
- Sage E. Hawn
- National Center for PTSD, Boston VA Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Matthew Hawrilenko
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | | | - Sarah Campbell
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | | | - Tracy L. Simpson
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
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Fujiwara T. Impact of adverse childhood experience on physical and mental health: A life-course epidemiology perspective. Psychiatry Clin Neurosci 2022; 76:544-551. [PMID: 36002401 DOI: 10.1111/pcn.13464] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) have been shown to have long-term effects on physical and mental health, not only in the US, but also other countries, including Japan. In this paper, measurement of assessment of ACEs has been discussed, that is, concept (what is ACEs), inquiry (how to ask about ACEs), scoring (how to count the number of ACEs), and prevalence (how many ACEs do we have). In addition, a possible mechanism on how ACEs affect health was summarized from a life-course perspective, using the critical/sensitive period model, pathway model, and cumulative model with recent evidence on neurological findings. Intergenerational transmission, that is, maternal ACEs affecting the health of the offspring was also reviewed. Finally, future directions on how to prevent and remedy the impact of ACEs on health was discussed.
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Affiliation(s)
- Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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11
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Lee KA, Bright CL, Sacco P, Smith ME. The Influence of Adverse Childhood Experiences on Perpetration of Intimate Partner Violence Among Black Men: The Moderating Role of Alcohol Use. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17248-NP17275. [PMID: 34192964 DOI: 10.1177/08862605211027997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study examined the moderating role of alcohol use on the association between adverse childhood experiences (ACEs) and intimate partner violence (IPV) perpetration among Black men in the United States. We conducted bivariate and logistic regression analyses using data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Bivariate results revealed significant relationships between eight of the 10 ACE factors physical neglect; emotional, physical and sexual abuse; witnessing a mother being abused; and having a parent guardian with an alcohol and drug problem and who was incarcerated and IPV perpetration. Similarly, examination of the relationship between ACEs and alcohol use in adulthood also revealed significant associations, with the exception of exposure to emotional neglect, emotional and sexual abuse, and witnessing a mother being abused. Findings from the logistic regression models revealed that alcohol use significantly moderated the relationship between ACEs and IPV perpetration, but only for men exposed to 1, 2, and ≥4 adversities in childhood. However, alcohol use appeared to exacerbate the relationship between ACEs and IPV perpetration for men without childhood adversity. Implications for practice, policy, and areas for further research are discussed.
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Affiliation(s)
- Kerry A Lee
- University of Maryland, College Park, MD, USA
| | | | - Paul Sacco
- University of Maryland, Baltimore, MD, USA
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12
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Qu X, Shen X, Xia R, Wu J, Lao Y, Chen M, Gan Y, Jiang C. The prevalence of sexual violence against female children: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2022; 131:105764. [PMID: 35779289 DOI: 10.1016/j.chiabu.2022.105764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/06/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sexual violence against female children is considered an important public health problem. However, there are currently no clear prevalence rates across the globe on which to base measures to protect these children. The objective of this study is to systematically summarize the prevalence of sexual violence against female children. METHODS We conducted a comprehensive search of the PubMed, Embase and Web of Science databases from their inception through April 2021 for pertinent studies reporting the prevalence of sexual violence against female children. The prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study-level characteristics were estimated through subgroup analysis and meta-regression. RESULTS A total of 28 cross-sectional studies were included (a total of 30,524 participants). The pooled sexual violence rate against female children was 0.24 (95 % CI = 0.20-0.27). Groups comparisons revealed that sexual violence rates obtained from 1981 to 2000 (0.28, 95 % CI = 0.21-0.36) were higher than those obtained from 2001 to 2020 (0.21, 95 % CI = 0.16-0.25), that rates were higher for female children from developed countries (0.25, 95 % CI = 0.20-0.29) than for those from developing countries (0.21, 95 % CI = 0.14-0.27), the rates for surveyed adults (0.22, 95 % CI = 0.17-0.28) than for surveyed female children (0.18, 95 % CI = 0.10-0.26), and that rates for those ≤15 years of age (0.10, 95 % CI = 0.01-0.20) were much lower than those for older children. CONCLUSIONS Nearly a quarter (24 %) of female children have been victims of sexual violence. Prevention strategies should be developed urgently to protect female children from aggression.
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Affiliation(s)
- Xianguo Qu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ruihong Xia
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ji Wu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yilei Lao
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Min Chen
- Department of Obstetrics and Gynaecology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Chunming Jiang
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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13
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Elliott M, Ragsdale JM. Stress exposure and well-being: correlates of meeting criteria for bipolar disorder, borderline personality disorder, or both. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1885-1896. [PMID: 34524518 DOI: 10.1007/s00127-021-02172-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 09/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Bipolar and borderline personality disorders share similar features, are challenging to differentiate and sometimes co-occur in the same individual. This paper compares people with bipolar, borderline, both or neither, analyzing sociodemographic characteristics, lifetime exposure to stressors, and emotional, social, and physical wellbeing to illuminate differences in life experiences associated with expressing symptoms consistent with bipolar, borderline, or both. METHODS Data were analyzed from the 2012-13 National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III), N = 36,309. Survey participants were classified as bipolar (N = 488, 1.3%), borderline (N = 1758, 4.8%), both (N = 388, 1.1%), or neither (N = 33,675, 92.8%). Differences between these groups regarding demographics, adverse childhood experiences, recent stressors, lifetime trauma, psychiatric co-morbidities, and emotional, social, and physical wellbeing were assessed with the adjusted Wald F test. RESULTS People with bipolar were more likely to also have borderline (44.3%) than the reverse (18.1%). People with both disorders were least advantaged socioeconomically, most exposed to stressors and traumas across the life course, and had the worst wellbeing emotionally, socially, and physically. Differences between people with both disorders vs. borderline only were smaller than between people with borderline vs. bipolar, although bipolar disorder was associated with considerable hardship relative to having neither disorder. CONCLUSION Borderline personality disorder alone or in combination with bipolar is associated with worse economic, social, and health outcomes than bipolar alone. Borderline can resolve with evidence-based treatment, and it is critical to correctly differentiate between the two conditions, so people with borderline and/or bipolar have the optimum chance for recovery.
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Affiliation(s)
- Marta Elliott
- Department of Sociology, University of Nevada, Reno, NV, USA.
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14
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Veldhuis CB, Juster RP, Corbeil T, Wall M, Poteat T, Hughes TL. Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women. PSYCHOLOGY & SEXUALITY 2022; 14:252-278. [PMID: 38549608 PMCID: PMC10978045 DOI: 10.1080/19419899.2022.2106147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
Abstract
Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW (N = 662; age range: 18-82; M = 40.0, SD = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.
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Affiliation(s)
| | | | - Thomas Corbeil
- Mental Health Data Science, New York State Psychiatric Institute
| | - Melanie Wall
- Mental Health Data Science, New York State Psychiatric Institute
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill
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15
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Pace CS, Muzi S, Rogier G, Meinero LL, Marcenaro S. The Adverse Childhood Experiences - International Questionnaire (ACE-IQ) in community samples around the world: A systematic review (part I). CHILD ABUSE & NEGLECT 2022; 129:105640. [PMID: 35662684 DOI: 10.1016/j.chiabu.2022.105640] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/01/2021] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Adverse Childhood Experiences International Questionnaire (ACE-IQ) collects additional data (e.g., witness community violence/terrorism) than the previous version. Despite ACE-IQ is widely used and validated in several languages, no reviews focus on this measure. OBJECTIVE The main goals are to: 1) synthesize the ACE-IQ prevalence rates and average means among community samples, both for total ACE and single dimensions (e.g., intrafamily abuse, bullying); 2) discuss these data in light of the characteristics of studies and samples; 3) identify main research lines of the field. PARTICIPANTS AND SETTING The search for studies using the ACE-IQ with community participants was conducted on seven academic databases, including retrieval of grey literature. The screening process led to include 63 documents. METHODS A systematic review following the PRISMA guidelines was performed. RESULTS 1) On average, 75% of community respondents experienced ACEs, with a mean of three, primarily emotional abuse and bullying. 2) Males experienced more ACEs, but they were underrepresented, as well as children and adolescents. Most studies were conducted in Asia or Africa, and different geographical areas showed different pathways of prevalence in subdimensions. 3) Most research focused on prevalence and relationships between ACE-IQ scores and respondents' mental and physical health, suicide and parenting, focusing on intrafamily ACEs more than on those outside the household. CONCLUSIONS Several issues emerged in terms of lack of reporting prevalence or means, lack of studies in Europe, America and Oceania, and no attention to collective/community/peer violence, plus a lack of consensus toward the dimensions of the ACE-IQ.
