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Warhaftig G, Almeida D, Turecki G. Early life adversity across different cell- types in the brain. Neurosci Biobehav Rev 2023; 148:105113. [PMID: 36863603 DOI: 10.1016/j.neubiorev.2023.105113] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
Early life adversity (ELA)- which includes physical, psychological, emotional, and sexual abuse is one of the most common predictors to diverse psychopathologies later in adulthood. As ELA has a lasting impact on the brain at a developmental stage, recent findings from the field highlighted the specific contributions of different cell types to ELA and their association with long lasting consequences. In this review we will gather recent findings describing morphological, transcriptional and epigenetic alterations within neurons, glia and perineuronal nets and their associated cellular subpopulation. The findings reviewed and summarized here highlight important mechanisms underlying ELA and point to therapeutic approaches for ELA and related psychopathologies later in life.
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Affiliation(s)
- Gal Warhaftig
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal QC H4H 1R3, Canada
| | - Daniel Almeida
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal QC H4H 1R3, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal QC H4H 1R3, Canada; Department of Psychiatry, McGill University, Montreal QC H3A 1A1, Canada.
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Abstract
BACKGROUND Maltreated children have many long-term consequences throughout their lives, but often maltreated children are not recognised in time by professionals. General practice could be central to the early recognition of child maltreatment due to the long-term relationship with families. OBJECTIVE How do general practitioners (GPs) and practice nurses (PNs) deal with suspected maltreatment in children below 18 years of age, and which factors influence them to report cases to social authorities. DESIGN AND SETTING A mixed methods study set in general practice in Denmark. METHOD AND SUBJECTS We combined data from a nationwide questionnaire with observations from five clinics and 20 interviews with GPs and PNs. We explored our data using the concept of uncertainty as a driver that shapes action and decision-making in general practice. RESULTS Most GPs (94%) said they would discuss cases of suspected child maltreatment with social services, but in many cases they would prefer to discuss their suspicions with a colleague first (83%) - most likely where there are no clear-cut signs. The qualitative data added nuance to these findings by highlighting the difficulty of communicating across sectors, the importance of maintaining a connection with the child's family, and practicing watchful waiting. CONCLUSION General practice has an opportunity to act early in cases of suspected child maltreatment if uncertainty is accepted as a critical part of the process of reaching a diagnosis. Communication across sectors is key, as is support for GPs with suspicions and for families in need of help.Key pointsGPs are often thought to underreport child maltreatment but despite low levels of reporting, this does not mean they ignore it.Building on the connection with the family, making follow appointments, and discussing suspicions with colleagues are typical of how GPs manage suspicions of child abuse.Accepting uncertainty as a condition of raising the alarm could help GPs to act quickly to support children at risk of abuse.
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Zhang T, Kan L, Jin C, Shi W. Adverse childhood experiences and their impacts on subsequent depression and cognitive impairment in Chinese adults: A nationwide multi-center study. J Affect Disord 2023; 323:884-892. [PMID: 36566934 DOI: 10.1016/j.jad.2022.12.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACES) are prevalent and have long-lasting effects. This study explored how ACE exposure is associated with subsequent depression and cognitive impairment and whether sociodemographic characteristics modify that association. METHOD This study used data on 14,484 participants of the 2015 China Health and Retirement Longitudinal Study (CHARLS) and 2014 CHARLS life history survey. Depression was assessed using the 10-item Center for Epidemiologic Studies Depression scale. Cognitive performance was evaluated via three composite measures: episodic memory, mental intactness, and global cognition. Twelve ACE indicators were measured using a validated questionnaire. Multiple regression models and stratified analyses explored the relationship between ACES and subsequent depression and cognitive impairment, as well as potential modifiers. RESULTS Compared with individuals without ACES, those who experienced four or more ACES had a higher risk of subsequent depression (adjusted odds ratio, aOR = 2.65, 95 % confidence intervals [CIs]: 2.21 to 3.16), poorer mental intactness (β = -0.317 [-0.508 to -0.125]), and worse global cognition (-0.437 [-0.693 to -0.181]). Trend analyses showed a dose-response association between accumulated ACES and subsequent depression and cognitive impairment. No modifications of those associations by age, sex, educational level, or family's financial status during childhood were observed. LIMITATIONS Self-reported measures could favour recall bias. CONCLUSION Our study suggests that ACES increase the risk of subsequent depression and cognitive impairment in Chinese adults regardless of sociodemographic characteristics. These findings provide important implications for mitigating the adverse effects of early-life stress and promoting health in adulthood.
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Affiliation(s)
- Tiantian Zhang
- School of Social Development and Public Policy, Fudan University, Shanghai, China; Fudan University Center for Population and Development Policy Studies, Fudan University, Shanghai, China; Fudan Institute on Ageing, Fudan University, Shanghai, China
| | - Lena Kan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Changbo Jin
- Tongji University School of Medicine, Shanghai, China.
