Adverse childhood experiences and intimate partner aggression in the US: sex differences and similarities in psychosocial mediation

Adverse childhood experiences and intimate partner violence: A meta-analysis

Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.

Understanding the effect of adverse childhood experiences on the risk of engaging in physical violence toward an intimate partner: The influence of relationship, social psychological, and sociodemographic contextual risk factors

BACKGROUND

Adverse childhood experiences (ACEs) increase the risk of engaging in intimate partner violence (IPV) in later life.

OBJECTIVE

This study investigates the association between ACEs and engaging in physical violence toward a romantic partner in emerging adulthood while also accounting for proximal life experiences, including social psychological, intimate relationship, and sociodemographic characteristics.

PARTICIPANTS AND SETTING

This study draws on two waves of data from the Toledo Adolescent Relationships Study, a 19-year population-based longitudinal cohort study of adolescents transitioning to adulthood from Lucas County, Ohio (United States). This investigation includes 878 (399 men and 479 women) emerging adults.

METHODS

To evaluate the association between ACEs and IPV perpetration, two waves of survey data were used, collected in 2001 and 2011-2012.

RESULTS

ACEs had a cumulative effect on IPV, where each additional ACE increased the odds of engaging in IPV by 51.0 % (p < 0.001). However, current drug use (OR = 1.131, p < 0.05), arguments between partners (OR = 1.517, p < 0.01), partner mistrust (OR = 1.663, p < 0.001), and jealousy and control (OR = 1.412, p < 0.001) were also significant correlates of IPV reports.

CONCLUSIONS

ACEs are a significant predictor of IPV perpetration among emerging adults, even when accounting for more proximal risk factors. These findings suggest that individuals working with clients who engage in IPV would do well to address the long-term trauma impacts of early life adversity in addition to more proximal risk factors to reduce the risk of continued violence.

Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse

Background: Childhood sexual abuse (CSA) may be a risk factor for poor mental health in adulthood. Survivors may experience emotions detrimental to their social and mental wellbeing. Some of these emotions may include anger, fear, rage, helplessness, guilt, shame, which may impact their coping strategies. The aim of this study was to determine the association between CSA and coping among older adults living with HIV (OALH). Method: Data were obtained from 91 OALH via convenience sampling. The participants were recruited from an immunology clinic and were at least 50 years or older and living with HIV. CSA was operationalized using questions from the Adverse Childhood Experiences Questionnaire. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, sex, race, gender, and income were used to determine the association between CSA and each coping subscale. The analyses were conducted in SAS version 9.4. Results: Crude analyses showed statistically significant associations between CSA and specific coping strategies: humor (β = 1.244; p = 0.0018), religion (β = 1.122; p = 0.0291), Self-blame (β = 1.103; p = 0.0154), planning β = 1.197; p = 0.0196), venting (β = 1.218; p = 0.0063), substance use (β = 0.828; p = 0.0335) and instrumental support (β = 0.949; p = 0.0416) After adjusting for sociodemographic characteristics, there was a statistically significant association between CSA and humor (β = 1.321; p = 0.0048) and self-blame (β = 1.046; p = 0.0382). Conclusion: OALH with a history of CSA were more likely to use humor and self-blame as coping strategies. Trauma-informed interventions should be geared towards decreasing self-blame for OALH who are CSA survivors.

Intimate Partner Violence in Khaliji Women: A Review of the Frequency and Related Factors

The Gulf Cooperation Council (GCC), locally known as Khaliji, is a group of six Arab nations, including Saudi Arabia, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates (UAE). Intimate partner violence (IPV) is a significant public health concern in the aforementioned region, but research that synthesises this trend has remained scarce. The present narrative review examines existing research on the prevalence and frequency of IPV among Khaliji women who inhabit the GCC nations. This review synthesised studies on physical and sexual violence, emotional abuse, and controlling behaviours perpetrated by an intimate partner. The prevalence rates of IPV among Khaliji women were observed to be high: women reported facing different types of abuse from their partners, namely physical (7-71%), sexual (3.7-81%), financial (21.3-26%), and psychological (7.5-89%), which is a culmination of controlling behaviour (36.8%), emotional violence (22-69%), and social violence (34%). Existing studies in the GCC region suggest that the most endorsed IPV was psychological abuse (89%), followed by sexual violence (81%). Qualitative analysis of the content of associated factors resulted in four significant descriptors, such as victim demographics, sociocultural factors, socioeconomic factors, and perpetrator-related issues. Research on IPV is still in its nascent stages, with very few studies emanating from the GCC region. The way forward will require developing culturally appropriate interventions that address the unique risk factors for IPV among the Khaliji population, strengthening institutional responses, and increasing awareness and social support for victims of IPV.

Stressful life events: Typology of aggression and mistreatment in male perpetrators of gender-based violence

The objective of this study was to analyze groups based on the stressful life events suffered and to know the relationship of these profiles with the type of abuse exercised against women in the couple. A sample of 118 heterosexual men who perpetrated gender-based violence was used, with a mean age of 40.46 years (SD = 11.14). The results show that those who suffered a greater number of adverse experiences abused their partners more frequently and with a more aggravated character. In addition, knowing typologies based on previous stressful life events could favor specific interventions in the elimination of the normalization of violence as a maladaptive relational strategy. It is necessary to continue investigating the characteristics of men who exercise gender-based violence, as well as to analyze previous exposure to violence in the family of origin due to the influence it exerts on subsequent abuse.

