1
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Spencer CN, Khalil M, Herbert M, Aravkin AY, Arrieta A, Baeza MJ, Bustreo F, Cagney J, Calderon-Anyosa RJC, Carr S, Chandan JK, Coll CVN, de Andrade FMD, de Andrade GN, Debure AN, Flor LS, Hammond B, Hay SI, Knaul FN, Lim RQH, McLaughlin SA, Minhas S, Mohr JK, Mullany EC, Murray CJL, O'Connell EM, Patwardhan V, Reinach S, Scott D, Sorenson RJD, Stein C, Stöckl H, Twalibu A, Vasconcelos N, Zheng P, Metheny N, Chandan JS, Gakidou E. Health effects associated with exposure to intimate partner violence against women and childhood sexual abuse: a burden of proof study. Nat Med 2023; 29:3243-3258. [PMID: 38081957 PMCID: PMC10719101 DOI: 10.1038/s41591-023-02629-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023]
Abstract
The health impacts of intimate partner violence against women and childhood sexual abuse are not fully understood. Here we conducted a systematic review by comprehensively searching seven electronic databases for literature on intimate partner violence-associated and childhood sexual abuse-associated health effects. Following the burden of proof methodology, we evaluated the evidence strength linking intimate partner violence and/or childhood sexual abuse to health outcomes supported by at least three studies. Results indicated a moderate association of intimate partner violence with major depressive disorder and with maternal abortion and miscarriage (63% and 35% increased risk, respectively). HIV/AIDS, anxiety disorders and self-harm exhibited weak associations with intimate partner violence. Fifteen outcomes were evaluated for their relationship to childhood sexual abuse, which was shown to be moderately associated with alcohol use disorders and with self-harm (45% and 35% increased risk, respectively). Associations between childhood sexual abuse and 11 additional health outcomes, such as asthma and type 2 diabetes mellitus, were found to be weak. Although our understanding remains limited by data scarcity, these health impacts are larger in magnitude and more extensive than previously reported. Renewed efforts on violence prevention and evidence-based approaches that promote healing and ensure access to care are necessary.
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Affiliation(s)
- Cory N Spencer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mariam Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly Herbert
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Alejandra Arrieta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - María Jose Baeza
- School of Medicine, The Pontifical Catholic University of Chile, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Flavia Bustreo
- Fondation Botnar, Basel, Switzerland
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
| | - Jack Cagney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jaidev Kaur Chandan
- Warwick Medical School, University of Warwick, Coventry, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Carolina V N Coll
- Department of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Center, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Alexandra N Debure
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ben Hammond
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Felicia N Knaul
- Institute for the Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA
| | - Rachel Q H Lim
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jasleen K Mohr
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Vedavati Patwardhan
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Center on Gender Equity and Health, UC San Diego School of Medicine, San Diego, CA, USA
| | | | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Reed J D Sorenson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Caroline Stein
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Aisha Twalibu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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2
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Gaietto K, Celedón JC. Child maltreatment and asthma. Pediatr Pulmonol 2022; 57:1973-1981. [PMID: 35583017 PMCID: PMC9398985 DOI: 10.1002/ppul.25982] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/08/2022]
Abstract
A growing body of evidence suggests a potential link between child maltreatment and asthma. Determining whether and how child maltreatment causes or worsens asthma would have major implications for disease prevention and treatment, as well as public health policy. In this article, we examine epidemiologic studies of child maltreatment and asthma and asthma-related outcomes, review the evidence for potential mechanisms underlying the child maltreatment-asthma association, and discuss future directions. To date, a child maltreatment-asthma link has been reported in most studies of children and adults, though the type of maltreatment associated with asthma has differed across studies. Such discrepant findings are likely explained by differences in study design and quality. All studies have been limited by potential under-reporting of child maltreatment and selection bias, and nonthorough assessment of asthma. Despite these limitations, the aggregate evidence from epidemiologic studies suggests a possible causal link between child maltreatment and asthma, though the relative contributions of various types of maltreatment (physical, sexual, emotional, or neglect) are unclear. To date, there is insufficient evidence of an association between child maltreatment and lung function in children or adults. Limited evidence further suggests that child maltreatment could influence the development or severity of asthma through direct effects on stress responses and anxiety- or depressive-related disorders, immunity, and airway inflammation, as well as indirect effects such as increased obesity risk. Future prospective studies should aim to adequately characterize both child maltreatment and asthma, while also assessing relevant covariates and biomarkers of stress, immune, and therapeutic responses.
