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Quezada-Gaibor K, Gomis-Pomares A, Villanueva L. Adverse childhood experiences: A health risk in emerging adulthood. J Health Psychol 2024:13591053241275592. [PMID: 39276079 DOI: 10.1177/13591053241275592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2024] Open
Abstract
Adverse Childhood Experiences (ACEs) represent a child's exposure to negative events that are detrimental to their mental and physical health. Despite this, very few studies have focused on the relationship between ACEs and physical health problems, in non-English-speaking populations and in emerging adulthood. Therefore, the objective of this study was to investigate the cumulative and differential impact of ACEs on diverse physical health problems in a Spanish population. Participants were 648 young adults (22% men), between the ages of 18 and 30 (mean age = 21.37, SD = 3.11), who completed the ACE Questionnaire and answered some questions about their health (e.g. asthma, obesity, global health). From the cumulative perspective, ACEs had a significant relationship with global health and asthma. Additionally, the differential approach revealed some specific ACEs related to three out of five health outcomes. Therefore, early detection of ACEs is of paramount importance to reduce their impact.
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Liu J, Guo Y, Huang Z, Zhu J, Li Y. Childhood abuse and risk of migraine: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024; 155:106961. [PMID: 39096662 DOI: 10.1016/j.chiabu.2024.106961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/29/2024] [Accepted: 07/23/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Childhood abuse is associated with an increased risk of migraines. However, the literature on this association is limited. OBJECTIVE To determine the pooled effect size of the association between childhood abuse and migraines. PARTICIPANTS AND SETTING System review and meta-analysis. METHODS A systematic literature search for studies published until September 20, 2023, was performed using the Embase, PubMed, and Web of Science databases. Specifically, original articles reporting the statistical effect size (odds ratio) of the association between childhood abuse and migraines were selected. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using random- or fixed-effects models. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. RESULTS Twelve studies involving 110,776 participants were included. Individuals with childhood abuse (OR = 1.60, 95 % CI: 1.49, 1.71) were at increased risk of migraine when compared with individuals with no childhood abuse. Of the different types of childhood abuse examined, sexual abuse (OR = 1.71, 95 % CI: 1.43, 2.04), physical abuse (OR = 1.47, 95 % CI: 1.38, 1.56), and emotional abuse (OR = 1.71, 95 % CI: 1.52, 1.93) were associated with an increased risk of migraine. CONCLUSIONS Childhood abuse increases migraine risk. Multifaceted interventions to curb abuse and related behaviors can effectively reduce migraine risk. However, considering that multiple factors, such as obesity and anxiety, are causatively associated with both childhood abuse and migraines, our findings should be interpreted with caution.
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Affiliation(s)
- Jianyi Liu
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China.
| | - Yizhi Guo
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China.
| | - Zhihua Huang
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
| | - Jianming Zhu
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
| | - Yandeng Li
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
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Osode E, Cook E, Tomlin A. Child Maltreatment and Metabolic Syndrome: A Systematic Review. Diabetes Metab Syndr Obes 2024; 17:3163-3176. [PMID: 39220800 PMCID: PMC11363932 DOI: 10.2147/dmso.s460058] [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: 03/05/2024] [Accepted: 07/16/2024] [Indexed: 09/04/2024] Open
Abstract
Background Evidence suggests that child maltreatment (CM) is associated with an elevated risk of adult diseases in later life. Emerging evidence shows that CM in childhood is associated with metabolic syndrome (MetS) in adulthood. However, no study has systematically examined the evidence. Hence, this review aims to synthesise the evidence on the association between forms of CM and MetS in adulthood. Methods Electronic databases of CINAHL, Medline, PsychInfo, SOCINDEX, and Scopus were systematically searched using predefined key terms to identify relevant published studies on the association between CM and MetS from the beginning of indexing to 1st January 2024. Studies were included if they met the selection criteria. The quality of studies was appraised using suitable criteria for cross-sectional and prospective studies. Results The search revealed a total of 2411 studies. Five studies met the inclusion criteria and were included in the review. The findings revealed that there was an association between physical abuse and MetS in women across two studies and one study in men. In addition, one study reported an association between emotional abuse and the risk of MetS in men, while two studies revealed increased odds with CM. However, no significant associations were reported between MetS and childhood sexual abuse and neglect, respectively. Conclusion These findings suggest that some forms of CM may increase a person's risk of having MetS. However, there is a need for methodological improvements due to heterogeneity in studies, mainly on the assessment and definition of CM. Further research is needed on forms of CM and MetS to understand the underlying mechanisms of the associations found and to identify targeted strategies to prevent the impact of CM on MetS and subsequent future health.
