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Perez N, He N, Wright F, Condon E, Weiser S, Aouizerat B. Social determinants of inflammatory markers linking depression and type 2 diabetes among women: A scoping review. J Psychosom Res 2024; 184:111831. [PMID: 38905780 DOI: 10.1016/j.jpsychores.2024.111831] [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: 03/14/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. METHODS PubMed, CINAHL, PsychINFO, and Web of Science were searched March-July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. RESULTS Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-α, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n = 6) or health system level (n = 0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. CONCLUSION The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity.
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Affiliation(s)
- Nicole Perez
- New York University, Rory Meyers College of Nursing, 433 1(st) Ave, New York, NY 10010, USA.
| | - Ning He
- New York University, Silver School of Social Work, 1 Washington Squire North, New York, NY 10003, United States of America.
| | - Fay Wright
- Northwell Health Northern Westchester Hospital, 400 East Main Street, Mt Kisco, NY 10549, United States of America.
| | - Eileen Condon
- University of Connecticut, College of Nursing, 231 Glenbrook Rd, Storrs, CT 06269, United States of America.
| | - Sheri Weiser
- University of San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, United States of America.
| | - Brad Aouizerat
- New York University, College of Dentistry, 345 E 24th St, New York, NY 10010, United States of America; University of San Francisco, School of Pharmacy, 513 Parnassus Ave, San Francisco, CA 94143, United States of America.
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Hiscock H, Kabir A, Honisett S, Morris T, Constable L, Forell S, Woolfenden S, Goldfeld S, Jorm A. Identifying Service, Research and Policy priorities for preventing the impacts of family adversity on children's mental health: An Australian national resource allocation study with professional and lived experience experts. Aust N Z J Public Health 2024; 48:100184. [PMID: 39217838 DOI: 10.1016/j.anzjph.2024.100184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/08/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES The objective of this study was to develop Service, Research and Policy priorities to prevent the impact of family adversity on child mental health and determine comparative priorities of diverse stakeholders to those with lived experience of adversity. METHODS Value-weighting approach conducted in a staged process: (i) professionals and experts with lived experience from health, education, justice and social care sectors attended a national symposium to identify priorities for family adversity and mental health and (ii) a subsequent resource allocation survey gathered views from participants and external experts on symposium priorities. RESULTS Consensus was reached on priorities. Service priorities included establishing intersectoral hubs for children and families and early childhood nurse home-visiting programs. Research priorities included scaling up evidence-based interventions and evaluating cross-sector, flexible funding models for services addressing childhood adversity. Policy priorities included developing evidence-based policies with evaluation and implementation plans and flexible funding models to support integrated care. CONCLUSIONS Our results provide detailed and actionable clarity on next steps to address family adversities. IMPLICATIONS FOR PUBLIC HEALTH The priorities call for a focus on cross-sectoral approaches to preventing or mitigating the effects of family adversity. The current Australian policy environment provides a timely opportunity to action the proposed interventions.
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Affiliation(s)
- Harriet Hiscock
- Health Services and Economics, Murdoch Children's Research Institute, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Ashraful Kabir
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Suzy Honisett
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Tamara Morris
- School of Clinical Medicine, University of New South Wales, Sydney, 2031, Australia
| | - Leanne Constable
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Suzie Forell
- Health Justice Australia, Sydney, NSW, 2000, Australia; School of Law, University of New South Wales, Australia
| | - Sue Woolfenden
- Community Paediatrics, Sydney Local Health District, Australia; Community Paediatrics, Central Clinical School, Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, 2006, Australia
| | - Sharon Goldfeld
- Policy and Equity, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, 3052, Australia; Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Anthony Jorm
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Victoria, 3010, Australia
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Cain SM, Rooney EA, Cacace S, Post A, Russell K, Rasmussen S, Baker JC, Cramer RJ. Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis. BMC Public Health 2024; 24:2052. [PMID: 39080601 PMCID: PMC11290251 DOI: 10.1186/s12889-024-19448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 07/11/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat). METHOD Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence. RESULTS Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs. CONCLUSIONS Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.
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Affiliation(s)
- Shannon M Cain
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Emily A Rooney
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Samantha Cacace
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Abigail Post
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Kirsten Russell
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Robert J Cramer
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
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Loveday S, Chen L, Constable LN, Kabir A, White N, Goldfeld S, Sanci L, Hiscock H. Opening Pandora's box - key facilitators of practice change in detecting and responding to childhood adversity - a practitioner perspective. BMC Pediatr 2024; 24:461. [PMID: 39026201 PMCID: PMC11256471 DOI: 10.1186/s12887-024-04918-5] [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: 04/16/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Childhood adversities worsen physical and mental health across the lifespan. Health and social care practitioners play a key role in identifying and responding to childhood adversity, however, may be reluctant to do so due to a perceived lack of services to refer to, time pressures and a deficit of training and confidence. We aimed to (1) quantify changes in practitioner comfort and confidence to identify and respond to childhood adversity following a multimodal intervention within an integrated child and family health and social care hub and (2) to understand barriers and facilitators of practice change. METHODS Hub practitioners were surveyed about their competence and comfort to directly ask about and confidence to respond to adversity at baseline and then at six and twelve months post training. Interviews were undertaken to explore practitioner barriers and enablers of practice change. Interviews were recorded, transcribed verbatim, and analysed using reflexive thematic analysis. The theoretical domains framework was used to identify the key drivers of practice change. RESULTS Fifteen of 18 practitioners completed all three surveys and 70% reported increased competence and comfort to directly ask, and confidence to respond across a range of adversities over the 12-month intervention. Twenty-one practitioners completed interviews. Six themes were identified as either facilitators or barriers to practice change. Facilitator themes included (1) connection matters, (2) knowledge provides assurance, (3) confidence in ability and (4) choosing change. Barrier themes were (1) never enough time and (2) opening Pandora's box. Following analysis, key drivers of practice change were 'social influence', 'belief in capability', 'knowledge' and 'behaviour regulation' while barriers to practice change were 'environmental context and resources' and 'emotion'. CONCLUSIONS Practitioners reported improved confidence in identifying and responding to adversity through a multimodal intervention delivered in an integrated Child and Family Hub. Changing practice requires more than just education and training. Opportunities for social connection and coaching to improve self-confidence and perceived competence are needed to overcome the fear of opening Pandora's box.
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Affiliation(s)
- Sarah Loveday
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Lingling Chen
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Leanne N Constable
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ashraful Kabir
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Natalie White
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Parkville, VIC, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
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Fares-Otero NE, Seedat S. Childhood maltreatment: A call for a standardised definition and applied framework. Eur Neuropsychopharmacol 2024; 87:24-26. [PMID: 39024857 DOI: 10.1016/j.euroneuro.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Natalia E Fares-Otero
- Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain.
| | - Soraya Seedat
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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Calik A, Liu HM, Montgomery A, Honisett S, Van Munster KA, Morris T, Eapen V, Goldfeld S, Hiscock H, Eastwood J, Woolfenden S. Moving from idea to reality: The barriers and enablers to implementing Child and Family Hubs policy into practice in NSW, Australia. Health Res Policy Syst 2024; 22:83. [PMID: 39010121 PMCID: PMC11247851 DOI: 10.1186/s12961-024-01164-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/23/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs. METHODS Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30-60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR). RESULTS Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care. CONCLUSIONS This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.
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Affiliation(s)
- Anna Calik
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.
| | - Huei Ming Liu
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Alicia Montgomery
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia
| | - Suzy Honisett
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia
| | - Kerri-Anne Van Munster
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia
| | - Tamara Morris
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia
- Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health/Faculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Sharon Goldfeld
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- The Royal Children's Hospital, Victoria, Australia
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- The Royal Children's Hospital, Victoria, Australia
- Health Services and Economics, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia
| | - John Eastwood
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia
| | - Susan Woolfenden
- Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
- Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.
- Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Yang L, Zheng J, Luo Y. The longitudinal association between adverse childhood experiences, childhood socioeconomic status, and lung function among middle-aged and older adults. CHILD ABUSE & NEGLECT 2024; 153:106858. [PMID: 38797117 DOI: 10.1016/j.chiabu.2024.106858] [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: 08/29/2023] [Revised: 03/01/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES This study aims to investigate the association between adverse childhood experiences (ACEs), childhood socioeconomic status (SES) with lung function among general Chinese middle-aged and older adults. METHODS Participants at baseline were 9052 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS), a population-based cohort of Chinese adults. Analyses were conducted with data from three waves (2011, 2013, and 2015). The ACEs included five threat-related indicators (i.e., physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and five deprivation-related adversities (i.e., emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death). The cumulative score of threat-related and deprivation-related ACEs was used for analysis. Lung function was assessed by peak expiratory flow (PEF). Two-level linear mixed growth models were used to evaluate the longitudinal association between and ACEs, childhood SES, and PEF. RESULTS Participants with more than three deprivation-related ACEs were significantly associated with lower PEF (b = -11.45 L/min, 95%CI: -18.40, -4.49) after adjusting for multiple confounding factors. Threat-related ACEs were not associated with PFF. Father's illiterate education predicted lower lung function (b = -8.49 L/min, 95%CI: -11.68, -5.31) for all middle-aged and older adults while mother's illiterate education was only significantly associated with PEF among the men (b = -9.21 L/min, 95%CI: -18.20, -0.22), and middle-aged adults (b = -7.96 L/min, 95%CI: -14.35, -1.57). DISCUSSION ACEs and disadvantaged childhood SES are important predictors of lower lung function during adulthood. Reducing ACEs and improving childhood SES may be beneficial for long-term health development.
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Affiliation(s)
- Lei Yang
- School of Public Administration, Beihang University, Beijing 100191, China; Charity and Social Innovation Studies, Beihang University, Beijing 100191, China
| | - Junhao Zheng
- School of Public Administration, Beihang University, Beijing 100191, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing 100191, China; Institute for Global Health and Development, Peking University.