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Affiliation(s)
- Kristina Gaietto
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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3
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Brassard MR, Hart SN, Glaser D. Psychological maltreatment: An international challenge to children's safety and well being. CHILD ABUSE & NEGLECT 2020; 110:104611. [PMID: 32660756 DOI: 10.1016/j.chiabu.2020.104611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment. OBJECTIVES This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment. PARTICIPANTS AND SETTINGS NA. METHOD Literature review, intervention description of fabricated or induced illness, and expert opinion. RESULTS PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence. CONCLUSIONS PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.
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Affiliation(s)
| | - Stuart N Hart
- Indiana University Purdue University at Indianapolis, USA
| | - Danya Glaser
- Great Ormond Street Hospital for Children and University College, London, UK
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4
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Strathearn L, Giannotti M, Mills R, Kisely S, Najman J, Abajobir A. Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect. Pediatrics 2020; 146:peds.2020-0438. [PMID: 32943535 PMCID: PMC7786831 DOI: 10.1542/peds.2020-0438] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 12/21/2022] Open
Abstract
Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.
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Affiliation(s)
- Lane Strathearn
- Department of Pediatrics, Carver College of Medicine, The University of Iowa, Iowa City, Iowa; .,Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa
| | - Michele Giannotti
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Ryan Mills
- School of Public Health, The University of Queensland, Herston, Queensland, Australia;,Department of Paediatrics, Logan Hospital, Meadowbrook, Queensland, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland and Princess Alexandra Hospital, Woolloongabba, Queensland, Australia;,Departments of Psychiatry and,Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; and
| | - Jake Najman
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Amanuel Abajobir
- School of Public Health, The University of Queensland, Herston, Queensland, Australia;,Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
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5
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Knox BL, Luyet FM, Esernio-Jenssen D. Medical Neglect as a Contributor to Poorly Controlled Asthma in Childhood. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:327-334. [PMID: 33088390 PMCID: PMC7561643 DOI: 10.1007/s40653-019-00290-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Child maltreatment, including medical neglect, is a frequent contributor to the development of asthma as well as a barrier to its proper management. This article aims to review the role of medical neglect as a contributor to poor asthma control. Medical neglect can present as failure of the caretaker to recognize severe asthma symptoms in a child, non-adherence to medical management, failure to prevent chronic exposure to allergens or tobacco smoke, poor child nutrition leading to obesity, and allowing a young child to manage his/her illness without supervision. This article will explore the different factors leading to medical neglect (as illustrated by two cases) and suggest possible interventions aiming to prevent emergency department visits, hospitalizations, and asthma-related deaths.
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Affiliation(s)
- Barbara L. Knox
- University of Wisconsin American Family Children’s Hospital, Madison, WI USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
- University of Wisconsin Department of Pediatrics, 600 Highland Avenue, H4-428 CSC, Madison, WI 53792-4108 USA
| | - Francois M. Luyet
- University of Wisconsin American Family Children’s Hospital, Madison, WI USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Debra Esernio-Jenssen
- Lehigh Valley Reilly Children’s Hospital, Allentown, PA USA
- Morsani College of Medicine USF Health, Tampa, FL USA
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6
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Landeo-Gutierrez J, Celedón JC. Chronic stress and asthma in adolescents. Ann Allergy Asthma Immunol 2020; 125:393-398. [PMID: 32653405 DOI: 10.1016/j.anai.2020.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/20/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE First, to review and critically discuss published evidence on psychosocial stressors, stress, and asthma in adolescents and, then, discuss potential future directions in this field. DATA SOURCES The data source is the National Library of Medicine (PubMed database). STUDY SELECTIONS A literature search was conducted for human studies on stressors or stress and asthma between 2000 and 2020. Studies that were published in English, contained a full text, and included adolescents were considered for inclusion in this review. RESULTS Compared with the available body of evidence in children and adults, relatively few studies have been published in adolescents. Current evidence suggests that exposure to stressors (at the individual, family, and community levels) or stress (acute and chronic) is associated with asthma and worse asthma outcomes, but such evidence must be cautiously interpreted owing to limitations in the design or the analytical approach of the published studies. CONCLUSION Future large studies with a prospective design should determine whether and how stressors or stress causes or worsens asthma in adolescents. At present, clinicians should assess exposure to stressors (eg, violence or abuse) and screen for anxiety and depressive disorders when caring for adolescents with asthma in addition to providing referrals to social workers or mental health professionals when appropriate. Public health policies are needed to reduce psychosocial stressors, such as gun violence and racism, in adolescents.
