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Ottendahl CB, Bjerregaard P, Svartá DL, Seidler IK, Olesen I, Nielsen MS, Larsen CVL. Childhood conditions and mental health among youth and young adults in Greenland: a latent class analysis. Int J Circumpolar Health 2024; 83:2400397. [PMID: 39283055 PMCID: PMC11407376 DOI: 10.1080/22423982.2024.2400397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Poor mental health among youth in Greenland is a major challenge, childhood conditions are critical for mental health later in life. The study aimed to examine the clustering of childhood conditions by considering risk and protective factors for mental health among youth and young adults in Greenland and to explore the relationship between these clusters and mental health outcomes in youth. The study included 565 participants aged 15-34 living in Greenland. Seven indicators including childhood adversities (ACEs), childhood residence, language, and cultural indicators (protective factors) were used to define clusters via latent class analysis (LCA). The associations between clusters and mental health outcomes (satisfaction with life (Cantrill's ladder), self-esteem, self-efficacy, loneliness, psychological distress (General Health Questionnaire) and mental illness (Kessler 6)) were assessed by logistic regression. Four clusters were identified through LCA. While most participants reported positive childhoods, 40% (in two clusters) experienced ACEs. The two clusters differed as more participants in one cluster had experienced protective factors than the other. ACEs were associated with increased odds of negative aspects of mental health in youth. However, participants who faced high levels of adversity and few protective factors also had reduced odds of positive aspects of mental health in youth.
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Affiliation(s)
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Durita Lyngsø Svartá
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ivalu Katajavaara Seidler
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute for Health and Nature, Ilisimatusarfik, University of Greenland, Nuuk, Greenland
| | - Ingelise Olesen
- Institute for Health and Nature, Ilisimatusarfik, University of Greenland, Nuuk, Greenland
| | - Martine Stecher Nielsen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute for Health and Nature, Ilisimatusarfik, University of Greenland, Nuuk, Greenland
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Licitis L, Suarez N, Anderson KN, Hertz MF, Verlenden JV, Viox MH, Pampati S. Alignment of parent-proxy report and teen self-report of adverse childhood experiences among U.S. teens. Ann Epidemiol 2024; 99:32-40. [PMID: 39322092 DOI: 10.1016/j.annepidem.2024.09.001] [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: 01/26/2024] [Revised: 08/19/2024] [Accepted: 09/21/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE Data on adverse childhood experiences (ACEs) among teens is collected using a single informant, a parent-proxy, or teen self-report. Little is known about alignment between these approaches. METHODS Surveys were administered online to teens ages 15-17 and their parents (n = 522 dyads) using the AmeriSpeak panel. We present descriptive statistics on the prevalence and measures agreement for 18 ACEs based on teen self-report and parent-proxy report. We fit multivariable models examining associations between teen and household demographic characteristics and discordance in ACE report. RESULTS Based on teen-self report and parent-proxy report, cumulative and individual ACE prevalence was overall similar. However, discordance was found in individual ACE reports within teen-parent dyads (discordance ranged: 2.9-21.2 %). Lowest agreement was among ACEs related to abuse, neglect, and violence victimization and highest among household challenges. Furthermore, parent-teen dyads with LGB+ youth (vs. heterosexual) and Black, Hispanic, and multiracial or another race (vs. White) youth were more likely to have discordant responses among several ACEs. CONCLUSIONS Surveillance and programmatic efforts should consider the type of ACE and the reporter when using data to inform prevention strategies. Teen self-report for abuse, neglect, and violence victimization and community challenges ACEs are particularly important to capture.
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Affiliation(s)
- Laima Licitis
- ORISE Fellow, Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Nicolas Suarez
- Health Scientist, Centers for Disease Control and Prevention (CDC), Division of Adolescent and School Health, Atlanta, GA, USA
| | - Kayla N Anderson
- Senior Advisor for Adverse Childhood Experiences, CDC National Center For Injury Prevention and Control, Atlanta, GA, USA
| | - Marci F Hertz
- Health Scientist, Centers for Disease Control and Prevention (CDC), Division of Adolescent and School Health, Atlanta, GA, USA
| | - Jorge V Verlenden
- Health Scientist, Centers for Disease Control and Prevention (CDC), Division of Adolescent and School Health, Atlanta, GA, USA
| | - Melissa Heim Viox
- Senior Research Director, NORC, University of Chicago, Chicago, IL, USA
| | - Sanjana Pampati
- Health Scientist, Centers for Disease Control and Prevention (CDC), Division of Adolescent and School Health, Atlanta, GA, USA.
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Lee HY, Kim I, Kim J. Adolescents' Mental Health Concerns in Pre- and During COVID-19: Roles of Adverse Childhood Experiences and Emotional Resilience. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01726-x. [PMID: 39017766 DOI: 10.1007/s10578-024-01726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/18/2024]
Abstract
Limited research has explored the trend of adolescent mental health concerns pre- and during the COVID-19 pandemic and how such mental health concerns are explained by emotional resilience and Adverse Childhood Experiences (ACEs). The purpose of this study is to investigate the prevalence and severity of mental health concerns among U.S. adolescents and examine the mediating role of emotional resilience in the relationship between ACEs and mental health concerns (i.e., anxiety and depression). Using the 2018-2021 National Survey of Children's Health, we analyzed a large sample of 12-17 aged adolescents. Descriptive statistics of the prevalence and severity of mental health concerns were conducted. Further, four separate mediation analyses were conducted to examine the association between ACEs, emotional resilience, and mental health concerns for each year. Two key findings are as follows. First, the prevalence and severity of mental health concerns have shown an upward trend across pre- and during COVID-19. Second, all paths in the mediation models were found to be statistically associated with one another over four years. We used parents' reports for variables of interest; further we used a single item to capture emotional resilience. This study not only demonstrates the trend of adolescent mental health concerns before and during COVID-19 but also highlights the crucial role of emotional resilience as a mediator of ACEs and mental health concerns. Findings emphasize the imperative for prevention and intervention efforts to strengthen adolescents' emotional capacity to cope with childhood adversities and additional life challenges.
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Affiliation(s)
- Hye Yeon Lee
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Isak Kim
- Department of Counseling, University of Nebraska Omaha, Omaha, NE, 68182, USA.
| | - Jaeyoung Kim
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, 48824, USA
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Goldstein E, Merrick JS, Edwards RC, Zhang Y, Sinche B, Raven J, Krislov S, Robledo D, Brown RL, Moskowitz JT, Tandon SD, Wakschlag LS. Personalized Mobile Health-Enhanced Cognitive Behavioral Intervention for Maternal Distress: Examining the Moderating Role of Adverse Childhood Experiences. Perm J 2024; 28:111-123. [PMID: 38263868 PMCID: PMC10940253 DOI: 10.7812/tpp/23.094] [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: 01/25/2024]
Abstract
BACKGROUND Maternal history of trauma is a risk factor for distress during pregnancy. The purpose of this paper was to examine the theorized differential impact of a cognitive behavioral intervention (Mothers and Babies Personalized; MB-P) on maternal distress and emotional regulation for those with ≥ 1 adverse childhood experiences (ACEs; vs no ACEs) from pregnancy to 3 months postpartum. METHODS Between August 2019 and August 2021, eligible pregnant individuals aged ≥ 18 years, < 22 weeks' gestation, and English-speaking were recruited from 6 university-affiliated prenatal clinics. Participants (N = 100) were randomized to MB-P (n = 49) or control (n = 51). Analyzable data were collected for 95 participants. Analyses tested progression of change (slope) and at individual timepoints (panel analysis) for perinatal mental health outcomes. RESULTS The majority of participants (n = 68, 71%) reported experiencing > 1 ACE (median = 1, range: 0-11). Participants demonstrated significant differential effects for depressive symptoms in absence of ACEs (standardized mean differences [SMD] = 0.82; 95% confidence interval [CI] = [0.13-1.51]) vs in presence of ACEs (SMD = 0.39; 95% CI = [-0.20 to 0.97]) and perceived stress in absence of ACEs (SMD = 0.92; 95% CI = [0.23-1.62]) vs in presence of ACEs (SMD = -0.05; 95% CI = [-0.63 to 0.53]). A panel analysis showed significantly reduced depressive symptoms postintervention and increased negative mood regulation at 3 months postpartum for individuals with ACEs. CONCLUSIONS Findings support effectiveness of the MB-P intervention to reduce prenatal distress for all pregnant individuals. Preliminary exploration suggests the possibility that individuals with ACEs may benefit from enhanced trauma-informed content to optimize the effects of a perinatal intervention.
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Affiliation(s)
- Ellen Goldstein
- Department of Population Health Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL, USA
| | - Jillian S Merrick
- Department of Psychiatry and Behavioral Health, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Renee C Edwards
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yudong Zhang
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brianna Sinche
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julia Raven
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephanie Krislov
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniela Robledo
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roger L Brown
- University of Wisconsin Schools of Nursing, Medicine and Public Health, Madison, WI, USA
| | - Judith T Moskowitz
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Darius Tandon
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Gibson J. Trauma, early life stress, and mindfulness in adulthood. BMC Psychol 2024; 12:71. [PMID: 38355582 PMCID: PMC10865675 DOI: 10.1186/s40359-024-01563-6] [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: 10/31/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
This article is a review that was inspired by recent studies investigating the effects of childhood trauma or early life stress (ELS) and mindfulness in adulthood. One recent study found that some forms of abuse and neglect led to higher scores in several subscales of a self-report measure of mindfulness. The authors concluded that some forms of ELS can help cultivate certain aspects of mindfulness in adulthood. However, and in contrast to this recent finding, much of the extant literature investigating ELS and trauma are linked to emotional dysregulation, alexithymia, and a host of psychopathologies in adulthood which makes the results of this study surprising. Central to the mindfulness literature is cultivating an open, non-reactive, or non-judgment awareness of inner experiences which are important for emotional regulation. In this paper, I review some of the effects of trauma or ELS on critical neural circuits linked to mindfulness, interoception, attachment, and alexithymia which I hope may clarify some of the conflicting findings from this study and throughout the literature and provide additional context and a framework that may inform research investigating these two constructs going forward.
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Affiliation(s)
- Jonathan Gibson
- South Dakota School of Mines and Technology, 501 E St. Joseph Street, Rapid City, SD, 57701, United States of America.
