The role of adverse childhood experiences and mental health care use in psychological dysfunction of male multi-problem young adults

Effects of expanded adverse childhood experiences including school bullying, childhood poverty, and natural disasters on mental health in adulthood

The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14-9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50-64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21-27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged.

Can adverse childhood experiences predict chronic health conditions? Development of trauma-informed, explainable machine learning models

Introduction

Decades of research have established the association between adverse childhood experiences (ACEs) and adult onset of chronic diseases, influenced by health behaviors and social determinants of health (SDoH). Machine Learning (ML) is a powerful tool for computing these complex associations and accurately predicting chronic health conditions.

Methods

Using the 2021 Behavioral Risk Factor Surveillance Survey, we developed several ML models-random forest, logistic regression, support vector machine, Naïve Bayes, and K-Nearest Neighbor-over data from a sample of 52,268 respondents. We predicted 13 chronic health conditions based on ACE history, health behaviors, SDoH, and demographics. We further assessed each variable's importance in outcome prediction for model interpretability. We evaluated model performance via the Area Under the Curve (AUC) score.

Results

With the inclusion of data on ACEs, our models outperformed or demonstrated similar accuracies to existing models in the literature that used SDoH to predict health outcomes. The most accurate models predicted diabetes, pulmonary diseases, and heart attacks. The random forest model was the most effective for diabetes (AUC = 0.784) and heart attacks (AUC = 0.732), and the logistic regression model most accurately predicted pulmonary diseases (AUC = 0.753). The strongest predictors across models were age, ever monitored blood sugar or blood pressure, count of the monitoring behaviors for blood sugar or blood pressure, BMI, time of last cholesterol check, employment status, income, count of vaccines received, health insurance status, and total ACEs. A cumulative measure of ACEs was a stronger predictor than individual ACEs.

Discussion

Our models can provide an interpretable, trauma-informed framework to identify and intervene with at-risk individuals early to prevent chronic health conditions and address their inequalities in the U.S.

Adverse childhood experiences and residential care environment: The mediating role of trauma-related symptoms and psychological maladjustment in adolescents

BACKGROUND

Research has consistently found poorer outcomes in adolescents who have been exposed to early interpersonal adversities, especially those in out-of-home placements. The presence of mental health problems also contributes to the perception of a more negative group climate and peer interactions through cascading effects.

OBJECTIVE

To analyze the sequential relationships between exposure to adverse childhood experiences (ACEs), trauma-related symptoms, psychological maladjustment, and the perception of group climate and peer interactions. In addition, the study analyzes the mediating role of trauma-related symptoms and psychological maladjustment.

PARTICIPANTS AND SETTING

The sample comprised 161 adolescents in out-of-home care (46.6 % males, 49.7 % females, 3.7 % non-binary), aged 12-18 (M = 15.22, SD = 1.59) from 24 residential facilities in Spain.

METHODS

This study is part of the VRINEP project. Group care workers reported about ACEs and trauma-related symptoms through online questionnaires, whereas adolescents self-reported about psychological maladjustment, group climate, and peer interactions.

RESULTS

Differential associations between ACEs with trauma-related symptoms and internalizing problems were found. The relationship between certain ACEs and externalizing problems was fully mediated by trauma-related symptoms. Likewise, psychological maladjustment was related to a more negative perception of the group climate and peer interactions. Although trauma-related symptoms were not directly associated with the perception of the residential environment, they were indirectly associated with peer relational aggression through externalizing problems.

CONCLUSIONS

Mental health has a significant impact on the perception of the group climate and peer interactions among adolescents in residential care who have been exposed to ACEs.

Sexual orientations in association between childhood maltreatment and depression among undergraduates in mainland of China

BACKGROUND

There is growing evidence that sexual minorities including lesbian, gay, bisexual and questioning individuals (LGBQ) have significantly higher rates of childhood maltreatment than heterosexuals. However, few studies focused on the association between different type of childhood maltreatment and depression in LGBQs.

METHODS

Cross-sectional study by random sampling was conducted among the undergraduates in mainland of China. A total of 1920 undergraduates from different majors and colleges completed self-report questionnaires to record depression, childhood maltreatment, sexual orientation and other related information. The associations were examined via a set of logistic regression analysis.