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Affiliation(s)
- Jeremy Landeo-Gutierrez
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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7
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Hancox RJ, Morgan J, Dickson N, Connor J, Baxter JM. Rape, asthma and dysfunctional breathing. Eur Respir J 2020; 55:13993003.02455-2019. [PMID: 32184316 DOI: 10.1183/13993003.02455-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/23/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Robert J Hancox
- Dept of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jane Morgan
- Dept of Sexual Health, Waikato Hospital, Hamilton, New Zealand
| | - Nigel Dickson
- Dept of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jennie Connor
- Dept of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Joanne M Baxter
- Kōhatu - Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
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8
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Landeo-Gutierrez J, Forno E, Miller GE, Celedón JC. Exposure to Violence, Psychosocial Stress, and Asthma. Am J Respir Crit Care Med 2020; 201:917-922. [PMID: 31801032 PMCID: PMC7159436 DOI: 10.1164/rccm.201905-1073pp] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/04/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jeremy Landeo-Gutierrez
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Gregory E. Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania; and
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9
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Abstract
Asthma is a chronic respiratory disease with complex etiology. Adverse childhood experiences (ACEs) have been linked to asthma in adulthood. Underlying potential mechanisms for the ACE-asthma relationship include stress-induced inflammatory pathways and immune dysregulation. We conducted a cross-sectional secondary data analysis of the 2013 Alberta ACE Survey to explore the relationship between latent ACE factors and self-reported adult asthma. We evaluated the underlying correlation structure among eight different ACEs using exploratory factor analysis. We conducted a logistic regression model to evaluate whether ACE factors retained from the factor analysis predicted self-reported asthma in adulthood. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). We analyzed ACE survey results from 1207 participants. Factor analysis yielded four ACE latent factors: factor 1/relational violence, factor 2/negative home environment, factor 3/illness at home, and factor 4/sexual abuse. Results of the logistic regression showed that experiencing sexual abuse (OR: 3.23; 95% CI: 1.89, 5.23), relational violence (OR: 1.99; 95% CI: 1.17, 3.38), and being exposed to a negative home environment (OR: 1.86; 95% CI: 1.03, 3.35) were predictive of a diagnosis of asthma in adulthood, whereas living in a household with someone experiencing illness did not show an effect (OR: 1.38; 95% CI: 0.75, 2.56). Factor analysis provides an effectual approach to understand the long-term impact of ACEs on respiratory health. Our findings have important implications to understand the developmental origins of asthma in adulthood and inform interventions aimed at reducing the lasting negative impact of childhood adversities on future respiratory health.
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10
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Kisely S, Najman J. Prospective data confirm the lasting effects of maltreatment on children. Med J Aust 2020; 212:15-16. [DOI: 10.5694/mja2.50445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Lopes S, Hallak JEC, Machado de Sousa JP, Osório FDL. Adverse childhood experiences and chronic lung diseases in adulthood: a systematic review and meta-analysis. Eur J Psychotraumatol 2020; 11:1720336. [PMID: 32128046 PMCID: PMC7034480 DOI: 10.1080/20008198.2020.1720336] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/18/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Adverse childhood experiences (ACE) affect physical and mental health and may appear as risk factors for the development of different conditions in adult life. Objective: To perform a literature review and meta-analysis on risk indicators for the development of chronic lung diseases in adulthood associated with ACE. Method: We conducted a systematic literature review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the online databases PubMed, PsycINFO, and Web of Science. Quantitative studies involving male and female adults were included. Fixed- and random-effect models were used in the estimation of meta-analytical measures. The heterogeneity between studies was assessed using I2 statistics and Cochran's Q test. Results: A total of 19 studies were selected for the meta-analysis. The analyses showed statistically significant associations between ACE and lung diseases in general (OR = 1.41; CI 95%: 1.28-1.54), besides specific associations with asthma (OR = 1.32; CI 95%: 1.13-1.50) and COPD (OR = 1.44; CI 95%: 1.13-1.76). When the mediating effect of smoking was assessed separately we found a significant - although not quite expressive - association (OR = 1.06; CI 95%: 1.02 to 1.10), which weakens the hypothesis that a direct relationship exists between childhood trauma and the occurrence of lung diseases. Conclusions: ACE are an important risk factor for the development of lung diseases in adulthood, whether through direct or indirect contribution to this outcome, which highlights the relevance of increasing the awareness of health staff for the early detection and intervention in situations of vulnerability or risk in childhood as an important preventative measure.