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Baldwin JR, Wang B, Karwatowska L, Schoeler T, Tsaligopoulou A, Munafò MR, Pingault JB. Childhood Maltreatment and Mental Health Problems: A Systematic Review and Meta-Analysis of Quasi-Experimental Studies. Am J Psychiatry 2023; 180:117-126. [PMID: 36628513 PMCID: PMC7614155 DOI: 10.1176/appi.ajp.20220174] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Childhood maltreatment is associated with mental health problems, but the extent to which this relationship is causal remains unclear. To strengthen causal inference, the authors conducted a systematic review and meta-analysis of quasi-experimental studies examining the relationship between childhood maltreatment and mental health problems. METHODS A search of PubMed, PsycINFO, and Embase was conducted for peer-reviewed, English-language articles from database inception until January 1, 2022. Studies were included if they examined the association between childhood maltreatment and mental health problems using a quasi-experimental method (e.g., twin/sibling differences design, children of twins design, adoption design, fixed-effects design, random-intercept cross-lagged panel model, natural experiment, propensity score matching, or inverse probability weighting). RESULTS Thirty-four quasi-experimental studies were identified, comprising 54,646 independent participants. Before quasi-experimental adjustment for confounding, childhood maltreatment was moderately associated with mental health problems (Cohen's d=0.56, 95% CI=0.41, 0.71). After quasi-experimental adjustment, a small association between childhood maltreatment and mental health problems remained (Cohen's d=0.31, 95% CI=0.24, 0.37). This adjusted association between childhood maltreatment and mental health was consistent across different quasi-experimental methods, and generalized across different psychiatric disorders. CONCLUSIONS These findings are consistent with a small, causal contribution of childhood maltreatment to mental health problems. Furthermore, the findings suggest that part of the overall risk of mental health problems in individuals exposed to maltreatment is due to wider genetic and environmental risk factors. Therefore, preventing childhood maltreatment and addressing wider psychiatric risk factors in individuals exposed to maltreatment could help to prevent psychopathology.
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Affiliation(s)
- Jessie R Baldwin
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Biyao Wang
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Lucy Karwatowska
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Tabea Schoeler
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Anna Tsaligopoulou
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Marcus R Munafò
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
| | - Jean-Baptiste Pingault
- Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London (Baldwin, Wang, Schoeler, Tsaligopoulou, Pingault); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Baldwin, Pingault); Great Ormond Street Institute of Child Health, University College London (Karwatowska); Department of Computational Biology, University of Lausanne, Lausanne, Switzerland (Schoeler); Child Study Center, Yale University School of Medicine, New Haven, Conn. (Tsaligopoulou); MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, School of Psychological Science, University of Bristol, and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, U.K. (Munafò)
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Williams B. Understanding the effects of adverse childhood experiences on older people. Nurs Older People 2023; 35:37-42. [PMID: 36475401 DOI: 10.7748/nop.2022.e1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 12/12/2022]
Abstract
There is increasing recognition that adverse childhood experiences are linked to suboptimal mental and physical health in later life. Despite this, there has been little research into the effects of adverse childhood experiences on older people. This article gives an overview of the long-term mental and physical effects of adverse childhood experiences and discusses how childhood trauma may manifest in older people. The author also discusses how nurses and unpaid family carers may themselves have been exposed to adverse childhood experiences and how this may affect their caring role. It is crucial that nurses adopt a trauma-informed approach to the care of older people to take account of possible adverse childhood experiences and prevent re-traumatisation.
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Affiliation(s)
- Bronwen Williams
- Bronwen Williams Training, Education and Development, Malvern, Worcestershire, England
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Rønneberg M, Mjølstad BP, Hvas L, Getz L. Perceptions of the medical relevance of patients` stories of painful and adverse life experiences: a focus group study among Norwegian General Practitioners. Int J Qual Stud Health Well-being 2022; 17:2108560. [PMID: 35983640 PMCID: PMC9397424 DOI: 10.1080/17482631.2022.2108560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose Adverse life experiences increase the risk of health problems. Little is known about General Practitioners’ (GPs') thoughts, clinical concepts, and work patterns related to eliciting, including, or excluding their patients’ stories of painful and adverse life experiences. We wanted to explore GPs’ perceptions of the medical relevance of stories of painful and adverse life experiences, and to focus on what hinders or facilitates working with such stories. Method Eighteen Norwegian GPs participated in three focus group interviews. The interviews were analysed using reflexive thematic analysis. Results The participating GPs’ views on the clinical relevance of patients’ painful and adverse experiences varied considerably. Our analysis revealed two distinct stances: a confident-accepting stance, and an ambivalent-conditional stance. GPs encountered barriers to exploring such stories: scepticism on behalf of the medical discipline; scepticism on behalf of the patients; and, uncertainty regarding how to address stories of painful and adverse experiences in consultations. Work with painful stories was best facilitated when GPs manifested personal openness and prepared availability, within the context of a doctor-patient relationship based on trust. Conclusions Clearer processes for handling biographical information and life experiences that affect patients’ health are needed to facilitate the work of primary care physicians.