RESULTS

Compared to the participants who had never experienced childhood maltreatment, the participants who reported emotional abuse (p < 0.001) and sexual abuse (p < 0.05) had higher odds of depression. The LGBQs have higher risk of being the victims of childhood maltreatment. The prevalence of depression was much higher in the LGBQ than that in the heterosexuals (33.9 % vs 16.1 %, χ2 = 43.627, p < 0.001). Compared to heterosexual adolescents, LGBQs had significantly higher odds of depression (p < 0.001).

LIMITATIONS

Cross-sectional design, self-reported information, and unable to examine underlying protective factors.

CONCLUSIONS

Emotional abuse, emotional neglect and sexual abuse have stronger association with LGBQ than other kind of childhood maltreatment. Emotional abuse and sexual abuse have stronger association with depression. Sexual abuse has stronger association with depression in LGBQs than heterosexuals. More attention to the mental health should be paid especially in LGBQs to reduce the risk of depression.

Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring

The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.

Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction as an Adverse Childhood Experience

BACKGROUND

This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE).

METHODS

A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11-19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses. Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications.

RESULTS

The higher levels of Attention problems (β = -0.228, P < 0.001) and externalizing problems (β = -0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel's T: Z = -5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD.

CONCLUSION

This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Sexual and gender minority adverse childhood experiences (SGM-ACEs), perceived social support, and adult mental health

BACKGROUND

Building on decades of research into the long-term developmental impacts of adverse childhood experiences (ACEs), researchers have called for expanding the ACEs framework to include experiences specific to minoritized identities. Recent empirical research has led to the development of a measure of sexual and gender minority adverse childhood experiences (SGM-ACEs). Within the SGM-specific ACEs framework, research on the long-term impact to adult mental health and the role of perceived social support are not well studied.

OBJECTIVE

The purpose of this paper was two-fold. First, examine whether SGM-ACEs adversely impact mental health in SGM adults. Second, examine the role of perceived social support in the association between SGM-ACEs and adult mental health.

PARTICIPANTS AND SETTING

Data were collected using a multifaceted sampling strategy. In total, 1819 self-identified SGM Texans completed an online survey inquiring about ACEs, SGM-ACEs, mental health, and demographic characteristics.

RESULTS

We estimated two competing structural equation models (SEM) examining the associations between SGM-ACEs and anxiety and depressive symptoms, and whether perceived social support may moderate or mediate his association. While both models demonstrated that SGM-ACEs were significantly associated with higher anxiety and depressive symptoms. However, we found more support for the mediation model such that SGM-ACEs had direct effects on anxiety and depressive symptoms, and an indirect effect on anxiety symptoms through family support.

CONCLUSIONS

Our findings confirmed that exposure to SGM-ACE is associated with poorer adult mental health. Additionally, SGM-ACEs exposure undermines SGM individuals' perceptions of family support, which increases symptoms of anxiety.

Substance Use Outcomes For Sexual and Gender Minority Adults With a History of Adverse Childhood Experiences: A Scoping Review

Purpose

The impacts of Adverse Childhood Experiences (ACEs) on behavioral, mental, and physical health have been extensively investigated. As such, it is paramount to synthesize their quantified effects, especially within vulnerable populations. The goal of this scoping review was to collect, summarize, and synthesize existing research on ACEs and substance use (SU) in adult sexual and gender minority (SGM) populations.

Methods

WebofScience, APA PsychInfo, LGBTQ+ Life (EBSCO), Google Scholar, and PubMed electronic databases were searched. We included reports published between 2014 and 2022 that assessed SU outcomes, ACEs in adult (18+) SGM populations, in the United States (US). We excluded those in which SU was not an outcome, measured community-based abuse or neglect, or investigated adulthood trauma. Data were extracted using the Matrix Method and categorized across three SU outcomes.

Results

Twenty reports were included in the review. Nineteen employed a cross-sectional design and 80% focused on a single SGM group (transgender women, bisexual Latino men, etc.). Nine of 11 manuscripts found SU frequency and quantity were higher among ACE exposed participants. Three of four studies found ACE exposure to correlate with substance use problems and substance misuse. Four of five studies found ACE exposure to be correlated with substance use disorders.

Conclusions

Longitudinal research is needed to comprehend the impact of ACE on SU within the diverse subgroups of SGM adults. Investigators should prioritize the use of standard operationalizations of ACE and SU to improve comparability across studies and include diverse samples from the SGM community.

Effects of school connectedness on the relationship between child maltreatment and child aggressive behavior: A mediation analysis

BACKGROUND

Children growing up in a vulnerable and unstable family environment including child maltreatment, poor family functioning, and low social-economic status, are at higher risk of developing undesirable behavioral outcomes compared to peers in the general population. School life plays a critical role during the development of adolescents.