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Affiliation(s)
- Samuel Lopes
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil
| | - Jaime Eduardo Cecilio Hallak
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - João Paulo Machado de Sousa
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Flávia de Lima Osório
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
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12
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Feng JY, Hsieh YP, Hwa HL, Huang CY, Wei HS, Shen ACT. Childhood poly-victimization and children's health: A nationally representative study. CHILD ABUSE & NEGLECT 2019; 91:88-94. [PMID: 30852428 DOI: 10.1016/j.chiabu.2019.02.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/25/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Although research on the negative effects of childhood poly-victimization is substantial, few studies have examined the relationship between poly-victimization and younger children's physical health and diseases. OBJECTIVE This study examines the associations between poly-victimization and children's health problems requiring medical attention. METHODS A national stratified cluster random sampling was used to select and approach 25% of the total primary schools in Taiwan, and 49% of the approached schools agreed to participate in this study. We collected data with a self-report questionnaire from 6233 (4th-grade) students aged 10-11, covering every city and county in Taiwan. RESULTS Logistic regression analyses demonstrate a significant dose-response relationship between children's poly-victimization exposure and their health problems including hospitalization, serious injury, surgery, daily-medication requirements, heart murmurs, asthma, dizziness or fainting, allergies, kidney disease, therapies for special needs, smoking, and alcohol use. The results indicate that children's risk of having a health problem grew significantly with each increase in the number of victimization types that children experienced. CONCLUSIONS These research findings underscore the effect of poly-victimization on children's health problems requiring medical attention, and stress the need for both proper screening methods for children's exposure to poly-victimization and stronger awareness of poly-victimization's effects on health conditions in healthcare clinics.
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Affiliation(s)
- Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, No. 1, University Road, Tainan City 701, Taiwan.
| | - Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, 225 Centennial Drive, Stop 7135, Grand Forks, ND, 58202, USA.
| | - Hsiao-Lin Hwa
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, No.1, Jen Ai Rd., Section 1, Taipei 100, Taiwan.
| | - Ching-Yu Huang
- Department of Psychology, Bournemouth University, Fern Barrow, BH12 5BB, UK.
| | - Hsi-Sheng Wei
- Department of Social Work, National Taipei University, 151, University Rd., San Shia District, New Taipei City 23741, Taiwan.
| | - April Chiung-Tao Shen
- Department of Social Work, National Taiwan University, 1, Roosevelt, Rd. Sec. 4, Taipei 106, Taiwan.
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13
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Riedl D, Beck T, Exenberger S, Daniels J, Dejaco D, Unterberger I, Lampe A. Violence from childhood to adulthood: The influence of child victimization and domestic violence on physical health in later life. J Psychosom Res 2019; 116:68-74. [PMID: 30654997 DOI: 10.1016/j.jpsychores.2018.11.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Previous research has shown a detrimental effect of child victimization (CV) on physical disease and mortality. Additionally, individuals with adverse experiences in childhood frequently face domestic violence (DV) in later life. As DV has also been observed to harm physical health, a potential cumulative effect has been proposed. Currently, however, only limited data on such a cumulative effect and its impact on patients' physical health are available. METHODS A cross-sectional observational study at the University Hospital of Innsbruck was conducted. Data on CV, DV and physical health were collected using self-report questionnaires. To evaluate the impact of CV and DV on patients' health, odds ratios (OR) were calculated using binary logistic regression. RESULTS A total of 1480 patients from various departments participated in the study. CV was found for 38% and DV for 16% of participants. A significantly higher occurrence of physical disease was observed in patients with poly-victimization (4+ CVs). When accounting for the cumulative effect of CV and DV, the occurrence was further increased for musculoskeletal disorders (OR:5.1), chronic pain (OR:5.0), gastrointestinal diseases (OR:3.0), metabolic diseases (OR:2.8) and respiratory diseases (OR:2.4). CONCLUSION CV and DV were found to be prevalent and highly correlated in patients treated in a primary care hospital. CV and DV - individually, combined and cumulatively - may thus present risks for physical health. Screening patients for the risk of DV as well as assessing CV may aid in early identification and initiation of psychosocial interventions to avoid further aggravation of physical and psychological problems.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Beck