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Affiliation(s)
- Eno Osode
- Institute for Health Research, University of Bedfordshire, Luto, UK
| | - Erica Cook
- School of Psychology, University of Bedfordshire, Luton, UK
| | - Ali Tomlin
- School of Psychology, University of Bedfordshire, Luton, UK
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Amiri S, Mahmood N, Yusuf R, Ghenimi N, Javaid SF, Khan MAB. Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1015. [PMID: 39201949 PMCID: PMC11352292 DOI: 10.3390/children11081015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024]
Abstract
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, and morbid obesity; (2) Methods: Three databases were searched: Web of Science, PubMed, and Scopus. Manual searches were conducted using Google Scholar and ResearchGate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between ACEs and BMI. A random-effects model was used to combine the ORs and CIs across studies; (3) Results: This meta-analysis included 71 studies. The pooled ORs for the relationship between ACEs and obesity was 1.42 (95% CI: 1.24-1.63, Z = 4.96, p < 0.001), indicating a significant association. ACEs showed a positive association with overweight (OR = 1.16, 95% CI: 1.06-1.27, Z = 3.24, p = 0.001). Specifically, ACEs ≥ 4 were strongly associated with obesity (OR = 2.06, 95% CI: 1.27-3.36, Z = 2.90, p = 0.004). Sexual abuse was also found to be significantly associated with obesity (OR = 1.46, 95% CI: 1.29-1.65, Z = 5.98, p < 0.001); (4) Conclusion: This study finds that individuals who have experienced ACEs are more likely to have a higher BMI in adulthood. Therefore, ACEs should be considered a factor associated with abnormal BMI.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran 17166, Iran;
| | - Nailah Mahmood
- Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Rahemeen Yusuf
- Emirates Center for Happiness Research, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Nadirah Ghenimi
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
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Senaratne DNS, Thakkar B, Smith BH, Hales TG, Marryat L, Colvin LA. The impact of adverse childhood experiences on multimorbidity: a systematic review and meta-analysis. BMC Med 2024; 22:315. [PMID: 39143489 PMCID: PMC11325707 DOI: 10.1186/s12916-024-03505-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/14/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been implicated in the aetiology of a range of health outcomes, including multimorbidity. In this systematic review and meta-analysis, we aimed to identify, synthesise, and quantify the current evidence linking ACEs and multimorbidity. METHODS We searched seven databases from inception to 20 July 2023: APA PsycNET, CINAHL Plus, Cochrane CENTRAL, Embase, MEDLINE, Scopus, and Web of Science. We selected studies investigating adverse events occurring during childhood (< 18 years) and an assessment of multimorbidity in adulthood (≥ 18 years). Studies that only assessed adverse events in adulthood or health outcomes in children were excluded. Risk of bias was assessed using the ROBINS-E tool. Meta-analysis of prevalence and dose-response meta-analysis methods were used for quantitative data synthesis. This review was pre-registered with PROSPERO (CRD42023389528). RESULTS From 15,586 records, 25 studies were eligible for inclusion (total participants = 372,162). The prevalence of exposure to ≥ 1 ACEs was 48.1% (95% CI 33.4 to 63.1%). The prevalence of multimorbidity was 34.5% (95% CI 23.4 to 47.5%). Eight studies provided sufficient data for dose-response meta-analysis (total participants = 197,981). There was a significant dose-dependent relationship between ACE exposure and multimorbidity (p < 0.001), with every additional ACE exposure contributing to a 12.9% (95% CI 7.9 to 17.9%) increase in the odds for multimorbidity. However, there was heterogeneity among the included studies (I2 = 76.9%, Cochran Q = 102, p < 0.001). CONCLUSIONS This is the first systematic review and meta-analysis to synthesise the literature on ACEs and multimorbidity, showing a dose-dependent relationship across a large number of participants. It consolidates and enhances an extensive body of literature that shows an association between ACEs and individual long-term health conditions, risky health behaviours, and other poor health outcomes.
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Affiliation(s)
- Dhaneesha N S Senaratne
- Chronic Pain Research Group, Division of Population Health & Genomics, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK.
| | - Bhushan Thakkar
- Chronic Pain Research Group, Division of Population Health & Genomics, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Blair H Smith
- Chronic Pain Research Group, Division of Population Health & Genomics, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Tim G Hales
- Institute of Academic Anaesthesia, Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Louise Marryat
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Lesley A Colvin
- Chronic Pain Research Group, Division of Population Health & Genomics, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
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Remmers MCC, Reijs RP, Hoebe CJPA. Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review. Scand J Public Health 2024:14034948241260105. [PMID: 39087715 DOI: 10.1177/14034948241260105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
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.