OBJECTIVE

The purpose of this study is to examine the role of school connectedness in the relationship between child maltreatment and aggressive behavior.

PARTICIPANTS AND SETTING

This study employed the Fragile Family and Child Well-being Study - Year 15. The final analytic sample size is 2285 families.

METHODS

Mediation analyses were conducted to evaluate the impact of CPS on child aggressive behavior mediated by school connectedness using OLS regression with robust standard errors. The bootstrap was used to estimate the standard error of the indirect effect.

RESULTS

The total effect of CPS contact on child aggressive behaviors was 0.14 (p < .001). The direct effect of CPS contact on child aggressive behavior was 0.13 (p < .001). The indirect effect, that school connectedness significantly mediated the relationship between CPS and child aggressive behavior, was tested and found statistically significant (Coef. = 0.01, p < .05).

CONCLUSIONS

Findings of the mediation model suggest that interventions targeted at improving school connectedness among adolescents involved in the child welfare system may promote positive outcomes by reducing aggressive behaviors among youth growing in fragile families. On-going trainings are needed for schoolteachers and social workers to better engage adolescents with child maltreatment at school.

The Role of Childhood Abuse and Psychological Symptoms in Discriminating Frequency of Drug Use and Self-Harm in Incarcerated Men Convicted of Robbery

The aim of the present study was to investigate the role of prior childhood abuse and current psychological symptoms on the frequency of drug use and self-harming behavior among a group of male prisoners convicted of robbery. The sample consists of 127 men convicted of armed, aggravated, unarmed/forced robbery, who were held in Metris T-type closed penitentiary state correctional institution. History of childhood abuse was assessed with The Childhood Trauma Questionnaire (CTQ) and psychological symptoms were assessed with The Brief Symptom Inventory (BSI). Frequency of drug use was assessed with three questions and self-harm was assessed through four questions both on the self-completed demographic information form. Among 127 men recruited, history of childhood abuse and psychological symptoms provided discrimination concerning frequency of drug use and self-harm. The rate of self-harming individuals in the present study was relatively high compared to the literature. There was a significant correlation between CTQ total and subscale scores and BSI total and subscale scores, except for the emotional neglect subscale.

Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care

For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.

Brief report: Free-living physical activity levels and cognitive control in multi-problem young adults

Previous studies indicate a positive association between physical activity and cognitive control in sedentary but healthy adults, yet not much is known about physical activity levels in multi-problem young adults. We examined the level of self-reported free-living physical activity (i.e., MET minutes per week) in an ecologically valid sample of young adults facing multiple problems, including unemployment, lack of education, frequent substance use, and history of delinquency. We compared cognitive control with an age- and sex-matched control sample. Additionally, the association between physical activity and cognitive control (i.e., response inhibition, error processing, interference effect) in the multi-problem group was examined. Physical activity and cognitive control were measured with the International Physical Activity Questionnaire-Long Form and three cognitive control experiments (i.e., Flanker, Go/NoGo, Stroop), respectively. With M = 4428 Metabolic Equivalents (METs), our multi-problem sample (n = 63) showed physical activity levels similar to the age- and sex-matched control sample from the general population (n = 62). The multi-problem young adults also showed impaired cognitive control indexed as decreased response inhibition and decreased Flanker correctness effect compared to their peers. We could not find an association between self-reported physical activity and cognitive control in the multi-problem sample. Due to the small sample size, results should be interpreted with caution. However, future dose-response studies could still use these results to further examine if within-individual increased physical activity may possibly lead to improved cognitive control in (already relatively active) multi-problem young adults.

Adverse childhood experiences and mental health conditions among multiracial adolescents

OBJECTIVE

The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children's Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents.

DESIGN

We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12-17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework.

RESULTS

Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents.

CONCLUSIONS

Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents' ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.

Development and psychometric properties of the sexual and gender minority adverse childhood experiences (SGM-ACEs): Effect on sexual and gender minority adult mental health

BACKGROUND

Research has consistently shown a relationship between adverse childhood experiences (ACEs) and poor mental health outcomes, and recent research shows that sexual and gender minority (SGM) individuals are at increased risk for ACEs. Moreover, SGM individuals may experience unique ACEs. Increased risk for exposure to traditional and SGM-specific ACEs are related to heterosexism.

OBJECTIVE

The purpose of this paper is two-fold. First, establish the need for an SGM specific ACEs framework that accounts for exposure to heterosexism. Second, assess the psychometric properties of the SGM-ACEs scale.