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Barcelona V, Condon EM, Jacoby SF. Leveraging biosocial methods to examine and address structural determinants of health and promote health equity. Nurs Outlook 2024; 72:102195. [PMID: 38810533 PMCID: PMC11330731 DOI: 10.1016/j.outlook.2024.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Biosocial approaches in nursing research have largely focused on the ways that social determinants of health influence individual-level outcomes, including symptom management, family and social support, and educational interventions. PURPOSE Theoretical, methodological, and practical strategies are needed to expand current biosocial methods for nursing science and focus on upstream, structural determinants of health and the policies that underlie health inequities. METHODS This paper summarizes presentations given at the 2023 Council for the Advancement of Nursing Science Advanced Methods Conference, Biosocial Methods to Advance Health Equity, in a panel titled "Individual, community, systems and policy related to biosocial methods." DISCUSSION Nurses are uniquely positioned to examine upstream, structural determinants of health by leveraging expertise in biosocial methods, collaborating with interdisciplinary researchers and community members, and advocating for policy change. By conducting theory-grounded biosocial research, nurse researchers can significantly advance scientific knowledge and promote health equity for individuals and communities. CONCLUSION Nurse scientists are conducting research using biosocial methods and provide recommendations for expansion of this approach in the field.
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Affiliation(s)
| | - Eileen M Condon
- University of Connecticut School of Nursing, Storrs, CT; Department of Pediatrics, University of Connecticut School of Medicine, Storrs, CT
| | - Sara F Jacoby
- Department of Family and Community, University of Pennsylvania School of Nursing, Philadelphia, PA
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Dickie DT, Langhinrichsen-Rohling J, McAnulty RD. College students' adverse childhood experiences and their anticipated risky behaviors: Early maladaptive schemas and emotion regulation difficulties as potential mediators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38917370 DOI: 10.1080/07448481.2024.2369854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
Objective: This study explicates the relationship between college student's adverse childhood experiences (ACEs) and their anticipated engagement in five types of risky behaviors. Two transdiagnostic mechanisms were tested cross-sectionally: disconnection/rejection early maladaptive schemas (cognitive) and difficulties in emotional regulation (emotional). Participants: 521 college student participants were majority female (66.8%), White (57.2%), freshman (54.9%), and heterosexual (72.2%). Methods: Participants completed an online, self-report, survey. Pearson bivariate correlations and parallel mediation analyses were conducted. Results: Sixty percent of students endorsed at least one ACE. Among the total sample, disconnection/rejection schemas partially mediated the relationship between ACEs and anticipated engagement in irresponsible academic/work behaviors, drug use, aggressive/illegal activities, and heavy drinking. Difficulties in emotion regulation partially mediated anticipated risky sexual activities and irresponsible academic/work behaviors. Sex differences were noted. Conclusions: Preventing irresponsible academic activity and other risky behaviors is critically important to college students, parents, and administrators. Intervention efforts should address cognitive and emotional mechanisms.
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Affiliation(s)
- Daniel T Dickie
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Richard D McAnulty
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
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Mercera G, Vervoort-Schel J, Offerman E, Pronk S, Wissink I, Lindauer R. Prevalence of Adverse Childhood Experiences in Adolescents with Special Educational and Care Needs in the Netherlands: A Case-File Study of Three Special Educational and Care Settings. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:541-554. [PMID: 38938950 PMCID: PMC11199457 DOI: 10.1007/s40653-024-00613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 06/29/2024]
Abstract
To date, Adverse Childhood Experiences (ACEs) in adolescents with special educational and care needs have received little attention as an important risk factor for their behavioral, emotional, and learning problems. This study provides insight into ACE prevalence and family risk factors in three Dutch special educational and care settings for vulnerable school-aged youth. 268 adolescents (10-18 years old) with severe and persistent problems at individual and family level, from a special educational setting (setting 1; n = 59), a residential care setting (setting 2; n = 86) and an alternative educational setting (setting 3; n = 123) were included. A retrospective cross-sectional study design was used. Data were collected between 2016 and 2019 through structured case-file analysis. A substantial proportion of the adolescents in all settings experienced at least one ACE, with 69.5% in setting 1, 84.9% in setting 2 and 95.1% in setting 3. Family risk factors were relatively common, among which a limited social network in all settings (20-50%) and debts in setting 2 and 3 (25-40%). The substantial ACE prevalence underlines the need for early ACE awareness. Trauma-informed care and education are needed to adequately understand trauma-related behaviors, prevent retraumatization, and enhance learning and healthy development. Given that ACEs regarding household dysfunction and family risk factors seem to be common in adolescents with special educational and care needs, family centered approaches should be implemented as well in the interest of lifelong health and well-being for both adolescents and their families.
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Affiliation(s)
- Gabriëlle Mercera
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, Oisterwijk, 5062 JT The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB The Netherlands
| | - Jessica Vervoort-Schel
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, Oisterwijk, 5062 JT The Netherlands
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, 1018 WS The Netherlands
| | - Evelyne Offerman
- Orion, Special Education, Bijlmerdreef 1289-2, Amsterdam 1103 TV The Netherlands
| | - Sanne Pronk
- Academic Workplace Youth at Risk (AWRJ), Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inge Wissink
- Department of Clinical Child & Family Studies, Utrecht University, Heidelberglaan 1, Utrecht, 3584 CS The Netherlands
| | - Ramón Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, Amsterdam, 1105 AZ The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ The Netherlands
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11
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Helland Lindborg T, Kristensson Hallström I, Synnøve Litland A, Åvik Persson H. Adolescent boys' experiences of mental health and school health services - an interview study from Norway. BMC Public Health 2024; 24:1464. [PMID: 38822302 PMCID: PMC11143580 DOI: 10.1186/s12889-024-18952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 05/24/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys' experiences of mental health and school health service. METHODS An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study. RESULTS The overall theme "barriers towards seeking help", and three categories- navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking-described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness. CONCLUSIONS Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.
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Affiliation(s)
- Tonje Helland Lindborg
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | | | - Helene Åvik Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, Lund, SE, 221 00, Sweden.
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12
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Miguel-Alvaro A, Messman BA, Weiss NH, Contractor AA. Do childhood experiences influence associations between posttraumatic stress disorder symptoms and positive autobiographical memories among military veteran students? An exploratory study. Memory 2024; 32:540-551. [PMID: 38727529 PMCID: PMC11262963 DOI: 10.1080/09658211.2024.2348685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Evidence links posttraumatic stress disorder (PTSD) symptoms and features of positive autobiographical memories (accessibility, vividness, coherence, sharing, emotional intensity, distancing). There is a knowledge gap on how adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) may influence these relationships. OBJECTIVES The current study explored whether the number ACEs or BCEs moderated associations between PTSD symptom severity and features of positive autobiographical memories. DESIGN AND METHODS The sample included 124 student military veterans who had experienced a trauma (Mage = 33.90; 77.4% male; 75.0% White). RESULTS Path analyses showed more PTSD symptom severity was significantly associated with less positive autobiographical memory vividness (β = -0.26, p = .019, R2 = 0.06). Further, the number of ACEs moderated the relationship between PTSD symptom severity and positive autobiographical memory accessibility (β = -0.25, p = .023, R2 = 0.10) and vividness (β = -0.20, p = .024, R2 = 0.10). Among individuals with more ACEs (1 SD above the mean) compared to those with fewer ACEs (1 SD below the mean), less accessibility and vividness of positive autobiographical memories was associated with greater PTSD symptom severity. The number of BCEs was not a significant moderator. CONCLUSIONS Positive memory-based interventions may be particularly useful to address PTSD symptoms among military veterans with a history of childhood adversity.
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Affiliation(s)
| | - Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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13
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Sahle BW, Reavley NJ, Morgan AJ, Yap MBH, Reupert A, Jorm AF. How much do adverse childhood experiences contribute to adolescent anxiety and depression symptoms? Evidence from the longitudinal study of Australian children. BMC Psychiatry 2024; 24:289. [PMID: 38632617 PMCID: PMC11022337 DOI: 10.1186/s12888-024-05752-w] [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: 02/16/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
This study aims to: (i) examine the association between adverse childhood experiences (ACEs) and elevated anxiety and depressive symptoms in adolescents; and (ii) estimate the burden of anxiety and depressive symptoms attributable to ACEs.Data were analyzed from 3089 children followed between Waves 1 (age 4-5 years) and 7 (16-17 years) of the Longitudinal Study of Australian Children. Logistic regression was used to estimate the associations between ACEs and child-reported elevated anxiety and depressive symptoms at age 16-17. Anxiety and depressive symptoms were measured using the Children's Anxiety Scale and Short Mood and Feelings Questionnaire, respectively. The punaf command available in STATA 14 was used to calculate the population attributable fraction (PAF).Before the age of 18 years, 68.8% of the children had experienced two or more ACEs. In the analysis adjusted for confounding factors, including co-occurring ACEs, both history and current exposure to bullying victimisation and parental psychological distress were associated with a statistically significant increased likelihood of elevated anxiety and depressive symptoms at age 16-17. Overall, 47% of anxiety symptoms (95% CI for PAF: 35-56) and 21% of depressive symptoms (95% CI: 12-29) were attributable to a history of bullying victimisation. Similarly, 17% (95% CI: 11-25%) of anxiety and 15% (95% CI: 4-25%) of depressive symptoms at age 16-17 years were attributable to parental psychological distress experienced between the ages of 4-15 years.The findings demonstrate that intervention to reduce ACEs, especially parental psychological distress and bullying victimisation, may reduce the substantial burden of mental disorders in the population.
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Affiliation(s)
- Berhe W Sahle
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, VIC, 3010, Australia.
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Marie Bee Hui Yap
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, VIC, 3010, Australia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Andrea Reupert
- Faculty of Education, Monash University, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, VIC, 3010, Australia
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14
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Bates RA, Dynia JM. Psychological and Physiological Stress and Stressors in Early Childhood Educators: An Observational Pilot Study. PSYCHOLOGY IN THE SCHOOLS 2024; 61:1413-1439. [PMID: 38933217 PMCID: PMC11198965 DOI: 10.1002/pits.23118] [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: 03/03/2023] [Accepted: 11/21/2023] [Indexed: 06/28/2024]
Abstract
While early childhood educators' mental health is important, it may also affect the well-being and education of their students. Yet, little research has described the stress and stressors of early childhood educators (ECEs), particularly as the pandemic wanes. This pilot study aimed to (1) describe ECEs' psychological and physiological stress and (2) examine the association between ECEs' psychological and physiological stress levels with stressors. A convenience sample of 67 ECEs, serving children 0-5 years old from 13 early educational centers completed surveys on psychological stress (perceived stress, anxiety, and depression), stressors (economic hardship, food insecurity, adverse childhood experiences), and demographics in Fall 2021. A subsample of ECEs provided hair samples, analyzed for cortisol, to estimate physiologic stress. Regarding stress, 63% met the criteria for major depressive disorder and 41% for generalized anxiety disorder. Only 26% were taking medications to manage mental health. About 25% experienced the stressors of food insecurity and economic hardship; 80% experienced at least one adverse childhood experience. Only education level significantly predicted perceived stress and depression - above and beyond stressors, household income, race, and age. The results have policy and practice implications for implementing evidence-based solutions to buffer stress and stressors in early childhood educators.