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Affiliation(s)
- Cecilia Serena Pace
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy.
| | - Stefania Muzi
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy
| | - Guyonne Rogier
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy
| | - Lara Lia Meinero
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy
| | - Sara Marcenaro
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy
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16
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Tynan M, Wooldridge JS, Rossi F, McLean CL, Gasperi M, Bosch J, Timko C, Herbert M, Afari N. Latent Class Patterns of Adverse Childhood Experiences and Their Relationship to Veteran Status and Sex in the National Epidemiologic Survey of Alcohol and Related Conditions Wave III. Mil Med 2022; 187:304-312. [PMID: 34977940 DOI: 10.1093/milmed/usab536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) are associated with poor psychosocial and health outcomes in adulthood. Veterans and females experience ACEs disproportionately. A greater understanding of this disparity may be achieved by examining the relationship between distinct ACE patterns and these demographic characteristics. Therefore, this study examined distinct ACE patterns and their association with Veteran status, sex, and other demographics in a nationally representative sample of U.S. adults to inform interventions tailored to ACE patterns experienced by specific groups. MATERIALS AND METHODS Latent class analysis (LCA) was conducted with data from the National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative structured diagnostic interview conducted from 2012-2013. The target population was the noninstitutionalized adult population living in the USA. The analytic sample was 36,190 (mean age 46.5 years; 48.1% male). Of these participants, 3,111 were Veterans. Data were analyzed between September 2020 and January 2021. RESULTS Latent class analysis revealed a four-class solution: (1) "Low adversity" (75.3%); (2) "Primarily household dysfunction" (9.0%); (3) "Primarily maltreatment" (10.7%); and (4) "Multiple adversity types" (5.1%). Compared to "Low adversity," members in the other classes were more likely to be Veterans (odds ratio (OR)C2vC1 = 1.33, ORC3vC1 = 1.55, ORC4vC1 = 1.98) and female (ORC2vC1 = 1.58, ORC3vC1 = 1.22, ORC4vC1 = 1.65). While lower education and income were also related to higher adversity class membership, Veteran status and sex were the strongest predictors, even when controlling for education and income. CONCLUSIONS Distinct and meaningful patterns of ACEs identified in this study highlight the need for routine ACE screenings in Veterans and females. As in the current study, operationalizing and clustering ACEs can inform screening measures and trauma-informed interventions in line with personalized medicine. Future work can test if classes are differentially associated with health outcomes.
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Affiliation(s)
- Mara Tynan
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92120, USA
| | - Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Fernanda Rossi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.,Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Caitlin L McLean
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Marianna Gasperi
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Jeane Bosch
- National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA
| | - Christine Timko
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Matthew Herbert
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
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17
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McCabe SE, Hughes TL, Beal S, Evans-Polce RJ, Kcomt L, Engstrom C, West BT, Veliz P, Leary K, McCabe VV, Boyd CJ. Sexual orientation differences in childhood sexual abuse, suicide attempts, and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in the US. CHILD ABUSE & NEGLECT 2022; 123:105377. [PMID: 34773839 PMCID: PMC9110097 DOI: 10.1016/j.chiabu.2021.105377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Childhood sexual abuse (CSA) contributes to increased risk of substance use and mental health disorders in the general population. OBJECTIVE To assess the prevalence and associations of CSA and suicide attempts, substance use, and mental health disorders as a function of sex (female, male) and sexual orientation (lesbian, gay, bisexual, heterosexual-identified with same-sex attraction and/or behavior, heterosexual-identified without same-sex attraction and/or behavior, and unsure). PARTICIPANTS AND SETTING Data were collected using structured diagnostic face-to-face interviews in a nationally representative sample of 36,309 US adults. METHODS We used descriptive statistics and logistic regression modeling to analyze data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). RESULTS Childhood sexual abuse was most prevalent among sexual minorities, especially bisexual females. Nearly one-third of bisexual females (30.6%) reported experiencing two or more types of CSA, p < .001. Among all participants, exposure to one or more types of CSA was associated with greater odds of lifetime suicide attempts, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol, tobacco or other drug use disorder, and mental health disorders, after adjusting for other childhood adversity/maltreatment and general life stressors. CONCLUSIONS Sexual minority females and males in the US are more likely than their heterosexual counterparts to report CSA. Higher risk of suicide attempts and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in adulthood was directly associated with CSA, particularly among bisexual females. Health professionals working with individuals who have experienced CSA should assess these risks and intervene as needed.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex (NCRC), Building 16, 2800 Plymouth Rd., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA; Rogel Cancer Center, University of Michigan, CCGC 6-303, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
| | - Tonda L Hughes
- School of Nursing, Columbia University, 560 W. 168th St., New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.
| | - Sarah Beal
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave., Cincinnati, OH 45267, USA.
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA.
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI 48202, USA.
| | - Curtiss Engstrom
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Brady T West
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex (NCRC), Building 16, 2800 Plymouth Rd., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Phil Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Kate Leary
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA.
| | - Vita V McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Department of Psychiatry, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA; Department of Surgery, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA.
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Department of Psychiatry, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA.
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18
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Ancheta AJ, Caceres BA, Zollweg SS, Heron KE, Veldhuis CB, VanKim NA, Hughes TL. Examining the associations of sexual minority stressors and past-year depression with overeating and binge eating in a diverse community sample of sexual minority women. Eat Behav 2021; 43:101547. [PMID: 34412003 PMCID: PMC8629849 DOI: 10.1016/j.eatbeh.2021.101547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 02/01/2023]
Abstract
Sexual minority stressors (e.g., stigma consciousness, internalized homophobia, discrimination) are posited to contribute to higher prevalence of overeating and binge eating among sexual minority women (SMW) relative to heterosexual women. Few studies have examined psychosocial mediators of the associations of minority stressors with overeating and binge eating in SMW. Using data from a diverse, community-based sample of SMW, we examined these associations, including the potential mediating effects of past-year depression. We also conducted exploratory analyses to determine if the associations of sexual minority stressors with overeating and binge eating differed by sexual identity or by race and ethnicity. The sample included 607 SMW (38.2% White, 37.1% African American, 24.7% Latina) with a mean age of 39.7 years. Approximately 17% and 9% of SMW reported overeating and binge eating, respectively, in the past 3 months. Greater stigma consciousness was associated with higher odds of overeating (AOR 1.31, 95% CI = 1.03-1.66). We found no significant associations between minority stressors and binge eating. Past-year depression did not mediate associations between minority stressors and overeating or binge eating. Although we found no sexual identity differences, stigma consciousness among Latina SMW was associated with higher odds of overeating relative to White SMW (AOR 1.95, 95% CI = 1.21-3.12) and African American SMW (AOR 1.99, 95% CI = 1.19-3.31). Findings highlight the importance of screening SMW for stigma consciousness as a correlate of overeating and considering racial and ethnic differences in overeating and binge eating in this population.
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Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Billy A Caceres
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Sarah S Zollweg
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Kristin E Heron
- Department of Psychology, Old Dominion University, Virginia Consortium Program in Clinical Psychology, 250 Mills Godwin Building, Norfolk, VA 23529, United States of America.
| | - Cindy B Veldhuis
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Nicole A VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences University of Massachusetts Amherst, 406 Arnold House, Amherst, MA 01003, United States of America.
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
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19
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Beveridge JK, Yeates KO, Madigan S, Stone AL, Wilson AC, Sumpton JE, Salberg S, Mychasiuk R, Noel M. Examining Parent Adverse Childhood Experiences as a Distal Risk Factor in Pediatric Chronic Pain. Clin J Pain 2021; 38:95-107. [PMID: 34743137 PMCID: PMC8719510 DOI: 10.1097/ajp.0000000000001002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/07/2021] [Accepted: 10/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs; ie, exposure to abuse, neglect, household dysfunction in childhood) are associated with poor mental and physical health outcomes across the lifespan. Emerging research suggests parent ACEs also confer risk for poor child outcomes. The relation between parent ACEs and child pain in youth with chronic pain has not yet been examined. The aim of the current longitudinal study was to examine the associations among parent ACEs, parent health, and child pain, in a clinical sample of youth with chronic pain. METHODS In total, 192 youth (75.5% female, 10 to 18 y old) and one of their parents (92.2% female) were recruited from tertiary pediatric chronic pain clinics in Canada. At baseline, parents completed self-report measures of ACEs, chronic pain status, anxiety and depressive symptoms, and posttraumatic stress disorder symptoms. At a 3-month follow-up, youth completed self-report measures of pain intensity and pain interference. RESULTS Regression and mediation analyses revealed that parent ACEs significantly predicted parent chronic pain status and depressive symptoms, but not parent anxiety or posttraumatic stress disorder symptoms. Moreover, parent ACEs were not significantly related to youth pain, either directly or indirectly through parent health variables. DISCUSSION Findings suggest that an intergenerational cascade from parent ACEs to parent health to child pain was not present in the current sample. Further research that examines the role of parent ACEs in the development of child chronic pain, as well as other risk and resiliency factors that may mediate or moderate the association between parent ACEs and child chronic pain, is needed.