PARTICIPANTS AND SETTING

Data were collected using a multifaceted sampling strategy. In total, 1725 self-identified SGM Texans completed an online survey about ACEs, SGM-ACEs, mental health diagnoses, and demographic characteristics.

RESULTS

The most commonly reported SGM-ACEs were seeing or hearing of other SGM being physical harmed (71.2%), being bullied in school for being SGM (67.9%), and hearing religious leaders say homophobic, biphobic, or transphobic things (60.8%). The EFA showed that 7-items loaded onto a single factor and the CFA indicated a good model fit, with items showing a significant factor loading higher than 0.60. SGM-ACE showed adequate to good psychometric properties and predicted depression (AOR = 1.49, CI = 1.20, 1.86), anxiety (AOR = 1.61, CI = 1.25, 2.00), and PTSD (AOR = 1.97, CI = 1.47, 2.66), when controlling for ACEs and demographic factors.

CONCLUSIONS

The 7-item SGM-ACEs measure is a psychometrically sound and unidimensional measure that can be quickly used to assess common adverse childhood experiences related to heterosexism.

The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity

Human capital—that is the cumulative abilities, education, social skills, and mental and physical health one possesses—is increasingly recognized as key to the reduction of inequality in societies. Adverse childhood experiences have been linked to a range of human capital indicators, with the majority of research in high-income, western settings. This study aims to examine the link between adverse childhood experiences and adult human capital in a South African birth cohort and to test whether associations differ by measurement of adversity. Secondary analysis of data from the Birth to Thirty study was undertaken. Exposure data on adversity was collected prospectively throughout childhood and retrospectively at age 22. Human capital outcomes were collected at age 28. Adversity was measured as single adverse experiences, cumulative adversity, and clustered adversity. All three measurements of adversity were linked to poor human capital outcomes, with risk for poor human capital increasing with the accumulation of adversity. Adversity was clustered by quantity (low versus high) and type (household dysfunction versus abuse). Adversity in childhood was linked to a broad range of negative outcomes in young adulthood regardless of how it was measured. Nevertheless, issues of measurement are important to understand the risk mechanisms that underlie the association between adversity and poor human capital.

Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life

The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.

E-Health in the Prevention of Drug Abuse in Adolescents: A Literature Review

Introduction: Electronic Health (E-Health) is the delivery of health services through the Web or on a computer. It has many advantages, and this application can be accessed in real-time. Therefore, with this system approach, drug abuse in adolescents can be prevented through smartphone devices. Various E-Health applications are also created, such as Health literacy, E-Health Lifestyle, Telemental Health, and even suicide risk applications called crisis care. Methods: This literature search used the Pubmed database, Science direct, and Proquest through the keywords "e-health, drugs, and adolescents", the articles found are filtered over the last ten years, open access, and not a type of review. Result: The Pubmed, Science Direct, and Proquest databases found 55,654 articles and then filtered based on inclusion and exclusion criteria, then a total of 5 articles were reviewed. Conclusion: E-Health can reduce drug abuse, be easily accessible, low cost, real-time, and provide complete information. Therefore, adolescents and their parents can directly consult or practice health literacy that affects their knowledge growth.

Occurrence of Psychiatric Disorders, Self-Sufficiency Problems and Adverse Childhood Experiences in a Population Suspected of Violent Extremism

BACKGROUND

Public health-inspired programs for Countering Violent Extremism (CVE) have developed internationally in a relatively short period of time. Research into these programs is scarce. There is a need for information that helps drive public health interventions.

OBJECTIVES

To present data on the occurrence of psychiatric disorders, self-sufficiency problems and adverse childhood experiences (ACE) in a population suspected of violent extremism.

METHODS

A cross-sectional study, with data from screening reports for 34 adult subjects included in a multi-agency case-based approach on violent extremism in Amsterdam, the Netherlands. Subjects were screened in the period between December 2015 to May 2021. Screening reports, which included the Screener for Intelligence and Learning Disabilities (SCIL) and the Dutch version of the Self-sufficiency Matrix (SSM-D), were used to gather information on the main outcome measures.