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Affiliation(s)
- Maarten C C Remmers
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Public Health Service Limburg-North, Venlo, Netherlands
| | - Rianne P Reijs
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
| | - Christian J P A Hoebe
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, Netherlands
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Tao Y, Wang H, Luo J, Zhang H, Zhang W, Yu M, Ji S, Peng S, Zhang X. The Association between Adverse Childhood Experiences and Frailty: A Systematic Review. J Am Med Dir Assoc 2024; 25:105042. [PMID: 38796164 DOI: 10.1016/j.jamda.2024.105042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Based on life-course theory, adverse childhood experiences (ACEs) have emerged as risk factors for health in later life. This study aimed to explore the association between ACEs and frailty. DESIGN Systematic review. SETTING AND PARTICIPANTS Frail older adults who have experienced ACEs. METHODS We searched 7 databases: PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO, and China National Knowledge Infrastructure (CNKI). The last searched date was October 27, 2023. Included studies should have investigated the association between exposure to at least 1 ACE and frailty. Two researchers independently assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale (NOS) and an adapted version of the NOS scale and also extracted relevant characteristics and outcomes of the included studies. RESULTS A total of 14 studies were finally included. Consistent associations with increased risk of frailty were only shown in studies that assessed family members with mental illness, low neighborhood quality, emotional abuse, sexual abuse, and combinations of ACEs. In addition, women exposed to ACEs were more likely to be at risk for frailty than men, and greater numbers or types of exposure to ACEs were associated with higher odds of frailty. The results of the quality assessment showed a moderate risk of bias in half of the studies. CONCLUSIONS AND IMPLICATIONS This study summarizes for the first time the evidence for an association between ACEs and frailty. Considered collectively, increased attention to ACEs may be one way to prevent frailty, and unhealthy lifestyles resulting from ACEs may serve as a breakthrough in developing interventions.
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Affiliation(s)
- Yanmin Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Jingsong Luo
- Jockey Club School of Public Health and Primary Care School, The Chinese University of Hong Kong, Hong Kong
| | - Hong Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wen Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Meng Yu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shuyang Ji
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sihan Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Xiangeng Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China.
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8
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Shidlo N, Lazarov A, Benyamini Y. Stressful life events and the occurrence of skin cancer. Psychooncology 2024; 33:e6343. [PMID: 38697780 DOI: 10.1002/pon.6343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/01/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. METHODS The sample included 268 individuals followed-up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non-melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. RESULTS Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p < 0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. CONCLUSIONS The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings.
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Affiliation(s)
- Noa Shidlo
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Aneta Lazarov
- Clinic for Early Detection of Skin Cancer, Herzliya, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Coupe K, Block A, Mark S, Cooper BA, Paul SM, Dunn LB, Hammer MJ, Conley YP, Levine JD, Miaskowski C. Increases in stress and adverse childhood experiences are associated with the co-occurrence of anxiety and depression in oncology patients. J Psychosoc Oncol 2024:1-24. [PMID: 38528755 PMCID: PMC11422520 DOI: 10.1080/07347332.2024.2326146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE Identify subgroups of patients with distinct joint anxiety AND depression profiles and evaluate for differences in demographic and clinical characteristics, as well as stress, resilience, and coping. DESIGN Longitudinal study. PARTICIPANTS Patients (n = 1328) receiving chemotherapy. METHODS Measures of state anxiety and depression were done six times over two cycles of chemotherapy. All of the other measures were completed prior to second or third cycle of chemotherapy. Latent profile analysis was used to identify the distinct joint anxiety and depression profiles. FINDINGS Three classes were identified (i.e. Low Anxiety and Low Depression (57.5%); Moderate Anxiety and Moderate Depression (33.7%), High Anxiety and High Depression (8.8%)). For all of the stress measures, a dose response effect was seen among the profiles. Two worst profiles reported higher occurrence rates for a number of adverse childhood experiences. IMPLICATIONS FOR PROVIDERS Patients need referrals for stress reduction techniques and mental health and social services.
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Affiliation(s)
- Katie Coupe
- School of Nursing, University of California, San Francisco, CA
| | - Astrid Block
- School of Nursing, University of California, San Francisco, CA
| | - Sueann Mark
- School of Nursing, University of California, San Francisco, CA
| | - Bruce A. Cooper
- School of Nursing, University of California, San Francisco, CA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA
| | - Laura B. Dunn
- School of Medicine, University of Arkansas, Little Rock, AK
| | | | | | - Jon D. Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA
- School of Medicine, University of California, San Francisco, CA
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Osibogun O, Erinoso O, Li W, Kalan ME, Bursac Z, Osibogun A. Adverse Childhood Experiences and Tobacco Use Patterns Among Adults in the United States: Exploring sex differences. HEALTH EDUCATION & BEHAVIOR 2024; 51:54-61. [PMID: 37329281 DOI: 10.1177/10901981231178696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States. METHODS This was a cross-sectional analysis of data from adults aged ≥18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes-1 or no/never-0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or ≥4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders. RESULTS Although we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported ≥4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49-8.63]), cigarette (2.57 [1.72-3.83]) and dual use (3.25 [1.79-5.91]) relative to nonuse. Males with ≥4 ACEs had higher odds of cigarette (1.75 [1.15-2.65]) and dual use (7.64 [3.95-14.79]). CONCLUSION Our findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults.