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Affiliation(s)
- Marianne Rønneberg
- Tingvoll Healthcare Centre, Tingvoll, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bente Prytz Mjølstad
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lotte Hvas
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Linn Getz
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Uccellini O, Benlodi A, Caroppo E, Cena L, Esposito G, Fernandez I, Ghazanfar M, Imbasciati A, Longo F, Mazza M, Marano G, Nacinovich R, Pignatto A, Rolnick A, Trivelli M, Spada E, Vanzini C. 1000 Days: The "WeCare Generation" Program-The Ultimate Model for Improving Human Mental Health and Economics: The Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16741. [PMID: 36554625 PMCID: PMC9779238 DOI: 10.3390/ijerph192416741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The COVID-19 pandemic stressed the necessity of a new resilience of the human population and health system. The "WeCare Generation" program is a new proposal of territorial intervention, with a new paradigm, on the diseases of the human body and mind. BACKGROUND In recent decades, the independent strands of investigation on brain plasticity and early trauma consequences have demonstrated that traumatic experiences in the period from pregnancy to the age of 3 years have an enormous impact on an individual's future development, and both physical and mental health. Research shows that adverse child experiences (ACEs) are associated with a strong risk of conditions such as: harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular diseases, stroke respiratory diseases and, as a consequence, to a high financial cost in Italy and also across Europe (1-9% GDP) and the USA (total annual costs estimated to be USD 581 billion in Europe and USD 748 billion in North America). All this suggests that an early intervention on that traumatized-slice of population leads to multiplied savings. METHODS A multi-center, randomized, controlled trial was designed. The parents of the future neonatal population (from pregnancy to delivery) with trauma will be enrolled, and randomized to treatment, or control arm. The article describes in detail how the primary outpoint (cost to the national health system), and some secondary outpoints, will be collected. DISCUSSION An overall rate of return on investment (ROI) statistically significant 13.0% per annum with an associated benefit/cost ratio (BCR) of 6.3 is expected as the primary outcome of the "WeCare Generation" program. Our proposed model predicts a new medical paradigm aiming to empower new generations, with a strong return on economy and health.
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Affiliation(s)
| | - Andrea Benlodi
- Clinical Psychology Unit Carlo Poma Hospital, ASST Mantova, 46100 Mantua, Italy
| | - Emanuele Caroppo
- Department of Mental Health, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38122 Trent, Italy
| | | | - Maria Ghazanfar
- Maternal and Child Department, ASST Brianza, 20871 Vimercate, Italy
| | - Antonio Imbasciati
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Francesco Longo
- Cergas Center for Research on Health and Social Care Management, SDA Bocconi University, 20136 Milan, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Renata Nacinovich
- Child and Adolescent Neuropsichiatry, ASST Monza, NeuroMI—Milan Center for Neuroscience, University of Milano Bicocca, 20126 Milan, Italy
| | - Antonio Pignatto
- Department of Psychology, IUSTO—Salesian University Institute Torino Rebaudengo, 10155 Turin, Italy
| | - Arthur Rolnick
- Department of Economics, Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marco Trivelli
- General and Economic Direction, ASST Brianza, 20871 Vimercate, Italy
| | | | - Cinzia Vanzini
- Training Sector Management, ASST Brianza, 20871 Vimercate, Italy
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Nakane N, Wada I. Estimating the Social Costs of Child Abuse in Residential Care for Children with Disabilities Using the Japanese Survey on the Interactions of Adverse and Positive Childhood Experiences toward Adulthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16476. [PMID: 36554361 PMCID: PMC9778703 DOI: 10.3390/ijerph192416476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
We sought to calculate the extra social costs resulting from child abuse in residential care facilities (RCFs) for children with disabilities (CWD) in Japan. We distributed a survey to 260 residential facilities for CWD in 2020 and obtained responses from 91 facilities. Among the children placed in these facilities, our estimates by four different criteria determined that 23-67% were affected by child abuse. We also estimated extra costs for each of the four criteria, which we estimated to average USD 647.7 million. This study is meaningful in that there are no existing official statistics or research findings on the extra costs of residential care due to child abuse in Japan.
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Affiliation(s)
- Naruhisa Nakane
- Department of Public Policy, Faculty of Welfare Society, Kyoto Prefectural University, 1-5, Shimogamohangi-cyo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Ichiro Wada
- Department of Interdisciplinary Studies, Faculty of International Liberal Arts, Dokkyo University, 1-1, Gakuen-cho, Soka-shi 340-0042, Japan
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Mei X, Li J, Li ZS, Huang S, Li LL, Huang YH, Liu J. Psychometric evaluation of an Adverse Childhood Experiences (ACEs) measurement tool: an equitable assessment or reinforcing biases? HEALTH & JUSTICE 2022; 10:34. [PMID: 36445502 PMCID: PMC9706892 DOI: 10.1186/s40352-022-00198-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Utilizing Adverse Childhood Experiences (ACEs) measurement scales to assess youths' adversities has expanded exponentially in health and justice studies. However, most of the ACEs assessment scales have yet to meet critical psychometric standards, especially for key demographic and minority groups. It is critical that any assessment or screening tool is not reinforcing bias, warranting the need for validating ACEs tools that are equitable, reliable and accurate. The current study aimed to examine the structural validity of an ACEs scale. Using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), which collected of 97,314 responses collected from adults across sixteen states. This study assessed the psychometric properties and measurement invariance of the ACEs tool under the structural equation modeling framework. RESULTS We found the 11-item ACEs screening tool as a second-order factor with three subscales, all of which passed the measurement invariance tests at metric and scalar levels across age, race, sex, socioeconomic status, gender identity, and sexual orientation. We also found that minority groups experienced more childhood adversity with small effect size, with the exception of the gender identity. CONCLUSION The ACEs measurement scale from the BRFSS is equitable and free from measurement bias regardless of one's age, race, sex, socioeconomic status, gender identity, and sexual orientation, and thus is valid to be used to compare group mean differences within these groups. The scale is a potentially valid, viable, and predictive risk assessment in health and justice and research settings to identify high-risk groups or individuals for treatments.
