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Heshmati R, Seyed Yaghoubi Pour N, Haji Abbasoghli P, Habibi Asgarabad M. Adverse Childhood Experience, Parental Bonding, and Fatherhood as Parenting Vulnerabilities to Social Anxiety Severity. Eur J Investig Health Psychol Educ 2024; 14:2057-2073. [PMID: 39056652 PMCID: PMC11276488 DOI: 10.3390/ejihpe14070137] [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: 06/26/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Background: The present study aims to elucidate the association between adverse childhood experiences, parental bonding, fatherhood, and social anxiety symptoms among emerging adults within an Iranian context. Methods: This prospective cross-sectional study utilized self-reported assessments to evaluate fatherhood, parental bonding, anxious thoughts, and childhood trauma. The study was administered to 242 university students exhibiting social anxiety symptoms. Among the participants, 181 (74.8%) were boys and 61 (25.2%) were girls between the ages of 18 and 29. In terms of educational background, 64.9% of them held a bachelor's degree, and 35.1% held a master's degree. A majority of them (84.3%) were of middle-class socio-economic status, 6.6% were of low income, and 9.1% were of high income. Results: Analysis via multiple linear regression revealed that individuals with adverse childhood experiences exhibited heightened levels of social anxiety symptoms (R2 = 0.32) compared to their counterparts without such experiences. Furthermore, fatherhood (R2 = 0.28), paternal bonding (R2 = 0.26), and maternal bonding (R2 = 0.26) were all significantly and equally associated with variance in social anxiety symptoms. The findings underscored the substantial correlation between ACEs, fatherhood, and both maternal and paternal bonding with social anxiety symptoms in adulthood. Conclusions: Accordingly, the study emphasizes the importance of thoroughly assessing the multifaceted contributors to social anxiety. Such insights are pivotal for the design and implementation of community-based preventive interventions aimed at reducing the societal burden of social anxiety disorders.
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Affiliation(s)
- Rasoul Heshmati
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz 5166616471, Iran; (N.S.Y.P.); (P.H.A.)
| | - Nazanin Seyed Yaghoubi Pour
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz 5166616471, Iran; (N.S.Y.P.); (P.H.A.)
| | - Parisa Haji Abbasoghli
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz 5166616471, Iran; (N.S.Y.P.); (P.H.A.)
| | - Mojtaba Habibi Asgarabad
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway
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Song C, Yao L, Chen H, Zhang J, Liu L. The relationship between adverse childhood experiences and depressive symptoms in rural left-behind adolescents: A cross-sectional survey. Heliyon 2024; 10:e26587. [PMID: 38420482 PMCID: PMC10900995 DOI: 10.1016/j.heliyon.2024.e26587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Objective We assessed the current status of depressive symptoms and the associated factors in rural left-behind adolescents. Moreover, we investigated the relationship between adverse childhood experiences and depressive symptoms. Methods Students from two rural junior high schools in Huaihua City were enrolled from July to September 2022. Before distributing the questionnaires, guardians of the students were contacted, and consent was obtained from the students themselves. The questionnaires were filled out anonymously and collected on-site. Results The prevalence of depressive symptoms among the 325 left-behind teenagers was 23.40%; the rate of emotional abuse in adverse childhood experiences was 17.50%, physical abuse was 15.70%, sexual abuse was 9.50%, emotional neglect was 24.60%, while physical neglect was 27.70%. The five dimensions of adverse childhood experiences were associated with depressive symptoms (r = 0.597, 0.395, 0.410, 0.498, 0.741, p < 0.01). Conclusions Depressive symptoms were common among rural left-behind adolescents. Adverse childhood experiences were associated with depressive symptoms in rural left-behind adolescents. Occurrence of adverse childhood experiences should be reduced to improve on depressive symptoms.
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Affiliation(s)
- Caini Song
- Department of Nursing, Hunan Normal University, Changsha, 410013, Hunan Province, China
| | - Libo Yao
- Minimally Invasive Surgery Center, The First Hospital of Changsha, Changsha, 410005, Hunan Province, China
| | - Huisu Chen
- Department of Nursing, Hunan Normal University, Changsha, 410013, Hunan Province, China
| | - Jingyi Zhang
- Department of Nursing, Hunan Normal University, Changsha, 410013, Hunan Province, China
| | - Lihua Liu
- Department of Nursing, Hunan Normal University, Changsha, 410013, Hunan Province, China
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Yeo G, Lansford JE, Hirshberg MJ, Tong EMW. Associations of childhood adversity with emotional well-being and educational achievement: A review and meta-analysis. J Affect Disord 2024; 347:387-398. [PMID: 38000469 DOI: 10.1016/j.jad.2023.11.083] [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: 09/05/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Profound negative implications of adverse childhood experiences (ACEs) have raised public health concern worldwide. METHOD This systematic review and meta-analysis examined associations of three types of ACEs (abuse, neglect, and household dysfunctions) with experiential (emotional quality of momentary and everyday experiences) and reflective (judgments about life satisfaction, sense of meaning, and ability to pursue goals that can include and extend beyond the self) facets of emotional well-being (EWB) and educational achievement. The systematic review yielded 100 studies with 176 effect sizes that met criteria for inclusion in the meta-analysis. RESULTS ACEs were related particularly strongly to lower EWB, r = -0.32, p < .001; [95 % CI: -0.44 to 0.01], but also to lower educational achievement, r = -0.18, p < .001; [95 % CI: -0.21 to -0.05]. Associations were stronger for abuse and composite indicators of ACEs than for household dysfunctions. Associations of ACEs with EWB and educational achievement were stronger in childhood and adolescence than in emerging or later adulthood. Associations did not differ for males and females or for Eastern versus Western cultural groups. Analyses provided evidence for the causal role of ACEs in the development of lower EWB and academic achievement as well as their reciprocal associations. LIMITATIONS There is no standard conceptualization of well-being and studies are not always clear about the types of ACEs examined, with limited research on educational achievement. CONCLUSION Findings have important implications for mental health professionals, policy makers and social service agencies in developing resources and intervention services that target ACEs to protect individuals and promote well-being and academic achievement.