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Affiliation(s)
| | | | - Wei Li
- Yale School of Medicine, New Haven, CT, USA
| | | | - Zoran Bursac
- Florida International University, Miami, FL, USA
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11
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Mrug S, Barker-Kamps M, Goering M, Patki A, Tiwari HK. Neighborhood Disadvantage and Parenting in Early Adolescence Predict Epigenetic Aging and Mortality Risk in Adulthood. J Youth Adolesc 2024; 53:258-272. [PMID: 37715862 DOI: 10.1007/s10964-023-01863-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
Youth who grow up in disadvantaged neighborhoods experience poorer health later in life, but little is known about the biological mechanisms underlying these effects and socioenvironmental factors that may protect youth from the biological embedding of neighborhood adversity. This study tests whether supportive and consistent parenting buffers associations between neighborhood disadvantage in early adolescence and epigenetic aging in adulthood. A community sample from Birmingham, Alabama, USA (N = 343; 57% female; 81% Black, 19% White) was assessed in early adolescence (T1; ages 11 and 13) and adulthood (T2; age 27). At T1, neighborhood poverty was derived from census data and neighborhood disorder was reported by caregivers. Both youth and parents reported on parental discipline and nurturance. At T2, methylation of salivary DNA was used to derive a mortality risk index and Hannum, Horvath, PhenoAge, and GrimAge epigenetic age estimators. Regression analyses revealed that neighborhood disadvantage was associated with accelerated epigenetic aging and/or mortality risk only when combined with high levels of harsh and inconsistent discipline and low child-reported parental nurturance. These findings identify epigenetic aging and mortality risk as relevant mechanisms through which neighborhood adversity experienced in adolescence may affect later health; they also point to the importance of supportive and consistent parenting for reducing the biological embedding of neighborhood adversity in early adolescence.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA.
| | - Malcolm Barker-Kamps
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Marlon Goering
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Amit Patki
- Department of Biostatistics, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Hemant K Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
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Calvo-Schimmel A, Paul SM, Cooper BA, Harris C, Shin J, Oppegaard K, Hammer MJ, Cartwright F, Conley YP, Kober KM, Levine JD, Miaskowski C. Various types of stress and greater use of disengagement coping are associated with worse sleep disturbance in oncology patients undergoing chemotherapy. Stress Health 2024; 40:e3279. [PMID: 37265072 PMCID: PMC10692307 DOI: 10.1002/smi.3279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/31/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Various types of stress and the choice of coping strategies may be risk factors for higher levels of sleep disturbance in oncology patients. Purposes were to evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and the use of coping strategies among three subgroups of patients with distinct sleep disturbance profiles (i.e., Low, High, Very High). Oncology outpatients (n = 1331) completed measures of global (Perceived Stress Scale), cancer-specific (Impact of Event Scale-Revised), and cumulative life (Life Stressor Checklist-Revised) stress, resilience (Connor-Davidson Resilience Scale) and coping (Brief Cope) prior to their second or third cycle of chemotherapy. Sleep disturbance was assessed six times over two chemotherapy cycles. Differences were evaluated using parametric and non-parametric tests. All stress measures showed a dose response effect (i.e., as the sleep disturbance profile worsened, levels of all types of stress increased). Compared to Low class, the other two classes reported higher levels of global perceived stress and higher occurrence rates and effect from previous stressful life events. Impact of Event Scale-Revised scores for the Very High class indicated post-traumatic symptomatology. Patients in High and Very High classes had resilience scores below the normative score for the United States population and used a higher number of disengagement coping strategies. Our findings suggest that very high levels of sleep disturbance are associated with higher levels of various types of stress, lower levels of resilience, and higher use of disengagement coping strategies. Clinicians need to perform routine assessments and implement symptom management interventions to reduce stress and encourage the use of engagement coping strategies.
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Affiliation(s)
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA
| | - Bruce A. Cooper
- School of Nursing, University of California, San Francisco, CA
| | - Carolyn Harris
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | - Joosun Shin
- School of Nursing, University of California, San Francisco, CA
| | - Kate Oppegaard
- School of Nursing, University of California, San Francisco, CA
| | | | | | | | - Kord M. Kober
- School of Nursing, University of California, San Francisco, CA
| | - Jon D. Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA
- School of Medicine, University of California, San Francisco, CA
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13
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Afzal HB, Jahangir T, Mei Y, Madden A, Sarker A, Kim S. Can adverse childhood experiences predict chronic health conditions? Development of trauma-informed, explainable machine learning models. Front Public Health 2024; 11:1309490. [PMID: 38332940 PMCID: PMC10851779 DOI: 10.3389/fpubh.2023.1309490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/27/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Decades of research have established the association between adverse childhood experiences (ACEs) and adult onset of chronic diseases, influenced by health behaviors and social determinants of health (SDoH). Machine Learning (ML) is a powerful tool for computing these complex associations and accurately predicting chronic health conditions. Methods Using the 2021 Behavioral Risk Factor Surveillance Survey, we developed several ML models-random forest, logistic regression, support vector machine, Naïve Bayes, and K-Nearest Neighbor-over data from a sample of 52,268 respondents. We predicted 13 chronic health conditions based on ACE history, health behaviors, SDoH, and demographics. We further assessed each variable's importance in outcome prediction for model interpretability. We evaluated model performance via the Area Under the Curve (AUC) score. Results With the inclusion of data on ACEs, our models outperformed or demonstrated similar accuracies to existing models in the literature that used SDoH to predict health outcomes. The most accurate models predicted diabetes, pulmonary diseases, and heart attacks. The random forest model was the most effective for diabetes (AUC = 0.784) and heart attacks (AUC = 0.732), and the logistic regression model most accurately predicted pulmonary diseases (AUC = 0.753). The strongest predictors across models were age, ever monitored blood sugar or blood pressure, count of the monitoring behaviors for blood sugar or blood pressure, BMI, time of last cholesterol check, employment status, income, count of vaccines received, health insurance status, and total ACEs. A cumulative measure of ACEs was a stronger predictor than individual ACEs. Discussion Our models can provide an interpretable, trauma-informed framework to identify and intervene with at-risk individuals early to prevent chronic health conditions and address their inequalities in the U.S.
