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Zhu J, Exner-Cortens D, Dobson K, Wells L, Noel M, Madigan S. Adverse childhood experiences and intimate partner violence: A meta-analysis. Dev Psychopathol 2024; 36:929-943. [PMID: 37009672 DOI: 10.1017/s0954579423000196] [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: 04/04/2023]
Abstract
Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.
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Affiliation(s)
- Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Deinera Exner-Cortens
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lana Wells
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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Buchanan M, Newton-Howes G, Cunningham R, McLeod GFH, Boden JM. The role of social support in reducing the long-term burden of cumulative childhood adversity on adulthood internalising disorder. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02674-6. [PMID: 38687359 DOI: 10.1007/s00127-024-02674-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Previous research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood. METHODS The Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members' birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support. RESULTS Results indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0 .98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) = .98 (0.97, 0.99), p < 001). CONCLUSION The findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA.
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Affiliation(s)
- Mary Buchanan
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Geraldine F H McLeod
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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3
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Buchanan M, Walker G, Boden JM, Mansoor Z, Newton-Howes G. Protective factors for psychosocial outcomes following cumulative childhood adversity: systematic review. BJPsych Open 2023; 9:e197. [PMID: 37855106 PMCID: PMC10594245 DOI: 10.1192/bjo.2023.561] [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] [Received: 04/02/2023] [Revised: 07/26/2023] [Accepted: 08/13/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The long-term cumulative impact of exposure to childhood adversity is well documented. There is an increasing body of literature examining protective factors following childhood adversity. However, no known reviews have summarised studies examining protective factors for broad psychosocial outcomes following childhood adversity. AIMS To summarise the current evidence from longitudinal studies of protective factors for adult psychosocial outcomes following cumulative exposure to childhood adversity. METHOD We conducted a formal systematic review of studies that were longitudinal; were published in a peer-reviewed journal; examined social, environmental or psychological factors that were measured following a cumulative measure of childhood adversity; and resulted in more positive adult psychosocial outcomes. RESULTS A total of 28 studies from 23 cohorts were included. Because of significant heterogeneity and conceptual differences in the final sample of articles, a meta-analysis was not conducted. The narrative review identified that social support is a protective factor specifically for mental health outcomes following childhood adversity. Findings also suggest that aspects of education are protective factors to adult socioeconomic, mental health and social outcomes following childhood adversity. Personality factors were protective for a variety of outcomes, particularly mental health. The personality factors were too various to summarise into meaningful combined effects. Overall GRADE quality assessments were low and very low, although these scores mostly reflect that all observational studies are low quality by default. CONCLUSIONS These findings support strategies that improve connection and access to education following childhood adversity exposure. Further research is needed for the roles of personality and dispositional factors, romantic relationship factors and the combined influences of multiple protective factors.
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Affiliation(s)
- Mary Buchanan
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Grace Walker
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M. Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Zara Mansoor
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Kaufman-Parks AM, Longmore MA, Manning WD, Giordano PC. Understanding the effect of adverse childhood experiences on the risk of engaging in physical violence toward an intimate partner: The influence of relationship, social psychological, and sociodemographic contextual risk factors. CHILD ABUSE & NEGLECT 2023; 144:106381. [PMID: 37542994 PMCID: PMC10528963 DOI: 10.1016/j.chiabu.2023.106381] [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: 05/23/2023] [Revised: 07/10/2023] [Accepted: 07/23/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increase the risk of engaging in intimate partner violence (IPV) in later life. OBJECTIVE This study investigates the association between ACEs and engaging in physical violence toward a romantic partner in emerging adulthood while also accounting for proximal life experiences, including social psychological, intimate relationship, and sociodemographic characteristics. PARTICIPANTS AND SETTING This study draws on two waves of data from the Toledo Adolescent Relationships Study, a 19-year population-based longitudinal cohort study of adolescents transitioning to adulthood from Lucas County, Ohio (United States). This investigation includes 878 (399 men and 479 women) emerging adults. METHODS To evaluate the association between ACEs and IPV perpetration, two waves of survey data were used, collected in 2001 and 2011-2012. RESULTS ACEs had a cumulative effect on IPV, where each additional ACE increased the odds of engaging in IPV by 51.0 % (p < 0.001). However, current drug use (OR = 1.131, p < 0.05), arguments between partners (OR = 1.517, p < 0.01), partner mistrust (OR = 1.663, p < 0.001), and jealousy and control (OR = 1.412, p < 0.001) were also significant correlates of IPV reports. CONCLUSIONS ACEs are a significant predictor of IPV perpetration among emerging adults, even when accounting for more proximal risk factors. These findings suggest that individuals working with clients who engage in IPV would do well to address the long-term trauma impacts of early life adversity in addition to more proximal risk factors to reduce the risk of continued violence.