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Affiliation(s)
| | - Keith O. Yeates
- Department of Psychology, University of Calgary
- Alberta Children’s Hospital Research Institute
- Hotchkiss Brain Institute, Calgary, AB
| | - Sheri Madigan
- Department of Psychology, University of Calgary
- Alberta Children’s Hospital Research Institute
| | - Amanda L. Stone
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Anna C. Wilson
- Department of Pediatrics, Oregon Health & Science University, Portland, OR
| | | | - Sabrina Salberg
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia
| | - Richelle Mychasiuk
- Department of Psychology, University of Calgary
- Alberta Children’s Hospital Research Institute
- Hotchkiss Brain Institute, Calgary, AB
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia
| | - Melanie Noel
- Department of Psychology, University of Calgary
- Alberta Children’s Hospital Research Institute
- Hotchkiss Brain Institute, Calgary, AB
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20
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Lee KA, Sacco P, Bright CL. Adverse childhood experiences (ACEs), excessive alcohol use and intimate partner violence (IPV) perpetration among Black men: A latent class analysis. CHILD ABUSE & NEGLECT 2021; 121:105273. [PMID: 34419899 DOI: 10.1016/j.chiabu.2021.105273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/20/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been linked to subsequent intimate partner violence (IPV) perpetration and alcohol use. Although higher rates of ACEs are found in racial/ethnic minority populations, there is a paucity of research examining ACEs patterns and risk for IPV perpetration and excessive alcohol use among Black men. OBJECTIVE To identify homogeneous subgroups based on ACEs among Black men using latent class analysis and assessing risk for later IPV perpetration and excessive alcohol consumption in adulthood. METHODS Using a sample of Black men (n = 2306) from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), we conducted latent class analysis (LCA) to examine their ACEs patterns based on 10 domains. ACE classes were used in logistic regression models to predict IPV perpetration and unhealthy alcohol use. RESULTS LCA revealed three classes: (1) High Household Dysfunction & Physical Neglect; (2) Physical/Emotional Abuse; and (3) Low ACEs. Men in the High Household Dysfunction & Physical Abuse (OR = 3.95, p < 0.001), and Physical/Emotional Abuse (OR = 2.37, p < 0.001) classes had increased risk for IPV perpetration (ref: Low ACEs class) controlling for sociodemographic factors. No significant association was found between class membership and unhealthy alcohol use. CONCLUSIONS Our findings highlight the need for interventions aimed at addressing ACEs among Black boys as they increase risk for negative outcomes in adulthood. Future research should explore heterogeneity in ACEs among youth and risk of IPV and explore possible causal mechanisms in the development of IPV among adults who have experienced ACEs.
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Affiliation(s)
- Kerry A Lee
- Graduate School of Social Work & Social Research, Bryn Mawr College, 300 Airdale Road, Bryn Mawr, PA 19010, United States of America.
| | - Paul Sacco
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD 21201, United States of America.
| | - Charlotte Lyn Bright
- School of Social Work, Colorado State University, 137 Education, 1586 Campus Delivery, Fort Collins, CO 80523-1586, United States of America.
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21
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Veldhuis CB, Porsch LM, Bochicchio LA, Campbell J, Johnson TP, LeBlanc AJ, Leonard KE, Wall M, Wilsnack SC, Xu M, Hughes TL. The Chicago Health and Life Experiences of Women Couples Study: Protocol for a Study of Stress, Hazardous Drinking, and Intimate Partner Aggression Among Sexual Minority Women and Their Partners. JMIR Res Protoc 2021; 10:e28080. [PMID: 34665154 PMCID: PMC8564669 DOI: 10.2196/28080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable population. Given the traditionally gendered lens with which women are primarily viewed as victims and men as perpetrators, understanding the dynamics of IPA in same-sex female couples can also advance research and practice related to IPA more generally. OBJECTIVE Guided by a recent extension of the minority stress model that includes relational (couple-level) sexual minority stress and the I-cubed theoretical perspective on IPA, we will collect individual and dyadic data to better characterize the links between hazardous drinking and IPA among SMW and their partners. First, this study aims to examine the associations among minority stress, hazardous drinking, and IPA in SMW and their partners. Minority stressors will be assessed as both individual and couple-level constructs, thus further extending the minority stress model. Second, we aim to examine potential mediators and moderators of the associations among minority stress, hazardous drinking, and IPA. Finally, we aim to test models guided by the I-cubed theoretical perspective that includes instigating (eg, relationship conflict), impelling (eg, negative affect and trait anger), and inhibiting (eg, relationship commitment and emotion regulation) or disinhibiting (eg, hazardous drinking) influences on IPA perpetration. METHODS This United States National Institutes of Health-funded project will draw from a large and diverse cohort of SMW currently enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study-a 21-year longitudinal study of risk factors and consequences associated with SMW hazardous drinking. SMW currently enrolled in the CHLEW and their partners will be invited to participate in the CHLEW Couples Study. By analyzing dyadic data using actor-partner interdependence models, we will examine how each partner's minority stress, hazardous drinking, and IPA experiences are associated with both her own and her partner's minority stress, hazardous drinking, and IPA perpetration. RESULTS Data collection began in February 2021 and will likely continue through 2023. Initial results should be available by mid-2024. CONCLUSIONS The CHLEW Couples Study will fill important gaps in knowledge and provide the basis for future research aimed at clarifying the causal pathways linking hazardous drinking and IPA among SMW. This will support the development of culturally appropriate targeted individual and dyadic prevention and intervention strategies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/28080.
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Affiliation(s)
- Cindy B Veldhuis
- School of Nursing, Columbia University, New York, NY, United States
| | - Lauren M Porsch
- School of Nursing, Columbia University, New York, NY, United States
| | | | - Jacquelyn Campbell
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Timothy P Johnson
- Department of Public Administration, University of Illinois - Chicago, Chicago, IL, United States
| | - Allen J LeBlanc
- Health Equity Institute, San Francisco State University, San Francisco, CA, United States
| | - Kenneth E Leonard
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, NY, United States
| | - Melanie Wall
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Sharon C Wilsnack
- School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Mariah Xu
- School of Nursing, Columbia University, New York, NY, United States
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, NY, United States
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22
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Caceres BA, Hughes TL, Veldhuis CB, Matthews AK. Past-year discrimination and cigarette smoking among sexual minority women: investigating racial/ethnic and sexual identity differences. J Behav Med 2021; 44:726-739. [PMID: 33797683 PMCID: PMC8486884 DOI: 10.1007/s10865-021-00217-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 03/18/2021] [Indexed: 12/22/2022]
Abstract
Although findings are mixed, discrimination has been identified as a risk factor for smoking in sexual minority women (SMW; e.g., lesbian and bisexual). We examined associations between past-year discrimination and cigarette smoking among SMW. Using regression analyses we examined associations of past-year discrimination including count of types of discriminatory experiences and attributions of the main reason for discrimination (i.e., sexual orientation, race/ethnicity, gender) with smoking outcomes (e.g., current smoking, nicotine dependence, smoking more cigarettes now than 12 months ago). We conducted exploratory analyses to examine whether race/ethnicity and sexual identity moderated the associations of past-year discrimination with smoking outcomes. The sample included 619 SMW. Most identified as lesbian (74.3%) and non-White (61.1%). SMW who reported a higher count of types of discriminatory experiences (AOR 1.54, 95% CI 1.12-2.12) and any gender-based discrimination in the past year (AOR 4.79, 95% CI 1.39-16.45) reported smoking more cigarettes now than 12 months ago. Associations of other past-year discrimination measures with other smoking outcomes were not significant. Compared to White SMW, any discrimination [B (SD) = 2.56 (0.83)] and a higher count of types of discriminatory experiences in the past year [B (SD) = 0.88 (0.31)] were associated with higher nicotine dependence scores in Black/African American SMW. Past-year discrimination are associated with smoking outcomes in SMW. Black/African American race moderated the associations of any past-year discrimination and a higher count of types of discriminatory experiences with nicotine dependence scores in SMW. Targeted interventions to mitigate the influence of discrimination on smoking among SMW are needed.
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Affiliation(s)
- Billy A Caceres
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032, USA.
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032, USA
| | - Cindy B Veldhuis
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032, USA
| | - Alicia K Matthews
- Professor, University of Illinois at Chicago's College of Nursing, 845 S. Damen Avenue, MC 802, Chicago, IL, 60612, USA
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Shaked E, Bensimon M, Tuval Mashiach R. Internalization and Opposition to Stigmatized Social Discourse among Incest Survivors. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:847-868. [PMID: 34459714 DOI: 10.1080/10538712.2021.1970680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Despite the high prevalence of incest, survivors are reluctant to disclose its existence for reasons such as shame, guilt and the presence of an accusatory and stigmatizing social discourse. The current mixed methods study examined the internal discourses of 13 incest survivors in Israel, reflected in self-reported internal dialogs which emerged during interviews. The qualitative analysis revealed a dialectical tension between two themes - one reflecting an internalization of the social discourse (manifested as quotes taken from social discourse and uttered by the survivors) and the other an agentic discourse (manifested in utterances either resisting the social discourse or showing an empowering advertence to one's own fulcrum). The quantitative analysis showed that for seven participants the internalized social discourse expressions were most frequent, for five the agentic expressions were most frequent, and that for one the discourses were at equilibrium. The ubiquitous sub-themes manifested in the internalized social discourse were: victimhood (feelings of vulnerability and helplessness), survivorship (meaningless existence, despair and hopelessness), negative self-esteem and self-pathology (perception of the self as having pathological psychological problems), and denial/repression of the abuse. The ubiquitous sub-themes manifested in the agentic discourse were: positive self-image and sense of potency, hope, optimism and positive perception of life, and uprising against the parents and institutions that did not give support. The discussion is based on Butler's concept of vulnerability, which suggests how to address the harms inflicted by incest without erasing aspects of the survivors' agency and growth.
