ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health

Childhood echoes: How benevolent and adverse childhood experiences shape adult mental well-being

BACKGROUND

Childhood adverse and favorable experiences before the age of 18 have enduring effects on an adult's mental health.

OBJECTIVE

We investigate the moderating effect of benevolent childhood experiences (BCEs) on the link between adverse childhood experiences (ACEs) and poor mental health outcomes (depression, anxiety, stress) in an adult's later life.

PARTICIPANTS AND SETTING

This cross-sectional study was conducted among 384 adults aged ≥40 years from September 2021 to March 2022 at Dhangara Union of Raiganj Upazila, Bangladesh.

METHODS

Face-to-face interviews were conducted in randomly selected households using a semi-structured questionnaire. Analysis and plots were generated using SPSS and R software.

RESULTS

Most of the respondents (95·6 %) experienced different types of ACEs, 20·5 % reporting >4 ACEs, and 31·7 % reporting all ten BCEs. Significant associations were found between ACEs and depression (b = 0.761, p = 0·001), anxiety (b = 0.740, p = 0·0003), stress (b = 0.812, p = 0·0003). The interactions showed that BCEs have moderating effect on the relationship between ACEs and depression (b = -0·35, p = 0·009), anxiety (b = -0·27, p = 0·009), and stress (b = -0·30, p = 0·018) symptoms. The Johnson-Neyman region of significance evidenced that the moderating effect of BCEs was significant up to a certain threshold (depression = 8·91, p = 0·05; anxiety = 9·04, p = 0·05; stress = 8·97, p = 0·05). Beyond this threshold, no significant change was observed, suggesting a limit to the buffering effect of BCEs.

CONCLUSIONS

Our findings suggest that beyond a certain threshold, the effects of ACEs become resistant to further mitigation by BCEs, resulting in poor mental health outcomes. So, it is essential to promote healthier childhood experiences by developing targeted interventions and policies.

Positive Childhood Experiences Support Cognition and Counteract Behavior and Emotion Problems During Early Adolescence

OBJECTIVE

This study aimed to identify the independent associations of positive childhood experiences (PCEs) on brain health (cognitive function, behavioral and emotional problems) among early adolescents.

METHODS

Data from the 2-year follow-up visit from the Adolescent Brain and Cognitive Development (ABCD) study were analyzed (N = 5449, mean age: 12.0 ± 0.7, age range = 10.6-13.4 years). Adverse childhood experiences (ACEs) were measured by parent report at baseline, and PCEs were measured by parent report at year two. Dependent variables included cognitive function domains (National Institutes of Health [NIH] Toolbox) and the child behavior checklist (CBCL) subscales at year two. Multivariate linear regression analyses were performed for each dependent variable, with the number of PCEs and ACEs as independent variables, adjusting for age, sex, race and ethnicity, puberty stage, and family income.

RESULTS

PCEs were associated with better cognitive function on tasks of picture vocabulary (b = 0.29, 95% CI 0.15-0.43), flanker (b = 0.14, 0.00-0.28), reading recognition (b = 0.19, CI 0.08-0.31), and picture sequence memory (b = 0.44, CI 0.21-0.67). The PCEs:ACEs interaction showed that greater PCEs predicted a weaker association of ACEs on the CBCL subscales: anxious-depressed (b = -0.06, -0.10 to -0.01), withdrawn (b = -0.06, -0.09 to -0.04), aggressive behavior (b = -0.11, -0.17 to -0.06), rule-breaking behaviors (b = -0.06, -0.09 to -0.04), social problems (b = -0.04, -0.07 to -0.01), somatic complaints (b = -0.03, -0.06 to 0.00), and total CBCL problems (b = -0.46, -0.69 to -0.23).

CONCLUSIONS

Exposure to PCEs supports cognition and is protective against psychopathology, even among children exposed to ACEs.

Adverse childhood experiences, positive childhood experiences, suicidal thoughts or behaviors and psychological distress among Kenyan youth-an exploratory analysis of the 2019 Kenya Violence Against Children and Youth Survey (VACS)

BACKGROUND

Early childhood experiences, whether positive or adverse, significantly impact health across the lifespan. Children and youth in low-resource settings face unique challenges that increase their vulnerability to poor mental health.

OBJECTIVE

To examine the relationship between adverse childhood experiences (ACEs) and suicidal thoughts or behaviors as well as psychological distress, and to explore the moderating role of parent-related positive childhood experiences (PPCEs) on this association.

PARTICIPANT AND SETTING

We used data from the 2019 Kenya Violence Against Children and Youth Survey.

METHODS

Analyses were restricted to youth ages 18-24. ACEs were dichotomized (into those who have experienced at least one ACEs and those who have not), and logistic regression was used to examine the relationship between ACEs, PPCEs, and suicidal thoughts or behaviors and psychological distress stratified by sex.

RESULTS

Significantly more males (75.8 %) than females (57.6 %) experienced at least 1 ACE in their lifetime (p = 0.0003). PPCEs are common; however, significantly more males (59.9 %) than females (41.2 %) had a strong father-child relationship (p = 0.0003). ACEs were positively associated with suicidal thoughts or behaviors and psychological distress, with notable sex-specific differences in the associations. Conversely, PPCEs were negatively associated with those outcomes, but there were also sex-specific differences in the associations. No significant interaction effect was observed between ACEs, PPCEs, and the mental health outcomes.

CONCLUSION

Suicidal thoughts or behaviors and psychological distress are pervasive problems that are common among youth in Kenya, and the associations with ACEs vary by sex. A multilevel approach and evidenced-based intervention strategies that consider the context of sociocultural norms are crucial to prevention and response efforts.

Adverse Childhood Events, Personality Disorders, and Multimorbidity in Older Adults: Exploring the Connections

OBJECTIVES

We investigated the association between adverse childhood events, personality disorders and multimorbidity in older adults.

METHODS

This is a cross-sectional analysis in a population of older adults including 40 people with a personality disorder and 75 healthy controls. The Childhood Traumatic Events Scale was used to assess adverse childhood events. Multimorbidity was defined as the presence of 2 or more predetermined chronic somatic and psychiatric disorders. Logistic regression analysis was used to assess the association between adverse childhood events, personality disorders and multimorbidity.

RESULTS

No significant association was found between adverse childhood events and multimorbidity (OR = 1.03, 95% CI = 0.96-1.09). The presence of a personality disorder was significantly associated with multimorbidity (OR = 12.95, 95% CI = 4.28-39.14).

CONCLUSIONS

Overall, we did not find an association between adverse childhood events and multimorbidity in older adults. Multimorbidity was more prevalent in subjects with personality disorders compared to healthy controls.

CLINICAL IMPLICATIONS

The findings suggest that personality disorders are associated with both mental and physical health challenges, underscoring the importance of integrated care approaches to address both aspects in clinical practice.

The California adverse childhood experiences screening roll-out: a survey study of ACEs screening implementation in primary care

Background

California adopted universal screening of adverse childhood experiences (ACEs) in January 2020 and dedicated significant financial and human resources to "ACES Aware," a statewide campaign to scale ACEs screening throughout the state. Provider perspectives after the roll-out of ACEs Aware have been understudied. The aim of this study was to understand provider perspectives on universal ACEs screening in primary care. We explored indicators of acceptability, utility, and barriers and facilitators of screening for ACEs. We also investigated treatments offered for disclosed ACEs.

Methods

A cross-sectional survey with quantitative and qualitative components was distributed via Facebook, Twitter, and electronic listservs between March and April 2022, 2 years after the launch of ACEs Aware. The survey included the validated and reliable "Acceptability of Implementation Measure" and "Feasibility of Implementation Measure" as well as multiple choice, ranking, and free-text items to understand determinants of screening and treatment approaches.