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Affiliation(s)
- Angela M Kaufman-Parks
- Assumption University, Department of Sociology & Criminology, 500 Salisbury Street, Worcester, MA 01609, United States.
| | - Monica A Longmore
- Bowling Green State University, Department of Sociology, 1001 E. Wooster Street, Bowling Green, OH 43403, United States
| | - Wendy D Manning
- Bowling Green State University, Department of Sociology, 1001 E. Wooster Street, Bowling Green, OH 43403, United States
| | - Peggy C Giordano
- Bowling Green State University, Department of Sociology, 1001 E. Wooster Street, Bowling Green, OH 43403, United States
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Perry KJ, Mutignani LM, Gissandaner TD, Penner F, Santos R, Sarver DE. Testing an integrated dimensional model of adverse childhood experiences: Associations with COVID-19 outcomes. CHILD ABUSE & NEGLECT 2023; 143:106239. [PMID: 37244078 PMCID: PMC10176107 DOI: 10.1016/j.chiabu.2023.106239] [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: 02/10/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a salient risk factor for a myriad of negative outcomes. Extant theoretical and empirical models traditionally quantify the impact of ACEs using cumulative representations. Recent conceptualizations challenge this framework and theorize that the types of ACEs children are exposed to differentially impacts their future functioning. OBJECTIVE The current study tested an integrated ACEs model using parent-report of child ACEs across four aims: (1) characterize heterogeneity in child ACEs using a latent class analysis (LCA); (2) examine mean level class differences in COVID specific and COVID non-specific environmental factors (i.e., COVID impact, ineffective parenting, effective parenting) and internalizing and externalizing problems during the COVID pandemic; (3) test interactions between COVID impact and ACEs classes in predicting outcomes, and (4) compare a cumulative risk approach to a class membership approach. PARTICIPANTS AND SETTING A nationally representative sample of U.S. parents (N = 796; 51.8 % fathers, M age = 38.87 years, 60.3 % Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021. METHOD Measures of child's ACEs history, COVID impact, effective and ineffective parenting, and children's internalizing and externalizing problems were completed by parents. RESULTS A LCA demonstrated three distinct classes of ACEs reflecting low-risk, trauma-risk, and environmental-risk classes. In general, the trauma-risk class had more negative COVID-19 outcomes than the other classes (small to large effect sizes). CONCLUSIONS The classes differentially related to outcomes, providing support for dimensions of ACEs and emphasizing the distinct types of ACEs.
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Affiliation(s)
- Kristin J Perry
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States of America.