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Affiliation(s)
- Hanin B. Afzal
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Tasfia Jahangir
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Yiyang Mei
- School of Law, Emory University, Atlanta, GA, United States
| | - Annabelle Madden
- Teachers College, Columbia University, New York, NY, United States
| | - Abeed Sarker
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, GA, United States
| | - Sangmi Kim
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
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14
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Liu L, Lu J, Yang J, Dong Y, Yin P, Chen Y. A marginal structural model analysis for the effect modification by education on the association between cancer diagnosis history and major depressive symptoms: Findings from Midlife Development in the U.S. (MIDUS). J Affect Disord 2023; 341:202-210. [PMID: 37640112 DOI: 10.1016/j.jad.2023.08.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Limited research has employed a longitudinal approach to investigate the role of education level as an effect modifier on the relationship between cancer diagnosis history and the experience of major depressive disorder (MDD) with a nationally representative sample. METHODS We harnessed data from three installments of the MIDUS Longitudinal study (n = 7108). A Marginal Structural Model facilitated the investigation of associations between a history of cancer diagnosis, MDD, and potential modifying effects of education level. Inverse probability weighting helped manage confounding factors. RESULTS Findings indicated that a cancer diagnosis made one year prior was linked with 3.741 times greater odds of experiencing MDD (95 % CI: 1.411-9.918, p < 0.01). This connection was absent for diagnoses made two years earlier. Among individuals with education up to high school, a recent cancer diagnosis significantly increased the likelihood of MDD in the subsequent wave by 3.45 times (95 % CI: 1.31-9.08, p < 0.05). This pattern was not apparent among better-educated individuals. LIMITATIONS As the exposure variable was dependent on self-reported questionnaires, recall bias could be a potential limitation. Moreover, unaccounted variables like genetic factors could introduce confounding. CONCLUSIONS A recent cancer diagnosis, particularly among less educated individuals, correlated with an increased probability of MDD, while the impact was not observed for older diagnoses. These findings emphasize that the timing of a cancer diagnosis and education level need consideration in the mental health assessment of cancer survivors.
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Affiliation(s)
- Lumin Liu
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junjie Lu
- Department of Social and Behavioral Sciences, Harvard University T.H. Chan School of Public Health, Boston, USA.
| | - Jiarui Yang
- Department of Biomedical Engineering, Boston University, Boston, USA.
| | - Yiyue Dong
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Yin
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Yuelai Chen
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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15
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D'Arcy-Bewick S, Turiano N, Sutin AR, Terracciano A, O'Súilleabháin PS. Adverse childhood experiences and all-cause mortality risk in adulthood. CHILD ABUSE & NEGLECT 2023; 144:106386. [PMID: 37542995 DOI: 10.1016/j.chiabu.2023.106386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have been associated with mortality risk in adulthood. It is unclear, however, whether ACEs perpetrated beyond parents may be associated with mortality risk, if the risk is accumulative or plateaus at a certain frequency, whether associations differ dependent on ACE types, whether types interact with one another, or if observed effects differ by sex. OBJECTIVE To examine associations between ACEs and mortality risk. PARTICIPANTS AND SETTING 6319 participants (age range 25-74 years, mean [SD] 46.91 [12.95] years; 51.6 % female) followed from 1995/96 to 2018 as part of the survey of Midlife Development in the United States. METHODS ACE variables were self-reported exposure to 20 ACE types from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Cox proportional hazards models were used to estimate mortality risk. RESULTS ACEs were accumulatively associated with increased mortality risk in adjusted models (HR = 1.033; p ≤ .001, 95 % CI, 1.014-1.053). The association was linear. Only physical abuse (HR = 1.05; p = .024, 95 % CI, 1.01-1.10) remained significantly predictive of increased mortality risk adjusting for other types. No interaction by sex or amongst ACE types was observed. CONCLUSIONS ACEs may be cumulatively associated with increased mortality risk, such that each individual ACE increases risk. Physical abuse may be an important ACE type within a mortality risk context. Individual ACE types warrant further study as each type may have their own differential impact on mortality risk.