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Kim J, Smith CK. Traumatic Experiences and Female University Students’ Career Adaptability. THE CAREER DEVELOPMENT QUARTERLY 2021. [DOI: 10.1002/cdq.12272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jiwon Kim
- Department of Rehabilitation and Counselor Education The University of Iowa
- Now at Department of Education Creighton University
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25
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Dolson RA, Morelen DM, Dodd JC, Clements AD. Pocket ACE: Child sexual abuse survivors missed by the ACEs Study Questionnaire. CHILD ABUSE & NEGLECT 2021; 117:105049. [PMID: 33862525 DOI: 10.1016/j.chiabu.2021.105049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND A 1998 seminal study catapulted adverse childhood experiences (ACEs) into the zeitgeist and shaped assessment of these experiences and long-term health consequences via The ACEs Study Questionnaire (ACE-SQ). However, the ACE-SQ's childhood sexual abuse (CSA) item requires the perpetrator have been 5-years or older than the survivor for endorsement. This may not adequately capture CSA and limit the questionnaire's ability to detect survivors. OBJECTIVE This study assessed whether CSA survivors were missed by this 5-year modifier, whether service access was restricted, and whether those missed were at elevated risk for adverse outcomes. PARTICIPANTS AND SETTING A sample of 974 women (Mage = 30.46) completed an online survey. METHODS Histories of CSA were assessed using the original ACE-SQ and an alternative version without the 5-year modifier. Participants were grouped by endorsement (Modifier, No Modifier, No CSA) and compared across numerous physical and mental health outcomes using MANOVA, ANOVA, and logistic regression. RESULTS Numerous CSA survivors are presently missed by the 5-year modifier (n = 118 of N = 249). This group demonstrated the same elevated depression (t = 3.44, p = .002, d = 0.34), heightened somatic symptom burden (t = 3.34, p = .003, d = 0.35), and poorer subjective health (t = -2.86, p = .012, d = 0.27) as those captured by the modifier. CONCLUSIONS Recommendations for research, practice, and policy include removing the 5-year modifier from CSA assessment, creating an empirically informed CSA definition, and eliminating or adjusting requisite cut-scores for accessing services.
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Affiliation(s)
- Robyn A Dolson
- Department of Psychology, East Tennessee State University, United States.
| | - Diana M Morelen
- Department of Psychology, East Tennessee State University, United States
| | - Julia C Dodd
- Department of Psychology, East Tennessee State University, United States
| | - Andrea D Clements
- Department of Psychology, East Tennessee State University, United States
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Werbeloff N, Hilge Thygesen J, Hayes JF, Viding EM, Johnson S, Osborn DP. Childhood sexual abuse in patients with severe mental Illness: Demographic, clinical and functional correlates. Acta Psychiatr Scand 2021; 143:495-502. [PMID: 33779997 PMCID: PMC8252558 DOI: 10.1111/acps.13302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To use data from electronic health records (EHRs) to describe the demographic, clinical and functional correlates of childhood sexual abuse (CSA) in patients with severe mental illness (SMI), and compare their clinical outcomes (admissions and receipt of antipsychotic medications) to those of patients with no recorded history of CSA. METHODS We applied a string-matching technique to clinical text records of 7000 patients with SMI (non-organic psychotic disorders or bipolar disorder), identifying 619 (8.8%) patients with a recorded history of CSA. Data were extracted from both free-text and structured fields of patients' EHRs. RESULTS Comorbid diagnoses of major depressive disorder, post-traumatic stress disorder and personality disorders were more prevalent in patients with CSA. Positive psychotic symptoms, depressed mood, self-harm, substance use and aggression were also more prevalent in this group, as were problems with relationships and living conditions. The odds of inpatient admissions were higher in patients with CSA than in those without (adjusted OR = 1.95, 95% CI: 1.64-2.33), and they were more likely to have spent more than 10 days per year as inpatients (adjusted OR = 1.32, 95% CI: 1.07-1.62). Patients with CSA were more likely to be prescribed antipsychotic medications (adjusted OR = 2.48, 95% CI: 1.69-3.66) and be given over 75% of the maximum recommended daily dose (adjusted OR = 1.72, 95% CI: 1.44-2.04). CONCLUSION Data-driven approaches are a reliable, promising avenue for research on childhood trauma. Clinicians should be trained and skilled at identifying childhood adversity in patients with SMI, and addressing it as part of the care plan.
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Affiliation(s)
- Nomi Werbeloff
- The Louis and Gabi Weisfeld School of Social WorkBar Ilan UniversityRamat GanIsrael,Division of PsychiatryUniversity College LondonLondonUK
| | - Johan Hilge Thygesen
- Camden and Islington NHS Foundation TrustLondonUK,Institute of Health InformaticsUniversity College LondonLondonUK
| | - Joseph F. Hayes
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Essi M. Viding
- Division of Psychology & Language SciencesUniversity College LondonLondonUK
| | - Sonia Johnson
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - David P.J. Osborn
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
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Sulaiman S, Premji SS, Tavangar F, Yim IS, Lebold M. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J 2021; 25:1581-1594. [PMID: 34036452 DOI: 10.1007/s10995-021-03176-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Total adverse childhood experiences (ACEs) are gaining prominence as a risk factor for preterm birth (PTB). The emerging literature examining this relationship reports inconsistent findings. The purpose of this systematic review was to summarize the available evidence exploring whether total ACEs predict PTB. METHODS A total of 386 studies were returned from searches on PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Nine studies were selected for final analysis and synthesis based on reporting of total ACEs and preterm birth gestational weeks or standard definition of birth before 37 weeks' gestational age. A systematic review rather than meta-analysis was selected to present the findings given the clinical and methodological (e.g., sample studied, measurement tools) heterogeneity of the retrieved studies and pregnancy outcomes measured. RESULTS The nine studies report on birth outcomes for 6,087 women from a range of sociodemographic and ethnic backgrounds. Despite a wide range of study designs, measurement tools, and timings of ACEs exposure across studies, seven of the nine included studies showed significant relationships between ACEs and PTB. CONCLUSION Systematic review of the literature suggests that total ACEs are associated with PTB and provides an overview on the known associations. However, to date only nine studies have assessed this link, and more studies are needed, to explore the associations between ACEs and PTB using appropriate and valid instruments and doing so among more diverse populations. Future research should also explore possible biological mechanisms (allostatic load), and moderating and mediating variables.
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Affiliation(s)
- Salima Sulaiman
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | | | - Farideh Tavangar
- Faculty of Health, School of Nursing, York University, Toronto, ON, Canada
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Margaret Lebold
- Faculty of Health, School of Nursing, York University, Toronto, ON, Canada
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Kisely S, Strathearn L, Najman JM. Risk Factors for Maltreatment in Siblings of Abused Children. Pediatrics 2021; 147:peds.2020-036004. [PMID: 33820849 DOI: 10.1542/peds.2020-036004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the association between child maltreatment (abuse and neglect) in one sibling and that in another as well as associated risk factors. METHODS The participants were 520 sibling pairs enrolled in a population-based birth cohort study in Brisbane, Australia (N = 1040). Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. Self-reports of childhood sexual abuse were also collected at the 21-year follow-up. RESULTS There were notifications in both children for 8.5% of the sibling pairs (n = 44). A notification in the first sibling was associated with a 60-fold increase in the likelihood of a notification in the second sibling (95% confidence interval: 29.3-125.1), resulting in nearly three-quarters being the subject of a report. In terms of the subtypes, neglect revealed the strongest association, followed by sexual abuse. At the 21-year follow-up, 58% of second siblings reported sexual abuse when the first sibling disclosed similar experiences. On adjusted analyses, maternal age of <20 years was the strongest and most consistent predictor of abuse, with indigenous status, maternal depression, parental relationship, and familial poverty playing a lesser role. CONCLUSIONS Our results highlight the close association between child abuse in one sibling and maltreatment in a second sibling as well as possible risk factors. Greater awareness of these factors may inform interventions, particularly primary and secondary prevention.
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Affiliation(s)
- Steve Kisely
- School of Medicine, The University of Queensland and Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; .,Departments of Psychiatry and.,Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lane Strathearn
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa.,Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa; and
| | - Jake M Najman
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
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Tang S, Jones CM, Wisdom A, Lin HC, Bacon S, Houry D. Adverse childhood experiences and stimulant use disorders among adults in the United States. Psychiatry Res 2021; 299:113870. [PMID: 33780857 PMCID: PMC8211100 DOI: 10.1016/j.psychres.2021.113870] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/11/2021] [Indexed: 11/18/2022]
Abstract
Recent data indicate a resurgence of stimulant use and harms in the United States; thus, there is a need to identify risk factors to inform development of effective prevention strategies. Prior research suggests adverse childhood experiences (ACEs) are common among individuals using stimulants and may be an important target for prevention. National Epidemiological Survey on Alcohol and Related Conditions was used to estimate prevalence of ACEs among U.S. adults using amphetamine-type stimulants (ATS), cocaine, or both. Multivariable logistic regression examined associations between ACEs and stimulant use and use disorders. Among adults reporting lifetime ATS use, 22.1% had ≥4 ACEs, 24.9% had 2-3 ACEs, 22.4% had 1 ACE, 30.6% reported no ACEs. Among adults with lifetime ATS use disorder, 29.3% reported ≥4 ACEs, 28.7% reported 2-3 ACEs, 21.6% reported 1 ACE, and 20.4% reported no ACEs. Multivariable logistic regression found a significant relationship between number of ACEs and stimulant use and use disorders. In conclusion, we found a strong relationship between increasing ACE exposures and stimulant use and use disorders. Advancing comprehensive strategies to prevent ACEs and treating underlying trauma among those using stimulants holds great promise to reduce stimulant use and its health and social consequences in the United States.