The Influence of Adverse Childhood Experiences on Perpetration of Intimate Partner Violence Among Black Men: The Moderating Role of Alcohol Use

This study examined the moderating role of alcohol use on the association between adverse childhood experiences (ACEs) and intimate partner violence (IPV) perpetration among Black men in the United States. We conducted bivariate and logistic regression analyses using data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Bivariate results revealed significant relationships between eight of the 10 ACE factors physical neglect; emotional, physical and sexual abuse; witnessing a mother being abused; and having a parent guardian with an alcohol and drug problem and who was incarcerated and IPV perpetration. Similarly, examination of the relationship between ACEs and alcohol use in adulthood also revealed significant associations, with the exception of exposure to emotional neglect, emotional and sexual abuse, and witnessing a mother being abused. Findings from the logistic regression models revealed that alcohol use significantly moderated the relationship between ACEs and IPV perpetration, but only for men exposed to 1, 2, and ≥4 adversities in childhood. However, alcohol use appeared to exacerbate the relationship between ACEs and IPV perpetration for men without childhood adversity. Implications for practice, policy, and areas for further research are discussed.

Adverse Childhood Experiences and Intimate Partner Violence; Findings From a Community Sample of Hispanic Young Adults

In the United States, a substantial proportion of the adult population (36% of women and 34% of men) from all socioeconomic and ethnic backgrounds report experiencing intimate partner violence (IPV) over the life course. Family risk factors have been linked to adolescent and young adult IPV involvement, yet few studies have examined the effect of multiple, co-occurring adverse childhood experiences (ACEs) in the stability and change of IPV behaviors over young adulthood-the period of highest risk for IPV. We investigated the relationship between the degree of ACE exposure and IPV victimization and perpetration at age 22 and two years later at age 24 among a sample of Hispanic young adults (N= 1,273) in Southern California. Negative binomial regression models compared the incident rate ratio (IRR) of past-year verbal and physical IPV victimization and perpetration of respondents with 1-3 ACE and with ≥4 ACE to their peers who reported no history of ACE cross-sectionally (age 22) and longitudinally (age 24). At age 22, participants with 1-3 and ≥4 ACE were overrepresented in all IPV behaviors and had higher IRRs of verbal and physical victimization and perpetration compared to their peers with no ACE. By age 24, respondents with a history of ≥4 ACE were at significantly greater risk for escalating IPV behaviors over this time period than their peers with 1-3 ACE and no ACE. These findings highlight the importance of investing in coordinated efforts to develop strategies that help young people cope with the downstream effects of early life adversity. Research should continue to identify what individual, community, and cultural assets that promote resilience and are promising foci of IPV prevention approaches among vulnerable populations.

Disparities by Gender and Race/Ethnicity in Child Maltreatment and Memory Performance

Adverse childhood experiences, which include child maltreatment, are a major public health issue nationally. Child maltreatment has been linked to poorer cognitive functioning, which can start in childhood and persist into adulthood. However, studies examining the potential disparities by gender and race/ethnicity are lacking. The aim of this study was to assess the gender and racial/ethnic disparities in the association between child maltreatment and memory performance. Data were obtained from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health (N = 11,624). Weighted multiple linear regression models were used to assess the associations between sexual abuse, physical abuse, neglect, and child maltreatment score and memory. Models were stratified by gender, race, and ethnicity. Men who were exposed to sexual abuse, neglect and two or three child maltreatment types scored one to three points lower (β = -1.44; 95% CI: -2.83, -0.06; β = -2.41; 95% CI: -3.75, -1.08; β = -3.35; 95% CI: -5.33, -1.37; β = -2.31; 95% CI: -3.75, -0.86) in memory performance compared to men who did not report sexual abuse, neglect, or child maltreatment, respectively. Black respondents who were exposed to sexual abuse scored two points lower (β = -1.62; 95% CI: -2.80, -0.44) in memory performance compared to Black respondents who did not report sexual abuse. Among Other race and Hispanic respondents, those who reported neglect scored four points lower (β = -4.06; 95% CI: -6.47, -1.66; β = -4.15; 95% CI: -5.99, -2.30) in memory performance, respectively, compared to their counterparts who did not report neglect. Gender- and racial/ethnic-responsive memory performance interventions addressing child maltreatment may be beneficial for affected populations.

Prevalence of adverse childhood experiences (ACEs) and association with dating violence and symptoms of mental illness among adolescents in the Dominican Republic

BACKGROUND

Adolescent dating violence (ADV) and mental illness are highly prevalent, interrelated public health priorities. Increasingly, scholars are looking to adverse childhood experiences (ACEs) to explain risk for these health concerns.

OBJECTIVES

Determine prevalence of ACEs, ADV perpetration and victimization, and anxiety and depression symptoms among adolescents in the Dominican Republic (DR). Evaluate the association of ACEs with these ADV and mental health outcomes.

PARTICIPANTS AND SETTING

Cross-sectional survey data were collected from 142 adolescents at middle and high schools in the DR.

METHODS

We assessed ACEs using the Childhood Experiences Survey, ADV using the Conflict in Dating Relationships Inventory, and depression/anxiety symptoms using Patient-Reported Outcomes Measurement Information System scales. Linear and logistic regressions were performed to test dose-response relationships between a cumulative ACE score and ADV and mental health outcomes while adjusting for age, gender, and rural/urban residence.