Results

Eighty two primary care providers in California, working primarily in pediatrics (84%), completed the survey. The majority (78%) received training on assessing ACEs and 60% reported using the Pediatric ACEs and Related Life-events Screener (PEARLS). About 22% "strongly agree" that PEARLS is acceptable and 32% "strongly agree" that PEARLS is feasible. Only 17% "strongly agree" that they like PEARLS. The top barriers were: (1) insufficient time; (2) unclear treatment pathway for detected ACEs; and (3) inadequate staffing to perform screening. The top facilitators for screening were: (1) financial incentives for providers to screen; (2) financial incentives for organizational leadership to implement screening; and (3) leadership support of screeners. The top approaches for addressing ACEs were: (1) behavioral therapy; (2) case navigation; and (3) trauma-informed care.

Conclusion

This study provided a first look at provider perspectives on ACEs screening and treatment in a sample of California providers. Most responding providers report currently screening for ACEs and using PEARLS. Perceptions of feasibility were slightly higher than for acceptability. Facilitators were largely top-down and organizational in nature, such as financial incentives and leadership support. Future directions could include an exploration into why some providers may find ACEs unappealing and research to identify effective and accessible treatment approaches for ACEs.

"I Just Wouldn't Like Him to go Through What I Went Through as a Kid": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population

Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.

Positive Childhood Experiences, Cognition, and Biomarkers of Alzheimer's Disease

Positive childhood experiences (PCEs) have unknown effects on late life cognition and Alzheimer's Disease biomarkers. We examined 406 Asian, 1179 Black, 349 Latinx, and 498 White KHANDLE and STAR study participants with data on PCEs, longitudinal cognitive measures, MRI (n = 560), and amyloid PET (n = 281). We conducted mediation and multigroup models within the structural equation modeling framework allowing us to examine the direct association of PCEs with episodic memory level and change as well as the indirect effects of PCEs through education. We additionally conducted linear regressions examining the association of PCEs with MRI and amyloid PET outcomes. Average participant age was 74 (53-90) and 62% were female. Overall, PCEs were positively associated with memory intercept and change. Education significantly mediated the association between PCEs and memory intercept. PCEs were not associated with hippocampal volume or amyloid burden in the combined sample or across individual ethnocultural groups. PCEs are positively related to episodic memory through the promotion of educational attainment.

Running up that hill: Applying the challenge model of resilience to understand the impact of the COVID-19 pandemic on youth resettled as refugees

The COVID-19 pandemic has significantly impacted global physical, mental, and public health and disproportionately affected refugee youth. Novel stressors, like a global pandemic, may compound previous stress and trauma exposure. We aimed to test the "challenge model of resilience" (i.e., moderate exposure to adversity may confer resilience to future stressors) and assess COVID-19-related stress severity in youth resettled in the United States as refugees of Syria (N = 66, Mage = 12.72 years). We recruited youth aged 10-17 years who had been previously screened for trauma exposure and conducted virtual assessments on COVID-19-related stress, posttraumatic stress symptoms, and anxiety symptoms between March 2021 and March 2022. An ANCOVA adjusted for age, posttraumatic stress, and anxiety indicated a significant dose-response effect of trauma on current COVID-19-related stress, F(2, 58) = 6.67, p = .002, h2 = .19. Youth exposed to high doses of adversity reported more distress than those exposed to low-to-moderate, p = .007, and no-to-minimal, p = .006, doses. Although youth exposed to low-to-moderate doses reported slightly less distress than those who reported no-to-minimal exposure, post hoc comparisons indicated that this contrast was nonsignificant. Our findings partially support the challenge model of resilience; however, the small size and homogeneity of the sample preclude generalization to other cohorts of stress-exposed youth. Regular screening for traumatic life events in youth could prompt early intervention to mitigate longer-term impacts. Increased integration of positive health-promoting programs in schools and communities that teach stress coping strategies could confer resilience to youth regardless of exposure level.

Positive childhood experiences in mental health of young adults across adverse childhood experiences levels: A study from Delhi-NCR, India

BACKGROUND

While the impact of adverse childhood experiences (ACEs) on adult health outcomes has received substantial scientific attention, the role of positive childhood experiences (PCEs) has far less widely been explored, especially in low- and middle-income countries.

OBJECTIVE

The present study aimed to understand the association of exposure to cumulative and individual PCEs with current depression, anxiety, stress, and well-being among young adults in Delhi-NCR, India, independently and across ACE exposure levels.

PARTICIPANTS AND SETTING

This cross-sectional study involved 1553 young adults (aged 18-25) of both sexes (70.3 % females) residing in Delhi-NCR.

METHODS

PCEs and ACEs were measured using the Benevolent Childhood Experiences scale and ACE- International Questionnaire, respectively. Depression, anxiety, stress, and well-being were screened using validated tools.

RESULTS

In the overall analysis, exposure to PCEs was negatively associated with depression, anxiety, and stress and positively associated with well-being, even after accounting for ACEs. Feeling comfortable with oneself emerged as the most important PCE item with respect to studied mental health conditions. The stratified analysis showed that while the PCE score was associated only with depression (negatively) in the no ACE category, it was associated with all the studied outcome variables in higher ACE categories.

CONCLUSIONS

The study found PCEs to be associated with better mental health outcomes across varying ACE levels, with the protective effect being particularly pronounced in high ACE contexts. Promoting PCEs can help improve mental health outcomes and well-being despite adversities.

The Impact of Positive Childhood Experiences: A Systematic Review Focused on Children and Adolescents

Childhood and adolescence are crucial stages of life, characterized by significant changes that profoundly influence overall development. While positive childhood experiences (PCEs) can help mitigate the effects of adverse events during these formative years, they have not been as thoroughly researched. Then, this systematic review aims to address this gap by organizing the existing literature on PCEs and examining their impact on both positive and negative outcomes in children and adolescents. A search through databases such as B-On, PsycINFO, PubMed, SCOPUS, and Scielo, as well as supplementary searches, identified 30 studies that met the inclusion criteria. The results indicate that most studies were published in the last 4 years, primarily in the USA, and focused on community populations with mixed samples. In addition, the results reveal that among children and adolescents, higher levels of PCEs were associated with better mental health outcomes (e.g., reduced depressive symptoms, anxiety, self-harm, substance use, and suicidal ideation), improved psychosocial outcomes (e.g., enhanced adult functioning and future orientation), better academic achievement (e.g., reduced absenteeism and fewer academic difficulties), and some improvements in physical health (e.g., reduced chronic pain). However, the relationship between PCEs and behavioral outcomes showed mixed results. Strengthening efforts to promote PCEs and resources that support child and adolescent resilience is crucial. Further research involving diverse samples is needed to gain a deeper understanding of the role of PCEs.

The relationship between benevolent childhood experiences and depression among Chinese university students: the serial mediating role of family relationships and sleep quality

Introduction

Depression represents a significant mental health challenge among university students. Previous studies have revealed a relationship between benevolent childhood experiences (BCEs) and depression, but the roles of family relationships and sleep quality in mediating the link between BCEs and depression remain unclear. This study constructed a serial mediating model to examine whether family relationships and sleep quality mediated the relationship between BCEs and depression among Chinese university students.

Methods

A total of 1830 university students from 25 universities in three provinces of China got recruited in this study. The assessment utilized the Benevolent Childhood Experiences Scale (BCEs-10) for childhood experiences, the Quality of Family Relationships Scale for family dynamics, the Pittsburgh Sleep Quality Index (PSQI) single-item for sleep quality, and the Center for Epidemiological Survey Depression Scale (CES-D-10) for depression. Correlation analyses and serial mediation modeling were conducted using SPSS 25.0 with PROCESS macro v3.4.1.

Results

BCEs, family relationships, and sleep quality scores were all found to be negatively correlated with depression scores (r = -0.46, -0.32, -0.47, respectively, all p < 0.01). Family relationships, and sleep quality scores were positively correlated with BCEs scores (r = 0.31, 0.27, respectively, both p < 0.01). There was a positive correlation between the family relationships score and sleep quality score (r = 0.22, p < 0.01). Mediating analysis indicated that BCEs had a direct effect on depression (the direct effect accounted for 71.54%). Depression was affected by BCEs partly through three different pathways: the mediating role of family relationships (the mediation effect accounted for 8.50%), the mediating role of sleep quality (the mediation effect accounted for 16.40%), and the serial mediating role of both family relationships and sleep quality (the serial mediation effect accounted for 3.56%).