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Affiliation(s)
- Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA.
| | - Christopher M Jones
- Office of the Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - April Wisdom
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - Hsien-Chang Lin
- School of Public Health, Indiana University, Bloomington, USA
| | - Sarah Bacon
- Office of Strategy and Innovation, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - Debra Houry
- Office of the Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
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30
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Christensen J, Beveridge JK, Wang M, Orr SL, Noel M, Mychasiuk R. A Pilot Study Investigating the Role of Gender in the Intergenerational Relationships between Gene Expression, Chronic Pain, and Adverse Childhood Experiences in a Clinical Sample of Youth with Chronic Pain. EPIGENOMES 2021; 5:epigenomes5020009. [PMID: 34968296 PMCID: PMC8594698 DOI: 10.3390/epigenomes5020009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations.
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Affiliation(s)
- Jennaya Christensen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
| | - Jaimie K. Beveridge
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
| | - Melinda Wang
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Serena L. Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
- Correspondence:
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31
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Leza L, Siria S, López-Goñi JJ, Fernández-Montalvo J. Adverse childhood experiences (ACEs) and substance use disorder (SUD): A scoping review. Drug Alcohol Depend 2021; 221:108563. [PMID: 33561668 DOI: 10.1016/j.drugalcdep.2021.108563] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The long-term negative effects of adverse childhood experiences (ACEs) and their impact on physical and mental health has been widely studied. However, research about the relationship between ACEs and substance use disorder (SUD) diagnosis in adolescence and adulthood is still scarce. Therefore, this scoping review was conducted to collect the existing research findings to explore the relationship between the experience of ACEs and the diagnosis of SUD later in life. METHODS The PsycINFO, Medline, Scopus, Web of Science, and Cochrane Library databases were searched. After identifying the records based on eligibility and exclusion criteria, 12 studies were finally selected for inclusion. RESULTS Most of the studies were conducted in the USA with adult male and female participants. All studies were cross-sectional in nature and assessed ACEs retrospectively. The main conclusions of the studies were that there is a higher prevalence of ACEs in the population with SUD than in the general population, and a positive association between ACEs and the development and severity of SUD in adolescence and adulthood. CONCLUSIONS It is difficult to make comparisons between studies and to draw solid conclusions because of the lack of standardized criteria for evaluating ACEs and due to the heterogeneity in the substance types examined. More research is needed to fully elucidate the underlying mechanism of the relationship between ACEs and SUD.
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Affiliation(s)
- Leire Leza
- Department of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona, Navarra, 31006, Spain
| | - Sandra Siria
- Department of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona, Navarra, 31006, Spain
| | - José J López-Goñi
- Department of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona, Navarra, 31006, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), c/ Irunlarrea 3, Pamplona, Navarra, 31008, Spain
| | - Javier Fernández-Montalvo
- Department of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona, Navarra, 31006, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), c/ Irunlarrea 3, Pamplona, Navarra, 31008, Spain.
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Hicks MR, Kernsmith P, Smith-Darden J. The Effects of Adverse Childhood Experiences on Internalizing and Externalizing Behaviors among Black Children and Youth. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:115-122. [PMID: 33708287 PMCID: PMC7900288 DOI: 10.1007/s40653-020-00316-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is limited research on the short-term effects of ACEs on Black children and youth. Black children and youth are disproportionately exposed to abuse, neglect, and other victimizations (Drake et al. 2009; Wade et al. Journal of Family Issues, 17(3), 283-316, 2014). Investigating ACEs will provide a broader understanding of childhood trauma on developmental processes. The current study investigates how ACES impacts psychological distress, substance use, and delinquency among Black children and youth. Hypotheses were tested using a subsample of longitudinal data from 265 participants who were recruited from six school districts in Southeast Michigan. ACEs at T1 significantly predicted depressive symptoms at T2 (β = .19, p < .05), which in turn predicted substance use (β = .20, p < .05), and delinquency (β = .19, p < .05). Psychological distress also mediated the associations between ACEs and substance use, and delinquency. To engage youth in prevention/interventions and practice, it is important to understand the contexts in which they develop i.e. having knowledge on the specific type of victimization instances that Black youth may experience more than their peers as well as the social factors. Therefore, taking a trauma-informed approach that will acknowledge the adverse childhood experiences that youth went through and to understand how these experiences shape their development through adolescence may be efficacious.
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Affiliation(s)
- Megan R. Hicks
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
| | - Poco Kernsmith
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
| | - Joanne Smith-Darden
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202 USA
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Holliday R, Forster JE, Schneider AL, Miller C, Monteith LL. Interpersonal Violence Throughout the Lifespan: Associations With Suicidal Ideation and Suicide Attempt Among a National Sample of Female Veterans. Med Care 2021; 59:S77-S83. [PMID: 33438887 DOI: 10.1097/mlr.0000000000001447] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Female veterans experience interpersonal violence (ie, physical and sexual violence) more often than male veterans and nonveteran females. There is limited knowledge of types of interpersonal violence across the lifespan in relation to suicidal ideation and suicide attempt. Prior research has also focused on those accessing the Veterans Health Administration (VHA) care. OBJECTIVE This study examined if physical and sexual violence at differing time points (ie, premilitary, during military service) were associated with suicidal ideation and a suicide attempt at subsequent time points. We anticipated that violence would be associated with an increased risk of suicidal ideation and attempt; however, given limited prior research, we were uncertain which types of violence and time points would be associated with risk. RESEARCH DESIGN Data from a cross-sectional national survey. SUBJECTS A total of 407 female veterans using, formerly using, or who never used VHA care. MEASURES Suicidal ideation, suicide attempt, physical violence, and sexual violence were assessed. RESULTS Premilitary sexual, but not physical, violence was associated with military suicidal ideation. Both premilitary and military sexual and physical violence were associated with postmilitary suicidal ideation. Premilitary and military sexual, but not physical, violence were associated with a postmilitary suicide attempt. These results were maintained after accounting for VHA use. A significant model for military suicide attempt was not generated. CONCLUSIONS Assessment of premilitary and military sexual violence among female veterans is warranted within the context of suicide risk assessment and prevention. Preventing sexual violence among female veterans may be important for preventing suicidal ideation and attempt.
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Affiliation(s)
- Ryan Holliday
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention
- Departments of Psychiatry
| | - Jeri E Forster
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention
- Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO
| | - Alexandra L Schneider
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention
| | - Christin Miller
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention
- Departments of Psychiatry
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Brunton R, Dryer R. Child Sexual Abuse and Pregnancy: A Systematic Review of the Literature. CHILD ABUSE & NEGLECT 2021; 111:104802. [PMID: 33218712 DOI: 10.1016/j.chiabu.2020.104802] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/07/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child sexual abuse is related to many negative outcomes but less known is the effect on pregnancy and childbirth. OBJECTIVE This review critically examined the literature on the occurrence of child sexual abuse and outcomes associated with this abuse during pregnancy and childbirth. METHODS Five databases were searched over 50 years using an iterative approach and the terms pregnancy, sexual abuse/assault, childbirth/labour, identifying 49 studies. RESULTS The prevalence of child sexual abuse in pregnant women ranged from 2.63% to 37.25 with certain characteristics more common with a higher (e.g., specific questions, low income) or lower (broad questions, higher education) prevalence. Compared to women with no history of abuse, child sexual abuse survivors may have more concerns with their care, greater health complaints, fear childbirth and have difficulties with delivery. They also had a higher likelihood of PTSD symptomology and anxiety, consumed more harmful substances (e.g., alcohol, cigarettes, and drugs) and had greater concerns with their appearance, poorer health, sleep and may also have a higher risk of re-victimisation. CONCLUSIONS The balance of evidence suggests that compared to non-abused women, women with a child abuse history have more adverse experiences with pregnancy, childbirth, and care, with their abuse history, likely contributes to harmful behaviours and psychopathology. However, variability in operationalisation and measurement of abuse may contribute to these findings so tentative conclusions are drawn. Future research should examine the generalisability of the findings (relating to scale limitations) and recommendations for screening (e.g., sensitive items, scoring). Clinical implications of the findings point to the need for early identification of women with a child abuse history as such women require trauma-sensitive care and consideration. A useful tool is the Pregnancy-related Anxiety Scale which provides insights into specific areas of concern.