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Affiliation(s)
- GeckHong Yeo
- Social Service Research Center, National University of Singapore, Singapore.
| | | | | | - Eddie M W Tong
- Social Service Research Center, National University of Singapore, Singapore
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Kim S, Han Y, Ma J. Profiles of adverse childhood experiences (ACEs) and psychosocial adjustment in South Korea: Comparison between probation and non-probation youth. CHILD ABUSE & NEGLECT 2023; 146:106453. [PMID: 37776728 DOI: 10.1016/j.chiabu.2023.106453] [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: 03/16/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are risk factors affecting adolescent psychosocial adjustment. Youth involved in the juvenile justice system are more likely to have ACEs, but few studies have investigated this topic outside the western context. OBJECTIVE This study aims to (1) compare latent profiles of ACEs among probation and non-probation youth in South Korea and (2) examine which profiles pose the greatest risk of maladaptive psychosocial adjustment (offline risk-taking, online risk-taking, school adjustment, and happiness). PARTICIPANTS AND SETTING South Korean data adopting survey questions from the Fourth International Self-Report Delinquency Study was analyzed. Adolescents with complete information on regression covariates were included (non-probation: 1846/probation: 368). METHODS Latent profile analysis was utilized to identify distinctive patterns of ACEs. Multiple linear regression and logistic regression were performed to predict the maladjustment experiences of each latent subgroup. RESULTS Four ACE profiles emerged for probation and non-probation samples. Three profiles were common (i.e., emotional/physical abuse, emotional neglect, high maltreatment/domestic violence) and one profile was unique (high maltreatment with family dysfunction for the probation sample; moderate maltreatment for the non-probation sample). In the probation sample, compared to the emotional neglect group, the other three profiles showed poorer adjustment in at least one domain. In the non-probation sample, profiles with high emotional/physical abuse and high maltreatment/family dysfunction had poorer outcomes than the emotional neglect group. CONCLUSIONS These findings indicate the need for a comprehensive approach toward adolescents and their family environments for preventing delinquency and promoting positive youth adjustment.
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Affiliation(s)
| | | | - Julie Ma
- University of Michigan-Flint, United States of America
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Thurston C, Murray AL, Franchino-Olsen H, Meinck F. Prospective longitudinal associations between adverse childhood experiences and adult mental health outcomes: a protocol for a systematic review and meta-analysis. Syst Rev 2023; 12:181. [PMID: 37777785 PMCID: PMC10541707 DOI: 10.1186/s13643-023-02330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/18/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Research cites a strong, dose-response relationship between adverse childhood experiences (ACEs) and poor adult mental health outcomes including anxiety, depression, post-traumatic stress disorder (PTSD), self-harm, suicidality, and psychotic-like experiences. AIM To systematically investigate the existence and strength of association between ACEs and adult mental health outcomes in prospective longitudinal studies. The review will focus on the outcomes: anxiety, depression, PTSD, self-harm, suicidal ideation, and psychotic-like experiences. METHODS Twelve electronic databases will be searched: Embase, PsycINFO, MEDLINE, and Global Health through the OVID interface. ProQuest will be used to search Public Affairs Information Service (PAIS), Dissertations and Theses, Sociology Database (including Sociological Abstracts and Social Services Abstracts), PTSDpubs (formerly The Published International Literature on Traumatic Stress (PILOTS) Database) and Applied Social Sciences Index and Abstracts (ASSIA). CINAHL, World Health Organisation (WHO) Global Index Medicus, and WHO Violence Info will also be searched. Eligible studies will be double screened, assessed, and their data will be extracted. Any disagreement throughout these processes will be settled by a third reviewer. If enough studies meet the criteria and the methodological quality of each study is sufficient, a meta-analysis will be conducted. ANALYSIS A narrative synthesis of included studies and the associations between ACEs and adult mental health will be completed. If the number of studies included per mental health outcome is two or more, a multi-level meta-analysis will be completed using odds ratio effect sizes as outcomes. DISCUSSION This review will contribute to the existing body of literature supporting the long-term effects of ACEs on adult mental health. This review adds to previous reviews that have either synthesised cross-sectional associations between ACEs and mental health outcomes, synthesised longitudinal studies exploring the effect of ACEs on different physical and mental health outcomes or synthesised longitudinal studies exploring the effect of ACEs on the same mental health outcomes using different methods. This review aims to identify methodological weaknesses and knowledge gaps in current literature that can be addressed in future primary studies. SYSTEMATIC REVIEW REGISTRATION This protocol has been registered in PROSPERO (CRD42021297882).
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Affiliation(s)
- Christina Thurston
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK.