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Qi C, Yang N. An examination of the effects of family, school, and community resilience on high school students' resilience in China. Front Psychol 2024; 14:1279577. [PMID: 38274696 PMCID: PMC10809992 DOI: 10.3389/fpsyg.2023.1279577] [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: 08/21/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Resilience plays a pivotal role in shaping the academic accomplishments, psychological well-being, and future prospects of high school students. Despite its significance, there is a notable dearth of studies examining the current state and determinants of resilience among high school students in China. Methods This research addresses this gap by assessing and exploring levels of resilience and their interconnections across four key domains-individual, family, school, and community-among Chinese high school students. The study also investigates variations in resilience based on factors such as gender, geographical location, and grade levels. A total of 667 high school students participated in the study, responding to four resilience scales. Results Chinese high school students exhibited generally low levels of resilience, with family resilience ranking the highest and community resilience the lowest. The study revealed that resilience is positively influenced by resilience levels in school, family, and community settings. Consequently, strategies aimed at fortifying resilience should prioritize interventions in familial, educational, and communal environments. Discussion Moreover, the research findings indicate noteworthy disparities in resilience among high school students based on gender, urban-rural divide, and grade levels. Female, urban, and lower-grade students displayed higher resilience compared to their male, rural, and higher-grade counterparts. This highlights the importance of focusing on resilience-building measures tailored to male, rural, and higher-grade high school students, given their increased likelihood of facing significant challenges and stressors in both academic and personal spheres. Conclusion This study contributes to the broader understanding of resilience by investigating the correlations between individual, family, school, and community resilience among Chinese high school students. The findings underscore the need for targeted interventions to enhance resilience, particularly in specific demographic groups, thereby advancing the efficacy of resilience-building techniques in high school settings.
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Affiliation(s)
- Chunlin Qi
- College of Education, Jiangxi Normal University, Nanchang, China
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Nguyen TNM, Disabato DJ, Gunstad J, Delahanty DL, George R, Muakkassa F, Mallat AF, Coifman KG. Can the positive buffer the negative? Testing the impact of protective childhood experiences on adjustment in adults following trauma exposure. ANXIETY, STRESS, AND COPING 2024; 37:60-76. [PMID: 37012026 PMCID: PMC10545812 DOI: 10.1080/10615806.2023.2193888] [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: 05/12/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND It is unclear if protective childhood experiences (PCEs), like emotional support and economic stability, exert influence on adulthood adjustment. Prior research suggests PCEs can promote childhood resilience through increased social connection. In contrast, research has demonstrated potential life-long negative impacts of adverse childhood experiences (ACEs) on psychological health. This study examined the role of PCEs and ACEs in psychological symptoms following potentially traumatic events (PTE) in adults. METHODS Participants (N = 128) were adults admitted to two Level 1 Trauma Centers following violence, motor-vehicle crashes, or other accidents. Participants reported childhood experiences and completed assessments of depression, PTSD, and social support at one, four, and nine months post-PTE. RESULTS Structural Equation Modeling was used to simultaneously model PCEs and ACEs as predictors of psychological symptoms over time, with potential mediation through social support. PCEs overall did not directly affect psychological symptoms nor indirectly through social support. However, the emotional support component of PCEs had an indirect effect on psychological symptoms at baseline through social support. ACEs predicted greater psychological symptoms at baseline and over time. CONCLUSION PCEs consisting of childhood emotional support indirectly promote adjustment in adults after PTEs through initial social support, while ACEs exert direct effects on psychological symptoms.
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Affiliation(s)
- Tam N M Nguyen
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - David J Disabato
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - John Gunstad
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - Douglas L Delahanty
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - Richard George
- Department of Trauma, Summa Health Systems - Akron Campus, Akron, OH, USA
- Department of Surgery, Northeast Ohio Medical University, Rootstown, OH, USA
| | | | - Ali F Mallat
- Cleveland Clinic, Akron General Hospital, Akron, OH, USA
| | - Karin G Coifman
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
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Ma J, Yang B, Wang S, Yao Y, Wu C, Li M, Dong GH. Adverse childhood experiences predict internet gaming disorder in university students: the mediating role of resilience. Curr Opin Psychiatry 2024; 37:29-37. [PMID: 37972967 DOI: 10.1097/yco.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND To investigate the relationship between adverse childhood experiences and internet gaming disorder (IGD) and the mediating role of resilience in the relationship between these two factors. METHODS The adverse childhood experience scale, resilience scale and IGD Scale were administered to 9349 university students. Correlations and mediating effects were calculated among these scores. RESULTS After controlling for sex and age, significant correlations among adverse childhood experiences, resilience and IGD were observed; resilience was a partial mediator variable in the relationship between adverse childhood experiences and IGD. CONCLUSIONS The more adverse childhood experiences an individual has, the less their mental toughness and the greater their tendency to become addicted to internet games. Adverse childhood experiences can effectively predict IGD, and the risk of becoming addicted to the internet can be decreased by increasing one's mental toughness.
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Affiliation(s)
- Jinghao Ma
- Center for Mental Health Education and Counselling, Hangzhou Normal University
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Bo Yang
- Center for Mental Health Education and Counselling, Hangzhou Normal University
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Shizhen Wang
- Center for Mental Health Education and Counselling, Hangzhou Normal University
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Yujie Yao
- Center for Mental Health Education and Counselling, Hangzhou Normal University
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Chencheng Wu
- Center for Mental Health Education and Counselling, Hangzhou Normal University
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Mei Li
- Center for Mental Health Education and Counselling, Hangzhou Normal University
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, School of Clinical Medicine and the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
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Montague R, Canning SE, Thielking P, Qeadan F. Adverse childhood experiences and psychotropic medication prescription among cancer patients. J Psychosoc Oncol 2023; 42:543-557. [PMID: 38127059 DOI: 10.1080/07347332.2023.2296040] [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: 12/23/2023]
Abstract
BACKGROUND This study aimed at identifying and characterizing adverse childhood experiences (ACEs) in a sample of cancer patients and subsequently evaluating the relationship between ACEs and prescription of psychotropic medication among them. Individuals with ACEs have a higher risk of mental health conditions and are more likely to be prescribed psychotropic medications. METHODS A sample of 178 adult patients receiving Supportive Oncology & Survivorship (SOS) services at Huntsman Cancer Hospital in Utah was obtained. ACEs and Brief Resilient Coping Scale (BRCS) questionnaires were administered confidentially. A multivariable mixed effect model, adjusting for sex, age, and insurance type while controlling for zip-codes clustering were employed. RESULTS Compared to the prevalence of ACEs in the general population, from the CDC-Kaiser Permanente ACEs Study, we found no significant difference in the prevalence of people who had experienced an adverse childhood event (ACEs score > = 1) between our study of cancer patients and the CDC-Kaiser study (67.4% vs. 63.6%, p = 0.29372), but found a significant difference in the prevalence of people who had experienced severe adverse childhood experiences (ACES score > =4) (25.3% vs. 12.1%, p < 0.00001). Furthermore, this study reveals a significant association between an increase of one unit in the total ACEs score and the odds of psychotropic medication prescription in the past 12 months (OR: 1.233; 95% CI: 1.025, 1.483). Those with a total ACEs score of three or more were found to have 280% higher odds of being prescribed psychotropic medication compared to those with ACEs ≤ 2 (OR: 3.822; 95% CI: 1.404,10.407). CONCLUSION A significant proportion of cancer patients have a history of ACEs, and thus trauma-informed care approach is essential during their treatment.
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Affiliation(s)
| | - Sarah Elise Canning
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Paul Thielking
- Novamind, Toronto, Canada, and Cedarpsychiatry, Murray, UT, USA
| | - Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
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Trigylidas TE, Schnitzer PG, Dykstra HK, Badolato GM, McCarter R, Goyal MK, Lichenstein R. Firearm Deaths among Youth in the United States, 2007-2016. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1359. [PMID: 37628358 PMCID: PMC10453890 DOI: 10.3390/children10081359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/25/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023]
Abstract
We sought to compare risk factors contributing to unintentional, homicide, and suicide firearm deaths in children. We conducted a retrospective review of the National Fatality Review Case Reporting System. We included all firearm deaths among children aged 0-18 years occurring from 2007 to 2016. Descriptive analyses were performed on demographic, psychosocial, and firearm characteristics and their relationship to unintentional, homicide, and suicide deaths. Regression analyses were used to compare factors contributing to unintentional vs. intentional deaths. There were 6148 firearm deaths during the study period. The mean age was 14 years (SD ± 4 years), of which 81% were male and 41% were non-Hispanic White. The most common manners of death were homicide (57%), suicide (36%), and unintentional (7%). Over one-third of firearms were stored unlocked. Homicide deaths had a higher likelihood of occurring outside of the home setting (aOR 3.2, 95% CI 2.4-4.4) compared with unintentional deaths. Suicide deaths had a higher likelihood of occurring in homes with firearms that were stored locked (aOR 4.2, 95% CI 2.1-8.9) compared with unintentional deaths. Each manner of firearm death presents a unique set of psychosocial circumstances and challenges for preventive strategies. Unsafe firearm storage practices remain a central theme in contributing to the increased risk of youth firearm deaths.
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Affiliation(s)
- Theodore E. Trigylidas
- Division of Emergency Medicine, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA; (G.M.B.); (M.K.G.)
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037, USA;
| | - Patricia G. Schnitzer
- The National Center for Fatality Review & Prevention, 2395 Jolly Road Suite 120, Okemos, MI 48864, USA; (P.G.S.); (H.K.D.)
| | - Heather K. Dykstra
- The National Center for Fatality Review & Prevention, 2395 Jolly Road Suite 120, Okemos, MI 48864, USA; (P.G.S.); (H.K.D.)
| | - Gia M. Badolato
- Division of Emergency Medicine, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA; (G.M.B.); (M.K.G.)
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037, USA;
| | - Robert McCarter
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037, USA;
| | - Monika K. Goyal
- Division of Emergency Medicine, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA; (G.M.B.); (M.K.G.)