RESULTS

80.6% of students reported at least one ACE. The most prevalent ACEs reported were physical abuse (49%) and witnessing domestic violence (48%). After adjusting for covariates, cumulative ACE scores were significantly associated with depression symptoms, anxiety symptoms, physical and emotional ADV perpetration, and physical and emotional ADV victimization.

CONCLUSIONS

Structural and community-based interventions to prevent ADV and promote mental health for adolescents in the DR should address ACEs.

Creencias sexistas en hombres en situación de suspensión de condena que han ejercido violencia contra las mujeres en la pareja

La violencia contra las mujeres en la pareja es un problema que afecta a la mayoría de las sociedades. Si bien se ha descrito a los hombres que ejercen esta violencia desde el punto de vista clínico, analizar la aceptación de las actitudes sexistas permitiría incorporar la influencia de otras variables contextuales que expliquen el fenómeno desde una perspectiva más amplia. En el presente trabajo se analiza, con una muestra de 121 hombres que han ejercido violencia contra las mujeres, la relación entre la percepción de la violencia como asunto privado y las actitudes sexistas. Los resultados muestran que quienes consideran que la violencia contra la pareja es un asunto privado obtienen puntuaciones más elevadas tanto en el componente hostil como en el benévolo, y que es en la dimensión hostil del sexismo donde se hallan mayores diferencias (t = 4.03; p = .000), con un tamaño del efecto alto (d = 0.75). Identificar la violencia contra las mujeres como un problema social y no como un asunto privado parece ser un paso relevante en las intervenciones para deconstruir las actitudes discriminatorias y erradicar la violencia hacia las mujeres.

Adverse Childhood Experiences (ACEs), Alcohol Use in Adulthood, and Intimate Partner Violence (IPV) Perpetration by Black Men: A Systematic Review

Intimate partner violence (IPV) is a serious social and public health problem in the United States. Adverse childhood experiences (ACEs) and alcohol use have been found to be associated with IPV perpetration; however, limited studies have examined the interrelationships of these variables among Black men. This is the first known study to systematically review and synthesize studies on the interrelationships of ACEs, alcohol use, and IPV perpetration among Black men. Comprehensive literature searches were conducted in PubMed and six EBSCOhost databases by a research librarian and two researchers. Twenty studies met inclusion criteria: empirical; available in English; included ACEs, alcohol use/substance abuse, and IPV perpetration variables in the analyses; and samples included Black/African American male IPV perpetrators aged ≥ 18 years. ACEs were found to be associated with IPV perpetration among Black men, but findings were mixed regarding the role of alcohol in relation to ACEs and IPV. Numerous ACE factors (1-6) were used across studies. However, findings regarding the co-occurrence of ACE factors are inconclusive because none of the studies examined the cumulative effects of exposure to more than one type of ACE on subsequent IPV perpetration. Implications for policy, practice, and research related to the interrelationships of ACEs, alcohol use, and IPV perpetration are provided. Future work is needed to better explicate the interrelationships among these constructs.

Early Life Adversity and Males: Biology, Behavior, and Implications for Fathers' Parenting

Fathers have an important and unique influence on child development, but influences on fathers' parenting have been vastly understudied in the scientific literature. In particular, very little empirical research exists on the effects of early life adversity (ELA; e.g. childhood maltreatment, parental separation) on later parenting among fathers. In this review, we draw from both the human and non-human animal literature to examine the effects of ELA, specifically among males, in the following areas: 1) neurobiology and neurocognitive functioning, 2) hormones and hormone receptors, 3) gene-environment interactions and epigenetics, and 4) behavior and development. Based on these findings, we present a conceptual model to describe the biological and behavioral pathways through which exposure to ELA may influence parenting among males, with a goal of guiding future research and intervention development in this area. Empirical studies are needed to improve understanding of the relationship between ELA and father's parenting, inform the development of paternal and biparental interventions, and prevent intergenerational transmission of ELA.

Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses

The long-term impacts of Adverse Childhood Experiences (ACEs) are of increasing interest to researchers and practitioners, including the effectiveness of screening for ACEs to improve health and social outcomes. Despite a focus on implementing such practices, there has been little focus on ACEs experiences for women experiencing domestic violence and substance use, or consideration of practice responses around ACEs routine enquiry for domestic violence and related services. The Irish study discussed in this paper used an action research approach to implement ACEs routine enquiry within a domestic violence service for women accessing the service (n = 60), while also utilizing co-operative inquiry groups for practitioners both within the organization (n = 10) and with those working in associated fields of infant mental health, child protection, substance misuse and welfare and community support (n = 7). Of the 60 women who completed the ACEs routine enquiry in the study, over one-half (58 per cent) reported experiencing at least two ACEs in their childhood, including one-third of all respondents reporting experiencing four or more; service users reported significant levels of overlap between direct child maltreatment and adverse home environments. Reported parental substance misuse with the home environment was substantially higher than in general population studies. These findings offered early indications of both ACEs prevalence as well the types of ACEs that most define the experiences of the women presenting to a domestic violence service that supports women with substance misuse and other related issues. This paper discusses the ways in which the co-operative inquiry groups used this information and other processes to enhance practitioner, organizational, and inter-agency understanding and service responses. The practitioners felt that this form of ACEs routine enquiry, while not an end in itself, was a useful tool to engage women in conversations about trauma and intergenerational patterns and a basis for developing trauma-informed interventions. We conclude with discussion about: considerations of the risks of "individualizing" women's traumatic experiences; skills and supports for practitioners; and resource implications.