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Affiliation(s)
- Randi A. Bates
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
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15
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Denhard L, Brown C, Kanagasabai U, Thorsen V, Kambona C, Kamagate F, Ramphalla P, Benevides R, Kamami M, McOwen J, Augusto A, Manuel P, Coomer R, Matthews S, Patel P, Annor FB. Service-seeking behaviors among male victims of violence in five African countries: The effects of positive and adverse childhood experiences. CHILD ABUSE & NEGLECT 2024; 150:106452. [PMID: 37704546 PMCID: PMC11244758 DOI: 10.1016/j.chiabu.2023.106452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Violence against boys and men is widely under-reported. Boys and men face unique and gendered barriers to accessing services following experiences of violence. PARTICIPANTS AND SETTING The study is a secondary data analysis of five nationally representative population-based Violence Against Children and Youth Surveys (VACS) conducted in Kenya (2019), Côte d'Ivoire (2018), Lesotho (2018), Mozambique (2019), and Namibia (2019). Analysis was limited to males between 18 and 24 years who experienced lifetime physical or sexual violence. OBJECTIVE AND METHODS We analyzed the association between positive and adverse childhood experiences (PCEs and ACEs), and seeking post-violence services among males using bivariate chi-squared tests and multivariable logistic regression. RESULTS 8.02 % (5.55-10.50 %) of male victims between the ages of 18 and 24 sought services for any lifetime physical or sexual violence. Witnessing interparental violence and experiencing death of one or both parents were each associated with increased odds of having sought post-violence services (aOR 2.43; 95 % CI: 1.25-4.79; aOR 2.27; 95 % CI: 1.14-4.50), controlling for education, violence frequency, and violence type. High parental monitoring was associated with increased odds of service seeking (aOR 1.79; 95 % CI: 1.02-3.16), while strong father-child relationship was associated with lower odds (aOR 0.45; 95 % CI: 0.23-0.89). CONCLUSION These findings contribute to limited research on service-seeking behaviors among men and boys. While some parent-youth relationship factors were associated with higher odds of service-seeking, the outcome remained rare. Age and gender-related barriers should be addressed where post-violence care services are offered.
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Affiliation(s)
- Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Côte d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Regina Benevides
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
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16
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 PMCID: PMC11238702 DOI: 10.1016/j.chiabu.2024.106701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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17
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Gilbert LK, Annor FB, Brown C, Dube SR. Introduction to the child abuse and neglect special issue "epidemiology, risk factors, and impacts of adverse childhood experiences in low- and middle-income countries.". CHILD ABUSE & NEGLECT 2024; 150:106748. [PMID: 38508913 PMCID: PMC11237978 DOI: 10.1016/j.chiabu.2024.106748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Affiliation(s)
- Leah K Gilbert
- Eunice Kennedy Shriver Pediatric Trauma and Critical Illness Branch, National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States of America.
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Colvette Brown
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Shanta R Dube
- Levine College of Health Sciences, Department of Public Health, Wingate University, Wingate, NC, United States of America
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18
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Wang X, Jiang L, Barry L, Zhang X, Vasilenko SA, Heath RD. A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges. TRAUMA, VIOLENCE & ABUSE 2024; 25:1695-1708. [PMID: 37594222 DOI: 10.1177/15248380231192922] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.
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19
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Silke C, Heary C, Bunting B, Devaney C, Groarke A, Major E, Durcan M, O'Brien C, Brady B. Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022. J Affect Disord 2024; 349:234-243. [PMID: 38163570 DOI: 10.1016/j.jad.2023.12.065] [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: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022). METHODS Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277). RESULTS Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide. LIMITATIONS These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings. DISCUSSION Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Ireland.
| | | | | | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Ireland
| | | | - Emmet Major
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Ireland
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20
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Erato G, Shreffler KM, Ciciolla L, Quigley A, Addante S. Maternal childhood adversity and pregnancy intentions as predictors of pregnancy happiness. J Reprod Infant Psychol 2024; 42:180-193. [PMID: 35819014 PMCID: PMC9834437 DOI: 10.1080/02646838.2022.2097208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/28/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Nearly half of all pregnancies in the U.S. are classified as unintended (e.g. unplanned, mistimed, or unwanted), which have been linked to numerous adverse consequences for maternal and child outcomes. Recent evidence suggests that happiness about a pregnancy is often a better predictor of maternal and infant health outcomes than pregnancy intentions, but few studies have examined maternal predictors of pregnancy happiness. METHODS Using a clinic-based sample of pregnant women (n = 177), we apply multiple regression analysis to examine the association between maternal adverse childhood experiences and pregnancy happiness, as well as the moderating role of pregnancy intentions. RESULTS Women with more childhood adversity and pregnancies that were unplanned and mistimed or unwanted reported lower levels of pregnancy happiness, compared with women with less childhood adversity and intended pregnancies. However, pregnancy intentions did not moderate the relationship between maternal adverse childhood experiences and pregnancy happiness. CONCLUSION Our results suggest that pregnancy happiness is lower among mothers with a history of childhood adversity and pregnancies classified as unplanned and mistimed or unwanted. Understanding the factors that impact pregnancy happiness is critical to inform prenatal clinical practice and health policy, particularly when caring for those with a history of adversity.
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Affiliation(s)
- Gina Erato
- Department of Psychology, Oklahoma State University
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21
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Reynolds A, Greenfield EA, Williams-Butler A. Early life adversity, race, and childhood socioeconomic status: intersecting drivers of later life cognition. Aging Ment Health 2024; 28:511-519. [PMID: 37572032 PMCID: PMC10859546 DOI: 10.1080/13607863.2023.2242296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/06/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES Research on associations between early life adversity (ELA) and later life cognition has yielded mixed results and generally have not considered how broader societal systems of stratification potentially influence associations. The current study addresses this gap by exploring if racialized identity and childhood socioeconomic status (cSES) moderate associations between ELA exposure and later life cognition. METHODS Using data from the Health and Retirement Study (Waves 2010-2018), we used growth curve modeling to examine if the confluence of ELA, cSES, and racialized identity is associated with cognition. RESULTS Among White participants, greater exposure to ELA was associated with poorer baseline cognitive functioning, and higher cSES buffered against this association. Among Black participants, exposure to ELA was not associated with baseline cognitive functioning, regardless of cSES. We did not find evidence of any associations between main predictors nor their interactions with change in cognition over time. CONCLUSIONS This study provides evidence that associations between ELA and later life cognition is contingent upon multiple social positions in the United States. These findings support the importance of integrating insights on intersecting social positions within life-course-oriented efforts to reduce racialized cognitive disparities.
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Affiliation(s)
- Addam Reynolds
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
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22
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Cheung CK, Miller KA, Goings TC, Thomas BN, Lee H, Brandon RE, Katerere-Virima T, Helbling LE, Causadias JM, Roth ME, Berthaud FM, Jones LP, Ross VA, Betz GD, Simmons CD, Carter J, Davies SJ, Gilman ML, Lewis MA, Lopes G, Tucker-Seeley RD. BIPOC experiences of (anti-)racist patient engagement in adolescent and young adult oncology research: an electronic Delphi study. Future Oncol 2024; 20:547-561. [PMID: 38197386 PMCID: PMC10988539 DOI: 10.2217/fon-2023-0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
Aims: To characterize Black, Indigenous and People of Color (BIPOC) adolescent and young adult (AYA) cancer patients' experiences of patient engagement in AYA oncology and derive best practices that are co-developed by BIPOC AYAs and oncology professionals. Materials & methods: Following a previous call to action from AYA oncology professionals, a panel of experts composed exclusively of BIPOC AYA cancer patients (n = 32) participated in an electronic Delphi study. Results: Emergent themes described BIPOC AYA cancer patients' direct experiences and consensus opinion on recommendations to advance antiracist patient engagement from BIPOC AYA cancer patients and oncology professionals. Conclusion: The findings reveal high-priority practices across all phases of research and are instructional for advancing health equity.
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Affiliation(s)
| | - Kimberly A Miller
- Department of Preventive Medicine and Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Bria N Thomas
- Temple University School of Podiatric Medicine, Philadelphia, PA 19107, USA
| | - Haelim Lee
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Rachel E Brandon
- University of Michigan School of Social Work, Ann Arbor, MI 48109, USA
| | | | - Laura E Helbling
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - José M Causadias
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ 85287, USA
| | - Michael E Roth
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - Valentina A Ross
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | - Gail D Betz
- University of Maryland Baltimore Health Sciences & Human Services Library, Baltimore, MD 21201, USA
| | - Cole D Simmons
- Bryn Mawr Graduate School of Social Work and Social Research, Bryn Mawr, PA 19010, USA
| | - Jay Carter
- University of Maryland School of Social Work, Baltimore, MD 21201, USA
| | | | - Megan L Gilman
- AYA Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mark A Lewis
- Department of Gastrointestinal Oncology, Intermountain Healthcare, Salt Lake City, UT, 84107 USA
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Trompeter N, Testa A, Raney JH, Jackson DB, Al-Shoaibi AAA, Ganson KT, Shao IY, Nagata JM. The Association Between Adverse Childhood Experiences (ACEs), Bullying Victimization, and Internalizing and Externalizing Problems Among Early Adolescents: Examining Cumulative and Interactive Associations. J Youth Adolesc 2024; 53:744-752. [PMID: 38066316 PMCID: PMC10838217 DOI: 10.1007/s10964-023-01907-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/14/2023] [Indexed: 02/04/2024]
Abstract
Both adverse childhood experiences (ACEs) and bullying victimization are linked with mental health problems in adolescents. However, little is known about the overlap between the two factors and how this impacts adolescent mental health problems (i.e., internalizing and externalizing problems). The current study analyzed data from 8,085 participants (47.7% female; 44.1% racial/ethnic minority) in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Regression analyses were used to estimate associations between ACEs, bullying victimization and mental health problems, respectively, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site. The findings showed that both ACEs and bullying victimization were independently associated with higher internalizing and higher externalizing problems. However, no significant interaction was found between ACEs and bullying victimization. Overall, the results align with the cumulative risk model of adversity, linking cumulative ACEs and bullying victimization to internalizing and externalizing problems in early adolescents.