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Exenberger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Daniel Dejaco
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Iris Unterberger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
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Sheikh MA. Retrospectively reported childhood adversity is associated with asthma and chronic bronchitis, independent of mental health. J Psychosom Res 2018; 114:50-57. [PMID: 30314579 DOI: 10.1016/j.jpsychores.2018.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/09/2018] [Accepted: 09/09/2018] [Indexed: 02/08/2023]
Abstract
Several researchers have raised the concern that the cross-sectional association of retrospectively reported childhood adversity with self-reported onset of asthma and chronic bronchitis in adulthood may be confounded, as well as mediated by an individual's mental health. The aim of this study was to assess the effect of retrospectively reported childhood adversity on self-reported onset of asthma and chronic bronchitis in adulthood, independent of potential confounding and mediating variables (including respondent's mental health). We used data collected in 2007-2008 within the framework of the Tromsø Study (N = 12,981), a representative study of adult men and women in Norway. The associations of childhood adversity with asthma and chronic bronchitis were assessed with Poisson regression models. Relative risks (RR) and 95% confidence intervals (CI) were estimated with bias-corrected bootstrapping. Childhood adversity was associated with a 9% increased risk of asthma (RR = 1.09, 95% CI: 1.02, 1.16) and a 14% increased risk chronic bronchitis (RR = 1.14, 95% CI: 1.03, 1.26) in adulthood, independent of age, sex, parental history of psychiatric problems/asthma/dementia, education, smoking, social support, and respondent's mental health. Controlling for indicators of respondent's mental health reduced the strength of associations of childhood adversity with asthma and chronic bronchitis; however, the associations were still present in the same direction (p < .05). These findings suggest that the association of retrospectively reported childhood adversity with asthma and chronic bronchitis is independent of respondent's mental health. We recommend controlling for indicators of the respondent's mental health to assess an unbiased association of retrospectively measured childhood adversity with self-reported asthma and chronic bronchitis.
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Fu H, Feng T, Qin J, Wang T, Wu X, Cai Y, Lan L, Yang T. Reported prevalence of childhood maltreatment among Chinese college students: A systematic review and meta-analysis. PLoS One 2018; 13:e0205808. [PMID: 30321243 PMCID: PMC6188789 DOI: 10.1371/journal.pone.0205808] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 10/02/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of childhood maltreatment among college students in China by a systematic review and meta-analysis. METHODS A systematic search of relevant articles in Pubmed, Wanfang Data, Chinese Scientific Journals Fulltext Database (CQVIP), China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBMdisc) was conducted on September 1, 2017. A random-effects model was used to estimate the pooled prevalence and sources of heterogeneity were explored using subgroup analyses. RESULTS In total, 32 studies were included in our review. The pooled prevalence of childhood maltreatment among college students was 64.7% (CI: 52.3%-75.6%). For childhood physical abuse(CPA), childhood emotional abuse(CEA), childhood sexual abuse(CSA), childhood physical neglect(CPN)and childhood emotional neglect (CEN), the pooled estimates were 17.4% (13.8%-21.3%), 36.7%(25.1%-49.1%), 15.7%(11.6%-20.2%), 54.9%(41.2%-68.1%) and 60.0% (45.0%-74.0%), respectively. Use of the Childhood Trauma Questionnaire (CTQ) yielded a higher pooled estimate than any other measurement tools in the subgroup analyses of CPA, CEA, CSA, CPN and CEN. The Egger's tests revealed no evidence of publication bias(P>0.05). CONCLUSIONS Childhood maltreatment is common among college students in China. Prevention policies and programmes should be urgently developed to stop the occurrence of child maltreatment, and special attention should be paid to maltreated college students.
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Affiliation(s)
- Hanlin Fu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan Province, China.,Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, China
| | - Tiejian Feng
- Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Xiaobing Wu
- Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, China
| | - Yumao Cai
- Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, China
| | - Lina Lan
- Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan Province, China
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