| | | | - Hannabeth Franchino-Olsen
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Humanities, North-West University, Potchefstroom, South Africa
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Liang Y, Wu R, Huang Q, Liu Z. Sex Differences in Patterns of Childhood Traumatic Experiences in Chinese Rural-To-Urban Migrant Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040734. [PMID: 37189983 DOI: 10.3390/children10040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Children and adolescents are likely to be exposed to various types of childhood traumatic experiences (CTEs) with gender-specific patterns. Rural-to-urban migrant children have been demonstrated a greater risk of CTE exposure than local children. However, no study has investigated sex differences in the patterns of CTEs and predictive factors among Chinese children. METHODS A large-scale questionnaire survey of rural-to-urban migrant children (N = 16,140) was conducted among primary and junior high schools in Beijing. Childhood trauma history, including interpersonal violence, vicarious trauma, accidents and injuries was measured. Demographic variables and social support were also examined. Latent class analysis (LCA) was utilized to examine patterns of childhood trauma, and logistic regression was used to examine predictors. RESULTS Four classes of CTEs were found among both boys and girls, labeled low trauma exposure, vicarious trauma exposure, domestic violence exposure, and multiple trauma exposure. The possibility of various CTEs in the four CTE patterns was higher among boys than girls. Sex differences also manifested in predictors of childhood trauma patterns. CONCLUSIONS Our findings shed light on sex differences in CTE patterns and predictive factors in Chinese rural-to-urban migrant children, suggesting that trauma history should be considered along with sex, and sex-specific prevention and treatment programs should be developed.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Ruiyao Wu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Qi Huang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
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Lee H, Park A. The Influence of Adverse Childhood Experiences on Suicidal Behaviors in South Korea: The Mediating Effects of Depressive Symptoms and Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231162658. [PMID: 37057336 DOI: 10.1177/08862605231162658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study examines the relationship between patterns of adverse childhood experiences (ACEs) and suicidal behaviors. It investigates the role of depressive symptoms as an underlying mechanism between patterns of ACEs and suicidal behaviors in South Korea. Data came from the 2012 Korean General Social Survey (KGSS), a nationally representative sample in South Korea (N = 1,048). The dependent variables included two suicidal behaviors: suicidal thoughts and a suicide plan or attempt. The independent variable was the patterns of ACEs identified using ten binary indicators of childhood adversity. The mediating variable of depressive symptoms was measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Covariates were also included to control for socio-demographic characteristics: age, gender, education, and household income. This study conducted a latent class analysis (LCA) to classify different patterns of ACEs and then employed path analysis to examine mediating effects of depressive symptoms in the relationship between ACEs and suicidal behavior. Among the results, three latent classes of ACEs were identified-child maltreatment, child maltreatment and family dysfunction, and low ACEs. The child maltreatment and child maltreatment and family dysfunction classes were more likely to have suicidal thoughts and to plan or attempt suicide compared to the low ACEs class. Path analysis also showed significant indirect pathways from ACEs exposure to suicidal behaviors through depressive symptoms. This evidence corroborates previous research that shows family dysfunction and child maltreatment as detrimental factors leading to depressive symptoms and suicidal behaviors. Practitioners and policy-makers should therefore consider childhood life experiences when assessing suicidal behaviors in health prevention and intervention strategies.
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Affiliation(s)
- Haenim Lee
- Dongguk University, Jung-gu, Seoul, Republic of Korea
| | - Aely Park
- Sunchon National University, Suncheon, Republic of Korea
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Nweze T, Ezenwa M, Ajaelu C, Hanson JL, Okoye C. Cognitive variations following exposure to childhood adversity: Evidence from a pre-registered, longitudinal study. EClinicalMedicine 2023; 56:101784. [PMID: 36618899 PMCID: PMC9813693 DOI: 10.1016/j.eclinm.2022.101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/27/2022] Open
Abstract
Background Different methodological approaches to studying the effects and timing of childhood adversity have been proposed and tested. While childhood adversity has primarily been operationalized through specificity (effects of individual adversity types) and cumulative risk (sum of all adversities reported by an individual) models, dimensional models (probeable through latent class and other cluster analyses) have recently gained traction given that it can overcome some of the limitations of the specificity and cumulative risk approaches. On the other hand, structured lifecourse modelling is a new statistical approach that examines the effects of the timing of adversity exposure on health outcomes by comparing sensitive periods and accumulation hypotheses. In this study, we apply these sets of methodological approaches and theoretical models to better understand the complex effects of childhood adversity on cognitive outcomes. Methods We analysed data obtained from the Avon Longitudinal Study of Parents and Children for 2965 participants (Male = 1125; Female = 1840). This included parental report of 11 types of childhood adversity when participants were between 8 months and 8.7 years, and performance on inhibition, working memory and emotion recognition neurocognitive tasks when participants were 24 years of age (April 1, 1992-October 31, 2017). We used latent class analysis to classify the participants into subgroups, while we used Kruskal-Wallis test to examine differences in cognitive performance among the adversity subgroups. Additionally, to test whether sensitive period or accumulation models better explain the effects of childhood adversity on cognitive functioning, we carried out separate analyses using structured lifecourse modelling approaches. Findings Latent class analysis showed evidence of 5 classes, namely: low adversity (71.6%), dysfunctional family (9.58%); parental deprivation (9.65%); family poverty (6.07%) and global adversity (3.1%). We observed group differences in cognitive performance among the adversity classes in an inhibition control task, χ2(4) = 15.624, p = 0.003 and working memory task, χ2(4) = 15.986, p = 0.003. Pairwise comparison tests showed that participants in the family poverty class performed significantly worse than those in the low adversity class, for the inhibition control task (p = 0.007) while participants in the global adversity class significantly performed worse than participants in the low adversity class (p = 0.026) and dysfunctional family class (p = 0.034) on the working memory task. A further analysis revealed that the associations between each individual adversity type and cognitive outcomes were mostly consistent with the observed class performance in which they co-occurred. Follow-up analyses suggested that adversity during specific sensitive periods, namely very early childhood and early childhood, explained more variability in these observed associations, compared to the accumulation of adversities. Interpretation These findings suggest that dimensional approaches e.g., latent class analysis or cluster analysis could be good alternatives to studying childhood adversity. Using latent class analysis for example, can help reveal the population distribution of co-occurring adversity patterns among participants who may be at the greatest health risk and thus, enable a targeted intervention. In addition, this approach could be used to investigate specific pathways that link adversity classes to different developmental outcomes that could further complement the specificity or cumulative risk approaches to adversity. On the other hand, findings from a separate analysis using structured lifecourse modelling approaches also highlight the vital developmental timeframes in childhood during which the impact of adversity exposure on cognitive outcomes is greatest, suggesting the need to provide comprehensive academic and mental health support to individuals exposed during those specific timeframes. Funding T.N. received funding from Cambridge Trust (University of Cambridge).