Discussion

The findings of this study demonstrated that family relationships and sleep quality partially mediated the association between BCEs and depression by serial mediating effects.Thus, improving sleep quality and family intervention may be effective measures to protect Chinese university students from depression.

Adverse Childhood Experiences (ACEs) in 252 Board-Certified Plastic Surgeons: Prevalences, ACE Clustering, and Effects on Adult Health and Behaviors, Including Self-Defined Depression, Work Addiction, and Burnout

BACKGROUND

The CDC/Kaiser Adverse Childhood Experiences (ACE) study documented that ACEs predict adult health and self-harming behaviors. ACEs have been documented in physicians and are higher in physicians treated for problematic behavior. Plastic surgeons have never been assayed.

OBJECTIVES

Might ACE prevalences in plastic surgeons predict their adult health and/or behavior?

METHODS

A total of 252 ABPS-certified plastic surgeons (72% men, 28% women) completed the 10-question CDC/Kaiser ACE survey by deidentified email. Data were collected on adult health and behaviors previously associated with ACEs in the literature.

RESULTS

In total 42% of plastic surgeons had 1 or more ACEs; 9.9% had 4 or more. Emotional abuse was 2 times higher than the control CDC/Kaiser population, although other ACEs were lower. Gender differences existed: female surgeons suffered more sexual abuse (17% vs 8%), physical neglect (7% vs 1%), violence against their mothers (7% vs 2%), and self-defined burnout (32% vs 17%). ACEs occurred in clusters. Total ACEs predicted autoimmune disorders, chronic pain/fatigue, self-defined depression, irritable bowel, antidepressant/anxiolytic use, alcohol abuse, >3 marriages, >10 sexual partners, sex and work addiction, eating disorders, and self-defined burnout (all P < .020). Emotional abuse predicted alcohol abuse. Sexual abuse predicted sex addiction. Emotional neglect predicted autoimmune disease, antidepressant/anxiolytic use, eating disorder, and work addiction. Physical neglect predicted chronic fatigue/chronic pain, depression, and burnout (all P < .001 or less).

CONCLUSIONS

Adverse childhood experiences occurred in 42% of our 252-member plastic surgeon cohort and predicted 13 adult illnesses and self-harming behaviors that can impair surgeons' lives and performances. This may facilitate their recognition and treatment.

Caregiver and Child Adverse Childhood Experiences: A Meta-Analysis

CONTEXT

Exposure to adverse childhood experiences (ACEs) is associated with adverse impacts on subsequent generations. The extent to which caregiver ACEs are associated with their child's ACE score is unclear.

OBJECTIVE

To meta-analytically examine the association between caregiver and child ACE score. Potential moderators of this association were explored.

DATA SOURCES

Systematic searches were conducted using MEDLINE, Embase, PsycINFO, and CINHAL from 1998, the year the ACEs questionnaire was published, to February 19, 2024.

STUDY SELECTION

Inclusion criteria were that the ACEs questionnaire was completed for both caregiver and child, an effect size was available, and the study was published in English.

DATA EXTRACTION

Variables extracted included sample size and magnitude of association between caregiver ACEs and child ACEs, mean caregiver and child age, sex (% female), race and ethnicity, and informant of ACEs.

RESULTS

Seventeen samples (4872 caregiver-child dyads) met inclusion criterion. Results revealed a large pooled-effect size between caregiver and child ACEs (r = 0.33; 95% CI, 0.25-0.41; P < .001), such that higher caregiver ACEs score was associated with higher child ACEs score. This association was stronger among studies with younger caregivers and studies that utilized caregiver-report compared with child self-report of ACEs.

LIMITATIONS

Many studies were conducted in North America with female caregiver samples, limiting generalizability beyond these populations.

CONCLUSIONS

Caregiver ACEs were strongly associated with child ACEs. Prevention and intervention efforts for caregivers should be trauma informed and focused on bolstering protective factors that may break cycles of intergenerational risk.

Multidimensional ADHD Symptom Profiles: Associations with Adverse Childhood Experiences

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with a range of negative health outcomes, including attention-deficit/hyperactivity disorder (ADHD) and neurocognitive deficits. This study identified symptom profiles in adult patients undergoing neuropsychological evaluations for ADHD and examined the association between these profiles and ACEs.

METHODS

Utilizing unsupervised machine learning models, the study analyzed data from 208 adult patients.

RESULTS

The Gaussian Mixture Model revealed two distinct symptom profiles: "Severely Impaired" and "Moderately Impaired". The "Severely Impaired" profile, 23.6% of the sample, was characterized by more severe ADHD symptomatology in childhood and worse neurocognitive performance. The "Moderately Impaired" profile, 76.4% of the sample, had scores in the average range for self-reported internalizing and externalizing psychopathology and better neurocognitive performance. There was a greater number of ACEs reported by patients in the Severely Impaired profile than the Moderately Impaired profile (p = .022). Specifically, using an ACEs cutoff of ≥4, 53.1% of patients in the Severely Impaired profile reported four or more ACEs, compared with 34.6% in the Moderately Impaired profile (p = .020). Profiles were not related to clinician-ascribed diagnosis.

CONCLUSIONS

Findings underscore the association between ACEs and worse symptom profiles marked by impaired neurocognitive function, increased internalizing and externalizing psychopathology, and heightened perceived stress in adults with ADHD. Future research may explore the effect of ACEs on symptom profiles in diverse populations and potential moderators or mediators of these associations. Findings offers valuable insights for clinicians in their assessment and treatment planning.

Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status in children within the context of adverse childhood experiences: a prospective cohort study

BACKGROUND

Despite potential protective and mitigating effects of positive childhood experiences (PCEs) on poor health outcomes, limited research has identified relevant PCEs and examined their individual and cumulative associations with weight status, or their mitigating effects on the associations between adverse childhood experiences (ACEs) and obesity in children. This study aims to develop an exploratory PCEs Index with the potential to protect against or mitigate the association between ACEs and unhealthy weight status.

METHODS

Data came from the Growing Up in New Zealand study. The analytic sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in a sample of 4,895 children. Nine individual ACEs and their cumulative scores, a newly developed PCEs index consisting of six individual PCEs and (their) cumulative scores, and an overweight/obesity variable were included in the analyses.

RESULTS

By age eight, experience of at least 3 PCEs was reported by 72.1% of the sample. However, the experience of the highest number of PCEs (5-6) was only reported by 23% of the sample. Four out of six assessed PCEs were associated with decreased likelihood of overweight/obesity. A dose-response effect was observed where experience of three or more PCEs was associated with decreased odds for obesity (AORs decreased from 0.77 for 3 PCEs to 0.54 for 5-6 PCEs). No consistent mitigating effects were found for individual PCEs; however interactions were found between reporting at least four of the six PCEs, experience of cumulative ACEs, and reduced odds for overweight/obesity at age 8.

CONCLUSIONS

A critical number of PCEs may be required to mitigate the detrimental impacts of ACEs on weight status among children. These findings reinforce the need to consider a constellation of strength-focused ecological domains to alleviate the burden of childhood obesity, particularly for children exposed to multiple adversities.

Prevalence and predictors of positive childhood experiences and their relationship with adverse childhood experiences among young adults in Delhi-NCR, India

BACKGROUND

Although positive childhood experiences (PCEs) have been reported to be crucial for healthy development and better mental and physical health outcomes, their epidemiology and relationship with adverse childhood experiences (ACE) exposure in low and middle-income countries, including India remain underexplored.

AIMS

The present study aimed to ascertain the prevalence and predictors of PCE exposure and understand the relationship between PCE and ACE exposure among young adults in Delhi-NCR, India.