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Affiliation(s)
- Nora Trompeter
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Julia H Raney
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Abubakr A A Al-Shoaibi
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Iris Yuefan Shao
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA
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Baker NS, VanHook C, Ziminski D, Semenza D, Lassiter T, Garmon J, Bonne S. What's missing? Violently injured Black men's narratives around Adverse Childhood Experiences (ACEs). CHILD ABUSE & NEGLECT 2024; 149:106644. [PMID: 38237241 DOI: 10.1016/j.chiabu.2024.106644] [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: 08/22/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Adverse childhood experiences have been associated with future outcomes; however, Felitti's 1998 ACEs questionnaire fails to capture the experiences of Black populations living in disinvested neighborhoods making it necessary to expand the ACEs questionnaire to examine the life experiences of violently injured Black men. OBJECTIVE The aim of the study was to advance the understanding of ACEs among Black male firearm violence survivors using the ACEs questionnaire and semi-structured interviews. PARTICIPANTS AND SETTING Ten Black male firearm violence survivors were recruited from an urban HVIP. Case managers conducted recruitment using the HVIP's REDcap database; active and previous HVIP participants were eligible for the study. METHODS A qualitative study design was used to understand the childhood experiences of Black male firearm violence survivors using Felitti's ACEs questionnaire and a semi-structured interview examining perceptions of their childhood experiences. Due to the COVID-19 pandemic, recruitment and interviews were conducted over the phone. RESULTS All participants experienced at least one ACE. Three themes arose from the interviews: youth incarceration, family separation and loss, and housing transition. Men at risk for violent injury experience ACEs beyond those measured in the current instrument.
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Affiliation(s)
- Nazsa S Baker
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States.
| | - Cortney VanHook
- University of Illinois- Urbana-Champaign, School of Social Work, 1010 W Nevada St, Urbana, IL 61801, United States
| | - Devon Ziminski
- Rutgers University-New Brunswick, School of Social Work, 120 Albany St, New Brunswick, NJ 08901, United States
| | - Daniel Semenza
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States; Rutgers University-Camden, Department of Sociology, Anthropology, and Criminal Justice, 405-7 Cooper Street, Camden, NJ 08102, United States
| | - Teri Lassiter
- Rutgers University-Newark, School of Public Health, 1 Riverfront Plaza, Newark, NJ 07102, United States
| | - Jeannie Garmon
- Rutgers University-Camden, 303 Cooper St, Camden, NJ 08102, United States
| | - Stephanie Bonne
- Hackensack University Medical Center, Department of Surgery, 30 Prospect Ave, Hackensack, NJ 07601, United States
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Negriff S, Sidell MA, DiGangi MJ. Adverse childhood experiences screening in healthcare settings: A focus on pediatric primary care. CHILD ABUSE & NEGLECT 2024:106709. [PMID: 38418328 DOI: 10.1016/j.chiabu.2024.106709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) screening in healthcare settings is emerging as one of the tangible responses to address the consistent evidence linking ACEs with health. Kaiser Permanente Southern California (KPSC) began ACEs screening in pediatric primary care in 2018 and has developed screening and referral processes based on continued feedback from stakeholders as well as data driven assessment. OBJECTIVE We give an overview of the state of ACEs screening in pediatric healthcare settings, challenges facing pediatric providers, and suggestions to address them. We then describe the development of our ACEs screening and referral process within KPSC as an example of how a large healthcare system has implemented and adapted ACEs screening from pilot testing, to phased expansion, to complete implementation. PARTICIPANTS AND SETTING Children aged 2-18 years old who were members of KPSC 2018-2023. RESULTS We present data on the tailored screening and referral workflows we have developed, rates of positive screens and referrals, and how the initiation of ACEs screening may affect the rates of visit to behavioral health as a treatment option. We also integrate qualitative data to demonstrate the perspective of parents, with the goal of understanding what might help or hinder receipt of behavioral health treatment after ACEs screening. CONCLUSIONS We close with future directions for ACEs screening in healthcare settings and considerations for pediatric healthcare providers who may want to begin ACEs screening or adapt their screening and referral processes.
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Affiliation(s)
- Sonya Negriff
- Kaiser Permanente Southern California, Department of Research & Evaluation, United States of America.
| | - Margo A Sidell
- Kaiser Permanente Southern California, Department of Research & Evaluation, United States of America
| | - Mercie J DiGangi
- Kaiser Permanente Southern California, Department of Pediatrics, United States of America
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Yu P, Jiang Z, Zheng C, Zeng P, Huang L, Jin Y, Wang K. Variety ACEs and risk of developing anxiety, depression, or anxiety-depression co-morbidity: the 2006-2022 UK Biobank data. Front Psychiatry 2023; 14:1233981. [PMID: 38234367 PMCID: PMC10793109 DOI: 10.3389/fpsyt.2023.1233981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Objectives Adverse childhood experiences (ACEs) and anxiety-depression co-morbidity are attracting widespread attention. Previous studies have shown the relationship between individual psychiatric disorders and ACEs. This study will analyze the correlation between anxiety-depression co-morbidity and different levels of ACEs. Methods Seven categories of ACE and four classifications of psychiatric disorders were defined in a sample of 126,064 participants identified by the UK Biobank from 2006-2022, and correlations were investigated using logistic regression models. Then, to explore nonlinear relationships, restricted spline models were developed to examine differences in sex and age across cohorts (n = 126,064 for the full cohort and n = 121,934 for the European cohort). Finally, the impact of the category of ACEs on psychiatric disorders was examined. Results After controlling for confounders, ACEs scores showed dose-dependent relationships with depression, anxiety, anxiety-depression co-morbidity, and at least one (any of the first three outcomes) in all models. ACEs with different scores were significantly positively correlated with the four psychiatric disorders classifications, with the highest odds of anxiety-depression co-morbidity (odds ratio [OR] = 4.87, 95% confidence intervals [CI]: 4.37 ~ 5.43), p = 6.08 × 10-178. In the restricted cubic spline models, the risk was relatively flat for females at ACEs = 0-1 and males at ACEs = 0-2/3 (except in males, where ACEs were associated with a lower risk of anxiety, all other psychiatric disorders had an increased risk of morbidity after risk smoothing). In addition, the risk of having anxiety, depression, anxiety-depression co-morbidity, and at least one of these disorders varies with each category of ACEs. Conclusion The prevalence of anxiety-depression comorbidity was highest across ACE scores after controlling for confounding factors and had a significant effect on each category of ACEs.
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Affiliation(s)
- Peilin Yu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zhou Jiang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chu Zheng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lihong Huang
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingliang Jin
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ke Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Annett J, Tillson M, Walker M, Webster JM, Staton M. Adverse childhood experiences and mental health among incarcerated women: Self-esteem as a mediating mechanism. CHILD ABUSE & NEGLECT 2023; 146:106486. [PMID: 37788588 PMCID: PMC10841516 DOI: 10.1016/j.chiabu.2023.106486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) and mental health problems are interrelated. However, less is known about this relationship in incarcerated women and how self-esteem impacts this relationship. OBJECTIVE To investigate the relationship between ACEs and mental health problems (traumatic stress, depression, and anxiety) in incarcerated women with opioid use disorder (OUD) and, the possible role of self-esteem as a mediator of the relationship. PARTICIPANTS AND SETTING Incarcerated women (N = 500) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed by research staff. METHODS Regression analyses and mediation models were used to examine the relationship between ACEs, mental health, and self-esteem. RESULTS ACEs were positively correlated with present mental health problems (traumatic stress, r = 0.407, p < .001; depression, r = 0.177, p < .001; and anxiety, r = 0.213, p < .001) and negatively correlated with current self-esteem (r = -0.241, p < .001). Linear regression analyses established that ACEs and self-esteem were significantly related to all three mental health variables of interest. Additionally, self-esteem mediated the relationship between ACEs and mental health. CONCLUSION This study shows that incarcerated women's experiences with ACEs are significantly related to poor mental health. Self-esteem plays a critical role in this relationship.
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Affiliation(s)
- Jaxin Annett
- University of Kentucky College of Education, Department of Educational, School, and Counseling Psychology, 597 S. Upper Street, Lexington, KY 40508, USA; University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Martha Tillson
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Meghan Walker
- University of Kentucky College of Medicine, E 1st Ave, Bowling Green, KY 42101, USA.
| | - J Matthew Webster
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
| | - Michele Staton
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
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Narayan AJ, Merrick JS, Lane AS, Larson MD. A multisystem, dimensional interplay of assets versus adversities: Revised benevolent childhood experiences (BCEs) in the context of childhood maltreatment, threat, and deprivation. Dev Psychopathol 2023; 35:2444-2463. [PMID: 37282577 DOI: 10.1017/s0954579423000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study expanded the Benevolent Childhood Experiences scale (termed the "BCEs-Original" scale) with 10 new multisystem items and identified a subset of items (termed the "BCEs-Revised" scale) that are systematically less commonly reported across samples. Total BCEs-Revised scores were tested against total BCEs-Original scores and three dimensions of childhood adversity (maltreatment, threat, and deprivation) as predictors of young adulthood mental health problems (depression, anxiety, and PTSD symptoms). Hypotheses expected stronger inverse associations of BCEs-Revised scores than BCEs-Original scores with all mental health problems. Participants were 1,746 U.S. young adults (M = 26.6 years, SD = 4.7, range = 19-35 years; 55.3% female, 42.4% male, 2.3% gender non-conforming; 67.0% White, 10.3% Asian, 8.6% Black, 8.4% Latine, 5.7% other) who completed a 20-item BCEs scale and well-validated instruments on childhood adversities and mental health problems. Compared to BCEs-Original scores, BCEs-Revised scores were significantly more strongly inversely associated with all mental health outcomes. Compared to childhood threat and deprivation, maltreatment was significantly more strongly associated with PTSD symptoms. After controlling for current depression symptoms, BCEs-Revised scores interacted with maltreatment to predict PTSD symptoms. Maltreatment and BCEs-Revised scores also influenced PTSD symptoms in person-oriented analyses. The BCEs-Revised scale has strong psychometric properties and unique strengths in research and practice. Implications for multisystem resilience are discussed.