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037, USA;
| | - Richard Lichenstein
- Department of Pediatrics, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD 21201, USA;
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Khanijahani A, Tomassoni L. Socioeconomic and Racial/Ethnic Disparities in Recovery from Childhood Behavioral or Conduct Problems: Evidence from a Nationally Representative Sample of 3-17 Years Old US Children. J Immigr Minor Health 2023; 25:744-754. [PMID: 36576672 DOI: 10.1007/s10903-022-01444-3] [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] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
Our study provides nationally-generalizable evidence on the racial/ethnic and socioeconomic disparities in diagnosis and recovery from childhood behavioral or conduct problems. We pooled data from 4 years (2016-2019) of the National Survey of Children's Health (NSCH) for 3 to 17 years old US children (N = 114,476). We performed several logistic regression models using complex survey data analysis statistical methodologies to estimate nationally representative and generalizable results in the Stata MP 16 program. About 20.1% of 3-17 years old US children previously diagnosed with behavioral or conduct problems no longer had the current diagnosis (were recovered). Hispanic children [Odds ratio (OR) 0.77, 95% Confidence Interval (CI) 0.65-0-95], immigrant children or children of immigrant parents (first or second generation immigrant children), and children from high-income families [200-399% Federal Poverty Level (FPL)] were about 23%, 38%, and 21% less likely than non-Hispanic White children, children of US native parents, and children with a family income of below 100% FPL to be currently diagnosed with behavioral or conduct problems, respectively. Conversely, Non-Hispanic Black and Hispanic children were about 50% and 40% more likely than non-Hispanic White children to recover from a past diagnosis. Moreover, children from higher-income families (at or above 300% of FPL) were between 1.59 to 1.79 times more likely than those from low-income families (below 100% FPL) to recover from a past diagnosis. Racial/ethnic and socioeconomic disparities in diagnosing appear to persist in recovering from behavioral or conduct problems.
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Affiliation(s)
- Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, 600 Forbes Avenue Pittsburgh, Pittsburgh, PA, 15282, USA.
| | - Larisa Tomassoni
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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12
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Huang CX, Halfon N, Sastry N, Chung PJ, Schickedanz A. Positive Childhood Experiences and Adult Health Outcomes. Pediatrics 2023; 152:e2022060951. [PMID: 37337829 PMCID: PMC10312234 DOI: 10.1542/peds.2022-060951] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can drive poor adult mental and physical health, but the impact of early life protective factors should not be overlooked. Positive childhood experiences (PCEs) measures quantify protective factors, but evidence is lacking on their link to health conditions independent of ACEs in nationally representative studies. This study examines associations between composite PCE score and adult health, adjusting for ACEs. METHODS The most recent 2017 wave of the Panel Study of Income Dynamics, a nationally representative study and its 2014 Childhood Retrospective Circumstances supplement (n = 7496) collected adult health outcomes, PCEs, and ACEs. Multivariable logistic regression assessed associations between PCE score and adult self-rated health or condition diagnosis, with and without ACEs adjustment. Cox proportional hazards models examined relationships between PCEs, ACEs, and annual risk of diagnosis. RESULTS Adults with 5 to 6 PCEs had 75% (95% confidence interval [CI], 0.58-0.93) of the risk of fair/poor overall health and 74% of the risk of any psychiatric diagnosis (CI, 0.59-0.89) compared with those with 0 to 2 PCEs, independent of ACEs. In survival analysis models accounting for PCEs and ACEs, reporting 5 to 6 PCEs was associated with a 16% lower annual hazard of developing any adult psychiatric or physical condition (hazard ratio, 0.84; CI, 0.75-0.94); reporting 3+ ACEs was associated with a 42% higher annual hazard (CI, 1.27-1.59). CONCLUSIONS PCEs were independently associated with lower risks of fair or poor adult health, adult mental health problems, and developing any physical or mental health condition at any given age after adjusting for ACEs.
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Affiliation(s)
- Cher X. Huang
- David Geffen School of Medicine at UCLA, Los Angeles, California
- Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Neal Halfon
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles,California
- Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, California
| | - Narayan Sastry
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Paul J. Chung
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles,California
- Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Adam Schickedanz
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles,California
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Pugh SJ, Murray C, Groenewald CB. Positive Childhood Experiences and Chronic Pain Among Children and Adolescents in the United States. THE JOURNAL OF PAIN 2023; 24:1193-1202. [PMID: 36775002 PMCID: PMC10330007 DOI: 10.1016/j.jpain.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
Positive childhood experiences (PCEs) are associated with better mental and physical health outcomes and moderate the negative effects of adverse childhood experiences (ACEs). However, knowledge of the associations between PCEs and childhood chronic pain is limited. We conducted a cross-sectional analysis of 2019 to 2020 National Survey of Children's Health (NSCH) to evaluate associations between PCEs and childhood chronic pain. Parents of 47,514 children ages 6 to 17 years old reported on their child's exposure to 7 PCEs and 9 ACEs. Associations between PCEs and chronic pain were evaluated using weighted, multivariate logistic regression analyses adjusted for sociodemographic factors. We found that PCEs had dose-dependent associations with pediatric chronic pain; children exposed to higher numbers of PCEs (5-7 PCEs) had the lowest reported rate of chronic pain (7.1%), while children exposed to 2 or fewer PCEs had the highest rate of chronic pain (14.7%). The adjusted analysis confirmed that children experiencing 5 to 7 PCEs had significantly lower odds of chronic pain relative to children experiencing 0 to 2 PCEs (adjusted odds ratio (aOR): .47, 95% confidence interval (CI): .39-.61, P < .0001). PCEs moderated associations between ACEs and chronic pain: among children reporting 2 or more ACEs, those reporting 5 to 7 PCEs were significantly less likely to report chronic pain as compared to children only reporting 0 to 2 PCEs (aOR: .64, 95%CI: .45-.89, P = .009). In conclusion, children with greater PCEs exposure had lower prevalence rates of chronic pain. Furthermore, PCEs was associated with reduced prevalence of chronic pain among children exposed to ACEs. PERSPECTIVE: This article estimates associations between survey-measured PCEs and pediatric chronic pain among children in the United States. Promoting PCEs could improve pediatric pain outcomes.
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Affiliation(s)
- Sarah J Pugh
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Caitlin Murray
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Department of Anesthesiology & Pain Medicine, Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington
| | - Cornelius B Groenewald
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Department of Anesthesiology & Pain Medicine, Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington.
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14
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Wei X, Lü W. Childhood trauma and internalizing and externalizing behavior problems among adolescents: Role of executive function and life events stress. J Adolesc 2023; 95:740-750. [PMID: 36751143 DOI: 10.1002/jad.12150] [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: 09/13/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Exposure to childhood trauma is found to increase internalizing and externalizing behavior problems in adolescents, however, the potential mechanism of this link remains underexplored. This study investigated the associations between childhood trauma and internalizing and externalizing behavior problems among adolescents, and tested the mediating role of executive function and the moderating role of life events stress in this relationship. METHODS Questionnaire data were collected from 952 junior students in Northwest China. Participants ranged in age from 11 to 15 years old (M = 12.88 years, SD = 0.72; 53% females). SPSS 26.0 was used to analyze the relationship between variables and examine the mediation model and the moderated mediation model. RESULTS Childhood trauma was positively associated with internalizing and externalizing behavior problems among adolescents. In addition, executive function partially mediated the relations between childhood trauma and internalizing and externalizing behavior problems. Life events stress was observed to moderate the relations between childhood trauma and executive function, as well as executive function and internalizing and externalizing behavior problems, but the effect sizes were relatively small. CONCLUSIONS These findings underscore the role of executive function and life events stress in the association between childhood trauma and behavioral problems among adolescents.
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Affiliation(s)
- Xiaomin Wei
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, Xi'an, USA
| | - Wei Lü
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, Xi'an, USA
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15
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Habayeb S, Onofaro KC, Hawila N, Druskin LR, Godoy L, Long M. Mental Health Screening in Pediatric Primary Care: Factors Associated With Screening Completion and Elevated Scores. Clin Pediatr (Phila) 2023; 62:584-591. [PMID: 36457153 DOI: 10.1177/00099228221139983] [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] [Indexed: 12/03/2022]
Abstract
This study aimed to examine predictors of complete and elevated youth mental health screens. Parents of 4- to 11-year-old children completed the Strengths and Difficulties Questionnaire (SDQ) during a routine, universal mental health screening initiative in primary care. Bivariate logistic regressions were run to examine associations between independent (visit age, sex, race/ethnicity, language, insurance, and guardian) and dependent variables (screening completion and elevated SDQ score). Parents of younger and Spanish-speaking (vs English-speaking) children were less likely to have a complete SDQ screen. Among those with complete SDQ screens, older children, male children, those with public or no insurance, and those who had a mother (vs father) complete the screener were more likely to have an elevated score. Understanding patterns of screening completion rates and predictors of elevated screens provides valuable information to improve resource mapping and planning. Findings can inform mental health screening implementation and optimization within primary care.
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Affiliation(s)
- Serene Habayeb
- Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Kayla C Onofaro
- Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Nour Hawila
- Penn State College of Medicine, Hershey, PA, USA
| | | | - Leandra Godoy
- Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Melissa Long
- Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
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16
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Janse van Rensburg E, Woolard A, Hill NTM, Reid C, Milroy H, Ohan JL, Lin A, Chamberlain C. The effect of childhood maltreatment on adult survivors' parental reflective function, and attachment of their children: A systematic review. Dev Psychopathol 2023:1-15. [PMID: 37052290 DOI: 10.1017/s0954579423000391] [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: 04/14/2023]
Abstract
BACKGROUND Parental reflective function (PRF) is a candidate mechanism in the transmission of intergenerational trauma. This systematic review examined (1) the association between parental history of childhood maltreatment and PRF, (2) how PRF relates to attachment in children of parent survivors, and (3) whether PRF moderates the association between parental maltreatment history and child attachment. METHODS Ten databases were searched (from inception to 10th November 2021). Inclusion criteria were primary study, quantitative, parent participants, measures of childhood maltreatment, and postnatal PRF. Exclusion criteria were qualitative, intervention follow-up, gray literature, or a review study. Risk of bias was assessed using recommended tools. Data were narratively synthesized. RESULTS One-thousand-and-two articles were retrieved, of which eleven met inclusion criteria (N = 974 participants). Four studies found a significant association between parental childhood maltreatment and disrupted PRF, six did not, one found mixed results. One study reported the association between childhood maltreatment and attachment (nonsignificant results). DISCUSSION There is no clear evidence PRF is routinely disrupted in parent survivors, though there is high heterogeneity in studies. Future research should standardize design to better understand whether PRF is a candidate mechanism in intergenerational trauma. OTHER PROSPERO CRD42020223594.