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Affiliation(s)
- Tochukwu Nweze
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Michael Ezenwa
- Department of Psychology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Cyriacus Ajaelu
- Department of Psychology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Jamie L. Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA, USA
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Kim Y, Park A, Murphy J. Patterns of Adverse Childhood Experiences and Mental Health: Evidence From College Students in Korea. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3011-3029. [PMID: 35584536 DOI: 10.1177/08862605221102487] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adverse childhood experiences (ACEs) are concerning exposures that may have detrimental effects on mental health. Much of the prior evidence on ACEs comes from the U.S and western developed countries. In light of the limited knowledge of ACEs in other social contexts and the interconnection among adversities, this study aims to identify distinct patterns of co-occurring ACEs and examines the associations between those adversities and mental health in South Korea. We used data from a national sample of Korean college students recruited via non-probability quota sampling in 2019 (N = 1037). The dependent variables included three measures of mental health assessed by the Brief Symptom Inventory depression symptoms, anxiety symptoms, and somatization symptoms. The independent variable was the patterns of ACEs identified using 14 indicators of childhood adversity. We conducted a Latent Class Analysis with a distal outcome, using the Bolck, Croons, and Hagenaars method. The analysis found four patterns of ACEs: extreme adversity (8%), family violence (20.3%), economic adversity (10.4%), and low adversity (61.3%). The extreme adversity group exhibited multiple exposures, including interpersonal violence in home environments, economic hardship, and bullying victimization by peers. The results suggest that the extreme adversity and family violence groups showed significantly worse mental health symptoms than the economic adversity and low adversity groups. Also, the extreme adversity group reported significantly higher levels of depression symptoms and somatization symptoms than the family violence group. This study expands the current understanding of ACEs and their harmful effects on mental health in young adulthood specific to Korea while comparing them with other social contexts. Researchers and practitioners should recognize the co-occurrence of child adversities, rather than overestimating sole adversity, to develop effective strategies for promoting mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Aely Park
- Department of Social Welfare, 65380Sunchon National University, Suncheon, South Korea
| | - Jennifer Murphy
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
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Miedema SS, Le VD, Chiang L, Ngann T, Shortt JW. Adverse Childhood Experiences and Intimate Partner Violence Among Youth in Cambodia: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1446-NP1472. [PMID: 35471130 PMCID: PMC10263171 DOI: 10.1177/08862605221090573] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adverse childhood experiences (ACEs) are a global public health problem, including in low- and middle-income country settings, and are associated with increased risk of intimate partner violence (IPV) during young adulthood. However, current measurement of ACEs may underestimate sequelae of different combinations, or classes, of ACEs and mask class-specific associations with adult exposure to IPV. We used data among ever-partnered young women and men aged 18-24 years from the Cambodia Violence Against Children Survey (Nw = 369; Nm = 298). Participants retrospectively reported on seven ACEs and lifetime physical and/or sexual IPV victimization and perpetration. Latent classes comprised of ACEs were used as predictors of physical and/or sexual IPV perpetration and victimization, controlling for household wealth. Identified latent classes for women were "Low ACEs" (60%), "Community Violence and Physical Abuse" (23%), and "Physical, Sexual and Emotional Abuse" (17%). Latent classes for men were "Low ACEs" (48%) and "Household and Community Violence" (52%). Among women, those in the Physical, Sexual and Emotional Abuse class were more likely to experience and perpetrate physical and/or sexual IPV in their romantic relationships compared to the reference group (Low ACEs). Women in the Community Violence and Physical Abuse class were more likely to perpetrate physical and/or sexual IPV, but not experience IPV, compared to women in the Low ACEs class. Among men, those in the Household and Community Violence class were more likely to perpetrate physical and/or sexual IPV against a partner, compared to men in the Low ACEs class. Overall, patterns of ACEs were differently associated with IPV outcomes among young women and men in Cambodia. National violence prevention efforts might consider how different combinations of childhood experiences shape risk of young adulthood IPV and tailor interventions accordingly to work with youth disproportionately affected by varied combinations of ACEs.
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Affiliation(s)
- Stephanie S. Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi Donna Le
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chiang
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thanak Ngann
- Gender and Development for Cambodia (GAD/C), Phnom Penh, Cambodia
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Aizpurua E, Caravaca-Sánchez F, Wolff N. Patterns of Childhood Adversities and Their Associations With Adult Victimization Among Incarcerated Men and Women in Spanish Prisons. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:89-104. [PMID: 35695392 PMCID: PMC9669728 DOI: 10.1177/0306624x221102845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adverse childhood experiences (ACEs) are prevalent and have long lasting effects. There is evidence of gender differences in exposure to different types of ACEs, with women experiencing higher levels of sexual abuse and cumulative adversity than men. Despite this, most research examining patterns of adversities have used joint samples, assuming that men and women have comparable profiles. The current study examines if distinct profiles of childhood adversities exist for men and women and analyzes their associations with multiple forms of interpersonal victimization during adulthood. Participants were 2,709 residents (91.6% men and 8.4% women) from eight prisons in Spain, who completed a self-administered survey. Latent Class Analysis revealed different patterns of childhood adversities for men and women. For both groups, higher adversity was associated with interpersonal harm during adulthood.