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Affiliation(s)
| | | | - Arianna S Lane
- Department of Psychology, University of Denver, Denver, CO, USA
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30
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Pollmann A, Fritz J, Barker E, Fuhrmann D. Networks of Adversity in Childhood and Adolescence and Their Relationship to Adult Mental Health. Res Child Adolesc Psychopathol 2023; 51:1769-1784. [PMID: 36331717 PMCID: PMC10661796 DOI: 10.1007/s10802-022-00976-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Adverse experiences before the age of eighteen are common and include diverse events ranging from sexual abuse to parental divorce. These stressful experiences have been linked to physical and mental health issues. Previous research has focused mainly on childhood adversity, such as experiences in the family environment. Little consideration has been given to adversities that may be particularly harmful in adolescence. To understand adolescents' adverse experiences, this project used data from the Avon Longitudinal Study of Parents and Children (ALSPAC, total N = 14,901, N ≈ 1,200 - 10,000 per measure). We modelled interrelations of adversities in childhood (1-11 years) and adolescence (11-23 years) and examined adversity clusters using network analysis. We found two similar clusters in the childhood and adolescence networks: (1) direct abuse and (2) adverse family factors. We identified a third cluster of (3) educational and social adversities for adolescence. For both age groups, emotional abuse in the family environment was closely linked to mental health in early adulthood and most adversities were linked with depression in early adulthood. In adolescence, housing and academic issues and abuse by a romantic partner were particularly central to the network of adversities. Thus, we found commonalities and differences in the relevance of adverse experiences at different developmental stages. These findings highlight the need to develop age-dependent frameworks for adversity research and policymaking.
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Affiliation(s)
- Ayla Pollmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK.
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Edward Barker
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, Henry Wellcome Building for Psychology, Denmark Hill Campus, SE5 8AF, London, UK
| | - Delia Fuhrmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK
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Zhang L, Mersky JP, Gruber AMH, Kim JY. Intergenerational Transmission of Parental Adverse Childhood Experiences and Children's Outcomes: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3251-3264. [PMID: 36205317 DOI: 10.1177/15248380221126186] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adverse childhood experiences (ACEs) are among the leading environmental causes of morbidity and mortality. Extending research on within-generation effects, more recent scholarship has explored between-generation consequences of ACEs. Despite growing interest in the intergenerational effects of parents' ACEs on children's outcomes, this line of scholarship has yet to be coalesced into a comprehensive review. The current study is a scoping review on the intergenerational transmission of parental ACEs and children's outcomes. Ten databases such as PubMed, APA PsycArticles, and Social Work Abstracts were searched. To be included, empirical studies must have been published in English and analyzed associations between a cumulative measure of at least four parental ACEs and children's outcomes. Sixty-eight studies qualified for the review and, among these, 60 were published in the most recent 5 years (2018-2022). Fifty-one studies had sample sizes smaller than 500, and 55 focused on the effect of maternal ACEs. Nearly all studies demonstrated that parental ACEs could affect children's outcomes directly or indirectly via mechanisms like maternal mental health problems or parenting-related factors. By scoping the extant literature, this review advances the knowledge base regarding the intergenerational impacts of parental childhood trauma and children's outcomes. It also reveals methodological limitations that should be addressed in future research to strengthen causal inferences along with practical implications for interventions that aim to interrupt the intergenerational transmission of trauma.
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Sikorski C, Mavromanoli AC, Manji K, Behzad D, Kreatsoulas C. Adverse Childhood Experiences and Primary Headache Disorders: A Systematic Review, Meta-analysis, and Application of a Biological Theory. Neurology 2023; 101:e2151-e2161. [PMID: 37879940 PMCID: PMC10663032 DOI: 10.1212/wnl.0000000000207910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Headache disorders are among the leading causes of disability worldwide. While an association between adverse childhood experiences and primary headaches has been reported, the pooled magnitude across studies and pathways of the association are unknown. Our objectives were (1) to estimate the pooled effect of ≥1 adverse childhood experience (ACE) on primary headache disorders in adulthood and (2) to test the hypothesis that ACEs categorized as "threat" traumas or "deprivation" traumas have distinct effects on primary headaches based on a selected theory from our narrative review of how ACEs affect human development along the life course. METHODS PubMed, EMBASE, MEDLINE, Web of Science, Google Scholar, Biological Psychiatry, and gray literature were searched up to March 16, 2023 (PROSPERO, CRD42020223403). Selected articles included (1) observational studies with a comparator group, (2) ACEs that occurred before 18 years of age, and (3) primary headaches occurring at or after 21 years of age. Pooled odds ratios (ORs) were calculated using multilevel linear random-effects modeling. The narrative review included theories that describe how ACEs affect human development and disease across the life course. We selected a theory from our narrative review and tested ACEs categorized according to this theory for any modification of point estimates. RESULTS Our search identified 32 studies, of which 28 were eligible for meta-analysis (n = 154,739 participants, 19 countries). The occurrence of ≥1 adverse childhood experience(s) was associated with primary headaches (pooled OR = 1.48 [95% CI 1.36-1.61]; high-quality evidence, 134,696 participants). As the number of ACEs increased, the odds of primary headaches increased (range: 1 ACE OR = 1.24 [95% CI 1.14-1.35] to ≥4 ACEs OR = 2.09 [95% CI 1.83-2.38], p for trend <0.0001). From the narrative review, a neurodevelopmental theory that categorizes ACEs into threat or deprivation was tested, and both were independently associated with primary headaches (threat OR = 1.46 [95% CI 1.32-1.60] and deprivation OR = 1.35 [95% CI 1.23-1.49], respectively), accounting for heterogeneity (p = 0.021). DISCUSSION This systematic review and meta-analysis confirm that ACEs are important risk factors of primary headache disorders in adulthood. Our findings provide epidemiologic support that ACEs categorized as threat and deprivation may manifest as distinct pathways of early adversity.
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Affiliation(s)
- Claudia Sikorski
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Anna C Mavromanoli
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karishma Manji
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Danial Behzad
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Catherine Kreatsoulas
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
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Islam MM, Rashid M, Rashid M. Adverse childhood experiences and association with poorer health and health-harming behaviours in adulthood among the Americans. Child Care Health Dev 2023; 49:943-954. [PMID: 36772922 DOI: 10.1111/cch.13104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 11/11/2022] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) such as abuse and neglect have an immediate impact on children and are associated with poorer health and behavioural outcomes in adulthood. This study examined the prevalence of ACEs and their association with socio-demographic factors, physical and mental health, morbidity and health-harming behaviours in adulthood among Americans. METHOD Data for the study come from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), covering a sample of 116 032 adult respondents from 22 states of the United States. Descriptive and inferential statistical techniques, including multiple logistic regression models, were employed to analyse the data. RESULTS At least one kind of ACE was found to be quite common among American adults, as 60% of adults had at least one kind of ACE, 22.5% had one ACE and 17% had four or more ACEs during 0-17 years of life. Of the total ACEs, 42.2% were due to abuse (physical, emotional or sexual), and 46% were due to any kind of household dysfunction. There is an increasing trend in ACEs in the United States. Adults with low socio-economic status, female, living in urban areas, gay or bisexual orientation, minority other than White and unemployed had a significantly higher prevalence of ACEs than their counterparts. ACEs were found to be significantly associated with poor physical and mental health; health-harming behaviours such as binge drinking, heavy drinking and smoking; and chronic morbidities. CONCLUSION Programmes aimed at reducing ACEs and mitigating the harms of ACEs among those who have already experienced them should be strengthened to improve public health and quality of life and reduce health-harming behaviours.
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Affiliation(s)
- M Mazharul Islam
- Department of Statistics, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Maieasha Rashid
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Mamunur Rashid
- Department of Mathematical Sciences, DePauw University, Greencastle, Indiana, USA
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Ng AE, Salam Z, Tkach N, Alcalá HE. Adverse Childhood Experiences and Family-Centered Care. JOURNAL OF PREVENTION (2022) 2023; 44:561-578. [PMID: 37380896 DOI: 10.1007/s10935-023-00738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
Adverse Childhood Experiences (ACEs) include experiences of child maltreatment and household dysfunction. Prior work has shown that children with ACEs may have suboptimal utilization of preventive health care, including annual well-visits, however little is known about the relationship between ACEs and quality of patient care. Using data from the 2020 National Survey of Children's Health (N = 22,760) a series of logistic regression models estimated associations between ACEs, both individually and cumulatively, and five components of family-centered care. Most ACEs were consistently associated with lower odds of family-centered care (e.g. financial hardship was associated with doctors always spend enough time with children, AOR = 0.53; 95% CI = 0.47, 0.61), except for having a parent or guardian die, which was associated with higher odds. Cumulative ACE score was also associated with lower odds of family-centered care (e.g. doctors always listened carefully to the parent, AOR = 0.86; 95% CI = 0.81, 0.90). These findings emphasize the importance of the consideration of ACEs in the context of family-centered care, and support the need for ACEs screening in the clinical setting. Future work should focus on mechanisms explaining the observed associations.
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Affiliation(s)
- Amanda E Ng
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Zoha Salam
- Department of Global Health, McMaster University , Hamilton, ON, L8S 4L8, Canada
| | - Nicholas Tkach
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, 11568, USA
| | - Héctor E Alcalá
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA.
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 21201, USA.
- Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, 21201, USA.
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Hall T, Constable L, Loveday S, Honisett S, Schreurs N, Goldfeld S, Loftus H, Jones R, Reupert A, Yap MBH, Woolfenden S, Montgomery A, Dalziel K, Bailey C, Pringle G, Fisher J, Forell S, Eapen V, Haslam R, Sanci L, Eastwood J, Hiscock H. Identifying and responding to family adversity in Australian community and primary health settings: a multi-site cross sectional study. Front Public Health 2023; 11:1147721. [PMID: 37771827 PMCID: PMC10525396 DOI: 10.3389/fpubh.2023.1147721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Background Unaddressed family adversity has potentially modifiable, negative biopsychosocial impacts across the life course. Little is known about how Australian health and social practitioners identify and respond to family adversity in community and primary health settings. Objective To describe, in two Australian community health services: (1) the number of adversities experienced by caregivers, (2) practitioner identification of caregivers experiencing adversity, (3) practitioner response to caregivers experiencing adversity, and (4) caregiver uptake of referrals. Methods Survey of caregivers of children aged 0-8 years attending community health services in Victoria and New South Wales (NSW). Analysis described frequencies of caregiver self-reported: (1) experiences of adversity, (2) practitioner identification of adversity, (3) practitioner response to adversity, and (4) referral uptake. Analyses were sub-grouped by three adversity domains and site. Results 349 caregivers (Victoria: n = 234; NSW: n = 115) completed the survey of whom 88% reported experiencing one or more family adversities. The median number of adversities was 4 (2-6). Only 43% of participants were directly asked about or discussed an adversity with a practitioner in the previous 6 months (Victoria: 30%; NSW: 68%). Among caregivers experiencing adversity, 30% received direct support (Victoria: 23%; NSW: 43%), and 14% received a referral (Victoria: 10%; NSW: 22%) for at least one adversity. Overall, 74% of caregivers accepted referrals when extended. Conclusion The needs of Australian families experiencing high rates of adversity are not systematically identified nor responded to in community health services. This leaves significant scope for reform and enhancement of service responses to families experiencing adversity.