Child Maltreatment, Youth Violence, Intimate Partner Violence, and Elder Mistreatment: A Review and Theoretical Analysis of Research on Violence Across the Life Course

This article reports the results of a scoping review of the literature on life-course patterns of violence that span the developmental periods of childhood, adolescence, and early and middle adulthood. We also assess the evidence on elder mistreatment and its relation to earlier forms of violence. Additionally, we draw on theories and empirical studies to help explain the transmission of violence over time and relational contexts and the factors that appear to mitigate risks and promote resilience in individuals exposed to violence. Results suggest that encounters with violence beginning in childhood elevate the risk for violence in subsequent developmental periods. The strongest connections are between child maltreatment (physical abuse, emotional abuse, sexual abuse, and neglect) and violence in adolescence and between violence in adolescence and violence in early and middle adulthood. Persistence of violence into older adulthood leading to elder mistreatment is less well-documented, but probable, based on available research. We conclude that more attention should be paid to studying developmental patterns and intersecting forms of violence that extend into old age. To eradicate violence in all its forms, considerably more must be done to increase awareness of the repetition of violence; to connect research to actionable steps for prevention and intervention across the life course; and to better integrate systems that serve vulnerable children, youth, and adults. Primary prevention is essential to breaking the cycle of violence within families and to alleviating the risks to children caused by poverty and other external factors such as social disconnection within communities.

Adverse Childhood Experiences and Subjective Cognitive Decline in the US

OBJECTIVE

The aim of this study was to determine the association between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) among a representative sample of the adult US population.

METHODS

Data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 82,688, ≥45 years). Adverse childhood experiences included sexual, physical/psychological and environmental ACEs, and a score. Multivariable logistic regression was used to determine the association between ACEs and SCD, and SCD-related outcomes.

RESULTS

Sexual (adjusted OR (aOR: 2.83; 95% CI: 2.42-3.31)), physical/psychological (aOR: 2.05; 95% CI: 1.83-2.29), and environmental (aOR: 1.94; 95% CI: 1.74-2.16) ACEs were associated with SCD in the past year. There was also a dose-response relationship between ACE score and SCD.

CONCLUSION

ACEs were associated with SCD. Interventions to maximize cognitive health in aging and prevent future cognitive impairment should consider the potential role of ACEs among affected populations.

A tangled start: The link between childhood maltreatment, psychopathology, and relationships in adulthood

BACKGROUND

Adults with a history of childhood maltreatment are more likely to experience distrust, feel distant from others, and develop an insecure attachment style which may also affect relationship quality. Furthermore, childhood maltreatment has been linked to several mental health problems; including, depression, anxiety, and alcohol dependance severity, that are also known to relationship quality.

OBJECTIVE

The current study was designed to investigate to what extent childhood maltreatment is associated with adult insecure attachment and intimate relationships and whether this association is mediated by psychopathology.

PARTICIPANTS AND METHOD

In a study comprised of 2035 adults aged 18-65, we investigated whether childhood maltreatment was associated with insecure adult attachment styles and the quality of intimate relationships and whether this was mediated by depression, anxiety, and alcohol dependence severity (based on repeated assessments of the Inventory of Depressive Symptomatology-Self Report, Beck Anxiety Index, and Alcohol Use Disorders Identification Test respectively).

RESULTS

The path model showed an acceptable fit, RMSEA = 0.05, and suggested full mediation of the association of childhood maltreatment with quality of intimate relationships by depression severity and a) anxious attachment (β = -4.0 ∗ 10^-2; 95% CI = -5.5 ∗ 10^-2, -2.7 ∗ 10^-2) and b) avoidant attachment (β = -7.2 ∗ 10^-2; 95% CI = -9.6 ∗ 10^-2, -4.9 ∗ 10^-2). Anxiety and alcohol dependence severity were not significant mediators.

CONCLUSIONS

Childhood maltreatment is associated with a lower quality of intimate relationships, which is fully mediated by depression severity and insecure attachment styles.

Adverse childhood experiences in New Zealand and subsequent victimization in adulthood: Findings from a population-based study

BACKGROUND

Adverse childhood experiences (ACEs) are widespread and are associated with adverse outcomes in later life, yet few studies have explored their prevalence and consequences in New Zealand.

OBJECTIVES

To provide prevalence estimates of ACEs in New Zealand using a large sample of adults, and to explore the associations between ACEs and experience of violence by intimate partners and non-partners in adulthood.

PARTICIPANTS AND SETTING

2,887 participants (1464 female, 1423 male) from the 2019 New Zealand Family Violence Survey, a population based study conducted in New Zealand between March 2017-March 2019.

METHODS

Descriptive statistics for prevalence of each of the eight ACE types, and cumulative ACE scores were estimated across sociodemographic groups. Multivariate logistic regression models were developed to assess association between ACEs and five IPV and two non-partner violence variables.