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Affiliation(s)
| | | | - Nancy Wolff
- The State University of New Jersey, New
Brunswick, USA
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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: 27] [Impact Index Per Article: 13.5] [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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Wolff N, Aizpurua E, Sánchez FC, Peng D. Childhood Abuse Classes for Incarcerated Men and Women: Are There Unique Gender Patterns in Abuse Classes? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP6355-NP6383. [PMID: 33073688 DOI: 10.1177/0886260520965974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Childhood adversity is predictive of poorer health and behavioral health outcomes in adulthood. Males and females are known to experience different types of childhood adversity, with females experiencing more sexual and emotional harm in childhood. Latent class analysis (LCA) has been used to identify patterns among types of childhood adversity. These studies have constructed class structures using single gender or blended gender samples. Class structures based on blended gender samples, however, may misrepresent the nuances of gender-specific adversity histories through averaging, potentially distorting the relative need for gender-specific types of intervention. This study investigated whether latent class structures of childhood abuse are equivalent for incarcerated males and females. Our sample included 4,204 residents (3,986 males, 218 females) drawn from a single prison system. Residents completed an hour-long audio computer-assisted self-interview that included questions on 10 types of childhood abuse, depression, and anxiety symptoms, the Beck Hopelessness Scale (BHS), Buss-Perry Aggression Questionnaire, and Criminal Sentiments Scale-Modified (CSS-M). Overall, female residents were both more likely to experience childhood abuse and have more extensive victimization experiences. Small subgroups of males, however, had even more extensive victimization experiences. Abuse patterns for males and females, while optimally clustering in four classes, are rather unique, especially for higher abuse classes, in terms of distribution of membership and types of abuse. These differences may matter in terms of identifying the relative need for therapeutic intervention among incarcerated males and females and targeting those interventions in ways that reflect the gradient and density of therapeutic need. The next step is to test whether using blended or gendered latent class structures matters in terms of predicting outcomes, such as prison-based behavioral health problems, suicidality, and victimization.
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Affiliation(s)
- Nancy Wolff
- Rutgers, The State University of New Jersey, NJ, USA
| | | | | | - Dan Peng
- Rutgers, The State University of New Jersey, NJ, USA
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14
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Wang L, Yu Z, Chen W, Zhang J, Bettencourt AF. Higher exposure to childhood adversity associates with lower adult flourishing. BMC Public Health 2022; 22:612. [PMID: 35351105 PMCID: PMC8966170 DOI: 10.1186/s12889-022-13063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are prevalent and associated with negative health and social outcomes. However, our understanding of how patterns of ACEs exposure relate to positive outcomes in adulthood remains limited. This study aims to identify patterns of ACEs and examine associations with flourishing in a sample of Chinese young adults. METHODS This cross-sectional study was conducted from August to November 2020. Young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China were recruited through convenience and snowball sampling to participate in a survey. The exposure to ACEs was measured by the twelve-item Chinese version of the ACE-International Questionnaire. Additional measures included six domains of flourishing assessed using the Chinese version of the Flourishing Measure, and demographic covariates (i.e., gender, age, year in university, marital status). Descriptive statistical analysis and latent class analysis (LCA) were performed using SPSS 27 and Mplus 8.5. RESULTS Participants included 9468 young adults (mean age = 20.1 years). Majority of participants were female (75.3%), undergraduate students (96.4%), and single (79.8%). Approximately 56% of participants reported at least one ACE; 7.0% reported four or more ACEs. Emotional neglect (33.2%), household violence (20.6%), and parental separation/divorce (13.9%) were the most frequently reported ACEs. LCA identified three ACEs classes: multiple maltreatment and household violence (4.7%), emotional neglect and household violence (16.2%), and low ACEs (79.1%). Individuals in the low ACEs class had the highest level of flourishing whereas individuals in multiple maltreatment and household violence had the lowest level of flourishing in all six domains. There were no significant differences in flourishing between the multiple maltreatment and household violence and the emotional neglect and household violence classes except in the physical and mental health (means = 6.17 vs 6.51, p = 0.02) and the financial and material stability domains (means = 5.25 vs 5.66, p = 0.04). CONCLUSIONS Patterns of multiple ACEs exposures were associated with lower levels of flourishing. Our findings have implications for efforts to prevent ACEs exposure through monitoring and promoting family well-being and routine screening to identify those with ACEs exposure to prevent negative social and health sequelae.
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Affiliation(s)
- Lin Wang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Zhiyuan Yu
- Johns Hopkins School of Nursing, 525N Wolfe Street, Baltimore, MD, 21205, USA.
| | - Wenyi Chen
- Johns Hopkins School of Nursing, 525N Wolfe Street, Baltimore, MD, 21205, USA
| | - Juan Zhang
- Departments of Nursing, School of Medicine, Shanghai Jiao Tong University, International Peace Maternity and Children Hospital of China Welfare Institution, Shanghai, China
| | - Amie F Bettencourt
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
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15
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Lacey RE, Howe LD, Kelly-Irving M, Bartley M, Kelly Y. The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2218-2241. [PMID: 32639853 PMCID: PMC8918866 DOI: 10.1177/0886260520935096] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Previous research has demonstrated a graded relationship between the number of Adverse Childhood Experiences reported (an ACE score) and child outcomes. However, ACE scores lack specificity and ignore the patterning of adversities, which are informative for interventions. The aim of the present study was to explore the clustering of ACEs and whether this clustering differs by gender or is predicted by poverty. Data on 8,572 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. ALSPAC is a regionally representative prenatal cohort of children born between 1991 and 1992 in the Avon region of South-West England. ACEs included parental divorce, death of a close family member, interparental violence, parental mental health problems, parental alcohol misuse, parental drug use, parental convictions, and sexual, emotional, and physical abuse, between birth and 19 years. Latent class analysis was used to derive ACE clusters and associations between poverty, gender, and the derived classes tested using multinomial logistic regression. Five latent classes were identified: "Low ACEs" (55%), "Parental separation and mother's mental health problems" (18%), "Parental mental health problems, convictions and separation" (15%), "Abuse and mental health problems" (6%), and "Poly adversity" (6%). Death of a close family member and sexual abuse did not cluster with other adversities. The clustering did not differ by gender. Poverty was strongly related to both individual ACEs and clusters. These findings demonstrate that ACEs cluster in specific patterns and that poverty is strongly related to this. Therefore, reducing child poverty might be one strategy for reducing ACEs.