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Affiliation(s)
- Teresa Hall
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Leanne Constable
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sarah Loveday
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Suzy Honisett
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Natalie Schreurs
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Hayley Loftus
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Renee Jones
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Marie B. H. Yap
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sue Woolfenden
- Sydney Institute Women, Children and their Families, Sydney Local Health District, Croydon, NSW, Australia
- Discipline of Paediatrics, University of New South Wales, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Alicia Montgomery
- Sydney Institute Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Kim Dalziel
- Health Economics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Cate Bailey
- Health Economics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Glenn Pringle
- Innovation and Community Care, IPC Health, Wyndham Vale, VIC, Australia
| | - Jane Fisher
- Global and Women's Health, Monash University, Clayton, VIC, Australia
| | - Suzie Forell
- Health Justice Australia, Darlinghurst, Sydney, NSW, Australia
- School of Law, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Infant Child and Adolescent Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Ric Haslam
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Lena Sanci
- Department of General Practice, The University of Melbourne, Parkville, VIC, Australia
| | - John Eastwood
- Sydney Institute Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Harriet Hiscock
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Health Services and Economics, Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
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Goldstein E, Brown RL. Influence of Maternal Adverse Childhood Experiences on Birth Outcomes in American Indian and non-Hispanic White Women. MCN Am J Matern Child Nurs 2023; 48:258-265. [PMID: 37326514 DOI: 10.1097/nmc.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Maternal adverse childhood experiences (ACEs) are an antecedent risk during prenatal and postpartum periods. We examined race-based differences of the mediating influences of antepartum health risks (prenatal depression, high blood pressure, gestational diabetes) on associations between ACEs and maternal and birth outcomes (postpartum depression, preterm birth, low birthweight) among American Indian and non-Hispanic White women. METHODS Public use data from the South Dakota Pregnancy Risk Assessment Monitoring System PRAMS (2017-2019) were used for this secondary analysis of postpartum women. ACEs and depression were measured based on self-report survey results. Antepartum risks and birth outcomes were extracted from birth certificate data. A moderated mediation logit model estimated direct, indirect, and moderating effects by race, controlling for maternal characteristics and perinatal risks to understand ACEs' impact on pregnancy and birth outcomes between groups. RESULTS The sample included 2,343 postpartum women. American Indian versus non-Hispanic White women had a higher mean ACE score (3.37 vs. 1.64) and substantial disparities. Race-based differences were attributed to social, economic, and health-related factors. Adjusting for proportional differences, members of both groups with ACEs demonstrated significantly increased odds of prenatal and postpartum depression. ACEs influenced postpartum depression and preterm birth through the indirect effect of prenatal depression in both races. Prenatal depression indirectly influenced the relationship between ACEs and low birthweight in non-Hispanic White women. CLINICAL IMPLICATIONS ACEs were associated with higher levels of prenatal depression, which may negatively influence maternal and birth outcomes in American Indian and non-Hispanic White women. Improving perinatal outcomes must emphasize psychosocial care along with medical care to address the high burden of maternal ACEs in the United States.
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Compton AB, Panlilio CC, Humphreys KL. What's the matter with ACEs? Recommendations for considering early adversity in educational contexts. CHILD ABUSE & NEGLECT 2023; 142:106073. [PMID: 36774310 PMCID: PMC10293056 DOI: 10.1016/j.chiabu.2023.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, some trauma-informed education practices use "ACE scores," a number that represents the sum of endorsed items from a survey derived from the Adverse Childhood Experiences (ACEs) study in 1998. We caution that the survey provides limited information within education, and such scores have limited utility for designing and delivering individualized intervention to support students who have experienced adversity. OBJECTIVE We sought to illustrate why ACEs are not well-suited for use in trauma-informed education, provide definitions for adversity-related terms from which a broader and common understanding of adversity can stem, and provide recommendations for integration of adversity-informed approaches to the educational context. METHODS We compiled definitions of adversity-related constructs and made recommendations based on review of relevant research from the fields of psychology and education. RESULTS Rather than tailoring educational practices to specific children based on the "traumatic" events they experience, we recommend educators focus their efforts on building supportive classrooms geared toward supporting students with best practices drawn from the Science of Learning, and with the understanding that early adversity can influence heterogeneous trajectories in student development and behavior. In addition, further research on educational practices, including the use of a shared language for describing and defining adversity-related experiences, are the concrete steps needed to better support a goal of adversity-informed education.
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Gresham B, Karatekin C. The role of adverse childhood experiences (ACEs) in predicting academic problems among college students. CHILD ABUSE & NEGLECT 2023; 142:105595. [PMID: 35382940 PMCID: PMC10117202 DOI: 10.1016/j.chiabu.2022.105595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE The complex associations between adverse childhood experiences (ACEs) and academic performance among college students are not well understood. The following aims were examined in this longitudinal study: the direct association of ACEs on academic problems after 4 years without (1) and with accounting for other academic risk factors (2a), the possible mechanisms linking ACEs and academic problems (2b). PARTICIPANTS AND SETTING First-semester freshmen (N = 268; 71.3% female; Mage = 18.30; 76.9% White, 14.6% Asian, 3.7% Black, 2.6% multiracial, 1.1% Native American, and 1.1% other) were recruited from a Midwestern U.S. university. METHODS Participants reported their ACEs, intrinsic motivation, psychological distress, and financial status as first-semester freshmen. Administrative records (i.e., SAT/ACT scores, GPA, courses taken not counted toward degree progress, and graduation) were collected prospectively over 4 years. Structural equation modeling was used to test the research aims. Post-hoc analyses without SAT/ACT scores were conducted. RESULTS ACEs were associated with academic problems assessed 4 years later, when studied in isolation (β = 0.36, p < .001) but not after adjusting for other risk factors (β = 0.08, p = .278). Psychological distress and SAT/ACT scores during the first semester predicted academic problems 4 years later (β = 0.33 and - 0.38, p < .001). There was an indirect effect of ACEs on academic problems through psychological distress (β = 0.13, p < .001). CONCLUSIONS There is a need to expand mental health services and address barriers to utilization on college campuses.
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Affiliation(s)
- Bria Gresham
- Institute of Child Development, University of Minnesota, United States of America.
| | - Canan Karatekin
- Institute of Child Development, University of Minnesota, United States of America.
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Ye M, Hessler D, Ford D, Benson M, Koita K, Bucci M, Long D, Harris NB, Thakur N. Pediatric ACEs and related life event screener (PEARLS) latent domains and child health in a safety-net primary care practice. BMC Pediatr 2023; 23:367. [PMID: 37461038 PMCID: PMC10351141 DOI: 10.1186/s12887-023-04163-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Research examining the connections between individual adverse childhood experiences (ACEs) and how groupings of interrelated adversities are linked with subsequent health is scarce, limiting our understanding of risk during a period of rapid expansion of ACE screening in clinical practice. The study objective was to conduct a psychometric analysis to derive latent domains of ACEs and related life events and assess the association between each domain and health outcome. METHODS Participants (3 months-11 years) were recruited from the University of California San Francisco Benioff's Children Hospital Oakland Primary Care Clinic. Children were screened with the Pediatric ACEs and Related Life Events Screener (PEARLS) (n = 340), which assessed 17 total ACEs and related life events, including forms of abuse, household challenges, and social risks. Domains were constructed using confirmatory factor analysis and associations between the three identified domains and 14 health outcomes were assessed using multivariable linear and logistic regression models. RESULTS Three PEARLS domains were identified: Maltreatment (ω = 0.73, ɑ=0.87), Household Challenges (ω = 0.70, ɑ=0.82), and Social Context (ω = 0.55, ɑ=0.70). Measurement invariance was supported across both gender and screening format. All domains were associated with poorer general and behavioral health and stomachaches. Maltreatment and Social Context were additionally associated with eczema while only Social Context was associated with increased odds of reporting headaches and somatic symptoms. CONCLUSION In an underserved, urban west-coast pediatric population, the PEARLS found three adversity domains of Maltreatment, Household Challenges, and Social Context that all had an independent statistically significant association with poorer child health. The results provide a timely and more nuanced representation of risk that can inform clinical practice and policy using more targeted resources and interventions.