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Affiliation(s)
- Elmie Janse van Rensburg
- Embrace, Telethon Kids Institute, WA, Australia
- School of Psychological Science, The University of Western Australia, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
| | - Alix Woolard
- Embrace, Telethon Kids Institute, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Medical School, University of Western Australia, WA, Australia
| | - Nicole T M Hill
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Centre for Child Health Research, University of Western Australia, WA, Australia
| | - Carol Reid
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Helen Milroy
- Embrace, Telethon Kids Institute, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Medical School, University of Western Australia, WA, Australia
| | - Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, WA, Australia
| | - Ashleigh Lin
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Centre for Child Health Research, University of Western Australia, WA, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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17
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The Role of the Mind-Body Connection in Children with Food Reactions and Identified Adversity: Implications for Integrating Stress Management and Resilience Strategies in Clinical Practice. CHILDREN 2023; 10:children10030563. [PMID: 36980121 PMCID: PMC10047561 DOI: 10.3390/children10030563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
Child adversity is often associated with poor quality of life in pediatric gastrointestinal disorders, including non-allergic food reactions (food intolerances), which may be improved using mind-body interventions. We conducted an observational study to (1) describe child adversity (stressors) and resilience factors in children with food intolerances, and (2) explore the association between stressors and self-reported use of integrative modalities. A retrospective chart review of children ≥4-years-old presenting to a pediatric food intolerances clinic from 2017 to 2020 was performed (n = 130). Use of integrative medicine at intake, demographic, illness, and social history data were collected. Qualitative analysis identified exposure to stressors and resilience strategies. Correlation was assessed using a chi-square test. Management of the medical condition was the most common stressor, indicating impact on quality of life. Resilience strategies included themes of self-coping and social support. Individuals with one or more stressors were more likely to be using an integrative modality (most commonly, mind-body interventions) prior to their visit (X2 = 8.1, p = 0.004). Our hypothesis-generating study suggests that screening for child adversity and integrative medicine use may be used to better address quality of life and personalized approaches to treat pediatric food intolerances.
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18
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Implementing trauma-informed care across the lifespan to acknowledge childhood adverse event prevalence: best clinical practices. Nurse Pract 2023; 48:14-21. [PMID: 36700790 DOI: 10.1097/01.npr.0000000000000002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
ABSTRACT Adverse childhood experiences and toxic stress in childhood have been correlated with negative physical and mental health outcomes, poor social outcomes, and early mortality. Understanding the prevalence of trauma and its effects on lifelong health outcomes has been the focus of an evolving concept of care delivery known as trauma-informed care (TIC). The aim of this article is to provide a general overview of TIC and to review current best-practice recommendations and models of care, thereby providing NPs with practical ways to empower a trauma-informed approach to care in their daily practice setting.
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19
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de Moraes VS, Fernandes M, Fernandes MNDF, Gimenez LBH, Camargo Júnior EB, Gherardi-Donato ECDS. Relationship between early-life stress and trait mindfulness in adulthood: a correlational study. BMC Psychol 2023; 11:15. [PMID: 36670498 PMCID: PMC9854227 DOI: 10.1186/s40359-022-01029-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/23/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To investigate the relationship between early-life stress (ELS) and the trait mindfulness level in workers. METHOD This study is quantitative cross-sectional and correlational research with a sample of 929 workers from a Brazilian public university. ELS and mindfulness assessment was performed using the Childhood Trauma Questionnaire (CTQ) and the Five-Facet Mindfulness Questionnaire-BR (FFMQ-BR), respectively. The data were submitted to correlation tests adopting a significance level of .05 and a multivariate linear regression analysis. RESULTS 50.0% of the participants obtained a score indicative of ELS exposure in at least one subtype among the five proposed by the CTQ, with emotional neglect predominating (63.0%). The group not exposed to emotional abuse had higher scores in the "describe-positive formulation" and "non-reactivity to inner experience" facets. Those that scored for physical abuse had higher values in "acting with awareness-autopilot". However, the group exposed to sexual abuse obtained the highest score in the "acting with awareness-autopilot" and "acting with awareness-distraction" facets. The correlation between FFMQ-BR and CTQ overall scores showed a weak correlation with statistical significance. The multiple linear revealed that the facets of mindfulness were significantly associated by at least one type of early stress; however, no significant association was found between CTQ and FFMQ-BR overall results. CONCLUSION The results showed that emotional regulation might have effectively occurred in this specific population, even with the presence of some childhood trauma.
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Affiliation(s)
- Vinícius Santos de Moraes
- grid.11899.380000 0004 1937 0722Graduate Program Psychiatric Nursing at the College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, Brazil
| | - Mariana Fernandes
- grid.11899.380000 0004 1937 0722Graduate Program Psychiatric Nursing at the College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, Brazil
| | - Maria Neyrian de Fátima Fernandes
- grid.411204.20000 0001 2165 7632Nursing Department of the Universidade Federal do Maranhão, Av. da Universidade, S/N, Dom Afonso Felipe Gregory, Imperatriz, MA CEP: 65915-240 Brazil
| | - Larissa Bessani Hidalgo Gimenez
- grid.11899.380000 0004 1937 0722Graduate Program Psychiatric Nursing at the College of Nursing, University of São Paulo at Ribeirão Preto, Ribeirão Preto, Brazil
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20
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Muacevic A, Adler JR, O. Omar ZT, Segun E, Evbayekha EO, Abolurin A, Egberuare EO, Ezegbe HC, Adegbosin A, Adedeji AG, Angaye EG, Izundu IC, Oyelade BO. Impact of Adverse Childhood Experiences on Resilience and School Success in Individuals With Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. Cureus 2022; 14:e31907. [PMID: 36579285 PMCID: PMC9792122 DOI: 10.7759/cureus.31907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 11/27/2022] Open
Abstract
Adolescents with emotional and behavioral disorders face known academic challenges and poor life outcomes. It was imperative to explore and find if the new diagnostic criterion for diagnosing autism profoundly affects educational outcomes and resilience in individuals diagnosed with co-occurring autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The literature is robust on the impact of adverse childhood experiences (ACEs) on educational outcomes and resilience in adolescents with no history of disability. Still, there remains a dearth of literature explaining, with no ambiguity, the complex relationships between ACEs and resilience, school engagement, and success in individuals with co-occurring ASD and ADHD. This study reviews the existing scholarships on the topic. The significance of this review is that it informs healthcare providers, rehabilitation counselors, and educators about the need for early identification of individuals with ASD and ADHD with a background in ACEs. This will enable interventions early enough to ensure they are more resilient and can obtain improved success in school-related and outside-school activities and eventually improved quality of life.
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21
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Okwori G. Role of Individual, Family, and Community Resilience in Moderating Effects of Adverse Childhood Experiences on Mental Health Among Children. J Dev Behav Pediatr 2022; 43:e452-e462. [PMID: 35385422 PMCID: PMC9462133 DOI: 10.1097/dbp.0000000000001076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/01/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mental health outcomes such as attention-deficit/hyperactivity disorder (ADHD), behavior disorders, anxiety, depression, and adverse childhood experiences (ACEs) are common disorders among children in the United States. Little is known on how potential resilient factors may moderate the relationship between exposure to ACEs and mental health outcomes. This study examines associations between ACEs and resilience on mental health outcomes using the 2018 National Survey of Children's Health (N = 26,572). METHOD Logistic regression and interactions examined the association between ACEs, resilience, and mental health outcomes. ACE exposure and low resiliency were associated with an increased likelihood of mental health outcomes. RESULTS There were significant interactions between exposure to ACEs and family resilience as well as significant interactions between ACE exposure and community resilience. On stratification, the presence of individual resilience and having all resilience measures decreased the odds of ADHD, behavioral disorders, anxiety, and depression and the presence of community resilience decreased the odds of depression among individuals who had experienced 4 or more ACEs. CONCLUSION These results illustrate the need to promote resilience measures for tackling mental health problems and reducing the negative effect of trauma in children.
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Affiliation(s)
- Glory Okwori
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN
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22
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Barbieri M, Mercado E. The impact of stay-at-home regulations on adolescents' feelings of loneliness and internalizing symptoms. J Adolesc 2022; 94:1022-1034. [PMID: 35938856 DOI: 10.1002/jad.12084] [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: 01/19/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted the daily social lives of adolescents by severely limiting social interactions which likely heightened levels of loneliness and a variety of internalizing symptoms. However, little is known about how social distancing adherence and subsequent stress caused by the novel social regulations impact adolescents' feelings of loneliness, and later mental health difficulties, including anxiety and depression. METHOD To close this gap, we examined the impact of social distancing regulations on adolescents' (N = 79; Mage = 16.16, SD = 1.15; 47 females; 23 males) depression and anxiety symptoms through loneliness by using data from a 5-week longitudinal study conducted on adolescents in the United States during the initial phases of COVID-19. RESULTS AND CONCLUSIONS Findings provided evidence that loneliness plays a unique mediating link between social distancing and symptoms of anxiety and depression. Overall, the present study highlights how social distancing during the COVID-19 pandemic has impacted adolescents' mental health during a developmental period that is considered a turning point for psychopathology.
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Affiliation(s)
- Marielena Barbieri
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Evelyn Mercado
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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23
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Anthony R, Paine AL, Westlake M, Lowthian E, Shelton KH. Patterns of adversity and post-traumatic stress among children adopted from care. CHILD ABUSE & NEGLECT 2022; 130:104795. [PMID: 33172646 DOI: 10.1016/j.chiabu.2020.104795] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/15/2020] [Accepted: 10/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Children adopted from care are more likely to have experienced early adversity, but little is known about the impact of early adversity on later post-traumatic stress (PTS) symptoms. OBJECTIVE To investigate sub-groups of adversity in a sample of adopted children and examine the association with later PTS symptoms. PARTICIPANTS AND SETTING A study of British children adopted from care using social worker records (N = 374) and questionnaire-based longitudinal study of n = 58 children over 4-years post adoptive placement. METHODS We used latent class analysis to identify subgroups of children based on commonalities in perinatal and postnatal adversity experienced prior to adoption and examined differences in PTS symptoms at 4-years post-placement between subgroups. RESULTS Nearly one in five (19 %) children were in the clinical or borderline ranges for symptoms of PTS arousal, 14 % for PTS avoidance and 8 % for PTS intrusion. The 5-class solution fitted the data best, with one class characterized by children with a low probability of experiencing any adversity, one perinatal adversity class and three classes capturing different patterns of adversity. The multiple complex adversity class involving both perinatal and postnatal adversity had significantly higher symptoms of PTS avoidance and arousal than other sub-groups. CONCLUSIONS The prevalence and complexity of PTS symptoms among adoptive children highlights the need for effective interventions considering different profiles of early adversity.