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16
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Kim Y, Lee H, Park A. Patterns of adverse childhood experiences and depressive symptoms: self-esteem as a mediating mechanism. Soc Psychiatry Psychiatr Epidemiol 2022; 57:331-341. [PMID: 34191037 PMCID: PMC8243305 DOI: 10.1007/s00127-021-02129-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE There is a growing interest in the co-occurring natures of adverse childhood experiences (ACEs) and unmeasured types of adversity. The current body of knowledge may also lack plausible mechanisms linking ACEs to mental health in young adulthood. This study aims to identify early adversity patterns using expanded ACEs items and investigate the pathway of ACEs and self-esteem to depressive symptoms in young adulthood. METHODS Data were obtained from the National Longitudinal Study of Adolescent and Adult Health, including a nationally representative sample in the U.S. (N = 10,702). We identified the ACEs patterns and estimated the direct and indirect associations between ACEs and depressive symptoms through self-esteem, using a latent class analysis with a distal outcome. RESULTS This study identified four distinct groups of ACEs that include Child Maltreatment, Household Dysfunction, Violence, and Low Adversity. The Child Maltreatment class showed a significantly higher risk of depressive symptoms compared to other ACEs groups. Self-esteem mediated the negative association of child maltreatment with depressive symptoms. The Violence class presented a significantly higher risk of depressive symptoms than Low Adversity, but no mediation of self-esteem was found. CONCLUSION The study highlights the profound consequence of child abuse/neglect and identifies self-esteem as a plausible mediating mechanism. Researchers and practitioners should increase collaboration efforts to prevent early adversity exposures and detrimental effects on mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, PO Box 842027, Richmond, VA 23220 USA
| | - Haenim Lee
- Department of Social Welfare and Counselling, Dongguk University, 30 Pildong-ro 1gil, Jung-gu, Seoul, South Korea 04629
| | - Aely Park
- Department of Social Welfare, Sunchon National University, 255 Jungang-ro, Suncheon, Jeonnam, South Korea 57922
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17
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Li S, Wang R, Thomas E, Jiang Z, Jin Z, Li R, Qian Y, Song X, Sun Y, Zhang S, Chen R, Wan Y. Patterns of adverse childhood experiences and depressive symptom trajectories in young adults: A longitudinal study of college students in China. Front Psychiatry 2022; 13:918092. [PMID: 35958653 PMCID: PMC9358020 DOI: 10.3389/fpsyt.2022.918092] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk. OBJECTIVE We aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students. METHODS A school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories. RESULTS We identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05). CONCLUSIONS The findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
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Affiliation(s)
- Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Rui Wang
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Erica Thomas
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Yan Qian
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Xianbing Song
- Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
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18
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The latent structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in a general population sample from USA: A factor mixture modelling approach. J Anxiety Disord 2022; 85:102497. [PMID: 34785481 DOI: 10.1016/j.janxdis.2021.102497] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
The validity of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), as measured by the International Trauma Questionnaire (ITQ; Cloitre et al., 2018) has been supported in many factor analytic and mixture modelling studies. There is, however, a paucity of research investigating the latent structure of the ITQ using factor mixture modelling (FMM). FMM was applied to data collected from a nationally representative sample of U.S. adults (N = 1834). FMM results demonstrated strong support for a two-factor second-order model with four qualitatively distinct latent classes: a 'PTSD class', a 'CPTSD class', a 'DSO' (Disturbances in Self-Organisation) class and a 'low symptoms class'. Sexual abuse increased likelihood of membership to the 'CPTSD' (OR = 3.22) and physical abuse decreased likelihood of membership to the 'PTSD' (OR=0.51). Trauma exposure in adulthood predicted 'PTSD' and 'CPTSD' class membership. The 'CPTSD class' was characterised by higher levels of psychopathological co-morbidities and poorer psychological wellbeing compared to all other classes. Results provide additional support for the validity of PTSD and CPTSD as measured by the ITQ.
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19
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Elma JHL, Hautalab D, Abrahamson-Richardsa T, Wallsb ML. Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes. CHILD ABUSE & NEGLECT 2021; 122:105326. [PMID: 34627041 PMCID: PMC8784163 DOI: 10.1016/j.chiabu.2021.105326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/29/2021] [Accepted: 09/03/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Extensive research demonstrates that Adverse Childhood Experiences (ACEs) are highly interconnected and have numerous health consequences well into adulthood. Yet, there is a dearth of focused research that examines ACEs and health inequities for American Indians (AIs). OBJECTIVE To assesses the prevalence of ten types of childhood adversities, explore constellations of exposures, and examine whether there are differential risks of mental health outcomes according to sub-group classification. PARTICIPANTS AND SETTING Adult AIs with type 2 diabetes from five reservation-based tribal communities in the Great Lakes region of the U.S. METHODS Prevalence was estimated using a modified version of the World Health Organization's ACE-International Questionnaire. To examine heterogeneity in ACEs exposures, latent class analysis was used. Risk of mental health outcomes was calculated by class. RESULTS The four most common ACEs reported were residing with someone who abused substances, witnessing household violence, incarceration of a household member, and sexual abuse. Three latent classes were identified: low risk (56.7%), family maladjustment with high probabilities of household violence, incarceration, and substance abuse (27.1%), and complex trauma (16.3%) with moderate to high probabilities of exposure to all ACEs. The most consistent differences in mental health outcomes were between the low risk and complex trauma classes. CONCLUSIONS Identification of a high number of participants in the low-risk class helps structure a more wholistic image of AI families, as negative stereotypes of AIs are abundant. For the minority of individuals in the complex trauma class, risk for chronic mental health challenges and co-morbidities appears to be high.