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Affiliation(s)
- Sinéad D'Arcy-Bewick
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | | | - Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
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16
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Rod NH, Bengtsson J, Elsenburg LK, Davies M, Taylor-Robinson D, Bhatt S, Rieckmann A. Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals. THE LANCET REGIONAL HEALTH. EUROPE 2023; 27:100588. [PMID: 36843914 PMCID: PMC9945708 DOI: 10.1016/j.lanepe.2023.100588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/12/2023]
Abstract
Background Childhood adversity such as poverty, loss of a parent, and dysfunctional family dynamics may be associated with exposure to environmental and behavioral hazards, interfere with normal biological functions, and affect cancer care and outcomes. To explore this hypothesis, we assessed the cancer burden among young men and women exposed to adversity during childhood. Methods We undertook a population-based study using Danish nationwide register data on childhood adversity and cancer outcomes. Children who were alive and resident in Denmark until their 16th birthday were followed into young adulthood (16-38 years). Group-based multi-trajectory modelling was used to categorize individuals into five distinct groups: low adversity, early material deprivation, persistent material deprivation, loss/threat of loss, and high adversity. We assessed the association with overall cancer incidence, mortality, and five-year case fatality; and cancer specific outcomes for the four most common cancers in this age group in sex-stratified survival analyses. Findings 1,281,334 individuals born between Jan 1, 1980, and Dec 31, 2001, were followed up until Dec 31, 2018, capturing 8229 incident cancer cases and 662 cancer deaths. Compared to low adversity, women who experienced persistent material deprivation carried a slightly lower risk of overall cancer (hazard ratio (HR) 0.90; 95% CI 0.82; 0.99), particularly due to malignant melanoma and brain and central nervous system cancers, while women who experienced high adversity carried a higher risk of breast cancer (HR 1.71; 95% CI 1.09; 2.70) and cervical cancer incidence (HR 1.82; 95% CI 1.18; 2.83). While there was no clear association between childhood adversity and cancer incidence in men, those men who had experienced persistent material deprivation (HR 1.72; 95% CI 1.29; 2.31) or high adversity (HR 2.27; 95% CI 1.38; 3.72) carried a disproportionate burden of cancer mortality during adolescence or young adulthood compared to men in the low adversity group. Interpretation Childhood adversity is associated with a lower risk of some subtypes of cancer and a higher risk of others, particular in women. Persistent deprivation and adversity are also associated with a higher risk of adverse cancer outcomes for men. These findings may relate to a combination of biological susceptibility, health behaviors and treatment-related factors. Funding None.
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Affiliation(s)
- Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Megan Davies
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | | | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark.,School of Public Health, Imperial College London, UK
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
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17
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Walker BH, Brown DC, Walker CS, Stubbs-Richardson M, Oliveros AD, Buttross S. Childhood adversity associated with poorer health: Evidence from the U.S. National Survey of Children's Health. CHILD ABUSE & NEGLECT 2022; 134:105871. [PMID: 36095924 DOI: 10.1016/j.chiabu.2022.105871] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/22/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The association between adverse childhood experiences (ACEs) and increased risk of health problems is well established. However, many studies have relied on unrepresentative or high-risk samples and have focused on a narrow range of health problems. Prior research assessing potential age differences in the ACE-health connection is also sparse. OBJECTIVE To comprehensively examine the extent to which ACEs are associated with physical, mental, and neurodevelopmental health outcomes in childhood and assess whether these associations differ between age groups. PARTICIPANTS & SETTING Pooled cross-sectional data from the 2016-2019 National Survey of Children's Health (N = 98,732). METHODS We estimated age-stratified binary logistic regression models examining associations between the number of ACEs and physical, mental, and neurodevelopmental health problems net of sociodemographic and socioeconomic controls. Separate models were estimated for the total population (ages 3-17), early childhood (ages 3-5), middle childhood (ages 6-11), and adolescence (ages 12-17). RESULTS We observed a dose-response relationship between ACE exposure and childhood physical, mental, and neurodevelopmental health problems in all age groups. The largest disparities exist between children with no ACEs and three or more ACEs. Compared to children without ACEs, children with three or more ACEs had significantly higher adjusted odds of externalizing disorders (OR = 4.40), internalizing disorders (OR = 5.13), neurodevelopmental disorders (OR = 2.40), and physical health problems (OR = 2.08). CONCLUSIONS Our results add to evidence linking ACEs to childhood health disparities. Further, findings indicate that ACEs have persistent negative effects across age groups and that clinicians should monitor ACEs when assessing children's physical, mental, and neurodevelopmental health at any age.
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Affiliation(s)
- Benjamin H Walker
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America.