METHODS

The present cross-sectional study involved a total of 1,573 young adults (18-25 years) of both sexes (69.7% females) recruited from two Universities in Delhi-NCR, India. PCEs and ACEs were measured using the Benevolent Childhood Experiences scale and ACE-International Questionnaire.

RESULTS

Of the total participants, 42.6% reported experiencing all 10 PCEs, while 50.2% had experienced 6 to 9, and 7.2% had experienced 0 to 5 PCEs. Further, the mean PCE score of the sample was 8.64. Certain sociodemographic groups, for instance, participants from immigrant families, sexual minority groups and those who were obese during childhood than their respective counterparts were at lower odds of high PCE exposure. Also, the study found a significant inverse correlation between ACE and PCE exposure levels; however, the effect size was moderate.

CONCLUSIONS

The study indicates the need for targeted PCE promotion interventions for disadvantaged sociodemographic groups. The intervention should simultaneously aim at reducing ACEs, as PCE promotion alone may not always lead to ACE reduction.

The Combined Effects of Adverse and Positive Childhood Experiences on Adolescent Bullying Victimization and Perpetration

Bullying is a persistent social and behavioral problem in the United States. Bullying victimization and perpetration are linked to a host of negative physical, social, and emotional outcomes. Research suggests that a key risk factor for bullying behaviors is adverse childhood experiences (ACEs). On the other hand, positive childhood experiences (PCEs) may counter some of the negative effects of ACEs. This study (a) assesses the independent effects of ACEs and PCEs on adolescent bullying victimization and perpetration, and (b) examines whether ACEs and PCEs interact to affect bullying victimization and perpetration.We use data from the 2020 to 2021 National Survey of Children's Health, a nationally representative survey of children ages 0 to 17 in the United States. The analytic sample was limited to children who were 6 years old or older at the time of the survey (N = 60,809). Using caregiver reports of bullying victimization and perpetration, we created a cumulative ACEs scale comprised of 10 items and a cumulative PCEs scale comprised of eight measures. We then estimated a set of logistic regression models to predict bullying behaviors. The results showed that ACEs are associated with a higher likelihood of both bullying victimization and perpetration. Although PCEs have a slight mitigating effect, ACEs and PCEs interact such that even in the presence of PCEs, children with many ACEs still have a higher likelihood of both bullying victimization and perpetration. This highlights the considerable impact of ACEs on bullying behaviors. These findings suggest that enhancing ACE-aware care and ACE prevention is important because even promoting PCEs is unlikely to decrease bullying levels on their own.

Health Associations of Positive Childhood Experiences: A Scoping Review of the Literature

We report the results of a scoping review of the literature investigating associations between positive childhood experiences (PCEs) and selected health outcomes to identify which have the highest level of research activity based on the indexed academic literature. Yielded articles underwent title/abstract (Ti/Ab) and full text screening utilizing inclusion/exclusion criteria. The review was guided by PCE categories from the Healthy Outcomes from Positive Experiences framework: relationships, environment, engagement, and emotional growth. The initial search yielded 8,919 unduplicated articles, 759 were retained following Ti/Ab review and 220 articles were retained after full text screening describing 795 tested associations across 23 PCE types in ten outcome categories. The outcomes most commonly examined were substance misuse (305 tested associations across 93 studies), suicidal behaviors (195 tested associations across 56 studies), and depression (112 tested associations across 55 studies). Physical health outcomes were less common (14 tested associations across six studies). Of the PCE exposures, relationships represented 415 of tested associations, 236 with environment, and 114 with social engagement. A significant body of research demonstrated associations between PCEs and health outcomes. While further research is needed, available research suggests that public health efforts to promote PCEs may have impact across multiple domains.

Relationship Between Adverse Childhood Experiences and Resilience: The Indirect Effect of a Sense of Purpose in Life

PURPOSE

This study examined the association between adverse childhood experiences (ACEs) and resilience through a sense of purpose in life (SP) among 578 college students, applying resilience theory and positive psychology.

MATERIALS AND METHODS

Using a cross-sectional, online survey design, data were collected. Most respondents were female (71.9%), heterosexual (69.9%), and Caucasian (61.6%) undergraduate students.

RESULTS

The results indicated that ACEs were not directly related to resilience (β = -.09, .05). SP had an indirect effect in the relationship between ACEs and resilience (β = -.11, 95% CI = -.16 to -.05). SP fully mediated the association between ACEs and resilience in college students.

DISCUSSION

This indicates that students with a history of ACEs tend to have lower levels of resilience due to their reduced levels of SP.

CONCLUSION

Trauma-informed, campus-wide interventions targeting SP for college students who were exposed to ACEs may be effective.

Trauma, Resilience, and Treatment Outcomes in a Pediatric MOUD Clinic

Background: In this study, we explored the relationship between adverse childhood experiences and childhood protective factors (i.e., resilience) with outpatient treatment outcomes among youths receiving buprenorphine-based medication for opioid use disorder over a six-month period. Methods: An observational study was conducted among 42 participants utilizing the modified Adverse Childhood Experience Questionnaire and the Southern Kennebec Healthy Start Resilience survey. Treatment outcomes included the end of treatment, buprenorphine-based medication treatment nonadherence, and opioid relapse. Cox proportional hazard models were fit for all treatment outcomes. Results: Reported adverse childhood experiences were high compared with the national average and demonstrated a significant inverse association with time to buprenorphine treatment nonadherence. Total resilience score was not significantly associated with any treatment outcome. Analysis of potential confounders and other covariates likewise demonstrated no relationship. Conclusions: Higher reported adverse childhood experience scores were associated with greater hazard of buprenorphine-based medication nonadherence. This finding underscores the need for ACE screening and trauma-informed care in this population.

Adverse childhood experiences, subsequent negative life events, and their impact on health in occupational rehabilitation patients: a mixed-methods study

Introduction

Adverse childhood experiences (ACEs) are prevalent globally and can negatively impact an individual's lifespan by not only increasing the likelihood of encountering other negative life events (NLEs), but also escalating the risk of illness, absenteeism due to sickness, unemployment, and reliance on disability benefits in adulthood. Therefore, the objective of this study was to explore the prevalence of ACEs and NLEs, as well as their health impacts among patients undergoing occupational rehabilitation.

Materials and methods

A total of 80 participants diagnosed with musculoskeletal disorders and/or common mental disorders who participated in two occupational rehabilitation programs in Norway were included. Data were collected by questionnaire and in-depth interviews (39 participants) at the start of the intervention. Comparative quantitative and qualitative analysis was conducted between individuals with a history of ACEs and those without these experiences. Thematic analysis was used to identify the impact of ACEs and NLEs on the health of the informants.

Results

Half of the participants reported ACEs. Of these, 18% reported one ACE, 22% reported 2-3 ACEs and 9% reported 4 or more ACEs. Also, 25% were categorized as revictimized. The two groups with ACEs had more NLEs in adulthood compared to those without ACEs (p < 0.001), revictimized the most (mean numbers between groups 3.1, 4.5 and 5.9). Furthermore, a history of ACEs was associated with a higher number of reported mental health issues compared to those who had not experienced ACEs (p < 0.01). However, there were no significant differences between the two ACE groups. NLEs had a substantial impact on the participants' current health status, whether they occurred in childhood or adulthood. In adult life, a high workload (psychologically or physically), interpersonal challenges, and financial struggles had an especially negative impact. Additionally, accidents and complications related to surgeries were also significant NLEs causing health problems. For most, there were complex interactions between NLEs and health.

Conclusions

The prevalence of ACEs and NLEs is high among occupational rehabilitation patients. ACEs are associated with subsequent victimization, interpersonal challenges, financial struggles, and increased mental health issues in adulthood. These findings highlight the need for systematic screening and a holistic, individualized approach in occupational rehabilitation programs to potentially mitigate the adverse effects of NLEs on health and work participation.