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Affiliation(s)
- Xiaohan Mei
- California State University, Los Angeles, 5151 State University Dr, Los Angeles, CA 90032 USA
| | - Jiayu Li
- Washington State University, Pullman, WA 99164-2520 USA
| | - Zhi-Shu Li
- Shenyang Open University, Shisiwei Rd, Heping District, Shenyang, Liaoning 110003 China
| | - Shun Huang
- Beijing Hospital, 1 Dahua Rd, Dongcheng, Beijing, 100051 China
| | - Li-Li Li
- Shenyang Maternity and Child Health Hospital, 41 Shenzhou Street, Shenhe District, Shenyang, 110000 China
| | - Yang-Hong Huang
- Shenyang Women and Children’s Hospital, No. 87 Danan street, Shenhe District, 110000 Shenyang, China
| | - Jianhong Liu
- University of Macau, Avenida da Universidade Taipa, Macau, 999078 China
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Grummitt L, Barrett E, Kelly E, Newton N. An Umbrella Review of the Links Between Adverse Childhood Experiences and Substance Misuse: What, Why, and Where Do We Go from Here? Subst Abuse Rehabil 2022; 13:83-100. [PMID: 36411791 PMCID: PMC9675346 DOI: 10.2147/sar.s341818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/09/2022] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A wealth of research has identified adverse childhood experiences (ACEs; abuse, neglect, violence or disorder in the home) as a strong risk factor for substance misuse. Synthesis of the existing evidence is critical to shape policy and inform directions for future research. Existing reviews have focused on specific substances or substance use outcomes (eg, disorder), and do not include discussion of the mechanisms that operate between ACEs and substance misuse. The current umbrella review aims to synthesize reviews on the relationship between ACEs and substance misuse, review the evidence on the mechanisms linking these, identify existing gaps in our knowledge, and discuss critical directions for future research, practice, and public policy. METHODS Two electronic databases (PsycINFO and Medline) were searched for reviews published between 1998 and 2022 on the link between ACEs and substance misuse. Twenty articles met eligibility criteria and were qualitatively synthesized. RESULTS Results overwhelmingly demonstrated an elevated risk of substance misuse or disorder, among adolescents and adults exposed to ACEs. Research on the mechanisms that explain this link highlights a multitude of potential intervention targets, with childhood stress propelling a cascade of effects across neurobiological, endocrine, immune, metabolic, and nervous systems, impacting psychosocial and cognitive functioning. Nonetheless, the literature is subject to limitations surrounding potential unmeasured cofounders and causality, as well as decontextualizing childhood adversity from broader structural issues that influence the link between ACEs and substance misuse. Research, policy, and practice that seek to holistically understand and address the relationship between ACEs and substance misuse within the broader social determinants of health is crucial.
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Affiliation(s)
- Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
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Lindert NG, Maxwell MY, Liu SR, Stern HS, Baram TZ, Poggi Davis E, Risbrough VB, Baker DG, Nievergelt CM, Glynn LM. Exposure to unpredictability and mental health: Validation of the brief version of the Questionnaire of Unpredictability in Childhood (QUIC-5) in English and Spanish. Front Psychol 2022; 13:971350. [PMID: 36438371 PMCID: PMC9682115 DOI: 10.3389/fpsyg.2022.971350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
Unpredictability is increasingly recognized as a primary dimension of early life adversity affecting lifespan mental health trajectories; screening for these experiences is therefore vital. The Questionnaire of Unpredictability in Childhood (QUIC) is a 38-item tool that measures unpredictability in childhood in social, emotional and physical domains. The available evidence indicates that exposure to unpredictable experiences measured with the QUIC predicts internalizing symptoms including depression and anxiety. The purpose of the present study was to validate English and Spanish brief versions (QUIC-5) suitable for administration in time-limited settings (e.g., clinical care settings, large-scale epidemiological studies). Five representative items were identified from the QUIC and their psychometric properties examined. The predictive validity of the QUIC-5 was then compared to the QUIC by examining mental health in four cohorts: (1) English-speaking adult women assessed at 6-months postpartum (N = 116), (2) English-speaking male veterans (N = 95), (3) English-speaking male and female adolescents (N = 155), and (4) Spanish-speaking male and female adults (N = 285). The QUIC-5 demonstrated substantial variance in distributions in each of the cohorts and is correlated on average 0.84 (r's = 0.81-0.87) with the full 38-item version. Furthermore, the QUIC-5 predicted internalizing symptoms (anxiety and depression) in all cohorts with similar effect sizes (r's = 0.16-0.39; all p's < 0.05) to the full versions (r's = 0.19-0.42; all p's < 0.05). In sum, the QUIC-5 exhibits good psychometric properties and is a valid alternative to the full QUIC. These findings support the future use of the QUIC-5 in clinical and research settings as a concise way to measure unpredictability, identify risk of psychopathology, and intervene accordingly.