| | - Lauren M Mutignani
- University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Blvd., Rochester, NY 14642, United States of America
| | - Tre D Gissandaner
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, United States of America
| | - Francesca Penner
- Yale Child Study Center, Yale University, 230 S Frontage Rd, New Haven, CT 06519, United States of America
| | - Roberto Santos
- Division of Infectious Diseases, Department of Pediatrics, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States of America
| | - Dustin E Sarver
- Department of Psychiatry and Human Behavior, School of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States of America; Center for the Advancement of Youth, University of Mississippi Medical Center, 4400 Old, Canton Rd, Jackson, MS 39211, United States of America
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Norman K, Burrows L, Chepulis L, Keenan R, Lawrenson R. Understanding weight management experiences from patient perspectives: qualitative exploration in general practice. BMC PRIMARY CARE 2023; 24:45. [PMID: 36782120 PMCID: PMC9926650 DOI: 10.1186/s12875-023-01998-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Obesity is a complex health issue affecting the quality of life of individuals and contributing to an unsustainable strain on healthcare professionals and national health systems. National policy guidelines indicate that general practice is best suited to deliver obesity healthcare, however, obesity rates continue to rise worldwide indicating interventions are ineffective in this space. The aim of this study was to explore the weight management experiences from patient perspectives. METHODS This qualitative study used semi-structured interviews with 16 rural Waikato general practice patients. Interviews were analysed using reflexive thematic analysis. RESULTS Four themes were identified: Inconsistent Information, Significance of Holistic Factors, Obesity Centre Need, and Education. Participants expressed frustration at contradictory health messages, commercial company and 'expert' definition distrust, and that 'holistic' aspects to health significant to the weight management journey were unable to be addressed in general practice. CONCLUSION Whilst primary care is positioned as suitable for delivering obesity healthcare, this study found that participants do not perceive general practice to be equipped to deliver this care. Instead, participants argued for a specialist obesity centre capable of meeting all their obesity healthcare needs. Further, wider issues including on-line commodification of health and neo-liberal capitalism - factors that exploit people with a stigmatised health issue - can cause further harm to the participant. A radical modernisation of education, information, and resources from regulated, qualified and 'trusted' healthcare professionals who can provide safe, non-stigmatising supportive services is recommended to meet the unique and changing food climate, reduce obesity rates and improve health outcomes.
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Affiliation(s)
- Kimberley Norman
- University of Waikato, Gate 1, Knighton Road, Hillcrest, Waikato District Health Board, Pembroke Street, Private Bag, Hamilton, 3200, New Zealand.
| | - Lisette Burrows
- grid.49481.300000 0004 0408 3579University of Waikato, Gate 1, Knighton Road, Hillcrest, Waikato District Health Board, Pembroke Street, Private Bag, Hamilton, 3200 New Zealand
| | - Lynne Chepulis
- grid.49481.300000 0004 0408 3579University of Waikato, Gate 1, Knighton Road, Hillcrest, Waikato District Health Board, Pembroke Street, Private Bag, Hamilton, 3200 New Zealand
| | - Rawiri Keenan
- grid.49481.300000 0004 0408 3579University of Waikato, Gate 1, Knighton Road, Hillcrest, Waikato District Health Board, Pembroke Street, Private Bag, Hamilton, 3200 New Zealand
| | - Ross Lawrenson
- grid.49481.300000 0004 0408 3579University of Waikato, Gate 1, Knighton Road, Hillcrest, Waikato District Health Board, Pembroke Street, Private Bag, Hamilton, 3200 New Zealand
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7
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Mlouki I, Naimi A, Sioud I, Bouanene I, El Mhamdi S. Adverse childhood experiences and sleep disorders among Tunisian adolescents: The mediating role of internet addiction. CHILD ABUSE & NEGLECT 2023; 136:106028. [PMID: 36652900 DOI: 10.1016/j.chiabu.2023.106028] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a prevalent health problem worldwide. Different side effects have been linked to this issue such as sleep disorders. This matter is well known. However, its influencing mechanisms are not well investigated in literature. OBJECTIVE To investigate the mediating role of internet addiction in the relation between adverse childhood experiences (ACEs) and sleep disorders among a population of high-school students in the region of Gafsa (Tunisia). PARTICIPANTS AND SETTING We performed a cross-sectional study, in February 2020, including adolescents registered in all secondary schools of Gafsa city. METHODS Sleep disorders were evaluated via the Pittsburgh Sleep Quality Index, internet addiction via the Internet Addiction Test and adverse childhood experiences via the Adverse Childhood Experiences-International Questionnaire. RESULTS A total of 414 students were enrolled in our study with a mean age of 17.18 ± 1.5 years. Exposure to intra-familial violence was more reported than social adversities with 99.1 % and 84 % respectively. Males showed higher rates of internet addiction (82.9 % vs 78.3 %, p < 0.001). Sleep disorders were reported in 94 % of students, predominantly among females (95.4 % vs 91 %, p < 0.001). Our results revealed that ACEs predict sleep disturbances through internet addiction (% mediation =18.3 %, p = 0.005). More particularly, an important mediation effect of internet addiction on the relationship between ACEs and sleep disorders was found among females (% mediation =30 %). CONCLUSION Internet addiction was found to be a mediating factor in the relation between ACEs and sleep disturbances among Gafsa high school students.