Resilience and hopelessness mediate the relationship between benevolent childhood experiences and life satisfaction: evidence from a cross-cultural study

BACKGROUND

A growing body of literature focuses on the role of benevolent childhood experiences (BCEs) in predicting adulthood well-being, in addition to adverse childhood experiences (ACEs). However, cross-cultural differences are generally ignored in this endeavor. Hence, this study aimed to explore the role of BCEs in predicting life satisfaction, resilience, and hopelessness. We also examined the potential of resilience and the role of hopelessness in mediating the relationship between BCE and life satisfaction.

METHODS

A total of 850 university students from Turkey (n = 371), Portugal (n = 248), and India (n = 231), aged 17 to 58 years (M = 22.12, SD = 4.41), participated in the study. Participants completed an online protocol consisting of measures to assess BCEs, life satisfaction, resilience, and hopelessness.

RESULTS

BCEs, hopelessness, and life satisfaction have significantly differed among the samples based on the country of residence. BCEs were positively correlated to resilience and life satisfaction and negatively to hopelessness. In the sequential mediation model, after controlling for country and sex, resilience and hopelessness sequentially mediated the relationship between BCEs and life satisfaction. BCEs were associated with life satisfaction, resilience, and hopelessness across countries and sexes. The model explains 42.8% of the variability.

CONCLUSION

Despite differences between countries, BCEs are important predictors of adult well-being in all three countries and should be monitored along with ACE. Further, resilience seems to have an important role in lowering the negative consequences of lower BCEs and feelings of hopelessness, pointing to the need to strengthen psychological resilience among adults.

Intergenerational transmission of adverse and positive childhood experiences and associations with child well-being

BACKGROUND

Parental adverse childhood experiences (ACEs) contribute to offspring adversity and poor health outcomes, but little is known about whether and to what extent parental positive childhood experiences (PCEs) influence offspring positive experiences and well-being.

OBJECTIVE

To investigate the association between parent and child ACEs and PCEs and their impact on child well-being and psychopathology.

PARTICIPANTS AND SETTING

A national sample of n = 1016 US parents of 1-5-year-olds completed online surveys in September 2019.

METHODS

Mediation analysis in a path modeling framework was used with stratified probability weights for generalizability to the US population.

RESULTS

Each additional parent PCE equated to 0.32 (95 % CI: 0.20, 0.45) increase in child PCEs and each additional parent ACE equated to 0.18 (95 % CI: 0.06, 0.31) increase in child PCEs and 0.13 (95 % CI: 0.08, 0.18) increase in child ACEs. In turn, an increase in 1 child PCE was associated with 0.10-0.16 SD increase in well-being and 0.06-0.10 decrease in psychopathology, and each additional child ACE equated to 0.10-0.18 SD increase in psychopathology.

CONCLUSIONS

Results support the intergenerational transmission of PCEs and ACEs, advancing understanding of the role that parent PCEs play in promoting child PCEs and fostering child well-being. Findings underscore the importance of extending clinical surveillance of ACEs to include PCEs in pediatric and adult healthcare settings. Dual-generation programs that address the negative consequences of parental ACEs may be able to increase their impact by adding a parallel emphasis on PCEs and providing parents with tools to foster PCEs in their children.

Positive Childhood Experiences and the Indirect Relationship With Improved Emotion Regulation in Adults With ADHD Through Social Support

OBJECTIVE

To identify direct and indirect associations between PCEs and social support to emotion regulation outcomes in adults with ADHD.

METHOD

Adults with ADHD (n = 81) reported PCEs, current social support, and emotion regulation. Conditional effects modeling examined the direct and indirect relationships between PCEs and emotion dysregulation through social support.

RESULTS

Higher PCEs were indirectly related to improved emotion regulation through increased social support generally (β = -.70, 95% CI [-1.32, -0.17], and specifically through belonging (β = -.43, 95% CI [ -0.87, -0.05], self-esteem (β = -.61, 95% CI [-1.08, -0.27], and tangible social support (β = -.50, 95% CI [-1.07, -0.02].

CONCLUSIONS

PCEs may protect emotion regulation in adults with ADHD through social support, possibly through facilitating social connections, increasing access to social support, and sustaining emotion regulation strategies.

Digital Health Innovations for Screening and Mitigating Mental Health Impacts of Adverse Childhood Experiences: Narrative Review

Background

Exposures to both negative and positive experiences in childhood have proven to influence cardiovascular, immune, metabolic, and neurologic function throughout an individual's life. As such, adverse childhood experiences (ACEs) could have severe consequences on health and well-being into adulthood.

Objective

This study presents a narrative review of the use of digital health technologies (DHTs) and artificial intelligence to screen and mitigate risks and mental health consequences associated with ACEs among children and youth.

Methods

Several databases were searched for studies published from August 2017 to August 2022. Selected studies (1) explored the relationship between digital health interventions and mitigation of negative health outcomes associated with mental health in childhood and adolescence and (2) examined prevention of ACE occurrence associated with mental illness in childhood and adolescence. A total of 18 search papers were selected, according to our inclusion and exclusion criteria, to evaluate and identify means by which existing digital solutions may be useful in mitigating the mental health consequences associated with the occurrence of ACEs in childhood and adolescence and preventing ACE occurrence due to mental health consequences. We also highlighted a few knowledge gaps or barriers to DHT implementation and usability.

Results

Findings from the search suggest that the incorporation of DHTs, if implemented successfully, has the potential to improve the quality of related care provisions for the management of mental health consequences of adverse or traumatic events in childhood, including posttraumatic stress disorder, suicidal behavior or ideation, anxiety or depression, and attention-deficit/hyperactivity disorder.

Conclusions

The use of DHTs, machine learning tools, natural learning processing, and artificial intelligence can positively help in mitigating ACEs and associated risk factors. Under proper legal regulations, security, privacy, and confidentiality assurances, digital technologies could also assist in promoting positive childhood experiences in children and young adults, bolstering resilience, and providing reliable public health resources to serve populations in need.

Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

The effects of adverse and positive experiences on cardiovascular health in Australian children

BACKGROUND

Limited evidence suggests that positive experiences in childhood may promote cardiovascular health, providing additional opportunities for prevention and early intervention. This study aimed to examine the effects of adverse and positive experiences on cardiovascular health in late childhood.

METHODS

Data sources: Longitudinal Study of Australian Children (N = 1874).

EXPOSURES

Adverse and positive experiences assessed repeatedly (age 0-11 years).

OUTCOMES

Cardiovascular health (high versus low or moderate) quantified by four health behaviors (diet, physical activity, cigarette smoking, and sleep) and four health factors (body mass index, non-high-density lipoprotein, blood pressure, and blood glucose) (age 11-12 years) as per the American Heart Association's Life's Essential 8 metrics.

ANALYSES

Separate generalized linear models with log-Poisson links were used to estimate the effects of adverse and positive experiences on cardiovascular health, adjusting for confounders.

RESULTS

Children exposed to multiple adverse experiences (≥ 2) were less likely to have high cardiovascular health (RR = 0.82, 95% CI = 0.67 to 1.02) than those not exposed. Children exposed to multiple positive experiences (≥ 2) were more likely to have high cardiovascular health (RR = 1.14, 95% CI = 0.94 to 1.38) than those not exposed. Stratified analyses suggested that exposure to multiple positive experiences might buffer the detrimental effects of multiple adverse experiences on cardiovascular health.

CONCLUSIONS

Both adverse and positive experiences were found to be modestly associated with cardiovascular health in Australian children. Future research and practice should not only consider addressing childhood adversity but also use a strengths-based approach to promoting positive experiences to improve cardiovascular health.

Cross-sectional study on university students' mental health during the COVID-19 pandemic: Exploring the influence of adverse and positive childhood experiences

Aim

This study examined the psychological impact of the COVID-19 pandemic on university students, focusing on how adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) influence mental health.

Methods

A web-based survey was administered to 3000 university students from October 26 to 31, 2022, following the peak of the COVID-19 pandemic. Mental health assessments included the Japanese version of the Kessler Psychological Distress 6-Item Scale (K6) for depressive/anxiety symptoms, the Impact of Event Scale-Revised (IES-R-J) for distress, fear of COVID-19, and a three-item loneliness scale.