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Affiliation(s)
- Robyn Brunton
- Charles Sturt University, School of Psychology, Bathurst, NSW 2795, Australia.
| | - Rachel Dryer
- Australian Catholic University, Strathfield, NSW 2135, Australia
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McCabe SE, Hughes TL, West BT, Evans-Polce RJ, Veliz PT, Dickinson K, McCabe VV, Boyd CJ. Sexual Orientation, Adverse Childhood Experiences, and Comorbid DSM-5 Substance Use and Mental Health Disorders. J Clin Psychiatry 2020; 81:20m13291. [PMID: 33264820 PMCID: PMC7790524 DOI: 10.4088/jcp.20m13291] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/17/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess the relationships between adverse childhood experiences (ACEs) and comorbid Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use and mental health disorders across 5 sexual orientation subgroups: lesbian/gay, bisexual, unsure, discordant heterosexual (ie, heterosexual-identified with same-sex attraction or behavior), and concordant heterosexual. METHODS Data were from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional, nationally representative survey of non-institutionalized US adults. Data were collected in households via structured diagnostic face-to-face interviews; the overall response rate was 60.1%. The sample included 36,309 US adults aged 18 years and older. RESULTS Sexual minorities (gay, lesbian, bisexual), especially bisexual women, reported the highest prevalence of ACEs and comorbid substance use and mental health disorders. Approximately 43.8% of bisexual women reported 4 or more ACEs, and 38.0% of bisexual women reported comorbid substance use and mental health disorders. Multivariable regression analyses indicated a curvilinear relationship between ACEs and comorbid substance use and mental health disorders, and sexual minorities consistently had a higher ACE mean than concordant heterosexual respondents. The majority of sexual minorities with high levels of ACEs had comorbid substance use and mental health disorders. CONCLUSIONS Sexual minorities are exposed to more ACEs than their heterosexual counterparts in the US. We found evidence that US sexual minorities are at higher risk of comorbid substance use and mental health disorders. These findings reinforce the importance of identifying exposure to ACEs and developing trauma-informed interventions to treat comorbidities in those exposed to multiple ACEs, especially sexual minorities..
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, 400 North Ingalls St, Ann Arbor, MI 48109. .,Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA.,Center for Sexuality and Health Disparities, Department of Systems, Population and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia
University, New York, New York, USA
| | - Brady T. West
- Survey Research Center, Institute for Social Research,
University of Michigan, Ann Arbor, Michigan, USA,Institute for Healthcare Policy and Innovation, University
of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health,
Department of Health Behavior and Biological Sciences, University of Michigan School
of Nursing, Ann Arbor, Michigan, USA
| | - Phil T. Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health,
Department of Health Behavior and Biological Sciences, University of Michigan School
of Nursing, Ann Arbor, Michigan, USA,Survey Research Center, Institute for Social Research,
University of Michigan, Ann Arbor, Michigan, USA,Institute for Research on Women and Gender, University of
Michigan, Ann Arbor, Michigan, USA
| | - Kara Dickinson
- Center for the Study of Drugs, Alcohol, Smoking and Health,
Department of Health Behavior and Biological Sciences, University of Michigan School
of Nursing, Ann Arbor, Michigan, USA
| | - Vita V. McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health,
Department of Health Behavior and Biological Sciences, University of Michigan School
of Nursing, Ann Arbor, Michigan, USA,Department of Psychiatry, University of Michigan, Ann
Arbor, Michigan, USA,Department of Surgery, University of Michigan, Ann Arbor,
Michigan, USA
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health,
Department of Health Behavior and Biological Sciences, University of Michigan School
of Nursing, Ann Arbor, Michigan, USA,Institute for Research on Women and Gender, University of
Michigan, Ann Arbor, Michigan, USA;,Institute for Healthcare Policy and Innovation, University
of Michigan, Ann Arbor, Michigan, USA,Department of Psychiatry, University of Michigan, Ann
Arbor, Michigan, USA
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Adverse childhood experiences in parents of youth with chronic pain: prevalence and comparison with a community-based sample. Pain Rep 2020; 5:e866. [PMID: 33134755 PMCID: PMC7593065 DOI: 10.1097/pr9.0000000000000866] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 01/04/2023] Open
Abstract
Supplemental Digital Content is Available in the Text. Parents of youth with chronic pain reported high rates of adverse childhood experiences, including significantly higher rates of physical neglect than a community-based sample. Introduction: Adverse childhood experiences (ACEs) are common occurrences that are related to poor health outcomes, including chronic pain, in youth and adults. Research suggests that children of parents exposed to ACEs are also at risk of poor outcomes. However, little is known about the risk that ACEs confer for chronic pain across generations. Parent ACEs may play an important role in pediatric chronic pain, given their association with key parent factors (eg, mental and physical health). Objectives: This study evaluated the prevalence of ACEs in parents of youth with chronic pain and compared these rates to a community-based sample. Methods: One hundred seventy parents of youth (aged 10–18 years) with chronic pain, recruited from a tertiary-level chronic pain program at a pediatric hospital in Canada, completed a self-report measure of ACEs. A comparison sample (n = 3914) was drawn from a local, community-based study that examined ACEs among adults in primary care. Results: Among parents of youth with chronic pain, 67.6% reported ≥1 ACE and 23.5% reported ≥4 ACEs. Controlling for sociodemographic factors, ACEs were similar across samples, except parents of youth with chronic pain reported significantly higher rates of physical neglect (odds ratio = 2.14; 95% confidence interval = 1.35–3.40) than the community-based sample. Conclusion: Adverse childhood experiences are prevalent among parents of youth with chronic pain, with physical neglect reported more frequently than the community-based sample. Further research that examines the association between parent ACEs and child chronic pain, as well as neurobiological and psychosocial factors that may mediate this potential relation, is needed.
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Alvanzo AAH, Storr CL, Reboussin B, Green KM, Mojtabai R, La Flair LN, Cullen BA, Susukida R, Seamans M, Crum RM. Adverse childhood experiences (ACEs) and transitions in stages of alcohol involvement among US adults: Progression and regression. CHILD ABUSE & NEGLECT 2020; 107:104624. [PMID: 32683202 PMCID: PMC7968748 DOI: 10.1016/j.chiabu.2020.104624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 06/23/2020] [Accepted: 07/05/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with a number of medical comorbidities. However, there is a paucity of data on the role ACEs play in transitions in stages of alcohol involvement. OBJECTIVE To examine the association between ACEs and transitions in alcohol problems progression and regression between No Problems, Moderate Problems and Severe Problems stages. PARTICIPANTS AND SETTING Data from 14,363 male and 19,774 female participants in Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). METHODS We used latent transition analysis (LTA) with propensity score adjustment to estimate the odds of transitioning across stages of alcohol involvement, between waves, based on the number of types of ACEs experienced. We hypothesized that ACEs would be associated with increased risk of progression and decreased risk of regression. RESULTS ACEs were associated with progression to higher alcohol involvement stages, with greatest likelihood of progression from No Problems to Severe Problems for those reporting ≥3 ACEs (males: aOR = 4.78 [CI (1.84-12.44)]; females: aOR = 3.81 [CI (1.69-8.57)]). ACEs were also associated with decreased odds of regression to less problematic alcohol involvement stages, with some distinctive patterns of associations in males and in females. CONCLUSIONS This study suggests that ACEs impact transitions in alcohol involvement in both males and females, affecting both progression and regression. The association is magnified for those with multiple types of ACE exposures. These results highlight the need for prevention, early identification and intervention to mitigate the risks associated with childhood maltreatment.
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Affiliation(s)
- Anika A H Alvanzo
- Divisions of General Internal Medicine and Addiction Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL- East Tower, Room E650, Baltimore, MD, 21224, USA.
| | - Carla L Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, 21201, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA
| | - Beth Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, 20742, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lareina N La Flair
- Research and Data Analysis Division, Washington State Department of Social and Health Services Olympia, WA, 98501, USA
| | - Bernadette A Cullen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA
| | - Marissa Seamans
- Department of Epidemiology, UCLA Fielding School of Public Health Los Angeles, CA, 90025, USA
| | - Rosa M Crum
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, 21205, USA
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Gaston SA, McWhorter KL, Parks CG, D'Aloisio AA, Rojo-Wissar DM, Sandler DP, Jackson CL. Racial/Ethnic Disparities in the Relationship Between Traumatic Childhood Experiences and Suboptimal Sleep Dimensions Among Adult Women: Findings from the Sister Study. Int J Behav Med 2020; 28:116-129. [PMID: 32725587 DOI: 10.1007/s12529-020-09905-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Traumatic childhood experiences (TCEs) are associated with poor adulthood sleep, but racial/ethnic disparities have not been well-studied. We investigated the TCE-adulthood sleep relationship among non-Hispanic (NH)-White, NH-Black, and Hispanic/Latina women. METHOD Women enrolled in the Sister Study from 2003 to 2009 reported the following TCEs in a follow-up interview (2008-2012): natural disasters; major accidents; household dysfunction; and sexual, physical, and psychological/emotional abuse. Sleep characteristics included short sleep duration (< 7 h vs. 7-9 h), long sleep onset latency (SOL) (> 30 vs. ≤ 30 min), frequent night awakenings (≥ 3 times/night ≥ 3 times/week [yes vs. no]), and frequent napping (≥ 3 vs. < 3 times/week). Using log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep characteristics among women with vs. without TCEs, we investigated racial/ethnic-specific associations and race/ethnicity as a moderator. RESULTS Among 40,082 participants (mean age = 55 ± 8.8 years), 55% reported ≥ 1 TCE (NH-White, 54%; NH-Black, 62%; Hispanic/Latina, 57%). NH-White, NH-Black, and Hispanic/Latina women reporting any TCE had a higher prevalence of short sleep compared with their within-race/ethnicity counterparts without TCEs. Associations were strongest among NH-Whites. Compared to NH-Whites with no TCEs, racial/ethnic minorities who reported any TCEs had a higher prevalence of short sleep (PRBlacks = 2.13 [95% CI 2.02-2.24], PRHispanics/Latinas = 1.47 [1.35-1.60]) and long SOL. When comparing racial/ethnic minorities with TCEs to NH-Whites with TCEs, PRs for short sleep (PRBlacks = 1.98 [1.88-2.08] and PRHispanics/Latinas = 1.36 [1.25-1.48]) and long SOL were weaker. CONCLUSION TCEs were positively associated with poor sleep characteristics among women, and TCEs appear to contribute to short sleep duration and long SOL disparities.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | - Ketrell L McWhorter
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | | | - Darlynn M Rojo-Wissar
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA. .,Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder. Dev Psychopathol 2020; 33:1351-1367. [DOI: 10.1017/s0954579420000553] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.