| | - Dustin C Brown
- Department of Sociology, Mississippi State University, Bowen Hall, 456 Hardy Road, Mississippi State, MS 39762, United States of America; Social Science Research Center, Mississippi State University, 1 Research Blvd, Suite 103, Starkville, MS 39759, United States of America
| | - Courtney S Walker
- Department of Psychiatry, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America
| | - Megan Stubbs-Richardson
- Social Science Research Center, Mississippi State University, 1 Research Blvd, Suite 103, Starkville, MS 39759, United States of America
| | - Arazais D Oliveros
- Department of Psychology, Mississippi State University, PO Box 6161, 202 Magruder Hall, Mississippi State, MS 39762, United States of America
| | - Susan Buttross
- Department of Pediatrics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America
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18
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Westmore MR, Chakraborty P, Thomas LA, Jenkins L, Ohri F, Baiden P. BMI moderates the association between adverse childhood experiences and COPD. J Psychosom Res 2022; 160:110990. [PMID: 35878540 PMCID: PMC9531576 DOI: 10.1016/j.jpsychores.2022.110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Cigarette smoking and obesity are leading risk factors for chronic obstructive pulmonary disease (COPD). Although studies have established an association between adverse childhood experiences (ACEs) and COPD, few studies have examined whether this association is moderated by cigarette smoking or body mass index (BMI). This cross-sectional study examined the association between ACEs and COPD, and whether cigarette smoking or BMI moderates this association. METHODS Data for this study came from the 2019 Behavioral Risk Factor Surveillance System survey. An analytic sample of 75,700 adults aged 18-79 years (50.7% female) were analyzed using binary logistic regression. The outcome variable investigated was self-reported physician-diagnosed COPD, and the main explanatory variable was ACEs. RESULTS Of the 75,700 respondents examined, 8.1% had COPD. About one in three (33.6%) respondents had no ACEs, 23.1% had one ACE, and about one in five (20.2%) had four or more ACEs. In the multivariable binary logistic regression, we found that the association between ACEs and COPD differs by BMI status. Controlling for the effects of other factors, the association between ACEs and COPD is strongest for respondents who are obese (AOR = 1.41, 95% CI = 1.04-1.91). CONCLUSIONS The findings of this study demonstrate that ACEs are associated with COPD later in adulthood, and BMI moderated this association. The findings of this study add to the number of studies demonstrating the adverse impact of ACEs on chronic health outcomes among adults.
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Affiliation(s)
- Megan R Westmore
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States
| | - Priyanjali Chakraborty
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States
| | - LaTisha A Thomas
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States
| | - Lacey Jenkins
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States
| | - Faheem Ohri
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States
| | - Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX 76019, United States.
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19
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Craner JR, Lake ES, Barr AC, Kirby KE, O'Neill M. Childhood Adversity among Adults with Chronic Pain: Prevalence and Association with Pain-Related Outcomes. Clin J Pain 2022; 38:551-561. [PMID: 35777964 DOI: 10.1097/ajp.0000000000001054] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) have been linked to the development and impact of chronic pain in adulthood. The goal of this study was to investigate the prevalence of ACEs in a treatment-seeking sample of adults with chronic pain and the relationship between number and type(s) of ACEs and pain-related outcomes. METHODS Adults (N=1794) presenting for treatment at a multidisciplinary pain management center completed self-report measures of childhood adversity, pain, functioning, emotional distress, and adjustment to pain. RESULTS Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared to individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health-related outcomes independent of number of ACEs. Significant sex differences were found in the number and type of ACEs reported, but not in the relationship between ACEs and outcome variables. CONCLUSION Findings suggest that the number and type of self-reported ACE(s) are associated with pain-related variables and psychosocial functioning in adults with chronic pain. Results highlight the importance of assessment of ACEs and trauma-informed care with patients with chronic pain.
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Affiliation(s)
- Julia R Craner
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy St. SE, Grand Rapids, MI 49503.,Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI 49503
| | - Eric S Lake
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy St. SE, Grand Rapids, MI 49503.,Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI 49503
| | - Aex C Barr
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy St. SE, Grand Rapids, MI 49503.,Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI 49503
| | - Krissa E Kirby
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy St. SE, Grand Rapids, MI 49503
| | - Mariceli O'Neill
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy St. SE, Grand Rapids, MI 49503
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20
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Yu HJ, Liu X, Yang HG, Chen R, He QQ. The association of adverse childhood experiences and its subtypes with adulthood sleep problems: A systematic review and meta-analysis of cohort studies. Sleep Med 2022; 98:26-33. [PMID: 35777139 DOI: 10.1016/j.sleep.2022.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experience (ACE) is a powerful risk factor for long-term sleep health. However, the degree to which ACE and its subtypes contribute to adulthood sleep problems remains unknown. For this systematic review and meta-analysis, PubMed, Embase, Web of Sciences, Cochrane library, and CNKI (Chinese) were searched from inception to 1 December 2021. Cohort studies that examined the association between ACEs (aged <18 y) and adulthood sleep outcomes (aged ≥18 y) were included. The most fully adjusted odds ratios (ORs) were extracted and pooled using the random-effects model. A total of nine articles involving 108 330 participants from five high-income countries were identified. Individuals with at least one ACE subtype were more likely to report adulthood sleep problems (OR = 1.14, 1.09-1.20, I2 = 77.5%, n = 9 studies) compared with those without ACE. The pooled ORs were approximately 1.20 for sexual, physical, and emotional abuse with high heterogeneity (I2 > 80%), 1.09 (95% CI: 0.99-1.19, I2 = 0%, n = 2) for neglect, and 1.21 (95% CI: 1.14-1.30, I2 = 73.6%, n = 3) for family dysfunction. Individuals with multiple ACEs were associated with a higher magnitude of the risk for sleep problems (OR = 1.33, 95% CI: 1.18-1.49, I2 = 87.3%, n = 3). In conclusion, the magnitude of the risk for sleep problems was similar across ACE subtypes except for childhood neglect. ACE may have cumulative detrimental effects on sleep health. More longitudinal evidence regarding ACE-sleep relationships, particularly in low- and middle-income countries, is needed. Furthermore, more policy efforts and evidence-based preventions are warranted to address ACEs among children.