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Affiliation(s)
| | - Megan Y. Maxwell
- Department of Psychology, Chapman University, Orange, CA, United States
| | - Sabrina R. Liu
- Department of Psychology, Chapman University, Orange, CA, United States
| | - Hal S. Stern
- Department of Statistics, University of California, Irvine, Irvine, CA, United States
| | - Tallie Z. Baram
- Department of Anatomy/Neurobiology, University of California, Irvine, Irvine, CA, United States
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
- Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, United States
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Victoria B. Risbrough
- Center of Excellence for Stress and Mental Health, Veterans Affairs, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Dewleen G. Baker
- Center of Excellence for Stress and Mental Health, Veterans Affairs, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Caroline M. Nievergelt
- Center of Excellence for Stress and Mental Health, Veterans Affairs, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Laura M. Glynn
- Department of Psychology, Chapman University, Orange, CA, United States
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The effect of adverse and positive experiences on inflammatory markers in Australian and UK children. Brain Behav Immun Health 2022; 26:100550. [PMID: 36420372 PMCID: PMC9677086 DOI: 10.1016/j.bbih.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Background The relationship between childhood adversity and inflammation is well-established. Examination of positive experiences can provide a more complete understanding of intervention opportunities. We investigated associations of adverse and positive experiences, and their intersection, with inflammation in children and adolescents. Methods Data sources: Longitudinal Study of Australian Children (LSAC; N = 1237) and Avon Longitudinal Study of Parents and Children (ALSPAC; N = 3488). Exposures: Adverse and positive experiences assessed repeatedly (LSAC: 0-11 years; ALSPAC: 0-15 years). Outcomes: Inflammation quantified by high sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA) (LSAC: 11-12 years; ALSPAC: 15.5 years). Analyses: Linear regression on the log-transformed outcomes estimated the relative difference in inflammatory markers with adverse/positive experiences, adjusting for socio-demographics and concurrent positive/adverse experiences, respectively. Results Most associations were in the expected direction but differed in magnitude by exposure, outcome and cohort. Across both cohorts, adverse experiences were associated with up to 7.3% higher hsCRP (95% CI: -18.6%, 33.2%) and up to 2.0% higher GlycA (95% CI: 0.5%, 3.5%); while positive experiences were associated with up to 22.1% lower hsCRP (95% CI: -49.0%, 4.7%) and 1.3% lower GlycA (95% CI: -2.7%, 0.2%). In LSAC, the beneficial effect of positive experiences on inflammation was more pronounced among those with fewer concurrent adverse experiences. Conclusion Across two cohorts, we found small but directionally consistent associations between adverse experiences and higher inflammation, and positive experiences and lower inflammation, particularly for GlycA. Future research should give further consideration to positive experiences to complement the current focus on adversity and inform the design and evaluation of early life interventions.
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Liu N, Zhao Z, Mandin C, Kan H, Zhang Y. Why should we target the burden of disease for indoor air pollutants? INDOOR AIR 2022; 32:e13147. [PMID: 36437648 DOI: 10.1111/ina.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Ningrui Liu
- Department of Building Science, Tsinghua University, Beijing, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Corinne Mandin
- Scientific and Technical Center for Building (CSTB)/Observatory of Indoor Air Quality, University of Paris-Est, Marne-la-Vallée, France
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
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Woodman J, Mc Grath-Lone L, Clery A, Weatherly H, Jankovic D, Appleton JV, Kirman J, Barlow J, Kendall S, Bennett S, Gilbert R, Harron K. Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences. BMJ Open 2022; 12:e066880. [PMID: 36175094 PMCID: PMC9528572 DOI: 10.1136/bmjopen-2022-066880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/17/2022] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Exposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children exposed to ACEs. A range of health visiting service delivery practices exist across England (from the minimum five recommended contacts to tailored intensive interventions), but there is a lack of evidence on who receives what services, how this varies across local authorities (LAs) and the associated outcomes. METHODS AND ANALYSIS This study will integrate findings from analysis of individual-level, deidentified administrative data related to hospital admissions (Hospital Episode Statistics (HES)) and health visiting contacts (Community Services Data Set (CSDS)), aggregate LA-level data, in-depth case studies in up to six LAs (including interviews with mothers), a national survey of health visiting services, and workshops with stakeholders and experts by experience. We will use an empirical-to-conceptual approach to develop a typology of health visiting service delivery in England, starting with a data-driven classification generated from latent class analysis of CSDS-HES data, which will be refined based on all other available qualitative and quantitative data. We will then evaluate which models of health visiting are most promising for mitigating the impact of ACEs on child and maternal outcomes using CSDS-HES data for a cohort of children born on 1 April 2015 to 31 March 2019. ETHICS AND DISSEMINATION The University College London Institute of Education Research Ethics Committee approved this study. Results will be submitted for publication in a peer-reviewed journal and summaries will be provided to key stakeholders including the funders, policy-makers, local commissioners and families.