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Predictive factors of chronic Post-Traumatic Stress Disorder in rape victims. Eur Psychiatry 2020; 13:281-7. [DOI: 10.1016/s0924-9338(98)80045-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/1997] [Revised: 02/28/1998] [Accepted: 03/11/1998] [Indexed: 11/23/2022] Open
Abstract
SummaryThis study aimed to investigate the psychological disorders following rape as well as the course of Post-Traumatic Stress Disorder (PTSD), and to determine clinical factors predictive of chronic PTSD. Seventy-three rape victims were observed in a systematic follow-up study over 1 year following rape using structured interview schedules. The frequency of PTSD was massive. The early disorders predicting PTSD 1 year after rape included somatoform and dissociative disorders, agoraphobia and specific phobias as well as depressive and gender identity disorders and alcohol abuse. Through stepwise logistic regressions, the following were found to be good models of prediction of chronic PTSD 1 year after rape: for the characteristics of the traumas, intrafamily rape, being physically assaulted outside rape, and added physical violence during rape; for the early psychological and behavioural attitudes, low self-esteem, permanent feelings of emptiness and running away; and for early mental disorders, agoraphobia and depressive disorders. Finally, among all these predictive factors, added physical violence during rape, low self-esteem, permanent feelings of emptiness and agoraphobia were shown to constitute a strong model of predictors. People presenting features such as the predictive factors of chronic PTSD found in the study should be asked about a history of rape and symptoms of PTSD.
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Schneider FD, Loveland Cook CA, Salas J, Scherrer J, Cleveland IN, Burge SK. Childhood Trauma, Social Networks, and the Mental Health of Adult Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1492-1514. [PMID: 29294679 DOI: 10.1177/0886260517696855] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The purpose of this study was to investigate the relationship of childhood trauma to the quality of social networks and health outcomes later in adulthood. Data were obtained from a convenience sample of 254 adults seen in one of 10 primary care clinics in the state of Texas. Standardized measures of adverse childhood experiences (ACEs), stressful and supportive social relationships, medical conditions, anxiety, depression, and health-related quality of life were administered. Using latent class analysis, subjects were assigned to one of four ACE classes: (a) minimal childhood abuse (56%), (b) physical/verbal abuse of both child and mother with household alcohol abuse (13%), (c) verbal and physical abuse of child with household mental illness (12%), and (d) verbal abuse only (19%). Statistically significant differences across the four ACE classes were found for mental health outcomes in adulthood. Although respondents who were physically and verbally abused as children reported compromised mental health, this was particularly true for those who witnessed physical abuse of their mother. A similar relationship between ACE class and physical health was not found. The quality of adult social networks partly accounted for the relationship between ACE classes and mental health outcomes. Respondents exposed to ACEs with more supportive social networks as adults had diminished odds of reporting poor mental health. Conversely, increasing numbers of stressful social relationships contributed to adverse mental health outcomes. Although efforts to prevent childhood trauma remain a critical priority, the treatment of adult survivors needs to expand its focus on both strengthening social networks and decreasing the negative effects of stressful ones.
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Affiliation(s)
| | | | - Joanne Salas
- Saint Louis University School of Medicine, MO, USA
| | | | | | - Sandra K Burge
- The University of Texas Health Science Center at San Antonio, TX, USA
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van Draanen J. Unique roles of childhood poverty and adversity in the development of lifetime co-occurring disorder. SSM Popul Health 2020; 10:100540. [PMID: 32140539 PMCID: PMC7047198 DOI: 10.1016/j.ssmph.2020.100540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/14/2022] Open
Abstract
Gender differences in stressors that affect the development of co-occurring psychiatric and substance use disorders (COD) have been given inadequate attention, despite evidence that women and men commonly develop different types of both psychiatric disorder and substance use disorders and have different experiences of illness and treatment. This paper assesses early life antecedents of COD, specifically childhood poverty and childhood adversity, and how they vary by gender. Weighted multinomial logistic regressions were conducted with the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC-III) (n = 33,676) nationally representative data from 2014-2015 to assess whether antecedents of COD are conditional on gender. Results demonstrate that overall nearly one in five people (17.5%) have lifetime COD, and disorder prevalence differs for males and females (COD: 18.0% vs 16.4%; psychiatric disorder: 8.5% vs. 20.9%; substance use disorder: 5.6% vs. 13.0%, respectively). Males with childhood poverty are more likely than males without to have COD but poverty does not affect COD risk for females. For both males and females, increases in number of adversities are associated with increased probability of COD, however, the magnitude of this association is stronger for males. To understand COD risk, conditional relationships between early poverty, early adversity and gender must be considered. With this knowledge, prevention and treatment efforts have the potential to be targeted more effectively.
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Affiliation(s)
- Jenna van Draanen
- Department of Sociology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC V6T 1Z1, Canada
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Feingold D, Livne O, Rehm J, Lev-Ran S. Probability and correlates of transition from cannabis use to DSM-5 cannabis use disorder: Results from a large-scale nationally representative study. Drug Alcohol Rev 2020; 39:142-151. [PMID: 31916333 DOI: 10.1111/dar.13031] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/11/2019] [Accepted: 12/12/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS It has been previously reported that more than 34% of individuals who use cannabis may qualify for a diagnosis of DSM-IV cannabis abuse or dependence throughout their lifetime. The introduction of the DSM-5 cannabis use disorder (CUD) diagnostic criteria reflects several intrinsic changes in the perception of substance use disorders. However, little is known about the probability of transition from cannabis use to CUD over time nor about the sociodemographic and clinical correlates associated with this transition. DESIGN AND METHODS Participants were individuals ≥18 years interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III in 2012-2013. Measurements included univariable and multivariable discrete-time survival analyses performed to examine the association between previously reported cannabis dependence predictors and the hazards of transitioning from cannabis use to CUD. Survival plots assessed the probability of transition from cannabis use to CUD over time since age of first use and differences in probability between predictor levels. RESULTS Among lifetime cannabis users (N = 11 272), lifetime probability of transition to CUD was approximately 27%. A higher probability of transition from cannabis use to CUD was observed in the following: men, participants belonging to an ethnic minority group, early-onset cannabis users and individuals who reported experiencing three or more childhood adverse events. DISCUSSION AND CONCLUSIONS This is the first study to explore transition from cannabis use to the DSM-5 CUD diagnosis. The current study identified specific predictors of this transition, which may assist in targeting at-risk populations.
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Affiliation(s)
| | - Ofir Livne
- Lev Hasharon Medical Center, Netanya, Israel
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany
| | - Shaul Lev-Ran
- Lev Hasharon Medical Center, Netanya, Israel.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Rhee TG, Barry LC, Kuchel GA, Steffens DC, Wilkinson ST. Associations of Adverse Childhood Experiences with Past-Year DSM-5 Psychiatric and Substance Use Disorders in Older Adults. J Am Geriatr Soc 2019; 67:2085-2093. [PMID: 31206597 PMCID: PMC10666528 DOI: 10.1111/jgs.16032] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine the prevalence of adverse childhood experiences (ACEs) and the associations of ACEs with psychiatric and substance use disorders among older adults in the United States. DESIGN Cross-sectional analysis of the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III (NESARC-III). SETTING Nationally representative drug-related health interview survey in the United States. PARTICIPANTS Survey respondents aged 65 or older (n = 5806 unweighted). MEASUREMENTS ACEs, the key independent variable, were assessed using validated measures. Outcome variables consisted of past-year psychiatric disorders (eg, major depressive disorder and generalized anxiety disorder) and substance use disorders (eg, alcohol use disorder) using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We estimated the national prevalence of ACEs in older adults and used multivariable-adjusted logistic regression analyses to assess the association between ACEs and the outcomes after adjusting for sociodemographics and clinical comorbidities. RESULTS Overall, 35.9% of older adults, representative of 14.8 million older adults nationwide, reported some form of ACEs. The most common types were parental psychopathology (20.3%), other traumatic events (14.0%), and physical/psychological abuse (8.4%). Having experienced any ACEs was associated with higher odds of having a past-year psychiatric disorder (adjusted odds ratio = 2.11; 95% confidence interval = 1.74-2.56). Similar results were found for substance use disorders (P < .01). CONCLUSION ACEs are linked to an increased risk for past-year psychiatric and substance use disorders in older adults. ACEs may have long-term effects on older adults' mental well-being. Although further research is needed, preventing ACEs may lead to large improvements in public mental health that persist well into older age. J Am Geriatr Soc 67:2085-2093, 2019.