RESULTS

ACEs were prevalent and co-occurring, with 55 % (95 % CI 53.2 %-56.8 %) of respondents reporting having experienced at least one ACE and 11.6 % (95 % CI 10.4 %-12.8 %) reporting at least four ACEs before the age of 18. Those who were younger, had lower socioeconomic status, and who identified as Māori reported higher prevalence of ACEs. Exposure to any ACE was significantly associated with later exposure to IPV and non-partner violence.

CONCLUSIONS

The findings provide the first comprehensive assessment of the prevalence of ACEs in the New Zealand population. They suggest that prevention of childhood trauma, maltreatment, and family dysfunction remain important and interconnected public health goals that need to be addressed to support the wellbeing of children and adults.

The Role of Gender, Child Maltreatment, Alcohol Expectancies, and Personality Pathology on Relationship Violence Among Undergraduates

Male (n = 1,104) and female (n = 1,337) college students' self-report surveys on childhood maltreatment, alcohol expectancies, and narcissistic personality traits are examined to determine their associations with relationship violence. Intimate partner violence was measured using the violence subscales of the revised Conflict Tactics. Because we were interested in the effects of gender and because z tests of the correlations and t tests of means indicated men and women differed significantly on several variables, ordinary least squares regression models were run separately for men and women. Results suggest there are both gender similarities and differences. Relationship violence was associated with child sexual abuse for both men and women, whereas high scores on negative alcohol expectancies and vulnerable narcissism, and low scores on grandiose narcissism, were significantly associated with violence for men only. In addition, z tests revealed the regression coefficients for child sexual abuse and negative alcohol expectancies were significantly different for men and women. Child sexual abuse and alcohol expectancies had stronger associations with men's than women's violent behavior. In addition, the models explained a greater amount of variance in men's than in women's behavior. Policy implications of the research will be discussed.

Traumatic Experiences and PTSD Symptoms in the Chinese Male Intrafamilial Physical Violence Perpetrators: A Comparative and Structural Equation Modeling Study

We aimed to compare traumatic experiences among the groups of perpetrators with or without violent pedigree, and establish a structural model of posttraumatic stress disorder (PTSD) symptoms as mediators of traumatic experiences and severe intrafamilial physical violence among Chinese male perpetrators. A cross-sectional survey and a face-to-face interview were conducted to examine intimate partner violence (IPV) perpetration and violent pedigree, childhood maltreatment, other traumatic events, PTSD symptoms, and severe intrafamilial physical violence in a community sample of 229 abusive men and 303 controlled men in China. Using structural equation modeling (SEM) techniques, the scores of the questionnaires were entered into the theoretical model and calculated. Findings demonstrated that the numbers of the traumatic events in four groups were significantly different with a declining trend, and the SEM data had an adequate fit. The loadings of pathways from childhood witness domestic violence (DV) to severe physical violence (SPV) were more salience than other pathways, and the indirect effect of every pathway, except for the childhood witness DV to PTSD symptoms, on severe intrafamilial physical violence in the model was significant. The results suggest that PTSD symptoms cluster as mediator of the intergenerational transmission of SPV perpetration in Chinese abusive men. Childhood witness IPV has effects on adulthood perpetration of IPV.

Childhood Sexual Trauma and Antiretroviral Therapy Adherence: A Mixed-Methods Systematic Review

Childhood sexual abuse (CSA) has been shown to be more prevalent among populations living with HIV. Antiretroviral therapy (ART) adherence is crucial for populations living with HIV as it significantly increases the likelihood of attaining and maintaining viral suppression. Previous findings on the association between CSA and ART adherence have been mixed. The current mixed-methods systematic review aimed to identify quantitative and qualitative studies from CINAHL, PsycInfo, PubMed, and Web of Science examining the relationship between CSA and ART adherence. Authors were also contacted if relevant data were unpublished. Studies had to be published from January 1, 2000 to April 1, 2019, written in English, and examined CSA as an exposure and ART adherence as an outcome. Four domains were combined: 1) childhood sexual abuse; 2) child; 3) antiretroviral; and 4) adherence. Eight quantitative and two qualitative studies were retained. The results showed that four quantitative studies found no association while the other four found factors such as timing of victimization, mental health and gender influenced the association between CSA and ART adherence. Themes emerging from the qualitative studies included use of ART evoking memories of CSA; CSA impacting mental health; and mental health treatment improving ART adherence. Mixed insights included the intricate links between CSA and ART adherence and the role of external factors on the relationship. ART adherence intervention programs may be needed for people who have experienced CSA. However, future studies are needed that will examine the association between CSA and ART adherence and include subgroup analyses.

Adverse childhood experiences (ACEs) research: A bibliometric analysis of publication trends over the first 20 years

BACKGROUND

The relative health and robustness of a field of research can be approximated by assessing peer reviewed journal publication trends for articles pertinent to the field. To date, there have been no such assessments of the burgeoning research on adverse childhood experiences (ACEs).

OBJECTIVE

The overall goal of this study was to examine ACEs research trends using bibliometric methods. More specifically, we sought to describe observed publication trends of the ACEs literature from its inception in the late 1990s. We also analyzed the nature of ACEs publications with regard to key characteristics of main outcomes, levels of analysis, and populations of primary focus.

METHODS

A search was conducted using Scopus to identify English language papers on ACEs published in peer-reviewed journals between 1998 and 2018. The primary field of research was determined by having independent raters code the title of the publishing journal into distinct categories. Main research outcomes were similarly coded.