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Affiliation(s)
- R Anthony
- Centre for Development, Evaluation, Complexity, and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK.
| | - A L Paine
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
| | - M Westlake
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
| | - E Lowthian
- Centre for Development, Evaluation, Complexity, and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK
| | - K H Shelton
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
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Myat Zaw AM, Win NZ, Thepthien BO. Adolescents’ academic achievement, mental health, and adverse behaviors: Understanding the role of resilience and adverse childhood experiences. SCHOOL PSYCHOLOGY INTERNATIONAL 2022. [DOI: 10.1177/01430343221107114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the relationship between exposure to adverse childhood experiences (ACEs) and health in adolescents with high or low levels of resilience. Data came from the 2020 Bangkok Behaviour Surveillance Survey (BBSS). Multivariate logistic regression analyses examined associations between ACEs and health conditions overall, and for adolescents with low versus high resilience on the Grotberg’s Resilience Scale. Overall, 54.9% of adolescents reported 0 ACEs. Compared to adolescents with no ACEs, it was found that those with ≥ 1 ACE were more likely to experience insomnia, sadness, suicide attempt, depression, and excess alcohol consumption. Those with a history of four or more ACEs had worse mental health, higher total undesirable behaviour, and lower academic achievement. When the sample was divided into high resilience (60.2%) and low resilience (39.8%), having at least 1 ACEs (vs. 0 ACEs) was associated with worse mental health and undesirable behaviour in adolescents with low resilience. History of ACEs can predict adverse health conditions and undesirable behaviour among adolescents, and the strongest correlation is among adolescents with low resilience. Future studies are needed to develop strategies and interventions to increase adolescent resilience, and test whether improvements in resilience reduce the adverse impact of ACEs on adolescent mental/behavioural health.
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Affiliation(s)
- Aye Myat Myat Zaw
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Nay Zar Win
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Bang-on Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
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Reducing Psychological Stress of Chinese Adolescents by Mindfulness-Based Intervention: The Mediating Role of Resilience. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Blackwell CK, Mansolf M, Sherlock P, Ganiban J, Hofheimer JA, Barone CJ, Bekelman TA, Blair C, Cella D, Collazo S, Croen LA, Deoni S, Elliott AJ, Ferrara A, Fry RC, Gershon R, Herbstman JB, Karagas MR, LeWinn KZ, Margolis A, Miller RL, O’Shea TM, Porucznik CA, Wright RJ. Youth Well-being During the COVID-19 Pandemic. Pediatrics 2022; 149:e2021054754. [PMID: 35301542 PMCID: PMC9169239 DOI: 10.1542/peds.2021-054754] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The family stress model proposes economic hardship results in caregiver distress and relational problems, which negatively impact youth outcomes. We extend this model to evaluate the impact of coronavirus disease 2019 pandemic-related family hardships on caregiver and youth stress, and, in turn, youth's psychological well-being. We also investigate how social supports moderate this relationship. METHODS We used 2 samples of cross-sectional survey data collected between May 2020 and May 2021: children aged 2 to 12 years (n = 977) and adolescents aged 11 to 17 years (n = 669). Variables included pandemic-related family hardships, stress, social support, and youth life satisfaction. Data were analyzed using structural equation modeling. RESULTS Experiencing more pandemic-related family hardships was associated with increased caregiver and youth stress (b = 0.04 to 0.21, SE = 0.01-0.02) and, in turn, decreased youth life satisfaction (b = -0.36 to -0.38, SE = 0.04-0.07). Social connectedness (b^ = 0.11-0.17, SE = 0.04) and family engagement (b^ = 0.12-0.18, SE = 0.05-0.06) had direct positive associations with life satisfaction; for children aged 2 to 12 years, greater family engagement was associated with decreased effect of child stress on life satisfaction (b^ = 0.15, SE = 0.05). For adolescents, females had higher levels of stress compared with males (b^ = 0.40, SE = 0.6), and having anxiety and/or depression was associated with decreased life satisfaction (b^ = -0.24, SE = 0.11). CONCLUSIONS Caregivers and youth who experienced more coronavirus disease 2019 pandemic hardships had higher levels of stress, particularly adolescent females. Although stress negatively impacted life satisfaction across all ages, family engagement was a protective factor for children aged 2 to 12 years, whereas having anxiety and/or depression was a risk factor for adolescents. For all youth, however, being more socially connected and engaged with family promoted life satisfaction.
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Maxwell Mansolf
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Phillip Sherlock
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jody Ganiban
- Department of Psychology & Brain Sciences, Columbian School of Arts and Sciences, George Washington University, Washington, DC
| | | | - Charles J. Barone
- Department of Pediatrics, Henry Ford Health System, Detroit, Michigan; School of Medicine, Wayne State University, Detroit, Michigan
| | | | - Clancy Blair
- New York University Langone Health, New York, New York
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shaina Collazo
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lisa A. Croen
- Kaiser Permanente North California, Oakland, California
| | - Sean Deoni
- Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Amy J. Elliott
- Avera Research Institute & Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota
| | | | - Rebecca C. Fry
- University of North Carolina, Chapel Hill, North Carolina
| | - Richard Gershon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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27
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Amone-P'Olak K. Prevalence, distribution and attributable risks of adverse childhood experiences in different family types: A survey of young adults in Botswana. CHILD ABUSE & NEGLECT 2022; 126:105513. [PMID: 35144077 DOI: 10.1016/j.chiabu.2022.105513] [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: 04/10/2021] [Revised: 11/15/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although adverse childhood experiences (ACEs) are often associated with poor outcomes in adulthood, little is known about its distribution in various family types, especially in low- and middle-income countries. OBJECTIVE We assessed the prevalence, distribution, and attributable risks of ACEs in different family types in early adults. METHODS Using data from 483 young adults (18-25 years of age), we assessed the prevalence and distribution of ACEs and employed binary logistic regressions to quantify the attributable risk of ACEs in different family types: nuclear (reference), single-mother, separated/divorced, and extended family types. We compared respondents without reports of ACEs (reference) to those reporting different numbers of ACEs (1 or more, 2 or more, 3 or more, 4 or more and 5 or more) to assess attributable risks of ACEs in different family types. RESULTS Out of the 483 participants, (female = 262 [53.3%]), 26.7% reported no ACEs, 21.1% reported 1 ACE, 13.3% reported 2 ACEs, and 38.9% reported 3 or more ACEs. Two hundred thirty-two (48%) and 153 (31.7%) students reported that they were from a nuclear and single-mother family types, respectively. Overall, there were higher densities of ACEs in single-mother and separated/divorced compared to nuclear family type. Compared to nuclear family type, the attributable risks of ACEs for single-mother family type ranged from 2.85 (95% Confidence Intervals (CI) 1.65) to 4.13 (95% CI: 1.92-8.91) and for separate/divorced family type ranging from 3.69 (95% CI: 1.72) to 6.32 (95% CI: 2.40-16.64). CONCLUSIONS The odds of ACEs differ with family types and were markedly pronounced in single-mother and separated/divorced compared to nuclear family types. Interventions to mitigate the effects of ACEs should be targeted at family types with a high density of ACEs. Professionals should design programmes targeting single-mother, separated/divorced and extended family types to alleviate the negative effects of childhood adversity.
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Affiliation(s)
- Kennedy Amone-P'Olak
- Department of Psychology, Faculty of Social Sciences, Kyambogo University, Uganda.
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28
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Offerman ECP, Asselman MW, Bolling F, Helmond P, Stams GJJM, Lindauer RJL. Prevalence of Adverse Childhood Experiences in Students with Emotional and Behavioral Disorders in Special Education Schools from a Multi-Informant Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063411. [PMID: 35329097 PMCID: PMC8948877 DOI: 10.3390/ijerph19063411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/20/2022] [Accepted: 03/08/2022] [Indexed: 02/05/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with an increased risk of developing severe emotional and behavioral problems; however, little research is published on ACEs for students with emotional and behavioral disorders (EBD) in special education (SE) schools. We therefore systematically explored the prevalence, type and timing of ACEs in these students from five urban SE schools in the Netherlands (Mage = 11.58 years; 85.1% boys) from a multi-informant perspective, using students’ self-reports (n = 169), parent reports (n = 95) and school files (n = 172). Almost all students experienced at least one ACE (96.4% self-reports, 89.5% parent reports, 95.4% school files), and more than half experienced four or more ACEs (74.5% self-reports, 62.7% parent reports, 59.9% school files). A large majority of students experienced maltreatment, which often co-occurred with household challenges and community stressors. Additionally, 45.9% of the students experienced their first ACE before the age of 4. Students with EBD in SE who live in poverty or in single-parent households were more likely to report multiple ACEs. Knowledge of the prevalence of ACEs may help understand the severe problems and poor long-term outcomes of students with EBD in SE.
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Affiliation(s)
- Evelyne C. P. Offerman
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
- Correspondence: ; Tel.: +31-65374496
| | - Michiel W. Asselman
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
| | - Floor Bolling
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
| | - Petra Helmond
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; (P.H.); (R.J.L.L.)
| | - Geert-Jan J. M. Stams
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands;
| | - Ramón J. L. Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; (P.H.); (R.J.L.L.)
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
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29
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Hagerman TK, McKernan GP, Carle AC, Yu JA, Stover AD, Houtrow AJ. The Mental and Physical Health of Mothers of Children with Special Health Care Needs in the United States. Matern Child Health J 2022; 26:500-510. [PMID: 35072870 DOI: 10.1007/s10995-021-03359-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the prevalence of poor mental and physical health among mothers of children with special health care needs (CSHCN) and to determine the association between maternal health and the child's number of special health care needs (SHCN) and severity of ability limitation. METHODS We used the combined 2016-2018 National Survey of Children's Health Dataset of 102,341 children ages 0-17 including 23,280 CSHCN. We used regression models to examine the associations of a child's number of SHCN and ability limitations with maternal health. RESULTS Twice as many mothers of CSHCN had poor mental and physical health compared to non-CSHCN (mental 10.3% vs. 4.0%, p < .001; physical 11.9% vs 5.0%, p < .001). In regression models, increased number of SHCN and severity of activity limitations were associated with significantly increased odds of poor maternal health. CONCLUSIONS FOR PRACTICE Mothers of CSHCN have worse health compared to mothers of non-CSHCN, especially those who experience social disadvantage and those with children with complex SHCN or severe ability limitations. Interventions to improve the health of these particularly vulnerable caregivers of CSHCN are warranted.