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Affiliation(s)
- Jenny Woodman
- Social Research Institute, UCL-Faculty of Education and Society (IOE), London, UK
| | - Louise Mc Grath-Lone
- Social Research Institute, UCL-Faculty of Education and Society (IOE), London, UK
| | - Amanda Clery
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child, London, UK
| | | | - Dina Jankovic
- Centre for Health Economics, University of York, York, UK
| | - Jane V Appleton
- OxINMAHR (Oxford Institute of Nursing, Midwifery and Allied Health Research), Oxford Brookes University, Oxford, UK (Please note JVA is formerly of OxINMAHR but now retired)
| | - Jennifer Kirman
- OxINMAHR (Oxford Institute of Nursing, Midwifery and Allied Health Research), Oxford Brookes University, Oxford, UK (Please note JVA is formerly of OxINMAHR but now retired)
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | | | - Ruth Gilbert
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child, London, UK
| | - Katie Harron
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child, London, UK
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Moonen X, Festen D, Bakker-van Gijsel E, Vervoort-Schel J. A Dutch Perspective on Two Health Related Issues Regarding Children and Adolescents with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11698. [PMID: 36141966 PMCID: PMC9517279 DOI: 10.3390/ijerph191811698] [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: 07/13/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
In this opinion article, we want to inspire readers by highlighting recent Dutch developments about two important health related issues regarding the quality of life of children and adolescents with intellectual disabilities. Firstly we focus on the prevention, treatment and reduction of (disability-related) somatic and psychological problems by specialized physicians for people with intellectual disabilities. Secondly, we emphasize the importance of the prevention of adverse childhood experiences and the promotion of protective and compensatory experiences. Subsequently, we stress the need for trauma informed care to support children and adolescents with intellectual disabilities who encounter adverse events. A specialized and multidisciplinary approach is advised as is the need for promoting healthy (family) relations with a focus on (co)regulation and connection as a basis for recovery.
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Affiliation(s)
- Xavier Moonen
- Ben Sajet Center, Zwanenburgwal 206, 1011 JH Amsterdam, The Netherlands
- Department of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands
| | - Dederieke Festen
- Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA Rotterdam, The Netherlands
| | | | - Jessica Vervoort-Schel
- Ben Sajet Center, Zwanenburgwal 206, 1011 JH Amsterdam, The Netherlands
- Department of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands
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Karamanos A, Stewart K, Harding S, Kelly Y, Lacey R. Adverse childhood experiences and adolescent drug use in the UK: The moderating role of socioeconomic position and ethnicity. SSM Popul Health 2022; 19:101142. [PMID: 35733836 PMCID: PMC9207135 DOI: 10.1016/j.ssmph.2022.101142] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/10/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022] Open
Abstract
Rationale There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Methods Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Results Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls' drug use at age 14 than age 17. Conclusions ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.
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Affiliation(s)
- A. Karamanos
- School of Life Course/ Nutritional Sciences, King's College London, UK
| | - K. Stewart
- Department of Social Policy and Centre for Analysis of Social Exclusion (CASE), London School of Economics and Political Science, UK
| | - S. Harding
- School of Life Course/ Nutritional Sciences, King's College London, UK
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Y. Kelly
- Department of Epidemiology & Public Health, University College London, UK
| | - R.E. Lacey
- Department of Epidemiology & Public Health, University College London, UK
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Neagoe IM, Papasteri CC. Adverse Childhood Experiences in Residential Care: Predicting Accumulation and Exploring Clustering of Adversity in Romanian Care Facilities. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09712-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Piontek K, Ittermann T, Wiesmann U, Arnold A, Grabe HJ, Völzke H, Apfelbacher C. Childhood maltreatment is not associated with atopic dermatitis in adults: results from a cross-sectional population-based cohort study. J Eur Acad Dermatol Venereol 2022; 36:2430-2437. [PMID: 35920760 DOI: 10.1111/jdv.18480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood maltreatment (CM) is related to poor physical and mental health outcomes in adults. Knowledge on the impact of CM on skin diseases is limited, and no study has previously addressed the association of CM with atopic dermatitis (AD) in adult age. OBJECTIVES To analyze the prevalence of CM in individuals with physician-diagnosed AD, and to examine the relationship between different types of CM with physician-diagnosed AD in a general population sample of German adults. METHODS Data from 2973 participants from the cross-sectional population-based Study of Health in Pomerania (SHIP) TREND-0 were analyzed (aged 20 to 83 years; 51.4% female). We administered the Childhood Trauma Questionnaire (CTQ) assessing emotional, physical and sexual abuse, and emotional and physical neglect. AD was diagnosed by dermatologists in a standardized clinical examination. We conducted logistic regression analyses adjusted for age, sex and school education to investigate the association of CM types with AD. RESULTS Among all individuals with AD, 20.6% reported to have experienced at least one type of moderate or severe CM. Emotional and physical neglect were the most frequently reported CM types. Overall, the prevalence of CM types among individuals with AD did not differ from those among individuals without AD. We found no association of CM type with AD. CONCLUSIONS This is the first study investigating the association of CM with AD in adults. CM was common in the present general population sample, emphasizing that CM is an important public health problem. Our findings suggest that CM is not a risk factor for AD. It might be hypothesized that AD severity is a crucial outcome, and that CM history is a factor with impact on disease severity and course rather than a risk factor for the development of AD. Longitudinal studies are required to address this question.