RESULTS

Major psychiatric disease categories were found to be mood and anxiety disorders and mild intellectual disability (each 29.4%), substance related disorders (35.3%), personality disorders (41.2%), and psychotic disorders (14.7%). Complex self-sufficiency problems, measured by the number of people who had self-sufficiency problems in 4+ domains and the number of people who had similar self-sufficiency problems as homeless people in Amsterdam, were found in 35.3 and 32.4% of the client sample. The most prevalent ACE were emotional neglect (47.1%), household mental illness (44.1%), and loss of a parent (38.2%), 35.3% had been exposed to 4+ ACE. An association was found between N_ACE and self-sufficiency problems on two domains, namely "Mental Health" (rho = 0.51, p = 0.002) and "Law and order" (rho = 0.42, p = 0.013).

CONCLUSIONS

An accumulation of social and psychiatric problems in people suspected of violent extremism underlines the importance of professionals in health and social care being actively involved in developing CVE approaches.

The Longitudinal Interplay Between Social Network and Psychopathology in Multi-Problem Young Adult Men; Separating Within-and Between-Person Effects

Young adulthood is characterized by many life changes. Especially for young men with problems across different life domains (i.e., multi-problem), these changes may entail obstacles. Incidences of psychopathology increase during young adulthood and at the same time important shifts in social networks - such as changing relations with peers and parents, isolation, or deviant peer affiliation - take place. The present study examined the longitudinal interplay between psychopathology and social network characteristics over the course of 1 year in multi-problem young adults, at both between-person and within-person level. A sample of 696 multi-problem young adult men (age 18-27) participated in this three wave study. We used traditional cross-lagged panel models (CLPM) to examine how social network characteristics and psychopathology are related at the between-person level, and random intercept cross-lagged panel models (RI-CLPM) to examine within-person links. Between-person associations between internalizing problems and social networks were bidirectional, and externalizing problems were related to problematic social network characteristics, but not vice versa. At the within-person level, no such cross-lagged paths were found. Overall, results indicated that in multi-problem young adults, social network characteristics and psychopathology are related. However, looking at within-person processes this relation is not reciprocal.

A Review of Predictors of Psychosocial Service Utilization in Youth with Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood disorders. Professional practice guidelines recommend combined treatment, psychopharmacological and psychosocial, for youth with ADHD. There have been multiple reviews of pharmacological prescription practices and utilization, however, less is known about predictors of ADHD psychosocial service utilization. Given the importance of accessing psychosocial treatment in relation to improving functional impairment, this review synthesizes evidence on predictors of ADHD psychosocial intervention utilization in clinic, community, and school settings. Eighteen studies were identified and included in the review. Findings are summarized across informant profile factors, predisposing characteristics, and barriers and facilitators. The most robust findings were for the impact of symptom severity/impairment, the presence of comorbidities, and age on ADHD psychosocial service utilization. Race/ethnicity, sex, parental knowledge of the disorder and insurance coverage were also identified as key factors. Future avenues of research are provided, and clinical and policy implications targeted at reducing psychosocial treatment disparities in youth with ADHD are discussed.

Disentangling multiproblem behavior in male young adults: A cluster analysis

Multiproblem young adults present with major problems across key life domains, but empirical studies investigating the nature of multiproblem behavior in accordance to ecobiodevelopmental theory are scarce. To address this gap, we performed a cluster analysis on indicators spanning the key life domains addiction, mental health, social network, and justice. In a large sample (N = 680) of multiproblem young adults, we identified five subgroups labeled "severe with alcohol and cannabis problems" (4.3%), "severe with cannabis problems" (25.6%), "severe without alcohol or drug problems" (33.2%), "moderate with mental health problems" (22.9%), and "moderate without mental health problems" (14.0%). There were large differences between the severe and moderate groups in terms of childhood risk factors such as emotional and physical abuse, concerning baseline functioning such as comorbid disorders and aggressive behavior, and in the outcome measure of violent offending. Our findings indicate that multiproblem young adult behavior clusters within profiles that differ according to the severity and nature of problems. Investing in screening for clustered problems may be beneficial for early problem differentiation and selection of appropriate intervention before and during treatment programs.

The roles of child maltreatment types and peer relationships on behavior problems in early adolescence

BACKGROUND

Although previous research has established that child maltreatment (CM) and peer relationships (i.e., deviant peer affiliation, being ignored by peers) are strong predictors of adolescent internalizing (INT) and externalizing (EXT) behavior problems, no study has examined the above effects concurrently. Nor have researchers investigated the potential peer relationship differences in the effects of CM types on adolescent behavior problems. Thus, this study aims to examine the independent and combined effects of different types of CM and peer relationships on behavior problems.