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Affiliation(s)
- Thomas K Hagerman
- Departments of Emergency Medicine and Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Gina P McKernan
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adam C Carle
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine and College of Arts and Sciences, Cincinnati, OH, USA
| | - Justin A Yu
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alyson D Stover
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amy J Houtrow
- Department of Pediatrics and Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
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30
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Lackova Rebicova M, Dankulincova Veselska Z, Husarova D, Madarasova Geckova A, Jansen DEMC, van Dijk JP, Reijneveld SA. Does Resilience Mediate the Association of Adverse Early Childhood Experiences With Emotional and Behavioural Problems? Int J Public Health 2021; 66:1604006. [PMID: 34899140 PMCID: PMC8656252 DOI: 10.3389/ijph.2021.1604006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To explore the role of resilience as a mediator in the association between adverse childhood experiences (ACE) and emotional and behavioural problems (EBP) among adolescents. Methods: We used data from the Slovak 2018 Health Behaviour in School-aged Children study, comprising 2,839 adolescents aged 13–15 (mean age 13.93; 49.6% boys). We used multivariate linear regression performed on 5000 bootstrap samples adjusted for age, gender, family affluence to explore mediation of the associations between ACE (measured using the adapted Adverse Childhood Experience Questionnaire) and EBP (measured using the Strengths and Difficulties Questionnaire) by resilience (measured with the Child and Youth Resilience Measure). Results: We found ACE [B = 0.78; 95% confidence interval (CI): 0.67|0.90] and resilience (B = −0.73; 95% CI: −0.79|−0.67) to be significantly associated with EBP. The association of ACE and EBP was mediated by resilience. The mediated indirect effect of resilience was ab = 0.25; 95% CI: 0.18|0.32. Conclusion: Resilience seems to play a mediator role in the relationship between ACE and EBP. Helping adolescents with ACE to build and use internal and external sources of resilience can decrease the negative impact of ACE on EBP.
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Affiliation(s)
- Miriama Lackova Rebicova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Daniela Husarova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech
| | - Danielle E M C Jansen
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia.,Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech
| | - Sijmen A Reijneveld
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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31
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Munk K, Rosenblum R, Blackburn S, Donahue E. The Impact of Education and Implementation Tools on Pre-Service Teachers' Attitudes About Classroom-Based Mindfulness. J Sch Nurs 2021; 38:547-557. [PMID: 34792417 DOI: 10.1177/10598405211059189] [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: 11/15/2022] Open
Abstract
A growing body of research suggests that incorporating classroom-based mindfulness interventions in elementary schools can lead to improvements in student behavior, self-regulation, and measures of mental health and wellness. This quality improvement project explored the impact of an educational intervention on pre-service teachers' perceptions, attitudes, and intentions to implement mindfulness interventions in their classrooms. A brief educational intervention and website resource were provided to multidisciplinary teaching credential students. Participants completed a pre- and post-intervention survey to evaluate their intentions to implement mindfulness practices, as well as their perceptions about the acceptability, reasonableness, and effectiveness of incorporating mindfulness interventions in the classroom. Significant differences in pre- to post-intervention survey scores indicate that exposure to mindfulness concepts, practices, and resources may increase the willingness of pre-service teachers to adopt these practices in their classrooms.
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Affiliation(s)
- Kirsten Munk
- Department of Nursing, 300424California State University, Northern California Consortium, Fresno and San Jose, CA, USA.,School of Nursing, 300424California State University, Sacramento, CA, USA
| | - Ruth Rosenblum
- Department of Nursing, 300424California State University, Northern California Consortium, Fresno and San Jose, CA, USA.,The Valley Foundation School of Nursing, San Jose State University, 7161San Jose, CA, USA
| | - Samantha Blackburn
- School of Nursing, 300424California State University, Sacramento, CA, USA
| | - Eden Donahue
- School of Nursing, 300424California State University, Sacramento, CA, USA
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32
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Crouch E, Radcliff E, Bennett KJ, Brown MJ, Hung P. Examining the Relationship Between Adverse Childhood Experiences and ADHD Diagnosis and Severity. Acad Pediatr 2021; 21:1388-1394. [PMID: 33746042 DOI: 10.1016/j.acap.2021.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/21/2021] [Accepted: 03/05/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although prior research has examined the prevalence of ACEs among children with attention deficit-hyperactivity disorder (ADHD), little is known about the household and family settings of children with ADHD. Our study utilizes a recent nationally representative dataset to examine the association between adverse childhood experiences (ACEs), child and household characteristics, and ADHD diagnosis and severity. METHODS Using the 2017-2018 National Survey of Children's Health (NSCH), our sample consisted of children three years of age or older, as this is the youngest age at which the NSCH begins to ask caregivers if a child has been diagnosed with ADHD (n = 42,068). Multivariable logistic regression was used to examine the association between ACE type, score, and ADHD and ADHD severity, controlling for child and household characteristics. RESULTS Children exposed to four or more ACEs had higher odds of ADHD (aOR 2.16; 95% CI 1.72-2.71) and moderate to severe ADHD (aOR 1.89; 95% CI 1.31-2.72) than children exposed to fewer than four ACEs. Other child characteristics positively associated with ADHD included age and public insurance; other Non-Hispanic races compared to Non-Hispanic White had lower odds of ADHD. Of children reported with ADHD, public insurance was also associated with caregiver-reported moderate to severe ADHD. CONCLUSIONS Children with ADHD have a higher prevalence of ACEs, making this study important for understanding the relationship between ACEs and ADHD at the population level.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health (E Crouch, E Radcliff, MJ Brown), University of South Carolina, Columbia, SC.
| | - Elizabeth Radcliff
- Rural and Minority Health Research Center, Arnold School of Public Health (E Crouch, E Radcliff, MJ Brown), University of South Carolina, Columbia, SC
| | - Kevin J Bennett
- Department of Family and Preventive Medicine (KJ Bennett), University of South Carolina School of Medicine, Columbia, SC
| | - Monique J Brown
- Rural and Minority Health Research Center, Arnold School of Public Health (E Crouch, E Radcliff, MJ Brown), University of South Carolina, Columbia, SC
| | - Peiyin Hung
- Rural and Minority Health Research Center, Arnold School of Public Health (E Crouch, E Radcliff, MJ Brown), University of South Carolina, Columbia, SC
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33
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Song J, Fogarty K, Suk R, Gillen M. Behavioral and mental health problems in adolescents with ADHD: Exploring the role of family resilience. J Affect Disord 2021; 294:450-458. [PMID: 34325164 DOI: 10.1016/j.jad.2021.07.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Family resilience and its role in behavioral and mental health problems has not been well documented among U.S. adolescents, especially those with ADHD. METHODS Using data from the 2016 and 2017 National Survey of Children's Health (NSCH), we examined associations between family resilience connection index (FRCI) and conduct problems, depression, anxiety, and substance abuse in adolescents with ADHD aged 11-17 (n=4,169). Data were analyzed using multivariate logistic regression and chi-square tests. RESULTS Adolescents with ADHD who had a lower FRCI score were more likely to have conduct problems (OR:1.64, CI:1.13-2.38) and depression (OR: 3.08, CI: 2.12-4.49). There were small differences between adjusted and unadjusted odds after controlling for adverse childhood experience and other covariates. LIMITATION We could not assert prediction or causation, only associations among variables, due to the cross-sectional design of the 2016-2017 NSCH; however, a major advantage of the NSCH is that it includes a nationally representative sample of children and allows inferences to be made for understanding of the adolescents with ADHD in the U.S. CONCLUSION Findings suggest that family resilience may serve as a protective factor that leads to decreasing conduct problems, despite experiencing adversity in childhood. Targeting family resilience, in terms of teaching families ways to cope with adversities such as: a child's diagnosis of ADHD; behavioral problems, and/or other adverse experiences in children's environments, has great potential to reduce adolescents' conduct and mental health problems.
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Affiliation(s)
- Jihee Song
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, United States.
| | - Kate Fogarty
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, United States
| | - Ryan Suk
- Center for Health Services Research, Department of Management, Policy and Community Health, UT Health School of Public Health, Huston, TX, United States
| | - Martie Gillen
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, United States
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34
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Morgart K, Harrison JN, Hoon AH, Wilms Floet AM. Adverse childhood experiences and developmental disabilities: risks, resiliency, and policy. Dev Med Child Neurol 2021; 63:1149-1154. [PMID: 33938573 DOI: 10.1111/dmcn.14911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/11/2023]
Abstract
Thanks to the seminal work of Robert Anda and Vincent Felitti, it is now widely accepted that adverse childhood experiences (ACEs) can have lifelong effects on physical, behavioral, and mental health and that many adult diseases can be considered developmental disorders that began early in life. Genomics has advanced the neurobiological understanding that underpins ACEs, wellness, and disease, which are modulated through stress pathways and epigenetic modifications. While data are currently limited, children with developmental disabilities have an increased ACE risk compared to typically developing peers. This recognition has important ramifications for health and policy interventions that address the root causes of ACEs, especially in this vulnerable population. With increased societal recognition, advances in policy will lead to medical, financial, and public benefits in years to come, hopefully changing healthcare models from 'sick care' to 'well care'. What this paper adds Adverse childhood experience (ACE) research has refocused medicine from the question 'What is wrong with you?' to 'What happened to you?'. Adopting ACE research into public policy can redirect healthcare models from providing 'sick care' to promoting 'well care'. Not exploring the role of ACEs in children with developmental disabilities leads to further vulnerability and morbidity. ACEs can be mitigated by early identification and implementation of evidence-based interventions.
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Affiliation(s)
| | - Joyce Nolan Harrison
- Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander H Hoon
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Anna Maria Wilms Floet
- Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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35
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Jeffrey JK, Venegas-Murillo AL, Krishna R, Hajal NJ. Rating Scales for Behavioral Health Screening System Within Pediatric Primary Care. Child Adolesc Psychiatr Clin N Am 2021; 30:777-795. [PMID: 34538448 DOI: 10.1016/j.chc.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Barriers to conducting standardized behavioral health screening within pediatric primary care settings include engaging youth and families, limited time available for this activity, and difficulties related to obtaining behavioral health consultation and treatment from specialists. Child and adolescent psychiatrists may assist pediatric primary care practices with engaging youth and families around screening by assisting with identifying rating scales that have good psychometric characteristics across multiple languages and are validated in diverse samples and available within the public domain. Additionally, they may partner with pediatric primary care professionals to assist with optimizing screening workflows and linkage to specialized services.
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Affiliation(s)
- Jessica K Jeffrey
- Department of Psychiatry & Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A7-372A, Los Angeles, CA 90095, USA.
| | - Angela L Venegas-Murillo
- Department of Pediatrics, College of Medicine, Charles R. Drew University of Medicine & Science, 1748 East 118th Street, Room N147, Los Angeles, CA 90059, USA; Department of General Internal Medicine and Health Service Research, UCLA Health, Los Angeles, CA, USA
| | - Rajeev Krishna
- Behavioral Health, Department of Psychiatry, Nationwide Children's Hospital, 444 Butterfly Garden's Drive, Columbus, OH 43215, USA
| | - Nastassia J Hajal
- Department of Psychiatry & Biobehavioral Sciences, Division of Population Behavioral Health, UCLA-Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA
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36
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Abstract
Most children will experience some type of trauma during childhood, and many children suffer from significant adversities. Research in genetics, neuroscience, and epidemiology all provide evidence that these experiences have effects at the molecular, cellular, and organ level, with consequences on physical, emotional, developmental, and behavioral health across the life span. Trauma-informed care translates that science to inform and improve pediatric care and outcomes. To practically address trauma and promote resilience, pediatric clinicians need tools to assess childhood trauma and adversity experiences as well as practical guidance, resources, and interventions. In this clinical report, we summarize current, practical advice for rendering trauma-informed care across varied medical settings.