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Affiliation(s)
- Morgan Ye
- San Francisco Departments of Medicine and Epidemiology and Biostatistics, University of California, 500 Parnassus Avenue, 94143-0841 San Francisco, CA USA
| | - Danielle Hessler
- San Francisco Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, 94143 San Francisco, CA USA
| | - Derek Ford
- Center for Psychological and Social Health, LLC, 2918 Westover Dr, Danville, VA 24541 USA
| | - Mindy Benson
- San Francisco Department of Pediatrics, University of California, 5220 Claremont Ave, Oakland, CA 94609 USA
| | - Kadiatou Koita
- Center for Youth Wellness, 3450 3rd St, 94124 San Francisco, CA USA
| | - Monica Bucci
- Center for Youth Wellness, 3450 3rd St, 94124 San Francisco, CA USA
| | - Dayna Long
- San Francisco Department of Pediatrics, University of California, 5220 Claremont Ave, Oakland, CA 94609 USA
| | | | - Neeta Thakur
- San Francisco Departments of Medicine and Epidemiology and Biostatistics, University of California, 500 Parnassus Avenue, 94143-0841 San Francisco, CA USA
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Giovanelli A, Mondi CF, Reynolds AJ, Ou SR. Evaluation of Midlife Educational Attainment Among Attendees of a Comprehensive Early Childhood Education Program in the Context of Early Adverse Childhood Experiences. JAMA Netw Open 2023; 6:e2319372. [PMID: 37347483 PMCID: PMC10288333 DOI: 10.1001/jamanetworkopen.2023.19372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/05/2023] [Indexed: 06/23/2023] Open
Abstract
Importance Educational attainment is a key social determinant of health and can be particularly consequential for racial and ethnic minority populations. Although the consequences of adverse childhood experiences (ACEs) are well established, there is little research on protective factors and policy-relevant strategies to mitigate ACE-related inequities. Objective To examine associations between early ACEs, comprehensive early intervention, and midlife educational attainment in a cohort of predominantly Black participants. Design, Setting, and Participants The Chicago Longitudinal Study is a prospective cohort study of Black and Latinx children from Chicago, Illinois. The intervention group included 989 children entering the Child-Parent Center (CPC) preschool Early Childhood Education (ECE) program in the 1980s. The comparison group comprised 550 children participating in usual early childhood services. All participants were followed up for 30 years after the end of the intervention. Analyses were conducted from July 1 to September 1, 2022. Intervention Attendance at the CPC preschool ECE program. Main Outcomes and Measures A standard battery of early childhood ACEs (conventional ACEs), a set of early childhood ACEs more commonly associated with high-poverty contexts (expanded ACEs), and educational attainment at 35 years of age were measured from self-report and administrative records. Results The original Chicago Longitudinal Study sample comprised 1539 participants (1430 Black participants [92.9%]; 774 female participants [50.3%]). Data on educational attainment and ACEs were available for 1083 of 1467 living participants (73.8%). Participants in the present study (1013 Black participants [93.5%]; 594 female participants [54.9%]) were a mean (SD) age of 35.1 (0.3) years at completion of the midlife survey. For the comparison group but not the CPC intervention group, having 1 or more conventional or expanded ACEs in early childhood was associated with fewer years of education (β = -0.64; 95% CI, -1.02 to -0.26), reduced likelihood of attaining a bachelor's degree or higher (odds ratio, 0.26; 95% CI, 0.09-0.70), and reduced likelihood of attaining an associate's degree or higher (odds ratio, 0.26; 95% CI, 0.11-0.62) after adjusting for covariates. Moderation analyses indicated that CPC participants with either conventional or expanded ACEs in early childhood attained a bachelor's degree or higher and an associate's degree or higher at rates similar to CPC participants without early ACEs (15.4% vs 13.6% for bachelor's degree or higher; 22.4% vs 19.9% for associate's degree or higher). Conversely, comparison group participants with early ACEs had significantly lower rates of educational attainment than their counterparts without ACEs (3.7% vs 12.1% for bachelor's degree or higher; 5.6% vs 17.1% for associate's degree or higher). Conclusions This cohort study suggests that early ACEs were associated with reduced educational attainment for the comparison group but not for the group participating in the CPC comprehensive early intervention. These results build on research suggesting that youths at higher risk can benefit most from intervention and support ECE as a tool for reducing ACE-related disparities.
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Affiliation(s)
- Alison Giovanelli
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco
| | - Christina F. Mondi
- Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arthur J. Reynolds
- Human Capital Research Collaborative, Institute of Child Development, University of Minnesota, Minneapolis
| | - Suh-Ruu Ou
- Human Capital Research Collaborative, Institute of Child Development, University of Minnesota, Minneapolis
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Dynes ME, Rasiah SS, Knox M. When Attitudes Become Obstacles: An Exploratory Study of Future Physicians' Concerns about Reporting Child Maltreatment. CHILDREN (BASEL, SWITZERLAND) 2023; 10:979. [PMID: 37371211 DOI: 10.3390/children10060979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Child maltreatment (CM) makes up a significant portion of events under the larger umbrella term of adverse childhood experiences (ACEs). Therefore, we need to develop a competent healthcare workforce that is prepared to assess and report CM in order to create a comprehensive framework for assessing and addressing ACEs. The objective of the present study was to examine the obstacles to reporting CM among a sample of future physicians. METHODS Two samples of medical students and residents (N = 196) completed the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale and rated how likely they would be to report suspected CM. RESULTS Medical students were found to have more negative feelings about and perceive more obstacles to reporting CM compared to residents in our sample. Scores on the Reporting Responsibilities subscale were not significantly associated with increased likelihood of reporting CM. However, lower scores on the Concerns about Reporting subscale were related to an increased likelihood of reporting CM. CONCLUSIONS Future physicians who perceived fewer obstacles to reporting CM reported being more likely to report suspected CM. Misinformed fears about outcomes such as retaliation, removal of the child from the home, and being sued may interfere with future physicians' adherence to mandated reporting responsibilities. Efforts should be made early in physician education to identify and address common myths and misconceptions around mandated reporting and its outcomes.
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Affiliation(s)
- Morgan E Dynes
- Department of Psychiatry, University of Toledo, Toledo, OH 43614, USA
| | - Stephne S Rasiah
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA
| | - Michele Knox
- Department of Psychiatry, University of Toledo, Toledo, OH 43614, USA
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Harris M, MacMillan H, Mepham J, Joshi D, Wekerle C, Atkinson L, Gonzalez A. Maternal Childhood Maltreatment History and Child Behavior Problems: Developmental Patterns and Mediation via Maternal Depressive Symptoms and Parenting Behavior. CHILD MALTREATMENT 2023; 28:254-264. [PMID: 35081793 PMCID: PMC10021123 DOI: 10.1177/10775595221074364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Maternal exposure to childhood maltreatment (CM) is associated with offspring behavioral problems; however, little work has examined these associations longitudinally across child development. This study examined the effects of maternal history of CM on trajectories of child internalizing and externalizing behavior measured from toddlerhood to preschool, and the role of maternal depressive symptoms and parenting behavior as potential mediators. Participants included 115 mother-child dyads recruited from a hospital maternity ward. Maternal CM was measured at 3-months postpartum. At 18, 36, and 60 months, maternal depressive symptoms and child behavior were assessed via maternal report and parenting behavior was assessed through direct observation. Findings indicated that children of mothers exposed to CM demonstrated poorer trajectories of problem behavior across early childhood. Maternal depressive symptoms mediated the relation between CM and children's internalizing problems. Findings highlight the importance of screening for maternal depressive symptoms and early intervention for maternal and child mental health.
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Affiliation(s)
- Madeleine Harris
- Neuroscience Graduate Program,
McMaster
University, Hamilton, ON, Canada
- Offord Centre for Child
Studies, Hamilton, ON, Canada
| | - Harriet MacMillan
- Offord Centre for Child
Studies, Hamilton, ON, Canada
- Department of Psychiatry and
Behavioural Neurosciences, McMaster
University, Hamilton, ON, Canada
- Department of Pediatrics,
McMaster
University, Hamilton, ON, Canada
| | - Jennifer Mepham
- Neuroscience Graduate Program,
McMaster
University, Hamilton, ON, Canada
- Offord Centre for Child
Studies, Hamilton, ON, Canada
| | - Divya Joshi
- Department of Clinical Epidemiology
and Biostatistics, McMaster University, Hamilton, ON,
Canada
| | - Christine Wekerle
- Offord Centre for Child
Studies, Hamilton, ON, Canada
- Department of Pediatrics,
McMaster
University, Hamilton, ON, Canada
| | - Leslie Atkinson
- Department of Psychology,
Ryerson
University, Toronto, ON, Canada
| | - Andrea Gonzalez
- Offord Centre for Child
Studies, Hamilton, ON, Canada
- Department of Psychiatry and
Behavioural Neurosciences, McMaster
University, Hamilton, ON, Canada
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Zhang J, Wiecaszek P, Sami S, Meiser-Stedman R. Association between panic disorder and childhood adversities: a systematic review and meta-analysis. Psychol Med 2023; 53:2585-2595. [PMID: 34776038 DOI: 10.1017/s0033291721004505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increase the risk of mental health difficulties in general, but the link to panic disorder (PD) has received comparatively little attention. There are no data for the magnitudes between ACEs and PD. This systematic review and meta-analysis estimated the overall, as well as the subgroups, odds ratio of having PD in adults who report ACEs, compared to adults who do not. METHODS The study was pre-registered on PROSPERO [CRD42018111506] and the database was searched in June 2021. In order to overcome the violation of independent assumptions due to multiple estimations from the same samples, we utilized a robust variance estimation model that supports meta-analysis for clustered estimations. Accordingly, an advanced method relaxing the distributional and asymptotic assumptions was used to assess publication bias and sensitivity. RESULTS The literature search and screening returned 34 final studies, comprising 192,182 participants. Ninety-six estimations of 20 types of ACEs were extracted. Pooled ORs are: overall 2.2, CI (1.82-2.58), sexual abuse 1.92, CI (1.37-2.46), physical abuse 1.71, CI (1.37-2.05), emotional abuse 1.61, CI (0.868-2.35), emotional neglect 1.53, CI (0.756-2.31), parental alcoholism 1.83, CI (1.24-2.43), and parental separation/loss 1.82, CI (1.14-2.50). No between-group difference was identified by either sociolegal classification (abuse, neglect, household dysfunction) or threat-deprivation dimensions (high on threat, high on deprivation and mixed). CONCLUSIONS There are links of mild to medium strength between overall ACEs and PD as well as individual ACEs. The homogeneous effect sizes across ACEs either suggest the effects of ACEs on PD are comparable, or raised the question whether the categorical or dimensional approaches to classifying ACEs are the definitive ways to conceptualize the impact of ACEs on later mental health.
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Affiliation(s)
- Joyce Zhang
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Saber Sami
- Dementia Research, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
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Hall T, Loveday S, Pullen S, Loftus H, Constable L, Paton K, Hiscock H. Co-designing an Integrated Health and Social Care Hub With and for Families Experiencing Adversity. Int J Integr Care 2023; 23:3. [PMID: 37033364 PMCID: PMC10077991 DOI: 10.5334/ijic.6975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/29/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Integrated care research often fails to adequately describe co-design methods. This article outlines the process, principles and tools to co-design an integrated health and social care Hub for families experiencing adversity. Research methods The Child and Family Hub was co-designed in four stages: (1) partnership building and stakeholder engagement, (2) formative research, (3) persona development and (4) co-design workshops and consultations. Local families, community members and intersectoral practitioners were engaged at each stage. The co-design workshops employed a human-centred design process and were evaluated using the Public and Patient Engagement Evaluation Tool (PEET). Results 121 family participants and 80 practitioners were engaged in the Hub's co-design. The PEET highlighted the co-design team's satisfaction achieved by community members working alongside practitioners to generate mutual learning. Resourcing was a key challenge. Discussion Human-centred design offered a systematic process and tools for integrating formative evidence with lived and professional experience in the Hub's co-design. Applying community engagement principles meant that a diverse range of stakeholders were engaged across all stages of the project which built trust in and local ownership of the Hub model. Conclusion Co-design research with families experiencing adversity should attend to language, engagement methods, team composition and resourcing decisions.