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Affiliation(s)
- K Piontek
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany
| | - T Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - U Wiesmann
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - A Arnold
- Department of Dermatology, University Medicine Greifswald, Greifswald, Germany
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany
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Cui N, Zlotnick C, Li Y, Golfenshtein N. Editorial: Childhood Adversity and Life-Course Consequences. Front Psychol 2022; 13:967180. [PMID: 35898992 PMCID: PMC9311373 DOI: 10.3389/fpsyg.2022.967180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Naixue Cui
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
- *Correspondence: Naixue Cui
| | - Cheryl Zlotnick
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Yang Li
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
| | - Nadya Golfenshtein
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
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Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr 2022; 111:1341-1353. [PMID: 35466444 PMCID: PMC9324783 DOI: 10.1111/apa.16370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Andrii Loboda
- Department of Paediatrics, Academic and Research Medical Institute Sumy State University Sumy Ukraine
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Vineis P, Barouki R. The exposome as the science of social-to-biological transitions. ENVIRONMENT INTERNATIONAL 2022; 165:107312. [PMID: 35635963 DOI: 10.1016/j.envint.2022.107312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
The understanding of disease etiology and pathogenesis has radically changed as a consequence of the new challenges posed by climate change, environmental degradation and emerging infectious diseases. The awareness of the influence of distal causes (e.g. planetary changes at the roots of new pandemics), of the social environment and of early life exposures calls for innovative models of disease onset. Here we propose a scheme for the practice of epidemiology and toxicology that incorporates new recent advancements in both disciplines, under the general umbrella of the "exposome". The exposome approach to disease encompasses a lifecourse perspective from conception onwards, and the investigation of the role played by all exposures individuals undergo in their lives. These include social inequalities and psychosocial influences, in addition to chemical, biological and physical exposures. We stress the role played by social differences and inequalities in the course of life as an overarching factor that influences downstream layers (including behaviours). We show that the idea of "lifecourse exposome" is compatible with the current interpretation of Adverse Outcome Pathways in toxicology, and in fact we propose an extension of the concept towards "lifecourse Adverse Outcome Pathways". We propose to merge different research perspectives and promote an encounter between the sociological perspective of "biography" (using Pierre Bourdieu's conceptual framework) and biology, according to the idea of accumulated biological capital of individuals. We also propose to treat social capital (including inequalities) no longer as a confounding factor but as an overarching determinant, perhaps the most important of all because it is the one that influences all other exposures downstream. The importance of early exposures in a lifecourse perspective leads to policy implications, i.e. investing more in the various forms of capital (social, economic, cultural) in early life.
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Affiliation(s)
- Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom.
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Schroeder K, Dumenci L, Sarwer DB, Noll JG, Henry KA, Suglia SF, Forke CM, Wheeler DC. The Intersection of Neighborhood Environment and Adverse Childhood Experiences: Methods for Creation of a Neighborhood ACEs Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137819. [PMID: 35805478 PMCID: PMC9265402 DOI: 10.3390/ijerph19137819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022]
Abstract
This study evaluated methods for creating a neighborhood adverse childhood experiences (ACEs) index, a composite measure that captures the association between neighborhood environment characteristics (e.g., crime, healthcare access) and individual-level ACEs exposure, for a particular population. A neighborhood ACEs index can help understand and address neighborhood-level influences on health among individuals affected by ACEs. Methods entailed cross-sectional secondary analysis connecting individual-level ACEs data from the Philadelphia ACE Survey (n = 1677) with 25 spatial datasets capturing neighborhood characteristics. Four methods were tested for index creation (three methods of principal components analysis, Bayesian index regression). Resulting indexes were compared using Akaike Information Criteria for accuracy in explaining ACEs exposure. Exploratory linear regression analyses were conducted to examine associations between ACEs, the neighborhood ACEs index, and a health outcome—in this case body mass index (BMI). Results demonstrated that Bayesian index regression was the best method for index creation. The neighborhood ACEs index was associated with higher BMI, both independently and after controlling for ACEs exposure. The neighborhood ACEs index attenuated the association between BMI and ACEs. Future research can employ a neighborhood ACEs index to inform upstream, place-based interventions and policies to promote health among individuals affected by ACEs.
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Affiliation(s)
- Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA 19122, USA
- Correspondence:
| | - Levent Dumenci
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA 19122, USA;
| | - David B. Sarwer
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University College of Public Health, Philadelphia, PA 19122, USA;
| | - Jennie G. Noll
- Department of Human Development and Family Studies, Penn State College of Health and Human Development, University Park, PA 16802, USA;
| | - Kevin A. Henry
- Department of Geography and Urban Studies, Temple University College of Liberal Arts, Philadelphia, PA 19122, USA;
| | - Shakira F. Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA;
| | - Christine M. Forke
- Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania, Center for Violence Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - David C. Wheeler
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA;
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Yu HJ, Liu X, Yang HG, Chen R, He QQ. The association of adverse childhood experiences and its subtypes with adulthood sleep problems: A systematic review and meta-analysis of cohort studies. Sleep Med 2022; 98:26-33. [PMID: 35777139 DOI: 10.1016/j.sleep.2022.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experience (ACE) is a powerful risk factor for long-term sleep health. However, the degree to which ACE and its subtypes contribute to adulthood sleep problems remains unknown. For this systematic review and meta-analysis, PubMed, Embase, Web of Sciences, Cochrane library, and CNKI (Chinese) were searched from inception to 1 December 2021. Cohort studies that examined the association between ACEs (aged <18 y) and adulthood sleep outcomes (aged ≥18 y) were included. The most fully adjusted odds ratios (ORs) were extracted and pooled using the random-effects model. A total of nine articles involving 108 330 participants from five high-income countries were identified. Individuals with at least one ACE subtype were more likely to report adulthood sleep problems (OR = 1.14, 1.09-1.20, I2 = 77.5%, n = 9 studies) compared with those without ACE. The pooled ORs were approximately 1.20 for sexual, physical, and emotional abuse with high heterogeneity (I2 > 80%), 1.09 (95% CI: 0.99-1.19, I2 = 0%, n = 2) for neglect, and 1.21 (95% CI: 1.14-1.30, I2 = 73.6%, n = 3) for family dysfunction. Individuals with multiple ACEs were associated with a higher magnitude of the risk for sleep problems (OR = 1.33, 95% CI: 1.18-1.49, I2 = 87.3%, n = 3). In conclusion, the magnitude of the risk for sleep problems was similar across ACE subtypes except for childhood neglect. ACE may have cumulative detrimental effects on sleep health. More longitudinal evidence regarding ACE-sleep relationships, particularly in low- and middle-income countries, is needed. Furthermore, more policy efforts and evidence-based preventions are warranted to address ACEs among children.