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Affiliation(s)
- Heather Forkey
- Department of Pediatrics, University of Massachusetts, Worcester, Massachusetts
| | - Moira Szilagyi
- Divisions of General and Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Erin T Kelly
- Ambulatory Health Services, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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37
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Kuhar M, Zager Kocjan G. Associations of adverse and positive childhood experiences with adult physical and mental health and risk behaviours in Slovenia. Eur J Psychotraumatol 2021; 12:1924953. [PMID: 34262663 PMCID: PMC8253200 DOI: 10.1080/20008198.2021.1924953] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/17/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48-9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46-0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.
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Affiliation(s)
- Metka Kuhar
- Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
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McKeen H, Hook M, Podduturi P, Beitzell E, Jones A, Liss M. Mindfulness as a mediator and moderator in the relationship between adverse childhood experiences and depression. CURRENT PSYCHOLOGY 2021; 42:6576-6586. [PMID: 34177211 PMCID: PMC8215089 DOI: 10.1007/s12144-021-02003-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 12/11/2022]
Abstract
Adverse childhood experiences (ACEs) have been associated with a variety of negative physical and psychological health outcomes. The mechanisms by which this occurs and potential protective factors present in this relationship are understudied. Mindfulness is a cognitive resource that may protect individuals against symptoms of psychological distress. It has five core facets and encourages a nonjudgmental acceptance of the present moment. The purpose of this study was to explore the role of mindfulness in the relationship between ACEs and depression, both as a mediator and as a moderator, or protective factor. We hypothesized that the aware, describe, and non-judgement facets of mindfulness would be key factors in both sets of analyses. Participants at a university (N = 279) were given the Five Factor Mindfulness Questionnaire (FFMQ), the Adverse Childhood Experiences Scale (ACES), and the Patient Health Questionnaire (PHQ-8) to measure depression. Results indicated that the describe CI [.02, .11], aware CI [.05, .17], and non-judgement CI [.06, .18] facets of mindfulness significantly mediated the relationship between ACEs and depression. Additionally, the aware facet of mindfulness was also a significant moderator in this relationship, [t (interaction) = -3.22, p < 0.01], such that individuals with a high level of awareness had no increase in depression even as the number of ACEs increased. Negative cognitions associated with ACEs may harm one's ability to effectively describe their feelings and to be fully aware of the present moment, which may contribute to symptoms of depression. Implications for mindfulness-based interventions (MBIs) are discussed.
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Affiliation(s)
- Haley McKeen
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Megan Hook
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Purnaja Podduturi
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Emily Beitzell
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Amelia Jones
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Miriam Liss
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
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Burstein D, Yang C, Johnson K, Linkenbach J, Sege R. Transforming Practice with HOPE (Healthy Outcomes from Positive Experiences). Matern Child Health J 2021; 25:1019-1024. [PMID: 33954880 PMCID: PMC8098787 DOI: 10.1007/s10995-021-03173-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Dina Burstein
- Center for Community-Engaged Medicine, Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, 800 Washington Street, Boston, MA 02111 USA
| | - Chloe Yang
- Center for Community-Engaged Medicine, Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, 800 Washington Street, Boston, MA 02111 USA
| | - Kay Johnson
- Johnson Group Consulting, Inc., Hinesburg, USA
| | | | - Robert Sege
- Center for Community-Engaged Medicine, Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, 800 Washington Street, Boston, MA 02111 USA
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Yuan Y. Mindfulness training on the resilience of adolescents under the COVID-19 epidemic: A latent growth curve analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 172:110560. [PMID: 33518868 PMCID: PMC7831962 DOI: 10.1016/j.paid.2020.110560] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/15/2020] [Accepted: 11/25/2020] [Indexed: 11/11/2022]
Abstract
As a preventive measure during the COVID-19 epidemic, we have had to stay at home for a long time. The lifestyle of adolescents has undergone severe changes. Almost every school started online education for the first time. Some adolescents have shown low resilience when faced with these changes. Most previous research has focused on mindfulness training and resilience by using cross-sectional or two-point tracking designs. However, little is known about the developmental trajectories of the impact of mindfulness training on resilience, particularly during this epidemic. Therefore, this study aims to explore how the developmental trajectories of resilience are impacted by mindfulness training. After administering the CD-RISC, we recruited 90 students with low levels of resilience in intervention group. Finally, 84 adolescents provided data at each assessment. At the same time, we selected 90 students in the control group. Paired sample t-test was used to compare every factor defined above by time. The result showed that mindfulness training increased students' resilience and emotional intelligence in experiment group. Then in the experiment group, latent growth modeling was used to (1) examine initial levels and changes in resilience over time and (2) predict initial levels and growth in resilience based on emotional intelligence. The findings of this study are as follows: during a mindfulness training intervention, (1) individual resilience tends to increase, and rate of increase grows gradually; there are also significant individual differences in the initial level and development speed; (2) individual emotional intelligence can promote the growth of resilience. With the worldwide outbreak of COVID-19, more and more attention is paid to the mental health of students. The research in this article shows that mindfulness training program should be given increasing consideration in the future.
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Affiliation(s)
- Yue Yuan
- Renming University of China, China
- The Second Middle School of Jimsar, China
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Dong C, Xu R, Xu L. Relationship of childhood trauma, psychological resilience, and family resilience among undergraduate nursing students: A cross-sectional study. Perspect Psychiatr Care 2021; 57:852-859. [PMID: 32959906 DOI: 10.1111/ppc.12626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/31/2020] [Accepted: 09/12/2020] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To analyze how family resilience mediates the relationship between childhood trauma and psychological resilience in undergraduate nursing students. DESIGN AND METHODS A cross-sectional survey design was used to investigate 698 nursing undergraduate students (mean age: 18.77 ± 0.86 years) using the Childhood Trauma Questionnaire, Family Resilience Assessment Scale, and Connor-Davidson Resilience Scale. The mediating effect of family resilience was estimated using structural equation modeling and the bootstrap method. FINDINGS Both childhood trauma and family resilience were associated with psychological resilience. Family resilience showed a partial mediating effect between childhood trauma and psychological resilience, accounting for 21.5% of the total effect. PRACTICE IMPLICATION Our findings may help inform family interventions to improve the psychological resilience of nursing students, especially for those with childhood trauma experience.
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Affiliation(s)
- Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ru Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liuqing Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
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42
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Pathways to well-being: Untangling the causal relationships among biopsychosocial variables. Soc Sci Med 2021; 272:112846. [DOI: 10.1016/j.socscimed.2020.112846] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 12/30/2019] [Accepted: 02/08/2020] [Indexed: 02/07/2023]
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Noel-London K, Ortiz K, BeLue R. Adverse childhood experiences (ACEs) & youth sports participation: Does a gradient exist? CHILD ABUSE & NEGLECT 2021; 113:104924. [PMID: 33461113 DOI: 10.1016/j.chiabu.2020.104924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/12/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Exposure to adverse childhood experiences (ACEs) may be an important factor in understanding sport participation in youth. Yet, very little research has examined this relationship directly using nationally representative data from the United States. OBJECTIVE This study aimed to examine the associations between ACEs and sport participation in adolescents. METHODS Using a 2017-2018 pooled dataset of the National Survey of Children's Health [NSCH], survey weighted chi-squared analysis and multivariable logistic regressions were implemented to assess the association between ACEs and sport participation among youth aged 10-17 years, comparing those without reports of ACEs (ref) to those reporting ACEs. The sample was also stratified to examine gendered differences. Models were adjusted for sociodemographic and child health covariates (physical activity, gender, age, BMI, race/ethnicity, parent reported child health, parental educational attainment, family structure, health insurance coverage, year and mental health conditions). RESULTS Of 23,557 youth included in our study (12,454 boys [51%], 11,303 girls [49%]; 21.9% reported 1 ACE, 10.1% reported 2 ACEs, and 14.3% reported 3 or more ACEs. In fully adjusted models, we observed significant associations between all levels of ACE exposure and decreased sport participation. When examined by gender, adjusted models revealed that only boys reporting 1ACE exhibited decreased odds of participating in sport OR = 0.70 (95% CI: 0.56, 0.89). CONCLUSIONS ACE exposure in adolescents is associated with reduced odds of sport participation. While sport is traditionally seen as an intervention for youth to build resilience, it may be prudent to consider targeted interventions that encourage sport participation in youth who experience ACEs. Special consideration may be needed for boys who experience ACEs. Additionally, the results suggest that utilising a trauma informed framework within the world of youth sport and sports medicine may be of value overall.
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Affiliation(s)
- Kemba Noel-London
- College for Public Health and Social Justice, Department of Health Management and Policy, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA.
| | - Kasim Ortiz
- Department of Sociology & Criminology, University of New Mexico, Albuquerque, New Mexico, NM, 87131, USA
| | - Rhonda BeLue
- College for Public Health and Social Justice, Department of Health Management and Policy, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA
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Hall A, Perez A, West X, Brown M, Kim E, Salih Z, Aronoff S. The Association of Adverse Childhood Experiences and Resilience With Health Outcomes in Adolescents: An Observational Study. Glob Pediatr Health 2021; 8:2333794X20982433. [PMID: 33614836 PMCID: PMC7868450 DOI: 10.1177/2333794x20982433] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022] Open
Abstract
The relationship between Adverse childhood experiences (ACEs), resilience, and health outcomes has not been as thoroughly studied in adolescents. Adolescents completed the ACEs Questionnaire and a validated resilience measure (Child Youth Resilience Measure, or CYRM). Poor health outcome was having 1 or more: obesity, hypertension, and/or depression. 34.5% of teens had a poor health outcome, 38.6% had ACE scores of 4 or more, and resilience ranged from 45 to 84 (mean = 74.6). By univariate and bivariate analysis, ACEs (OR = 1.11, 95% CI = 1.03-1.19, P = .0039; OR = 1.08, 95% CI = 1.0-1.16, P = .045) and resilience (OR = 0.95, 95% CI = 0.92-0.98, P = .0016; OR = 0.96, 95% CI = 0.93-0.99, P = .016) were significantly associated with poor health outcome. Resilience relationship subscale was significantly associated with reduced health risk (OR = 0.85, 95%CI = 0.75-0.95, P = .005). ACEs are associated with poor health outcomes in adolescents, resilience is inversely related, and the caregiver relationship may be the driving force.