Results

Of the respondents, 46.9% reported depressive/anxiety symptoms, 55.4% reported distress, and 37.3% reported fear of COVID-19. Factors such as current psychiatric treatment history and reduced income (either parental or personal) were predictive of worsening depressive/anxiety symptoms, distress, and loneliness. ACEs were found to exacerbate depressive/anxiety symptoms and distress, while PCEs mitigated these symptoms, and vice versa.

Conclusion

This study underscores the importance of considering both ACEs and PCEs in supporting the mental health of university students. PCEs were found to independently prevent mental health deterioration, including depressive/anxiety symptoms and distress, which may include post-traumatic stress disorder symptoms, even in the presence of ACEs. Recognizing and fostering PCEs emerged as an effective strategy for mitigating mental health issues.

The influence of Adverse and Positive Childhood Experiences on facets of empathy

BACKGROUND

Although Adverse Childhood Experiences (ACEs) have been associated with empathy, research findings have been incongruous. In contrast, positive parenting practices have been consistently, and positively, associated with empathy.

OBJECTIVE

The current study investigated whether the relationship between ACEs and facets of empathy (i.e., perspective taking, empathic concern, personal distress, fantasy) were moderated by Positive Childhood Experiences (PCEs).

PARTICIPANTS AND SETTING

A sample of 923 participants completed an online survey.

METHOD

Participants completed online versions of the Childhood Experiences Scale-17, the Benevolent Childhood Experiences Scale, and the Interpersonal Reactivity Index.

RESULTS

We found that ACEs were not significantly associated with any facet of empathy. PCEs, on the other hand, were positively associated with fantasy, empathic concern, and perspective taking, and moderated the relationships between (a) ACEs and empathic concern, and (b) ACEs and perspective taking.

CONCLUSIONS

These results provide a more nuanced understanding of the role ACEs and PCEs play in empathy. Specifically, PCEs appear to be a protective factor when ACEs are low, but when people experience above average levels of childhood adversity, PCEs have little influence on empathic concern or perspective taking.

A replication and extension of adverse and benevolent childhood experiences along with contemporaneous social support and sociodemographic stress for perinatal mental health problems

This study replicated and extended Narayan and colleagues' (2018) original benevolent childhood experiences (BCEs) study. We examined associations between adverse and positive childhood experiences and mental health problems in a second sample of low-income, ethnically diverse pregnant individuals (replication). We also examined effects of childhood experiences on perinatal mental health problems while accounting for contemporaneous support and stress (extension). Participants were 175 pregnant individuals (M = 28.07 years, SD = 5.68, range = 18-40; 38.9% White, 25.7% Latina, 16.6% Black, 12.0% biracial/multiracial, 6.8% other) who completed standardized instruments on BCEs, childhood maltreatment and exposure to family dysfunction, sociodemographic stress, and perinatal depression and post-traumatic stress disorder (PTSD) symptoms. They completed the Five-Minute Speech Sample at pregnancy and postpartum to assess social support from the other biological parent. Higher family dysfunction predicted higher prenatal depression symptoms, while higher BCEs and prenatal social support predicted lower prenatal PTSD symptoms. Prenatal depression and prenatal PTSD symptoms were the most robust predictors of postnatal depression and PTSD symptoms, respectively, although higher postnatal social support also predicted lower postnatal PTSD symptoms. Findings replicated many patterns found in the original BCEs study and indicated that contemporaneous experiences are also associated with perinatal mental health problems.

Considering the associations of adverse and positive childhood experiences with health behaviors and outcomes among emerging adults

Childhood is a sensitive period of development during which early life experiences can facilitate either positive or negative health trajectories across subsequent developmental periods. Previous research has established strong links between adverse childhood experiences (ACEs) and adverse health outcomes (e.g., sleep-related problems, pain, substance use). Despite this, less is known about positive childhood experiences (PCEs) and how they may buffer the effects of ACEs on health outcomes. The current study investigated whether PCEs moderate the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference) in a sample of at-risk emerging adults. Participants (N = 165) were undergraduate college students (18-25 years of age) who reported frequent alcohol and/or cannabis use (≥3 times in the past week). A significant positive association was found between ACEs and cannabis use. There were also significant negative associations found between PCEs and pain interference and intensity. PCEs did not moderate any of the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference). Findings suggest that PCEs may be unlikely to serve as a strong enough protective factor during early life to decrease risk for suboptimal health and health behaviors during emerging adulthood among individuals who report a greater accumulation of ACEs. Longitudinal research is needed to identify additional related risk and protective factors during early life to further support health and health behavior during this transitional period of development and beyond.

Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review

AIMS

Various concepts are used to study the impact of stress on childhood development. These concepts are often used inconsistently or interchangeably. Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences; ACEs) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research.

METHODS

For this descriptive review, we systematically searched for literature published before 4 August 2021, on PubMed, Embase and PsycInfo. Two independent reviewers included studies. Exclusion criteria were: no systematic review, not peer reviewed, not published in English, selected stress concepts were no predetermined variable or a substantial topic in the discussion, full text was unobtainable or study described non-human or non-childhood populations. Data extraction forms were used. Descriptives were gathered, publication fields were identified through Journal Citation Reports categories, and verbatim descriptions were ordered in text and Venn diagrams.

RESULTS

Of 264 screened studies, 124 were included. ACEs, childhood adversity and childhood trauma were used most. ACEs were the main concept used most frequently (47.6%). A total of 11 of 14 public and environmental health journals used ACEs. All concepts refer to prolonged, repeated, interpersonal stress from 0 to 18 years, that can alter physiological systems. Four concepts were stressor oriented, two concepts focused on stress response and effect and one on the state of challenged homeostasis.

CONCLUSIONS

ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.

Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences

BACKGROUND

Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored.

OBJECTIVE

To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample.

METHODS

A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire.

RESULTS

ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels.

CONCLUSIONS

This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.

Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis

BACKGROUND

Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat).

METHOD

Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence.

RESULTS

Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs.

CONCLUSIONS

Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.

Allostasis, health, and development in Latin America

The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.

Risk and Protective Factors for Sexual Exploitation in Male and Female Youth From a Cross-Cultural Perspective: A Systematic Review

Youth are at elevated risk of becoming victims of sexual exploitation, which has a detrimental impact on their physical and psychological well-being. Understanding factors associated with sexual exploitation is key for prevention efforts and adequate and timely treatment. This systematic review sheds more light on this by providing an overview of both risk and protective factors for sexual exploitation in male and female youth from a cross-cultural perspective. In all, 65 studies were selected meeting the inclusion criteria: qualitative or quantitative peer-reviewed studies in English, Dutch, or German with findings on risk and protective factors associated with sexual exploitation in youth aged up to 24 years. Results show that there are common risk factors in male and female youth worldwide (e.g., adverse childhood experiences, lack of a social network, substance use, and running away). Positive and supportive relationships are an important protective factor in mitigating the risk of sexual exploitation. Geographic differences were found. In non-Western continents, more environmental factors (e.g., economic vulnerabilities, residential instability) were cited. Research in countries outside the United States is limited and protective factors and males are underexamined. To fully understand vulnerabilities in youth, their interactions, and possible gender differences and to address the needs of diverse populations, more insight should be gained into the broader range of risk and protective factors worldwide. This systematic review has made a valuable contribution to this by providing practice, policy, and research guidance in the establishment of more targeted prevention efforts, adequate treatment, and areas to address in future research.

The trajectory of anxiety in therapy: The role of ACEs

The connection between adverse childhood experiences (ACEs) and anxiety disorders is well-documented. Additionally, therapy has been shown to be effective at reducing anxiety symptoms. Yet more needs to be known about how ACEs may shape the process of therapy and the trajectory of anxiety symptoms. This study was designed to compare the trajectory of improvement in anxiety symptoms over the course of 12 sessions of therapy in adults (N = 472), who reported more (greater than four) and fewer (fewer than four) ACEs using a multigroup latent growth curve analysis. Data were drawn from the Marriage and Family Therapy Practice Research Network database. Results suggested that the rate of improvement in those with more and fewer ACEs was not significantly different; however, those with more ACEs had a significantly higher average starting point of anxiety symptoms.