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Affiliation(s)
- Imen Mlouki
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia; Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia; Research Laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia.
| | - Arij Naimi
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia
| | - Imen Sioud
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia
| | - Ines Bouanene
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia
| | - Sana El Mhamdi
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia; Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia; Research Laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
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Hashemi L, Fanslow JL, Gulliver P, McIntosh T. Relational Mobility and Other Contributors to Decline in Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21119-NP21142. [PMID: 34894826 PMCID: PMC9554399 DOI: 10.1177/08862605211055193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study explored whether changes in risk and protective factors of intimate partner violence (IPV) can account for the noted reduction in 12-month IPV prevalence in New Zealand between 2003 and 2019. Changes in relational mobility over time were also explored. Data from two population-based surveys of 18-64 year-old ever-partnered women in New Zealand that were conducted according to identical procedures in 2003 (n=2764) and 2019 (n=944) were used. Changes in a variety of potential risk and protective factors over time and their possible contribution to IPV reduction were assessed. The findings indicated that there was no change in the prevalence of the strongest risk and protective factors of IPV victimisation and perpetration over time (e.g. partner concurrent relationship, previous exposure to violence for both respondent and partner, and partner's problematic alcohol/drug use). However, a combination of factors including decline in women's problematic alcohol or drug use, decline in the number of children within families, and increases in the proportion of women and partners with a qualification higher than secondary education are likely to be associated with the reduction in IPV prevalence. A greater degree of relational mobility, demonstrated through a greater proportion of women who left their abusive partner permanently and increased numbers of relationships that women had, was also observed between two study years. Overall, these results indicate that changes in 12-month IPV prevalence over time are likely to be linked with changes that increase women's autonomy and ability to move out of violent relationships. To achieve sustained reductions in IPV, more comprehensive and planned efforts are needed to address other underlying and exacerbating causes, including problematic alcohol/drug use and previous exposure to violence during childhood and adulthood.
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Affiliation(s)
- Ladan Hashemi
- Social and Community Health, School
of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Janet L. Fanslow
- Social and Community Health, School
of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Pauline Gulliver
- Social and Community Health, School
of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- Māori Studies and Pacific Studies,
Faculty of Arts,University of Auckland, Auckland, New Zealand
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Bellis MA, Hughes K, Ford K, Madden HCE, Glendinning F, Wood S. Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study. BMJ Open 2022; 12:e053915. [PMID: 35105582 PMCID: PMC8829847 DOI: 10.1136/bmjopen-2021-053915] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy. DESIGN National cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group. SETTING Households in Wales during national COVID-19 restrictions (December 2020 to March 2021). PARTICIPANTS 2285 Welsh residents aged ≥18 years. MEASURES Nine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination). RESULTS Increasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18-29 years. CONCLUSIONS ACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.