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Affiliation(s)
- Jessica H L Elma
- University of Washington, United States of America; Johns Hopkins University, United States of America.
| | - Dane Hautalab
- University of Washington, United States of America; Johns Hopkins University, United States of America
| | | | - Melissa L Wallsb
- University of Washington, United States of America; Johns Hopkins University, United States of America
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20
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Haahr-Pedersen I, Hyland P, Hansen M, Perera C, Spitz P, Bramsen RH, Vallières F. Patterns of childhood adversity and their associations with internalizing and externalizing problems among at-risk boys and girls. CHILD ABUSE & NEGLECT 2021; 121:105272. [PMID: 34438263 DOI: 10.1016/j.chiabu.2021.105272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Different types of childhood adversity often cluster and overlap, underlining the importance of studying likely patterns of adversity co-occurrences and their impact on child functioning. Further sex-specific investigations of adversity co-occurrences and their associations with child mental health are warranted. OBJECTIVE To investigate if different sex-specific patterns of childhood adversity exist among at risk-children living in Denmark and to explore if divergent constellations of adversity are differentially associated with externalizing and internalizing problems. PARTICIPANTS AND SETTING Participants (N = 2198) were a sample of children ages 1-17 who have been in contact with the Danish child protection system due to suspected child abuse. The study included existing data collected as a part of child case procedures. METHOD Latent class analysis was used to identify patterns of adversity co-occurrences among girls and boys, respectively. Inter-class differences on age and child mental health were assessed using ANOVAs. RESULTS Greater variation and complexity in adversity exposure was found among girls (5 classes) compared to boys (3 classes). The female classes differed on age (p < .001, η2 = 0.06), internalizing (p < .001, η2 = 0.05), and externalizing problems (p = .002, η2 = 0.02). The male classes differed on internalizing (p < .001, η2 = 0.02) and externalizing problems (p < .001, η2 = 0.04). Overall, classes characterized by multiple adversities displayed higher scores of mental health problems compared to less exposed classes. CONCLUSIONS Exposure to multiple adversities is common among at-risk children. Information on different sex-specific patterns of adversity co-occurrences can guide intervention planning for affected children.
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Affiliation(s)
- Ida Haahr-Pedersen
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland; ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark; The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | - Philip Hyland
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland; Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Maj Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Camila Perera
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland
| | - Pernille Spitz
- The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | | | - Frédérique Vallières
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland.
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21
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Wang P, Kelifa MO, Yu B, Yang Y. Classes of childhood adversities and their associations to the mental health of college undergraduates: a nationwide cross-sectional study. Environ Health Prev Med 2021; 26:73. [PMID: 34273939 PMCID: PMC8286578 DOI: 10.1186/s12199-021-00993-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Childhood adversities pose deleterious consequences on health and well-being, but limited studies explore whether unique patterns of adverse childhood experiences (ACEs) impact the mental health of emerging adults and the mediating role of current stressful events (CSEs). This study examined classes of ACEs and how they relate to CSEs, psychological distress, and subjective well-being among Eritrean College undergraduates. Methods Cross-sectional data on ACEs, CSEs, symptoms of psychological distress, and subjective well-being were collected from a national sample of college students (N = 507). We identified ACE patterns using latent class analysis and further examined whether CSEs mediated the effects of ACE classes on psychological distress and subjective well-being. Results 86.4% of the sample experienced at least one ACE. Collective violence, domestic violence, and physical abuse were the most common ACEs. Three subgroups, low ACEs (66.3%), household violence (19.1%), and multiple ACEs (14.6%) were identified. We found that relative to low ACEs, household violence (β = 0.142, 95% CI 0.046, 0.248) and multiple ACEs (β = 0.501, 95% CI 0.357, 0.666) indirectly influenced psychological distress through CSEs, and CSEs mediated the relationships between household violence (β = −0.096, 95% CI −0.176, −0.033), multiple ACEs (β = −0.338, 95% CI −0.498, −0.210), and subjective well-being. However, there were nonsignificant relative direct effects of ACE patterns on both psychological distress and subjective well-being. Conclusions Experiencing multiple ACEs and household violence in conjunction with CSEs significantly predict psychological distress and subjective well-being. Contextual interventions for the early identification of ACEs and the management of CSEs may play a crucial role in the prevention of mental health problems. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00993-7.
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Affiliation(s)
- Peigang Wang
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China
| | - Mohammedhamid Osman Kelifa
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China.,Orotta College of Medicine and Health Sciences, Asmara, Meakel, Eritrea
| | - Bin Yu
- Department of Surgery, Duke University, Durham, NC, 27710, USA
| | - Yinmei Yang
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China.
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22
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Cloitre M, Hyland P, Prins A, Shevlin M. The international trauma questionnaire (ITQ) measures reliable and clinically significant treatment-related change in PTSD and complex PTSD. Eur J Psychotraumatol 2021; 12:1930961. [PMID: 34211640 PMCID: PMC8221157 DOI: 10.1080/20008198.2021.1930961] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The International Trauma Questionnaire (ITQ) is a validated measure that assesses ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). An important task is to determine whether the ITQ is an appropriate evaluative measure for clinical trials. Objective: To assess the psychometric properties of the ITQ in the context of treatment and determine if the ITQ measures reliable and clinically significant change over the course of a psychosocial intervention. Method: Analyses were based on data from an online skills training programme delivered to 254 U.S. Veterans. Reliability and validity of the ITQ scores were assessed at baseline. Changes in symptom scores and probable diagnostic rates were compared at pre-, mid- and post-treatment. A reliable change index (RCI) score was computed to classify participants as improved, unchanged, or worsened. The PCL-5 was used as a comparison measure. Results: Baseline concurrent and factorial validity was similar to previous studies. Internal consistency at each assessment was excellent and comparable to the PCL-5. Decline in symptoms from pre-to-post-treatment was significant for PTSD and CPTSD symptom profiles. Rate of probable disorder (PTSD or CPTSD) declined significantly from pre-treatment to post-treatment. Pre-to-post treatment declines exceeded the critical RCI values for the ITQ. Clinically significant changes were observed where most participants improved, some stayed the same, and few worsened. The performance of the ITQ was consistent with the PCL-5 regarding sensitivity to change. Conclusion: This study provides the first demonstration that the ITQ measures reliable and clinically significant treatment-related change of ICD-11 PTSD and CPTSD symptoms.