Leveraging Public Health and Public School Partnerships for Local Surveillance of Positive Childhood Experiences

Childhood psychosocial experiences can have a lifelong effect on health. These experiences can be measured together as positive and adverse childhood experiences or individually as positive childhood experiences (PCEs) or adverse childhood experiences. Most research on PCEs has focused on how PCEs promote health outcomes. However, limited research has been conducted on the prevalence of PCEs among adolescents in local areas served by public health departments. The St. Joseph County Department of Health developed a study to test the feasibility of surveillance of PCEs through local public health departments and to establish a prevalence for PCE exposure among a population of urban public-school students in Indiana. We conducted a survey in spring 2022 that collected demographic information on students at 2 high schools and 1 middle school and assessed exposure to PCEs. We assessed prevalence of PCEs on a 5-point Likert scale (0 = never, 1 = rarely, 2 = sometimes, 3 = usually, 4 = always). PCE scores were grouped into low (0-2), medium (3-5), and high (6 or 7). The prevalence of individual PCE items ranged from 35.6% to 86.8%. Among 798 respondents, 189 (23.7%) reported low PCE scores, 396 (49.6%) reported medium scores, and 213 (26.7%) reported high scores. This research demonstrates the feasibility of school-based PCE surveillance and establishes a baseline prevalence of PCE exposure among a population of middle and high school students. These methods are applicable to different contexts and can provide both local health departments and school systems with a new tool to address adverse childhood experiences.

Promotive and protective effects of community-related positive childhood experiences on adult health outcomes in the context of adverse childhood experiences: a nationwide cross-sectional survey in Japan

OBJECTIVE

Although adverse childhood experiences (ACEs) are associated with poor health in adulthood, positive childhood experiences (PCEs) can reduce the risk of negative health outcomes. This study aimed to investigate whether PCEs in the community (CPCEs, ie, trusted adults other than parents, supportive friends, belongingness to school, or community traditions) would have an independent effect on better health outcomes and moderate the association between ACEs and adult illnesses.

DESIGN

Cross-sectional survey.

SETTING

Data were gathered from a nationwide, cross-sectional internet survey conducted in Japan in 2022.

PARTICIPANTS

This study included 28 617 Japanese adults aged 18-82 years (51.1% female; mean age=48.1 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

The associations among self-reported ACEs, CPCEs before the age of 18 years and current chronic diseases (eg, cancer and depression) were investigated using multivariable logistic regression models.

RESULTS

CPCEs were associated with lower odds of adult diseases (such as stroke, chronic obstructive pulmonary disease (COPD), chronic pain, depression, suicidal ideation and severe psychological distress) after adjusting for ACEs. More CPCEs weakened the association between ACEs and adult diseases. Specifically, among those with ACEs, ≥3 CPCEs (vs 0-2 CPCEs) lowered the adjusted prevalence by ≥50% for stroke (2.4% to 1.2%), COPD (2.2% to 0.7%) and severe psychological distress (16.4% to 7.4%).

CONCLUSION

CPCEs could reduce ACE-related risk of poor physical and mental health in later life. Early-life interventions that enhance PCEs in schools and/or neighbourhoods are recommended.

The resounding influence of benevolent childhood experiences

Research with Indigenous communities has demonstrated the detrimental impacts of intergenerational trauma and disproportionate adverse childhood experiences (ACEs) on health and behavioral outcomes in adulthood. A more balanced narrative that includes positive childhood experiences is needed. The construct of benevolent childhood experiences (BCEs) facilitates assessment of positive early life experiences and their impact on well-being for Indigenous peoples. We consider associations between BCEs and well-being when taking into account ACEs and adult positive experiences. Participants are from Healing Pathways, a longitudinal, community-based panel study with Indigenous families in the Midwestern United States and Canada. Data for the current analyses are derived from 453 participants interviewed at wave 9 of the study. Participants reported high levels of positive childhood experiences in the form of BCEs, with 86.5% of the wave 9 participants reporting experiencing at least six of seven positive indicators. BCEs were positively associated with young adult well-being. This relationship persisted even when accounting for ACEs and adult positive experiences. While ACEs were negatively correlated with young adult well-being, they were not significantly associated with well-being when considering family satisfaction and receiving emotional support. Evidence of high levels of BCEs reflects realities of strong Indigenous families and an abundance of positive childhood experiences.

Two Sides of the Coin: The Roles of Adverse Childhood Experiences and Positive Childhood Experiences in College Students' Mental Health

Several studies have established a link between adverse childhood experiences (ACEs) and mental health issues in college students. However, less is known about how positive childhood experiences (PCEs) may promote mental health and well-being, and potentially act as a buffer in the relationship between risk exposure and poor outcomes. This study investigates how ACEs and PCEs relate to college students' mental health (N = 321), within the framework of Resiliency Theory with specific attention focus on the compensatory and the protective factors models. Three key hypotheses were examined using quantitative data collected by way of an online anonymous survey: (1) ACEs will predict poorer mental health outcomes; (2) PCEs will predict better mental health outcomes and will lessen the negative effects of ACEs on mental health outcomes (compensatory factor model), and (3) PCEs will moderate the association between ACEs and mental health outcomes so that the relationship will be weaker among participants with higher PCEs (protective factor model). Findings supported each of these hypotheses and are important for our understanding of the long-term mental health correlates of ACEs and PCEs among college students. Our study underscores the importance of promoting PCEs while also underscoring the necessity of proactively preventing ACEs. Practical implications are discussed in relation to improving assessments of student needs and providing targeted interventions for those at risk.

Child and Adolescent Health in the United States: The Role of Adverse and Positive Childhood Experiences

Background

Adverse childhood experiences (ACEs) have been associated with poorer health from childhood into adulthood. There has been limited prior research examining the associations between positive childhood experiences (PCEs) and health among children.

Objective

The present study examines the association between PCES and child health, controlling for ACE counts, using a nationally representative sample.

Participants and Setting

: The data for this study came from the 2019-2020 National Survey of Children's Health and were limited to children six years of age or older with complete demographic information and information on ACEs, PCEs, and child health (n = 46,913).

Methods

Bivariate analyses between PCEs, ACEs, child/adolescent characteristics, or caregiver's characteristics and child/adolescent health were examined using Pearson's Chi-square tests, weighted to produce nationally representative distributions. Multivariable regression models were used to examine the association between selected PCEs and good health, controlling for whether a child had two or more ACEs.

Results

In adjusted analyses, children who experienced any of the following PCEs had a higher odds of good health, compared to children who did not experience each type of these PCEs: after school activities (aOR 1.85; 95% CI 1.11-3.09), resilient family (aOR 2.22; 95% CI 1.45-3.41), supportive neighborhood (aOR 1.56; 95% CI 1.01-2.41), and connected caregiver (aOR 1.84; 95% CI 1.22-2.77).

Conclusions

Examining and understanding PCEs and how they are associated with child health is a unique opportunity to guide more targeted policies and intervention efforts. Efforts to provide PCEs in schools, homes, and communities may help to reduce health inequities early in childhood.

Depressive Symptoms in Later Life in China: Situating "Long Arm" of Child Physical Maltreatment Within a Family Context

Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture.

Sexual exploitation of young men: Background characteristics and needs from a life-course perspective

BACKGROUND

Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.

OBJECTIVE

By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.

METHODS

Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs.

RESULTS

Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.

CONCLUSIONS

These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation.

Risk factors for COVID-19-related stress among college-going students

OBJECTIVE

To explore the degree of COVID-19-related stress among college students enrolled in higher level institutions and identify socio-demographic and psychosocial factors that may predict, or be associated with, higher levels of pandemic-related distress.