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Affiliation(s)
- Taeho Greg Rhee
- Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, Connecticut
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
- Yale Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut
- US Department of Veterans Affairs Connecticut Healthcare System, Mental Illness Research, Education and Clinical Center of New England, West Haven, Connecticut
| | - Lisa C Barry
- Center on Aging, School of Medicine, University of Connecticut, Farmington, Connecticut
- Department of Psychiatry, School of Medicine, University of Connecticut, Farmington, Connecticut
| | - George A Kuchel
- Center on Aging, School of Medicine, University of Connecticut, Farmington, Connecticut
| | - David C Steffens
- Center on Aging, School of Medicine, University of Connecticut, Farmington, Connecticut
- Department of Psychiatry, School of Medicine, University of Connecticut, Farmington, Connecticut
| | - Samuel T Wilkinson
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
- Yale Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut
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Chou PH, Koenen KC. Associations between childhood maltreatment and risk of myocardial infarction in adulthood: Results from the National Epidemiologic Survey on alcohol and Related Conditions. J Psychiatr Res 2019; 116:172-177. [PMID: 30553535 DOI: 10.1016/j.jpsychires.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although childhood maltreatment has been reported to be associated with the incidence of cardiovascular diseases, its association with specific major cardiovascular events remains unclear. This study aimed to examine the relationship between different types of childhood maltreatment (CM) and myocardial infarction (MI) occurrence in a nationally representative sample. METHODS We used data from the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative US sample of adults aged 20 years and older (N = 34, 653). Logistic regression models were constructed to investigate the associations between five types of CMs including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse and the risk of MI adjusting for sociodemographic variables. RESULTS After adjusting for sociodemographic variables, childhood sexual abuse was significantly associated with increased odds of MI occurrence (adjusted odds ratio [aOR] = 1.85, 95%CI = 1.24-2.76, p = 0.003). Additionally, childhood physical abuse was significantly associated with increased odds of MI occurrence in men (aOR = 2.45, 95%CI = 1.35-4.44, p = 0.004) but this association was not observed in women (aOR = 0.72, 95%CI = 0.32-1.66, p = 0.440). Compared to those who did not experience CM, those who experienced more than three types of CMs showed increased odds of MI occurrence (adjusted OR = 2.08-3.05, all p < 0.05). CONCLUSIONS Using data from a nationally representative US sample of adults, we found significant positive associations between CM and odds of MI occurrence in adulthood. Future longitudinal prospective studies are needed to confirm our findings.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, 40447, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, 40402, Taiwan.
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Caceres BA, Veldhuis CB, Hughes TL. Racial/Ethnic Differences in Cardiometabolic Risk in a Community Sample of Sexual Minority Women. Health Equity 2019; 3:350-359. [PMID: 31312782 PMCID: PMC6626969 DOI: 10.1089/heq.2019.0024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: To examine the intersection of sexual identity and race/ethnicity on self-reported cardiometabolic risk in sexual minority women (SMW). Methods: Data from the Chicago Health and Life Experiences of Women study were analyzed. Logistic regression models examined racial/ethnic differences in cardiometabolic risk (including obesity, hypertension, and diabetes) in SMW, accounting for psychosocial and behavioral factors. A variable accounting for the intersection of sexual identity and race/ethnicity was added to regression models (White lesbian women were the reference group). Results: The analytic sample included 601 SMW (237 White, 219 Black, 145 Latina). Black (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI]=1.48-5.94) and Latina (AOR 2.30, 95% CI=1.18-4.48) SMW had higher rates of lifetime trauma than White SMW. Black SMW reported higher rates of obesity (AOR 3.05, 95% CI=1.91-4.88), hypertension (AOR 1.99, 95% CI=1.08-3.66), and diabetes (AOR 3.77, 95% CI=1.46-9.74) relative to White SMW. Intersectional analyses revealed that Black lesbian (AOR 2.94, 95% CI=1.74-4.97) and Black bisexual (AOR 3.43, 95% CI=1.69-6.96) women were more likely to be obese than White lesbian women. Black lesbian women also reported higher rates of hypertension (AOR 2.09, 95% CI=1.08-4.04) and diabetes (AOR 3.31, 95% CI=1.26-8.67) than White lesbian women. No differences in cardiometabolic risk were found between Latina and White SMW. Conclusion: This study extends previous research on racial/ethnic differences in cardiometabolic risk among SMW. Prevention strategies are needed to reduce cardiometabolic risk in Black SMW. Findings highlight the need for cardiovascular disease research in SMW that incorporates longitudinal designs and objective measures.
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Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. REPRINT OF: Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 2019; 56:774-786. [PMID: 31104722 DOI: 10.1016/j.amepre.2019.04.001] [Citation(s) in RCA: 372] [Impact Index Per Article: 74.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. METHODS A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. RESULTS More than half of respondents reported at least one, and one-fourth reported ≥2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. CONCLUSIONS We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
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Affiliation(s)
- Vincent J Felitti
- Department of Preventive Medicine, Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California
| | - Robert F Anda
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dale Nordenberg
- Department of Pediatrics, Emory University School Medicine, Atlanta, Georgia
| | - David F Williamson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alison M Spitz
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Valerie Edwards
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary P Koss
- Department of Family and Community Medicine, University of Arizona Health Sciences Center, Tucson, Arizona
| | - James S Marks
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Caceres BA, Veldhuis CB, Hickey KT, Hughes TL. Lifetime Trauma and Cardiometabolic Risk in Sexual Minority Women. J Womens Health (Larchmt) 2019; 28:1200-1217. [PMID: 31099702 DOI: 10.1089/jwh.2018.7381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. Materials and Methods: An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. Next, multiple logistic regression was used to examine the associations of different forms of trauma throughout the life course (childhood, adulthood, and lifetime), with psychosocial and behavioral risk factors and self-reported cardiometabolic risk (obesity, hypertension, and diabetes) in SMW adjusted for relevant covariates. Results: A total of 547 participants were included. Older age was associated with higher rates of childhood and adulthood trauma. SMW of color reported higher rates of childhood trauma than white participants. Higher education was associated with lower rates of adulthood trauma. All forms of trauma were associated with probable diagnosis of post-traumatic stress disorder and lower perceived social support. Adult trauma was associated with anxiety, whereas childhood and lifetime trauma were associated with higher odds of depression. No significant associations between forms of trauma and behavioral risk factors were noted, except that childhood trauma was associated with higher odds of past-3-month overeating. Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Conclusions: Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.
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Affiliation(s)
| | | | | | - Tonda L Hughes
- Columbia University School of Nursing, New York, New York
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David Kothgassner O, Plener PL, Sachser C, Witt A, Brähler E, Michael Fegert J. Adverse Childhood Experiences and Avatar Preferences in Online Games. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 48:15-23. [PMID: 30777484 DOI: 10.1024/1422-4917/a000647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study investigates the relationship between adverse childhood experiences (ACEs), age, and sex with respect to their avatar preference in online games. The analyses comprise a subsample of n = 1817 adolescents and adults from 14 to 60 years within a representative German population-based study. Results indicate that 14 % of this sample uses avatars in online games, with significantly more males (22.6 %) than females (7.7 %) doing so. Persons with multiple ACEs (≥ 4) have a higher OR of 2.05 (95 % CI: 1.418-2.956) to use avatars in online games. Regarding avatar preference, females are more likely to play supporters than males, and males are more likely to choose damagers and mixed-type avatars than females. Participants with an experience of parental divorce during their childhood reported higher preference of playing supporter or mixed-type avatars in comparison with damager avatars. Moreover, participants with mental illness or suicide in the family show a higher preference of mixed-type avatars compared to damager, but not to supporter avatars. Knowledge about the use of avatars can be an interesting source of information for supporting psychotherapeutic treatment in a young age group.
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Affiliation(s)
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria.,Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Germany
| | - Jörg Michael Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
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Bostwick WB, Hughes TL, Steffen A, Veldhuis CB, Wilsnack SC. Depression and Victimization in a Community Sample of Bisexual and Lesbian Women: An Intersectional Approach. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:131-141. [PMID: 29968037 PMCID: PMC6314920 DOI: 10.1007/s10508-018-1247-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/02/2018] [Accepted: 05/26/2018] [Indexed: 05/06/2023]
Abstract
Mental health inequities among bisexual and lesbian women are well-documented. Compared to heterosexual women, both bisexual and lesbian women are more likely to report lifetime depressive disorders, with bisexual women often faring the worst on mental health outcomes. Risk factors for depression, such as victimization in childhood and adulthood, are also more prevalent among bisexual women. Less is known about the intersection of racial/ethnic and sexual minority identities, and how depression and victimization may differ across these multiple, co-occurring identities. Data were from Wave 3 of the Chicago Health and Life Experiences of Women study, an 18-year, community-based longitudinal study of sexual minority women's health. We constructed a six-category "intersection" variable based on sexual identity and race/ethnicity to examine group differences in lifetime depression and victimization. We tested childhood and adult victimization as moderators of lifetime depression (n = 600). A majority (58.2%) of the total sample met criteria for lifetime depression. When considering the intersection of race/ethnicity and sexual identity, Black bisexual and Black lesbian women had significantly lower odds of depression than White lesbian women, despite their higher reports of victimization. Latina bisexual and lesbian women did not differ from White lesbians on depression. Victimization did not moderate the association between the intersection variable and depression. More research is needed to better understand risk and protective factors for depression among racially/ethnically diverse sexual minority women (SWM). We highlight the need to deliberately oversample SWM of color to accomplish this goal.
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Affiliation(s)
- Wendy B. Bostwick
- Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612;
| | | | - Alana Steffen
- Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612;
| | | | - Sharon C. Wilsnack
- Department of Psychiatry and Behavioral Science, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND
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