RESULTS

A total of 789 articles on ACEs appearing in 351 different academic journals were published between 1998 and 2018. There was considerable growth in the number of ACEs papers published over the past several years. General medicine and multidisciplinary research were the most frequent of 12 primary fields of research characterizing ACEs research. Of 16 primary outcomes on which ACEs research focused, the most common were mental health and physical health.

CONCLUSION

Significant growth in ACEs research over the past several years suggest the field is thriving. Observed publication trends and publication characteristics are discussed briefly.

Mediation of Childhood Adversity and Health by Relationship Quality in Diverse Couples

Individuals with economic disadvantage experience greater (a) adverse childhood experiences (ACE), (b) risk for low relationship quality and relationship dissolution, and (c) disparity in physical and mental health. Thus, a critical need exists to understand the connections between areas of disparity in family and relational health on physical and mental health for those most vulnerable to the deleterious effects. The researchers therefore tested a dyadic model for the mediation of ACE and health by relationship quality with data from 503 couples with economic disadvantage and a racial or ethnic minority background (76.9%). The data fit the proposed model and explained a majority of the variance in health, 82.3% of the variance in men's health and 56.5% in women's health-both large effects. Moreover, the significant indirect pathway between ACE and health through relationship quality contributed 98.05% and 57.40% of the total effects for men and women, respectively. Overall, a significant relationship existed between ACE, relationship quality, and health for men and women at the actor-level and the dyadic influence between members of a couple contributed to the overall model fit. Results add to support for the role of relationship quality as a dyadic social determinant of health disparities with implications for prevention and intervention.

Adverse childhood experiences, stress, and intimate partner violence among newlywed couples living with low incomes

The stress-generation model, commonly applied in studies of psychopathology, purports that vulnerabilities to depression (e.g., rumination, doubt, self-blame, social withdrawal) increase the likelihood that stressful events will later occur, thus activating depressive vulnerabilities and worsening the course of depression. We adapt this model to examine whether adversities experienced early in life serve to channel individuals into stressful circumstances that then evoke situational intimate partner violence (IPV) in adulthood. Cross-sectional self-report data on early adversity, stress, and IPV from 231 ethnically diverse newlywed couples living in low-income communities were analyzed with structural equation modeling. Replicating prior research, reports of early adversity and current life stress covaried reliably with IPV, for husbands and wives. Among husbands, early adversity was linked to IPV via stress, whereas for wives, no such mediation emerged. Results remained robust against alternative models (e.g., controlling for relationship satisfaction, substituting relationship satisfaction for IPV, and examining the interaction between adversity and stress as a predictor of IPV). These findings indicate that the situations that are a defining feature of situational IPV may themselves be a reflection of the adversities that men face early in life; in the absence of these stressors, the association between early adversity and later IPV falls to nonsignificance. Assisting men raised in risky environments to appreciate the effects of stress on their interpersonal exchanges in marriage could reduce rates of IPV. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Childhood adversity, mental health, and the perpetration of physical violence in the adult intimate relationships of women prisoners: A life course approach

BACKGROUND

Adverse childhood experiences (ACEs) are common, with nearly two-thirds of adult samples reporting exposure to at least one and one-quarter reporting exposure to three or more distinct types of ACEs. ACEs have been linked to various negative outcomes across the life course, including mental health problems, and the perpetration of physical violence in intimate relationships. However, little is known about the relationships between ACEs, PTSD symptomology, and use of physical violence against an adult intimate partner among incarcerated women.

OBJECTIVE

The purpose of this paper is to examine the relationships between ACEs, PTSD symptoms, and the perpetration of the physical violence in the adult intimate relationships of women prisoners.

METHODS

Using data from the 2014 Oklahoma Study of Incarcerated Mothers and Their Children (N = 349) and structural equation modeling (SEM) techniques, we investigate the potential mediating effect of PTSD symptoms in the relationship between ACEs and perpetrating violence against an intimate partner.

RESULTS

Our findings indicate that PTSD symptomology fully mediates the relationship between ACEs and the perpetration of physical violence against an adult intimate partner, indicating that PTSD experiences may be central to understanding women's pathways toward violence.

CONCLUSIONS

Women prisoners who were exposed to ACEs during childhood were at a particularly elevated risk of developing PTSD symptomology and perpetrating physical violence against an adult intimate partner. Based on the current study's findings, treatment programs that address these complex relationships between ACEs, particularly focusing on the central role of mental health in these processes, are needed for incarcerated women.

Mediating effects of self-esteem in the relationship between childhood maltreatment and non-suicidal self-injury among adolescents: The roles of sex and only-child status

RATIONALE

Although childhood maltreatment is known to be associated with non-suicidal self-injury (NSSI), few studies have investigated the mediating effect of self-esteem on this relationship. Additionally, it is unknown whether the impacts vary by sex or only-child status.

OBJECTIVE

We investigated the mediating effects of self-esteem on the relationship between childhood maltreatment and NSSI in adolescents and identified the significance of sex and only child status.

METHOD

An adolescent health survey was conducted in 15 schools in China between 2013 and 2014. In total, 9704 students aged 11-19 years completed standard questionnaires to report the details of childhood maltreatment, NSSI, and self-esteem.