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Affiliation(s)
- Hong-Jie Yu
- School of Public Health, Wuhan University, Wuhan, China
| | | | | | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.
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21
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Mocelin HT, Fischer GB, Bush A. Adverse early-life environmental exposures and their repercussions on adult respiratory health. J Pediatr (Rio J) 2022; 98 Suppl 1:S86-S95. [PMID: 34922896 PMCID: PMC9510907 DOI: 10.1016/j.jped.2021.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To review in the literature the environmental problems in early life that impact the respiratory health of adults. SOURCES Non-systematic review including articles in English. Search filters were not used in relation to the publication date, but the authors selected mainly publications from the last five years. SUMMARY OF THE FINDINGS In this review, the authors present the exposure pathways and how the damage occurs depending on the child's stage of development; the authors describe the main environmental pollutants - tobacco smoke, particulate matter, air pollution associated with traffic, adverse childhood experiences and socioeconomic status; the authors present studies that evaluated the repercussions on the respiratory system of adults resulting from exposure to adverse environmental factors in childhood, such as increased incidence of Chronic Obstructive Pulmonary Disease (COPD), asthma and allergies; and, a decline in lung function. The authors emphasize that evidence demonstrates that adult respiratory diseases almost always have their origins in early life. Finally, the authors emphasize that health professionals must know, diagnose, monitor, and prevent toxic exposure among children and women. CONCLUSION The authors conclude that it is necessary to recognize risk factors and intervene in the period of greatest vulnerability to the occurrence of harmful effects of environmental exposures, to prevent, delay the onset or modify the progression of lung disease throughout life and into adulthood.
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Affiliation(s)
- Helena Teresinha Mocelin
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Pediatria, Porto Alegre, RS, Brazil; Hospital da Criança Santo Antônio, Seção de Pneumologia Pediátrica, Porto Alegre, RS, Brazil.
| | - Gilberto Bueno Fischer
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Pediatria, Porto Alegre, RS, Brazil; Hospital da Criança Santo Antônio, Seção de Pneumologia Pediátrica, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós-Graduação em Pediatria, Porto Alegre, RS, Brazil
| | - Andrew Bush
- Imperial College London, Faculty of Medicine, National Heart and Lung Institute, Section of Paediatrics, London, United Kingdom; Royal Brompton Hospital, Department of Paediatric Respiratory Medicine, London, United Kingdom
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22
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Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
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Nwanaji-Enwerem JC, Van Der Laan L, Kogut K, Eskenazi B, Holland N, Deardorff J, Cardenas A. Maternal adverse childhood experiences before pregnancy are associated with epigenetic aging changes in their children. Aging (Albany NY) 2021; 13:25653-25669. [PMID: 34923483 PMCID: PMC8751604 DOI: 10.18632/aging.203776] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023]
Abstract
Emerging research suggests associations of physical and psychosocial stressors with epigenetic aging. Although this work has included early-life exposures, data on maternal exposures and epigenetic aging of their children remain sparse. Using longitudinally collected data from the California, Salinas Valley CHAMACOS study, we examined relationships between maternal Adverse Childhood Experiences (ACEs) reported up to 18 years of life, prior to pregnancy, with eight measures (Horvath, Hannum, SkinBloodClock, Intrinsic, Extrinsic, PhenoAge, GrimAge, and DNAm telomere length) of blood leukocyte epigenetic age acceleration (EAA) in their children at ages 7, 9, and 14 years (N = 238 participants with 483 observations). After adjusting for maternal chronological age at delivery, pregnancy smoking/alcohol use, parity, child gestational age, and estimated leukocyte proportions, higher maternal ACEs were significantly associated with at least a 0.76-year increase in child Horvath and Intrinsic EAA. Higher maternal ACEs were also associated with a 0.04 kb greater DNAm estimate of telomere length of children. Overall, our data suggests that maternal preconception ACEs are associated with biological aging in their offspring in childhood and that preconception ACEs have differential relationships with EAA measures, suggesting different physiologic utilities of EEA measures. Studies are necessary to confirm these findings and to elucidate potential pathways to explain these relationships, which may include intergenerational epigenetic inheritance and persistent physical and social exposomes.
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Affiliation(s)
- Jamaji C Nwanaji-Enwerem
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, GA 30322, USA.,Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.,Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Lars Van Der Laan
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Katherine Kogut
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Brenda Eskenazi
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA.,Community Health Sciences Division, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Nina Holland
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Julianna Deardorff
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA.,Community Health Sciences Division, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Computational Biology, School of Public Health, University of California, Berkeley, CA 94720, USA.,Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA 94720, USA
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