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Affiliation(s)
- Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Philip Hyland
- Department of Psychology, National University of Ireland Maynooth, Kildare, Ireland.,Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland
| | - Annabel Prins
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Shevlin
- School of Psychology Derry, Ulster University, Coleraine, Northern Ireland
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23
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Relational adverse childhood experiences questionnaire: development and retrospective validation among young Iranian people. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01874-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Choi H, Lee W, Hyland P. Factor structure and symptom classes of ICD-11 complex posttraumatic stress disorder in a South Korean general population sample with adverse childhood experiences. CHILD ABUSE & NEGLECT 2021; 114:104982. [PMID: 33561718 DOI: 10.1016/j.chiabu.2021.104982] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 01/16/2021] [Accepted: 01/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACE) are known as risk factors for poor adulthood mental health, including ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). While many studies focused on the association of ACE and CPTSD, examining variant symptom patterns related to ACE is lacking. OBJECTIVE This study aimed to identify the factorial validity of the ICD-11 CPTSD and its distinctive symptom classes in Korean adults with ACE from a representative community sample and examine the risk factors and clinical symptoms that distinguish the CPTSD symptom classes. METHODS We conducted a cross-sectional retrospective study with the International Trauma Questionnaire data from 800 adult general population with ACE histories. A confirmatory factor analysis, latent class analysis, analysis of variance and multinomial logistic regression were conducted. RESULTS Results of confirmatory factor analysis supported a six-factor correlation model, while a two-factor higher-order model with PTSD and disturbances in self-organization (DSO) as correlated constructs also showed excellent fit. A latent class analysis identified six classes, including a distinctive ICD-11 CPTSD and PTSD, additionally a DSO with sense of threat, a DSO, an emotion dysregulation, and a low symptom class, showing distinguished features in ACE patterns, lifetime trauma, depression, somatization, panic disorder, and subtypes of dissociation. CONCLUSIONS The factorial and discriminant validity of ICD-11 CPTSD for Korean ACE survivors were confirmed. Recognizing the pervasive impact of patterns of ACEs and lifetime trauma would be helpful in access to and delivery of appropriate mental health services. Variation in symptom presentations of CPTSD and the role of dissociation should be of concern, that it may bring complicated life outcomes to people with ACEs.
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Affiliation(s)
- Hyunjung Choi
- Department of Psychology, Chungbuk National University, Cheongju, South Korea.
| | - Wooyeol Lee
- Department of Psychology, Chungbuk National University, Cheongju, South Korea
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
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Caravaca-Sánchez F, Aizpurua E, Stephenson A. Substance Use, Family Functionality, and Mental Health among College Students in Spain. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:221-231. [PMID: 33463401 DOI: 10.1080/19371918.2020.1869134] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mental health symptoms are overrepresented among college students worldwide. The current research investigates the associations among substance use, family functionality, and mental health (depression, anxiety, and stress) among college students in Spain. A total of 828 (59.2% female and 40.8% male) college students from two public universities completed a self-reported online survey that included items on demographic information, substance use (alcohol, tobacco, cannabis, cocaine, prescription sedatives, and recreational sedatives), mental health symptoms (using the DASS-21 questionnaire) and family functionality (using the APGAR questionnaire). College students reporting substance use (especially recreational sedatives) and family dysfunctionality were more likely to exhibit symptoms of depression, anxiety and stress. These findings provide support for the underlying role of substance use and family functionality on mental health symptoms. Treatments targeting depression, anxiety, and stress among college students in Spain should aim to reduce substance use by and increase family support of students.
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Affiliation(s)
| | - Eva Aizpurua
- School of Law, Trinity College Dublin. The University of Dublin, Dublin, Ireland
| | - Andrew Stephenson
- Center for Social and Behavior Research, University of Northern Iowa, Cedar Falls, Iowa, USA
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Rink J, Lipinska G. Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample. Eur J Psychotraumatol 2020; 11:1818965. [PMID: 33282146 PMCID: PMC7685205 DOI: 10.1080/20008198.2020.1818965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Both post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) have been included in the 11th edition of the International Classification of Diseases (ICD-11). Although the validity of CPTSD has been controversial, a growing number of studies support the distinction between PTSD and CPTSD. However, the majority of this research has originated in high-income countries (HICs), whereas the prevalence of trauma experience associated with PTSD/CPTSD diagnosis is significantly higher in low- and middle-income countries (LMICs). Objective: This study assessed whether a sample from an LMIC setting produced distinct classes that reflect ICD-11 criteria for PTSD and CPTSD. Furthermore, this study investigated whether childhood trauma distinguished between PTSD and CPTSD. Method: International Trauma Questionnaire responses from a sample of South African university undergraduates were used as indicator variables in a latent class analysis (LCA). Chi-squared tests of independence and Kruskal-Wallis H tests were used to assess between-class differences. Results: The LCA identified four distinct classes: a PTSD class with elevated symptoms of PTSD, but low endorsement of disturbances in self-organization (DSO; symptoms that are specific to CPTSD); a CPTSD class with elevated symptoms of PTSD and DSO; a DSO class with low symptoms of PTSD, but elevated symptoms of DSO; and a Low class with low endorsements on all symptoms. Regarding childhood trauma, participants in the CPTSD class had more severe childhood abuse and neglect, specifically emotional abuse and neglect, than participants in the PTSD class. Conclusions: Findings were consistent with the distinction between PTSD and CPTSD symptom profiles in the ICD-11. Our findings support a similar qualitative distinction between PTSD and CPTSD in our LMIC context, as previously reported in HICs. This distinction is especially relevant in LMICs because of the significant number of individuals vulnerable to these disorders.
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Affiliation(s)
- James Rink
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT), Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Gosia Lipinska
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT), Department of Psychology, University of Cape Town, Cape Town, South Africa
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