RESULTS

Childhood maltreatment was negatively correlated with self-esteem and positively correlated with the frequency of NSSI. Lower self-esteem was also correlated with higher NSSI frequency. Self-esteem mediated the relationship between childhood maltreatment and NSSI, and the estimated ratio of the total effect of childhood maltreatment that could be explained by mediation through self-esteem was 16.3%. The ratio was higher in boys (28.6%) than in girls (9.9%), and it was higher in only children (31.5%) than in children with siblings (11.0%).

CONCLUSIONS

Childhood maltreatment is positively correlated with the frequency of NSSI and may be mediated by self-esteem. Interventions aimed at reducing NSSI associated with childhood maltreatment may be enhanced by efforts to strengthen self-esteem, especially in boys and only children.

Adverse childhood experiences and mental health: Comparing the link in rural and urban men who have sex with men

BACKGROUND

Research shows individuals experiencing adverse childhood experiences (ACEs) as well as identifying as a man who has sex with other men (MSM) are at an increased risk for mental health issues. Less has been studied, however, on ACEs in MSM; with even fewer studies investigating non-urban (e.g., rural/small town/suburban) MSM, as most research features urban samples. This is problematic due to studies showing that rurality can influence the behavior of MSM. The current study comparatively investigates the impact of ACEs on the mental health of rural/small town/suburban and urban MSM.

METHODS

Participants included 156 MSM residing in Oklahoma. Linear regression was used to test the association between ACEs' and mental health (anxiety, depressive symptoms, and loneliness). Split-sample regressions were conducted on rural/small town/suburban and urban MSM.

RESULTS

ACEs were associated with all three mental health outcomes in the full sample. However, ACEs were significantly linked to anxiety and depressive symptoms only in urban MSM.

LIMITATIONS

Limitations include a smaller sample size with limited racial/ethnic variations.

CONCLUSIONS

Results suggest that living in an urban environment may amplify the risks of ACEs, rural/small town/suburban MSM may acquire outside, unique support networks which work to limit the effect of ACEs, or that rural/small town/suburban MSM may manifest the effects of ACEs differently (or a combination of the three). Trauma-informed programming has been shown to effectively reduce mental health issues, yet consideration is generally not given with regards to rurality. Future programming and research should consider rurality/urbanity as influential factor.

Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis

BACKGROUND

The Center for Disease Control (CDC) and Kaiser Permanente developed the Adverse Childhood Experiences (ACE) scale to identify negative experiences in childhood. The goal of this study is to systematically review outcomes associated with the ACEs in the CDC-Kaiser ACE scale to understand the diversity of outcomes associated with this scale.

METHODS

The authors conducted a search of English language articles published through September 30, 2016 using OVID Medline®; Ovid Medline® Daily; Epub Ahead of Print, In-Process & Other Non-indexed citations; ERIC®; HAPI®; and SCOPUS®. Articles were selected by trained reviewers based on a priori inclusion criteria including: research, healthy sample, used the CDC-Kaiser ACE scale, and assessed some health outcome. Two reviewers used an abstraction form to independently collect data from each study. Unadjusted and adjusted odds ratio associated with ACE scale scores were aggregated and compared.

RESULTS

From 3167 unique titles, we identified 96 articles that assessed health outcomes associated with the ACEs in the CDC-Kaiser ACE scale. There were more studies focusing on psychosocial/behavioral outcomes than medical outcomes. The majority of the included studies were retrospective, observational, and relied on the same data set. Psychosocial/behavioral outcomes had higher odds ratio than medical outcomes with increasing ACE scale scores.

CONCLUSIONS

Exposure to multiple ACEs is associated with a wide variety of outcomes. This data suggests a benefit of screening for ACEs using this scale and highlights the need to find interventions to ameliorate their effects.

Associations of Adverse Childhood Experiences with Past-Year DSM-5 Psychiatric and Substance Use Disorders in Older Adults

OBJECTIVES

To examine the prevalence of adverse childhood experiences (ACEs) and the associations of ACEs with psychiatric and substance use disorders among older adults in the United States.

DESIGN

Cross-sectional analysis of the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III (NESARC-III).

SETTING

Nationally representative drug-related health interview survey in the United States.

PARTICIPANTS

Survey respondents aged 65 or older (n = 5806 unweighted).

MEASUREMENTS

ACEs, the key independent variable, were assessed using validated measures. Outcome variables consisted of past-year psychiatric disorders (eg, major depressive disorder and generalized anxiety disorder) and substance use disorders (eg, alcohol use disorder) using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We estimated the national prevalence of ACEs in older adults and used multivariable-adjusted logistic regression analyses to assess the association between ACEs and the outcomes after adjusting for sociodemographics and clinical comorbidities.

RESULTS

Overall, 35.9% of older adults, representative of 14.8 million older adults nationwide, reported some form of ACEs. The most common types were parental psychopathology (20.3%), other traumatic events (14.0%), and physical/psychological abuse (8.4%). Having experienced any ACEs was associated with higher odds of having a past-year psychiatric disorder (adjusted odds ratio = 2.11; 95% confidence interval = 1.74-2.56). Similar results were found for substance use disorders (P < .01).