METHOD

Data were obtained from a cross-sectional survey completed by 321 college students primarily recruited from Universities in Ireland. Ages ranged between 18-21 years (n = 176) and 22-25 years (n = 145). Participants answered some demographic questions before completing scales assessing their experience of childhood adversity, their present resilience and levels of psychological distress, as well as their COVID-19-specific stress.

RESULTS

Multiple regression analysis revealed that students who were female, who had chronic illness, who experienced monetary concerns and who expressed psychological distress experienced greater stress related to COVID-19.

CONCLUSION

Findings suggest that certain categories of college students may be at higher risk for experiencing poor mental health during a global pandemic. Higher level institutions should consider this when designing and delivering support services aiming to promote student mental health and alleviate mental distress.

Examining childhood experiences and personality functioning as potential predictors for the speed of recovery during psychotherapy of patients with anxiety disorders

Background

Adverse childhood experiences were previously identified as relevant risk factors for the development of anxiety disorders. Furthermore, anxiety disorders were shown to be associated with impairments of personality functioning. The objective of this study was to investigate adverse and protective childhood experiences as well as personality functioning, as defined by the Operationalized Psychodynamic Diagnosis system, as potential predictors for the speed of recovery during psychotherapy for patients with anxiety disorders.

Methods

The sample consisted of n = 312 completed psychotherapies. The speed of recovery, defined as symptom abatement over time, was calculated using a two-stage hierarchical linear model. The effects of adverse and protective childhood experiences as well as personality functioning on the speed of recovery during psychotherapy were then examined using a structural equation model.

Results

The presence of adverse childhood experiences predicted a lower speed of recovery during psychotherapy. In addition, a higher number of adverse childhood experiences was associated with greater impairments in the abilities of perception and regulation as dimensions of personality functioning. A higher number of protective childhood experiences was associated with fewer impairments in the communication and attachment dimensions. Impairments in personality functioning in patients with anxiety disorders did not predict the speed of recovery during psychotherapy.

Conclusions

Among patients with anxiety disorders, adverse childhood experiences lead to a lower speed of recovery during psychotherapy. Therefore, childhood adversity should be routinely assessed before and thoroughly addressed during psychotherapy in patients with anxiety disorders.

Examining the Association Between Adverse Childhood Experiences and Lifetime History of Head or Neck Injury and Concussion in Children From the United States

OBJECTIVE

Our objective was to determine whether there is an association between adverse childhood experiences (ACEs) and lifetime history of early childhood mild head or neck injury and concussion in a nationally representative US cohort.

SETTING AND DESIGN

This is a cross-sectional study using data from the Adolescent Brain Cognitive Development (ABCD) Study (data release 3.0), a prospective investigation of child brain development and health.

PARTICIPANTS

There were 11 878 children aged 9 or 10 years at baseline, recruited from 21 school-based sites in the United States. After excluding children with missing questionnaires for the primary exposure variable and children with severe brain injuries involving more than 30-minute loss of consciousness, the final sample size was 11 230 children.

MEASURES

The primary exposure variable was ACEs. We measured eight ACEs: sexual abuse, physical abuse, emotional neglect, parent domestic violence, parent substance use disorder, parental mental illness, parent criminal involvement, and parent divorce. The primary outcomes were head or neck injury and concussion, measured using the Ohio State University Traumatic Brain Injury Screen-Identification Method Short Form.

RESULTS

The sample ( N = 11 230) was 52% boys with a mean age of 9.9 years (SD = 0.62 years). The racial and ethnic makeup was reflective of national demographics. Having a higher overall ACE count was associated with higher odds of head or neck injury, with greater odds with more ACEs reported. Children with 2 ACEs had 24% greater odds of head or neck injury (AOR = 1.24, 95% confidence interval [CI] = 1.06-1.45) and 64% greater odds of concussion (AOR = 1.64, 95% CI = 1.18-2.22), and children with 4 or more ACEs had 70% greater odds of head or neck injury (AOR = 1.7, 95% CI = 1.14, 2.49) and 140% greater odds of concussion (AOR = 2.4, 95% CI = 1.15-4.47). The individual ACE categories of sexual abuse, parent domestic violence, parental mental illness, and parent criminal involvement were significantly associated with increased risk of head or neck injury and parental mental illness with increased risk of concussion.

CONCLUSIONS AND RELEVANCE

ACEs are associated with early childhood mild head or neck injury and concussion and should be integrated in head injury prevention and intervention efforts.

Mindfulness Through Storytelling for Mental Health of Primary School Children: Impact on Acceptability and Its Associations with Personality

Purpose

Acceptability of mindfulness-based programs (MBPs) in primary school settings seems to represent a critical factor influencing the intervention effects on children's mental health. This study aims at assessing the acceptability of an MBP delivered through the technique of storytelling, as well as identifying which participants' personality characteristics can influence it.

Participants and Methods

Italian children in grades 3-to-5 (n = 147, 47.6% girls) participated in a 24-session MBP, which included 225 minutes of formal mindfulness practices and was delivered by the pupils' school teachers. Children's personality traits were assessed with the junior Temperament and Character Inventory (jTCI), while their subjective experiences and acceptability of the program were investigated using a survey containing open-ended and closed-ended questions.

Results

Program acceptability was 2.9 ± 0.7 on a 0-4 scale. Higher jTCI scores of persistence, cooperativeness, and self-transcendence were related to higher ratings in liking the program, finding it useful and engaging themselves in it. Moreover, 57.8% of the children generalized the mindfulness practices in daily life and 93.9% of them declared they would recommend the program to their friends/parents. Five main themes emerged from children's answers on what they learned: "help for difficulties (emotional, mental, and physical)", "calm, relax, tranquility", "resilience, positiveness, personal growth", "self-exploration, interoception", and "attention, concentration, and here-and-now".

Conclusion

Program acceptability was generally higher than in similar programs in the literature, and children reported personal gains in various areas related to psychological well-being. The study also suggests which children's personality traits should be considered when proposing an MBP in order to improve its acceptability and utility.

Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago

BACKGROUND

Adverse childhood experiences (ACE) are important predictors of mental health outcomes in adulthood. However, commonly used ACE measures such as the Behavioural Risk Factor Surveillance System (BRFSS) have not been validated among Black sexually minoritized men (SMM) nor transgender women (TW), whom are known to have higher rates of ACE and poorer mental health outcomes. Assessing the psychometric properties of the measure is important for health equity research, as measurements that are not valid for some populations will render uninterpretable results.

METHODS

Data are drawn from the Neighborhoods and Networks (N2) study, a longitudinal cohort of Black SMM and TW living in Southern Chicago. We conducted confirmatory factor analysis, correlation analysis and a two-parameter Item Response Theory (IRT) on the BRFSS ACE measure, an 11-item measure with 8 domains of ACE.

RESULTS

One hundred forty seven participants (85% cisgender male) completed the BRFSS ACE measurement in the N2 study with age ranges from 16-34. The cohort were from a low socioeconomic background: about 40% of the cohort were housing insecure and made than $10,000 or less annually. They also have a high number of ACEs; 34% had endorsed 4 or more ACE domains. The three-factor structure fit the BRFSS ACE measure best; the measurement consisted of three subscales: of "Household Dysfunction", "Emotional / Physical", and "Sexual Abuse" (CFI = 0.975, TLI = 0.967, and RMSEA = 0.051). When the 8 domains of ACE were summed to one score, the total score was is correlated with depressive symptoms and anxiety scores, establishing concurrent validity. Item Response Theory model indicated that the "parental separation" domain had a low discrimination (slope) parameter, suggesting that this domain does not distinguish well between those with and without high ACE.

CONCLUSIONS

The BRFFS ACE measure had adequate reliability, a well-replicated structure and some moderate evidence of concurrent validity among Black SMM and TW. The parental separation domain does not discriminate between those with high and low ACE experiences in this population. With changing population demographics and trends in marriage, further examination of this item beyond the current study is warranted to improve health equity research for all.