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Affiliation(s)
- Hong-Jie Yu
- School of Public Health, Wuhan University, Wuhan, China
| | | | | | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.
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Mo J, Cao B, Liu N, Sun Z, Xu Y, Zhu Y, Zhang Y. 建筑空气环境人因工程学:问题、思考与初探. CHINESE SCIENCE BULLETIN-CHINESE 2022. [DOI: 10.1360/tb-2022-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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75
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Childhood adversity and the link between social inequality and early mortality. THE LANCET PUBLIC HEALTH 2022; 7:e100-e101. [DOI: 10.1016/s2468-2667(21)00303-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/23/2022] Open
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76
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Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
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Brindle RC, Pearson A, Ginty AT. Adverse childhood experiences (ACEs) relate to blunted cardiovascular and cortisol reactivity to acute laboratory stress: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 134:104530. [PMID: 35031343 DOI: 10.1016/j.neubiorev.2022.104530] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 01/09/2022] [Indexed: 12/24/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with poor future mental and physical health. Altered biological reactivity to mental stress may be a possible mechanism linking ACEs to poor health. However, it is not clear if ACEs relate to blunted or exaggerated stress reactivity. This meta-analysis aimed to determine whether exposure to ACEs is associated with cardiovascular and cortisol stress reactivity. A systematic review yielded 37 sources. Random-effects modelling tested the aggregate effects of 83 studies of the association between ACEs and stress reactivity. Exposure to ACEs was associated with relatively blunted cardiovascular and cortisol stress reactivity. Effect sizes did not vary as a function of sample sex or reactivity measure (e.g., heart rate, blood pressure, or cortisol). Meta-regression revealed preliminary evidence of greater blunting in samples of a younger age and samples reporting greater ACE exposure. Subgroup analyses for stress task, ACE measurement instrument, and sample race were not conducted because of a lack of between-study variability. Exposure to ACEs is associated with dysregulation of multiple components of the human stress response system.
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Affiliation(s)
- Ryan C Brindle
- Department of Cognitive and Behavioral Science, Washington and Lee University, Lexington, VA, United States; Neuroscience Program, Washington and Lee University, Lexington, VA, United States.
| | - Alexandra Pearson
- Department of Cognitive and Behavioral Science, Washington and Lee University, Lexington, VA, United States
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
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78
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Demakakos P, Steptoe A, Mishra GD. Adverse childhood experiences are associated with increased risk of hysterectomy and bilateral oophorectomy: A national retrospective cohort study of women in England. BJOG 2022; 129:1481-1489. [PMID: 34978369 PMCID: PMC9250543 DOI: 10.1111/1471-0528.17088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022]
Abstract
Objective To examine the associations between adverse childhood experiences (ACE) and the risk of hysterectomy and bilateral oophorectomy in a national sample of women in England. Design Retrospective cohort study. Setting A stratified random sample of households across England. Population 2648 women aged ≥55 years in 2007 from the English Longitudinal Study of Ageing (ELSA) were included in the bilateral oophorectomy analyses and 2622 in the hysterectomy analyses. Methods Logistic and multinomial logistic regression analyses of the associations between categories of the ACE summary score (0, 1, 2, ≥3 ACE), eight individual ACE, and hysterectomy and bilateral oophorectomy. Results 615 women had undergone hysterectomy and 259 women bilateral oophorectomy. We found graded associations between the summary ACE score and risk of hysterectomy and bilateral oophorectomy. In the fully adjusted model, compared with women with no ACE, those with ≥3 ACE had double the odds of hysterectomy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.30–3.11) and more than double the odds of bilateral oophorectomy (OR 2.61, 95% CI 1.54–4.42). The exclusion of women with cancer history made the associations stronger, especially in women who underwent hysterectomy at age <40 years or bilateral oophorectomy at age ≤44 years. Several individual ACE were positively associated with both outcomes. Conclusions ACE are associated with increased risk of hysterectomy and bilateral oophorectomy. Individual‐level covariates did not explain these associations. Our findings highlight the importance of a life course approach to understanding surgical menopause and add to our knowledge of the societal and public health impact of ACE. Tweetable abstract Adverse childhood experiences are associated with increased risk of hysterectomy and bilateral oophorectomy in a national sample of women in England. Adverse childhood experiences are associated with increased risk of hysterectomy and bilateral oophorectomy in a national sample of women in England. Linked article: This article is commented on by Walter A. Rocca, pp. 1491–1492 in this issue. To view this minicommentary visit https://doi.org/10.1111/1471-0528.17105.
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Affiliation(s)
- Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Sciences and Health, University College London, London, UK
| | - Gita D Mishra
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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The economic costs linked to adverse childhood experiences in Europe. LANCET PUBLIC HEALTH 2021; 6:e789-e790. [PMID: 34756165 DOI: 10.1016/s2468-2667(21)00233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022]
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