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Affiliation(s)
- Teresa Hall
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Sarah Loveday
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Sandie Pullen
- Innovation, Design & Communications, Manager, IPC Health, AU
| | - Hayley Loftus
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Leanne Constable
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Kate Paton
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Harriet Hiscock
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
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Atkinson L, Joshi D, Raina P, Griffith LE, MacMillan H, Gonzalez A. Social engagement and allostatic load mediate between adverse childhood experiences and multimorbidity in mid to late adulthood: the Canadian Longitudinal Study on Aging. Psychol Med 2023; 53:1437-1447. [PMID: 37010223 PMCID: PMC10009404 DOI: 10.1017/s0033291721003019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/10/2021] [Accepted: 07/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with multimorbidity in adulthood. This link may be mediated by psychosocial and biological factors, but evidence is lacking. The current study evaluates this mediation model. METHOD We analyzed data from the Canadian Longitudinal Study of Aging (N = 27 170 community participants). Participants were 45-85 years at recruitment, when allostatic load and social engagement data were collected, and 3 years older at follow-up, when ACEs and multimorbidity data were collected. Structural equation modeling was used to test for mediation in the overall sample, and in sex- and age-stratified subsamples, all analyses adjusted for concurrent lifestyle confounds. RESULTS In the overall sample, ACEs were associated with multimorbidity, directly, β = 0.12 (95% confidence interval 0.11-0.13) and indirectly. Regarding indirect associations, ACEs were related to social engagement, β = -0.14 (-0.16 to -0.12) and social engagement was related to multimorbidity, β = -0.10 (-0.12 to -0.08). ACEs were related to allostatic load, β = 0.04 (0.03-0.05) and allostatic load was related to multimorbidity, β = 0.16 (0.15-0.17). The model was significant for males and females and across age cohorts, with qualifications in the oldest stratum (age 75-85). CONCLUSIONS ACEs are related to multimorbidity, directly and via social engagement and allostatic load. This is the first study to show mediated pathways between early adversity and multimorbidity in adulthood. It provides a platform for understanding multimorbidity as a lifespan dynamic informing the co-occurrence of the varied disease processes represented in multimorbidity.
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Affiliation(s)
- Leslie Atkinson
- Department of Psychology, Ryerson University, Toronto, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Harriet MacMillan
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Honisett S, Loftus H, Liu H, Montgomery A, De Souza D, Hall T, Eastwood J, Hiscock H, Goldfeld S. Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families-A scoping study. Health Promot J Austr 2023; 34:211-221. [PMID: 36448724 PMCID: PMC10947353 DOI: 10.1002/hpja.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
ISSUE ADDRESSED To determine if Australian policies support a primary health care system to identify family adversity and subsequently support these families. METHODS Two methodological approaches were used: (i) a scoping review of Australian federal and two states (Victoria and New South Wales) policies related to family adversity (e.g., childhood maltreatment or household dysfunction, such as parental mental illness); (ii) thirteen semi-structured interviews with Victorian Community Health Service (CHS) staff and government policy makers, recruited via snowball sampling to understand the context of policy making and service implementation. Data collected were subsequently discussed in relation to the Stages Model of policy analysis. RESULTS One hundred and eighty-eight policies referenced family adversity. Of these, 37 policies met all eligibility criteria including a focus on early intervention within primary care and were included in the review. Most policies were developed within health departments (78%) and included a wide range of adversities, with the majority based within maternal and child health and CHS platforms. Most policy development included consultation with stakeholders. Although most policies received some level of funding, few included funding details and only a third included evaluation. CONCLUSIONS There are many policies related to family adversity in Australia, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity. SO WHAT More work needs to be done to ensure policies are adequately implemented, evaluated and transparently and appropriately funded. The co-occurrence of adversity should focus policy action; and potentially lead to more effective and efficient outcomes.
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Affiliation(s)
- Suzy Honisett
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Hayley Loftus
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - HueiMing Liu
- Health Systems Science, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Alicia Montgomery
- Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia
| | | | - Teresa Hall
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Eastwood
- Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia
- Centre for Research Excellence for Integrated Health and Social Care, University of Sydney Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Prevalence of Poor Mental Health Days and Adverse Childhood Experience Reporting in U.S. Adults Before and After COVID-19. Community Ment Health J 2023; 59:233-242. [PMID: 35829803 PMCID: PMC9859877 DOI: 10.1007/s10597-022-01001-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/09/2022] [Indexed: 01/25/2023]
Abstract
This is the first study of US adults to examine change in the prevalence of psychological burden (i.e., self-reported poor mental health days in the past 30 days, and ACEs recollections) before compared to after COVID-19 started. We analyzed the prevalence of self-reported poor mental health days, and ACEs recollections from 17 states using the Behavioral Risk Factor Surveillance System. Adjusted models identified an increase in prevalence from before compared to after COVID-19 onset in those married or partnered reporting 48% more poor mental health days in the past 30 days; persons of color reporting living with anyone with mental illness during childhood by 73% and reporting more ACEs by 35%; those employed or self-employed reporting childhood sexual abuse by 45%. This ecological-level analysis revealed population-level changes in psychological well-being reporting of U.S. adults from before compared to after the pandemic onset.
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Tao H, Zeng X, Hou M, Chen S, Shen J, Liao X, Zou C. Association of adverse childhood experiences and depression among medical students: the role of family functioning and insomnia. Front Psychol 2023; 14:1134631. [PMID: 37205075 PMCID: PMC10185847 DOI: 10.3389/fpsyg.2023.1134631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Background Few studies have explored the mechanisms linking adverse childhood experiences (ACEs) to depression in medical students. This study aimed to investigate the relationship between ACEs and depression through the serial mediation effect of family functioning and insomnia. Methods A cross-sectional survey was conducted with 368 medical students from university in Chengdu in 2021. The participants were asked to complete four self-report questionnaires, including ACEs scale, the family APGAR index, the ISI and PHQ-9. Singe and serial mediation analyses were conducted using structural equation modeling by Mplus 8.3. Results ACEs had a significant direct effect on depression (β = 0.438, p < 0.001) and through three significantly indirect pathways: (1) through family functioning (β = 0.026, 95% CI: 0.007-0.060), accounting for 5.9% of the total effect; (2) through insomnia (β = 0.103, 95% CI: 0.011-0.187), accounting for 23.5% of the total effect; and (3) through the serial mediators involving in family functioning and insomnia (β = 0.038, 95% CI: 0.015-0.078), accounting for 8.7% of the total effect. The total indirect effect was 38.1%. Limitations This cross-sectional study prevented us from establishing causality. Conclusion This study highlights the role of family functioning and insomnia as serial mediators of the relationship between ACEs and depression. Findings help to elucidate the mechanism that underlines the pathway between ACEs and depression in medical students. These findings may indicate developing measures to strengthen family functioning and improve insomnia aiming to reduce depression in medical students with ACEs.
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Affiliation(s)
- Hongxia Tao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xin Zeng
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Mutian Hou
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
| | - Shanping Chen
- The Department of Geriatric Medicine, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Jing Shen
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xiaoyang Liao
- General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
| | - Chuan Zou
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
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The association between adverse childhood experiences and common mental disorders and suicidality: an umbrella review of systematic reviews and meta-analyses. Eur Child Adolesc Psychiatry 2022; 31:1489-1499. [PMID: 33638709 DOI: 10.1007/s00787-021-01745-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/11/2021] [Indexed: 10/22/2022]
Abstract
Adverse childhood experiences (ACEs) are related to increased risk of common mental disorders. This umbrella review of systematic reviews and meta-analyses aimed to identify the key ACEs that are consistently associated with increased risk of mental disorders and suicidality. We searched PsycINFO, PubMed, and Google Scholar for systematic reviews and meta-analyses on the association between ACEs and common mental disorders or suicidality published from January 1, 2009 until July 11, 2019. The methodological quality of included reviews was evaluated using the AMSTAR2 checklist. The effect sizes reported in each meta-analysis were combined using a random-effects model. Meta-regressions were conducted to investigate whether associations vary by gender or age of exposure to ACEs. This review is registered with PROSPERO (CRD42019146431). We included 68 reviews with moderate (55%), low (28%) or critically low (17%) methodological quality. The median number of included studies in these reviews was 14 (2-277). Across identified reviews, 24 ACEs were associated with increased risk of common mental disorders or suicidality. ACEs were associated with a two-fold higher odds of anxiety disorders (pooled odds ratios (ORs): 1.94; 95% CI 1.82, 2.22), internalizing disorders (OR 1.76; 1.59, 1.87), depression (OR 2.01; 1.86, 2.32) and suicidality (OR 2.33; 2.11, 2.56). These associations did not significantly (P > 0.05) vary by gender or the age of exposure. ACEs are consistently associated with increased risk of common mental disorders and suicidality. Well-designed cohort studies to track the impact of ACEs, and trials of interventions to prevent them or reduce their impact should be global research priorities.
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Honisett S, Hall T, Hiscock H, Goldfeld S. The feasibility of a Child and Family Hub within Victorian Community Health Services: a qualitative study. Aust N Z J Public Health 2022; 46:784-793. [PMID: 36126218 DOI: 10.1111/1753-6405.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Explore the feasibility of an integrated Child and Family Hub within Victorian Community Health Services (CHS) to identify and respond to family adversities as preventable determinants of child mental health problems. METHODS Thirteen Victorian CHS staff and government policy makers (PMs), recruited via snowball sampling, participated in semi-structured interviews exploring: 1) barriers and facilitators for implementing a hub; 2) feasibility of a proposed integrated hub; and 3) resources needed to scale and sustain a hub. Transcripts were analysed employing framework analysis. RESULTS 1) Barriers included inadequate and activity-based funding, inability to fund community paediatricians and inadequate workforce competencies. Facilitators included CHS engagement with vulnerable communities and readiness to act. 2) The proposed hub model was identified as feasible to implement. Local co-design, co-location, and virtual delivery would support hub implementation. 3) To sustainably scale a hub, clear policy leadership and workforce and funding model reviews are needed. CONCLUSIONS A hub was perceived as feasible when based in CHS; however, local and system-wide issues need consideration to support its sustainable scaling. IMPLICATIONS FOR PUBLIC HEALTH Findings will inform the scaling of hub models of care across Victoria and other states to potentially optimise broader child and family health outcomes.
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Affiliation(s)
- Suzy Honisett
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria
| | - Teresa Hall
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria
| | - Harriet Hiscock
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria.,Royal Children's Hospital, Victoria.,Department of Paediatrics, The University of Melbourne, Victoria
| | - Sharon Goldfeld
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria.,Royal Children's Hospital, Victoria.,Department of Paediatrics, The University of Melbourne, Victoria
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