METHODS

The Generalized Estimating Equations approach was conducted using the Longitudinal Studies of Child Abuse and Neglect. Child-Protective-Services reports and youth self-reports were used for each type of CM. Deviant peer affiliation (DP) has been assessed using a modified version of the Youth-Risk-Behavior-and-Monitoring-the-Future Survey, while being ignored by peers was assessed using a single question. Adolescent INT and EXT were measured using the Youth-Self-Report.

RESULTS

Emotional abuse was associated with both INT and EXT, whereas physical abuse was associated with EXT. Higher DP and higher incidence of being ignored by peers were both associated with higher levels of INT and EXT. Emotionally abused youth with higher levels of DP had less INT, compared to emotionally abused youth with lower levels of DP.

CONCLUSION

The Findings indicate the need for interventions that 1) take into account the different effects of CM types, specifically for emotionally abused youth; 2) help youth to build positive relationships with peers; and 3) work to reduce the possibility of affiliation with deviant peers.

A Systematic Review of Household and Family Alcohol Use and Childhood Neurodevelopmental Outcomes in Low- and Middle-Income Countries

Childhood exposure to alcohol misuse by household adults has been related to childhood developmental delay, cognitive impacts, mental illness, and problem behaviours. Most evidence comes from high income countries. This systematic review only included studies from low- and middle-income countries (LMICs). Five databases were searched from 1990-2020. Twenty-eight studies of children 0-12 years were included, with 42,599 participants from 11 LMICs. The most common outcome was behavioural problems/disorders (19 studies). Despite varying study designs, this review found that alcohol misuse by household members in LMICs is associated with adverse child neurodevelopmental outcomes, although casual inferences cannot be drawn in the absence of well conducted prospective studies. Statistically significant correlations were described between parental alcohol misuse and child emotional and behavioural difficulties, cognitive delay, and risky behaviours. In future, prospective cohort studies are recommended, with adjustment for confounders.

Exposure to Adverse Childhood Experiences (ACEs) and Stress among the Community-based Urban Pediatric Population in Korea

BACKGROUND

This study aimed to investigate the impact of exposure to adverse childhood experiences (ACEs) and stress among the community-based urban pediatric population in Korea.

METHODS

In 2017, the analysis was conducted on 3,937 children and adolescents in an urban area in Korea based on the impact of actual traumatic experience, addiction, and mental health. The respondents were excluded if they were missing data on the survey, resulting in a final sample size of 3,556. The collected data were analyzed by applying cross-sectional and correlation analyses.

RESULTS

Among the respondents in the study group (mean age = 13.77), 43.1% were boys (n = 1,532) and 56.9% were girls (n = 2,024). Overall, 23.5% (n = 835) reported at least one ACE and 1.8% (n = 63) reported experiencing four or more ACEs. Emotional abuse (13.2%) was the most commonly reported ACE, followed by abandonment (7.7%) and physical abuse (7.5%). Self-reported measures of stress were associated with the ACE scores.

CONCLUSION

This is the first study of self-reported ACEs from a community-based pediatric population in Korea. We found that the number of the students revealed more than one ACEs was similar to the data in the US community study with self-reporting among the community samples and exposure to adverse experiences is highly correlated with various stress responses.

Neurocognitive predictors of treatment completion and daytime activities at follow-up in multiproblem young adults

Previous research has shown an association between cognitive control deficits and problematic behavior such as antisocial behavior and substance use, but little is known about the predictive value of cognitive control for treatment outcome. The current study tests whether selected markers of baseline cognitive control predict (1) treatment completion of a day treatment program involving a combination of approaches for multiproblem young adults and (2) daytime activities a year after the start of treatment, over and above psychological, social, and criminal characteristics. We assessed individual, neurobiological, and neurobehavioral measures, including functional brain activity during an inhibition task and two electroencephalographic measures of error processing in 127 male multiproblem young adults (age 18-27 years). We performed two hierarchical regression models to test the predictive power of cognitive control for treatment completion and daytime activities at follow-up. The overall models did not significantly predict treatment completion or daytime activities at follow-up. However, activity in the anterior cingulate cortex (ACC) during response inhibition, years of regular alcohol use, internalizing problems, and ethnicity were all significant individual predictors of daytime activity at follow-up. In conclusion, cognitive control could not predict treatment completion or daytime activities a year after the start of treatment over and above individual characteristics. However, results indicate a direct association between brain activity during response inhibition and participation in daytime activities, such as work or school, after treatment. As adequate baseline inhibitory control is associated with a positive outcome at follow-up, this suggests interventions targeting cognitive control might result in better outcomes at follow-up.