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Affiliation(s)
- Mark A Bellis
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Karen Hughes
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Kat Ford
- College of Human Sciences, Bangor University, Bangor, UK
| | - Hannah C E Madden
- College of Human Sciences, Bangor University, Bangor, UK
- School of Social Sciences, Liverpool Hope University, Liverpool, UK
| | | | - Sara Wood
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
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Hashemi L, Fanslow J, Gulliver P, McIntosh T. Exploring the health burden of cumulative and specific adverse childhood experiences in New Zealand: Results from a population-based study. CHILD ABUSE & NEGLECT 2021; 122:105372. [PMID: 34717153 DOI: 10.1016/j.chiabu.2021.105372] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can influence later health, but there are gaps in understanding how ACEs may interact with Positive Childhood Experiences (PCEs). Additionally, there are gaps in understanding how ACEs impact on positive markers of health. OBJECTIVES To explore associations of ACEs with both negative and positive markers of physical and mental health in adulthood and to examine whether positive childhood experiences (PCEs) can mitigate the negative effects of ACEs on health. PARTICIPANTS AND SETTING 2887 participants (1464 female, 1423 male) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017-March 2019. METHODS Multivariable logistic regressions were conducted to ascertain how both ACE score and ACE subtypes influenced the odds of experiencing adverse and positive mental and physical health after adjusting for socio-demographic predictors. A combined ACE-PCE variable was created and included in the multivariable logistic regression models to examine whether PCEs can mitigate the negative effects of ACEs. RESULTS Findings indicated that respondents with higher ACE scores had an increased likelihood of reporting each adverse outcome. Higher ACE scores had the strongest association with poor mental health followed by disability and chronic physical health conditions. Respondents with higher ACE scores had a decreased likelihood of reporting each positive health outcome. Exposure to ACEs was detrimental to health even in the presence of PCEs, with minimal effects observed from PCEs given the limited variance observed from its assessment. CONCLUSION This study documents the deleterious impacts of ACEs on a wide range of health outcomes and demonstrates that these effects are persistent. Findings should provide the impetus for widespread prevention and intervention initiatives that seek to address ACEs. Further exploration of PCEs with a more complete assessment is needed to determine if they can mitigate the detrimental consequences of ACEs.
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Affiliation(s)
- Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Janet Fanslow
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Pauline Gulliver
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Tracey McIntosh
- Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand.
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11
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Hashemi L, Fanslow J, Gulliver P, McIntosh T. Intergenerational Impact of Violence Exposure: Emotional-Behavioural and School Difficulties in Children Aged 5-17. Front Psychiatry 2021; 12:771834. [PMID: 35058819 PMCID: PMC8764379 DOI: 10.3389/fpsyt.2021.771834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: The intergenerational impacts of parental exposure to violence during childhood and adulthood have largely been investigated separately. This limits our understanding of how cumulative violence exposure over a lifespan elevates the risk of subsequent generation's maladjustment. To address this, we examined if parental exposure to violence during childhood and during adulthood was associated with increased emotional-behavioural and school difficulties among the children of these parents. Further, we examined if parental exposure to cumulative violence increased the odds of their children experiencing difficulties. Participants and Setting: 705 participants (354 mothers and 351 fathers) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017 and March 2019. Methods: Multivariable logistic regressions were conducted to ascertain the impact of parental exposure to violence on children's outcomes after adjustment for sociodemographic characteristics. The impact of parental cumulative violence exposure on children's outcomes was also explored. Results: Findings indicated that children of parents who had histories of exposure to violence during childhood were at increased risk for experiencing emotional-behavioural or school difficulties. However, where parents reported a history of childhood abuse but not adult experience of violence, their children had similar odds of experiencing difficulties as the children of parents who had not been exposed to any violence in their lifetime. Children of parents who had been exposed to violence only during adulthood were at higher risk of experiencing emotional-behavioural difficulties compared with children of parents with no violence exposure. Children of parents with histories of exposure to violence during both childhood and adulthood had the highest prevalence of experiencing emotional/behavioural and school difficulties. Conclusion: These findings highlight the intergenerational impacts of violence exposure and the complex intersections between parents' and children's life experiences. Our findings suggest the need for violence prevention initiatives to foster the development of safe, stable and nurturing relationships and to expand services for parents already exposed to violence to build resilience and to break the inter-generational cycle of disadvantage.
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Affiliation(s)
- Ladan Hashemi
- Department of Social and Community Health, Faculty of Medical and Health Sciences, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Janet Fanslow
- Department of Social and Community Health, Faculty of Medical and Health Sciences, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Pauline Gulliver
- Department of Social and Community Health, Faculty of Medical and Health Sciences, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
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