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Affiliation(s)
- Ashleigh Hall
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Alberly Perez
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Xandria West
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Maryilyn Brown
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Ella Kim
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Zainab Salih
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Stephen Aronoff
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Struck S, Stewart-Tufescu A, Asmundson AJN, Asmundson GGJ, Afifi TO. Adverse childhood experiences (ACEs) research: A bibliometric analysis of publication trends over the first 20 years. CHILD ABUSE & NEGLECT 2021; 112:104895. [PMID: 33388607 DOI: 10.1016/j.chiabu.2020.104895] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/26/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The relative health and robustness of a field of research can be approximated by assessing peer reviewed journal publication trends for articles pertinent to the field. To date, there have been no such assessments of the burgeoning research on adverse childhood experiences (ACEs). OBJECTIVE The overall goal of this study was to examine ACEs research trends using bibliometric methods. More specifically, we sought to describe observed publication trends of the ACEs literature from its inception in the late 1990s. We also analyzed the nature of ACEs publications with regard to key characteristics of main outcomes, levels of analysis, and populations of primary focus. METHODS A search was conducted using Scopus to identify English language papers on ACEs published in peer-reviewed journals between 1998 and 2018. The primary field of research was determined by having independent raters code the title of the publishing journal into distinct categories. Main research outcomes were similarly coded. RESULTS A total of 789 articles on ACEs appearing in 351 different academic journals were published between 1998 and 2018. There was considerable growth in the number of ACEs papers published over the past several years. General medicine and multidisciplinary research were the most frequent of 12 primary fields of research characterizing ACEs research. Of 16 primary outcomes on which ACEs research focused, the most common were mental health and physical health. CONCLUSION Significant growth in ACEs research over the past several years suggest the field is thriving. Observed publication trends and publication characteristics are discussed briefly.
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Affiliation(s)
- Shannon Struck
- S113-750 Bannatyne Avenue, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
| | - Ashley Stewart-Tufescu
- S113-750 Bannatyne Avenue, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
| | - Aleiia J N Asmundson
- Department of Psychology, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15282, United States.
| | - Gordon G J Asmundson
- Department of Psychology and Anxiety and Illness Behaviours Lab, University of Regina, Regina, Canada.
| | - Tracie O Afifi
- S113-750 Bannatyne Avenue, Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, R3E 0W5, Canada.
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Hays-Grudo J, Morris AS, Beasley L, Ciciolla L, Shreffler K, Croff J. Integrating and synthesizing adversity and resilience knowledge and action: The ICARE model. AMERICAN PSYCHOLOGIST 2021; 76:203-215. [PMID: 33734789 PMCID: PMC8188569 DOI: 10.1037/amp0000766] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article proposes a model for understanding the effects of adverse childhood experiences (ACEs) as dynamic and interrelated biobehavioral adaptations to early life stress that have predictable consequences on development and health. Drawing upon research from multiple theoretical and methodological approaches, the intergenerational and cumulative adverse and resilient experiences (ICARE) model posits that the negative consequences of ACEs result from biological and behavioral adaptations to adversity that alter cognitive, social, and emotional development. These adaptations often have negative consequences in adulthood and may be transmitted to subsequent generations through epigenetic changes as well as behavioral and environmental pathways. The ICARE model also incorporates decades of resilience research documenting the power of protective relationships and contextual resources in mitigating the effects of ACEs. Examples of interventions are provided that illustrate the importance of targeting the dysregulated biobehavioral adaptations to ACEs and developmental impairments as well as resulting problem behaviors and health conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jennifer Hays-Grudo
- Department of Psychiatry and Behavioral Science, OSU Center for Health Sciences
| | | | - Lana Beasley
- Department of Human Development and Family Science, Oklahoma State University
| | | | - Karina Shreffler
- Department of Human Development and Family Science, Oklahoma State University, Tulsa
| | - Julie Croff
- Department of Rural Health, OSU Center for Health Sciences
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Smith E, Milaney K, Henderson RI, Crowshoe L. Adverse childhood experiences and health among indigenous persons experiencing homelessness. BMC Public Health 2021; 21:85. [PMID: 33413243 PMCID: PMC7791826 DOI: 10.1186/s12889-020-10091-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Current literature has established that adverse childhood experiences (ACEs) are associated with the onset of a variety of physical, mental, and behavioural illnesses. However, there are few studies that have thoroughly examined this association in low-income or marginalized groups. Methods To address this knowledge gap, this study used self-reported data on childhood experiences and adult health outcomes in a sample of 91 Indigenous persons experiencing homelessness. While the primary focus of the study was to assess the relationship between ACEs and health status, we also assessed reports on use and perceptions of health care services to test for potential illness-mitigating factors. Results Results indicated that reported number of ACEs was significantly associated with reported levels of mental illness (p < .001, d = 1.12). Significant associations were not observed for physical illness or patterns of substance use. We also found that the number of reported ACEs was significantly correlated with the number of formal health care services that an individual used (r = 0.32). Conclusions Our results reveal that the relationship between ACEs and adult illness is not as deterministic as the current literature suggests. Access to formal health care services may allow individuals to mitigate their adverse health, thereby eliminating some of the effects of ACEs. Conversely, current tools used to measure ACEs may not translate to an Indigenous population, which speaks to a need to revise ACE related surveys to include additional adversity categories. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10091-y.
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Affiliation(s)
- Eric Smith
- University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Katrina Milaney
- University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
| | - Rita I Henderson
- University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Lyndon Crowshoe
- University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
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Berken JA, Heard-Garris N, Wakschlag LS. Guardians at the Gate: Early Adversity, Neurocognitive Development, and the Role of the Pediatrician in the Era of COVID-19. Front Pediatr 2021; 9:665335. [PMID: 33937157 PMCID: PMC8079717 DOI: 10.3389/fped.2021.665335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/22/2021] [Indexed: 01/22/2023] Open
Abstract
Adverse childhood experiences (ACEs) profoundly impact neurocognitive development. Specifically, when these events occur during critical periods of brain plasticity, a time of significant synaptogenesis, neural pruning, and myelination, typical neurodevelopment can become derailed. Adverse childhood experiences promote morphological changes in neuronal microcircuitry which may lead to diminished cognitive flexibility, inattention, increased impulsivity, decreased school readiness, and disruptive behaviors. In this regard, the current COVID-19 pandemic represents an especially complex adverse experience that disturbs a child's social milieu and support network, likely interfering with brain maturation and executive function. Here, we take a neurodevelopmental approach to argue for the critical role that pediatricians must fulfill in mitigating the potentially detrimental consequences of COVID-19. We call for ACE screening and anticipatory guidance in the primary care setting, and the use of validated interventions and skills to bolster resilience, when ACEs are identified. We present a clinical workflow for the physician to proactively assess, identify, stratify, and address the severity of ACEs worsened by COVID-19. We discuss home-based activities and resources for children and adolescents to promote stress reduction, connectiveness, and self-awareness and create a more positive environment to maximize neurodevelopmental potential in the face of the ongoing pandemic.
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Affiliation(s)
- Jonathan A Berken
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Nia Heard-Garris
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Mary Ann & J. Milburn Smith Child Health, Outreach, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Lopez M, Ruiz MO, Rovnaghi CR, Tam GKY, Hiscox J, Gotlib IH, Barr DA, Carrion VG, Anand KJS. The social ecology of childhood and early life adversity. Pediatr Res 2021; 89:353-367. [PMID: 33462396 PMCID: PMC7897233 DOI: 10.1038/s41390-020-01264-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 01/30/2023]
Abstract
An increasing prevalence of early childhood adversity has reached epidemic proportions, creating a public health crisis. Rather than focusing only on adverse childhood experiences (ACEs) as the main lens for understanding early childhood experiences, detailed assessments of a child's social ecology are required to assess "early life adversity." These should also include the role of positive experiences, social relationships, and resilience-promoting factors. Comprehensive assessments of a child's physical and social ecology not only require parent/caregiver surveys and clinical observations, but also include measurements of the child's physiology using biomarkers. We identify cortisol as a stress biomarker and posit that hair cortisol concentrations represent a summative and chronological record of children's exposure to adverse experiences and other contextual stressors. Future research should use a social-ecological approach to investigate the robust interactions among adverse conditions, protective factors, genetic and epigenetic influences, environmental exposures, and social policy, within the context of a child's developmental stages. These contribute to their physical health, psychiatric conditions, cognitive/executive, social, and psychological functions, lifestyle choices, and socioeconomic outcomes. Such studies must inform preventive measures, therapeutic interventions, advocacy efforts, social policy changes, and public awareness campaigns to address early life adversities and their enduring effects on human potential. IMPACT: Current research does not support the practice of using ACEs as the main lens for understanding early childhood experiences. The social ecology of early childhood provides a contextual framework for evaluating the long-term health consequences of early life adversity. Comprehensive assessments reinforced with physiological measures and/or selected biomarkers, such as hair cortisol concentrations to assess early life stress, may provide critical insights into the relationships between early adversity, stress axis regulation, and subsequent health outcomes.
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Affiliation(s)
- Marcela Lopez
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Monica O. Ruiz
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Cynthia R. Rovnaghi
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Grace K-Y. Tam
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Jitka Hiscox
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Civil Engineering, Stanford School of Engineering, Stanford, CA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University School of Humanities & Sciences, Stanford, CA
| | - Donald A. Barr
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA,Stanford University Graduate School of Education, Stanford, CA
| | - Victor G. Carrion
- Department of Psychiatry (Child and Adolescent Psychiatry), Clinical & Translational Neurosciences Incubator, Stanford University School of Medicine, Stanford, CA
| | - Kanwaljeet J. S. Anand
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
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50
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Daniel R, Ring K, Husbands T, Marshall H, Wang J, Shah A, Chan RY. Resilience in the Setting of Adverse Childhood Experiences: A Cross-Sectional Study. Clin Pediatr (Phila) 2020; 59:1296-1300. [PMID: 32718184 DOI: 10.1177/0009922820941633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Raeye Daniel
- Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA
| | - Krista Ring
- Kaiser Permanente Medical Center, Los Angeles, CA, USA
| | | | - Hannah Marshall
- State University of New York Downstate Medical Center, New York, NY, USA
| | - Julia Wang
- University of Southern California, Los Angeles, CA, USA
| | - Ankit Shah
- University of Southern California, Los Angeles, CA, USA
| | - Randall Y Chan
- Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA.,University of Southern California, Los Angeles, CA, USA
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