CONCLUSION

ACEs are linked to an increased risk for past-year psychiatric and substance use disorders in older adults. ACEs may have long-term effects on older adults' mental well-being. Although further research is needed, preventing ACEs may lead to large improvements in public mental health that persist well into older age. J Am Geriatr Soc 67:2085-2093, 2019.

Is there a female cycle of violence after exposure to childhood maltreatment? A meta-analysis

Several studies have demonstrated a vicious cycle of violence, in which experiences of childhood maltreatment (CM) transition into later perpetration of aggressive acts. But evidence for the presence of this cycle in adult women is mixed. The aim of this meta-analysis is to investigate the strength of associations and the mechanisms underlying a cycle of violence in women. Databases were searched for terms related to female aggression, violence, delinquency, antisocial behavior, or offending in addition to exposure to traumatic experiences, abuse, or maltreatment during childhood. Only peer-reviewed studies were included that investigated associations between any type of CM and different acts of aggression. Multi-level meta-analyses were applied, as well as meta-regressions, all based on Cohen's d. K = 34 studies were identified. The overall association between exposure to CM was in the positive but small range (Cohen's d = 0.30). There was no significant difference between specific types of abuse and/or neglect. However, associations were smaller for the perpetration of sexual aggression and violent crime compared with other acts of aggression. These findings underline the long-lasting and devastating impact of CM, including types of maltreatment that were long assumed to be less severe. Due to the limited number of available studies, interactions between types of CM and aggression could not be modeled, thus compromising their probable interacting contribution to the cycle of violence. Early interventions targeting families and women at risk are critical in order to prevent ongoing cycles of violence.

Youth exposure to violence involving a gun: evidence for adverse childhood experience classification

Adverse childhood experiences (ACEs) have historically included child maltreatment, household dysfunction, and other critical issues known to impact children negatively. Although youth experiences with violence are broadly captured in some ACE measures, youth exposure to violence involving a gun has not been included specifically in the operationalizing, and therefore scientific study, of ACEs. There are numerous implications of this omission, including limiting access to ACE interventions that are currently available and resources for individuals who have been exposed to gun violence. Thus, and given the persistent prevalence of gun violence in the US, we conducted a systematic review of the literature over the past two decades on the assessment of and response to ACEs and gun violence. Eighty-one journal articles across four search engines met our inclusion criteria. Our findings provide evidence that youth gun violence exposure should be classified as an ACE. In addition to increasing access to resources for youth affected by gun violence, these findings may improve the likelihood of funding and research into gun violence, with direct implications for prevention and intervention efforts.

Childhood physical abuse and physical dating violence in young adulthood: The mediating role of adverse mental health

OBJECTIVE

The purpose of this study was to examine whether adverse mental health (i.e., symptoms of anxiety, posttraumatic stress disorder, and depression) mediated the relation between childhood physical abuse (CPA) and physical dating violence (DV) victimization/perpetration in young adulthood.

METHOD

We used four waves of data from an ongoing longitudinal study. The sample consisted of 864 adolescents including 282 Hispanic Americans, 248 European Americans, 240 African Americans, and 94 other, with a mean age of 17 years at Wave 3.

RESULTS

Structural equation modeling suggested that posttraumatic stress disorder symptoms mediated the link between CPA and both physical DV victimization (β = .06, 95% CI: 0.01, 0.11) and perpetration (β = .07, 95% CI: 0.02, 0.13). Anxiety and depressive symptoms, however, did not show significant indirect effects.

CONCLUSIONS

Findings highlight the importance of interventions targeting posttraumatic stress symptoms for adolescents who experienced CPA in preventing physical DV in young adulthood.

Exploring the association between parenting stress and a child's exposure to adverse childhood experiences (ACEs)

Nearly half of U.S. children age 0-17 have been exposed to adverse childhood experiences (ACEs), accounting for over 34 million of children nationwide. Parenting stress (negative feelings related to the demands of parenting) is a primary risk factor for child maltreatment and neglect; yet has been an overlooked factor for ACEs. Understanding the degree of parenting stress and its subsequent associations with ACEs will facilitate future designations of relevant interventions to keep children safe. We analyzed 2016 data from the National Survey of Children's Health to examine whether increased levels of parenting stress are associated with higher counts of ACEs among children. About 4.4% of caregivers reported "high parenting stress" and children living with them were three times more likely (OR: 3.05; 95% CI: 2.23-4.15) to experience four or more ACEs by the age of 18. Lowering parenting stress through parenting interventions could decrease the level of childhood trauma experienced by a child or may lessen one type of stress in a home where many other stressors exist.

Adolescent sexual violence: Prevalence, adolescent risks, and violence characteristics

The purpose of this research is to investigate peer-to-peer sexual violence victimization and perpetration among male and female adolescents in a large, racially and economically diverse, community-based sample. Using cross-sectional data over a four-year period (2009-2013) from a regional sample of middle school and high school students in southeastern Michigan, we examined the prevalence and correlates of peer-to-peer sexual violence victimization and perpetration among adolescents. 33.9% of males and 53.5% of females reported sexual violence victimization, while 22.8% of males and 12.6% of females reported sexual violence perpetration. The majority of peer-to-peer sexual victimization and perpetration occurred by someone of the opposite sex, however, same-sex victimization and perpetration were not uncommon. Substance use, depression, Attention Deficit Hyperactivity Disorder (ADHD), and conduct disorder were associated with peer-to-peer sexual violence (victimization or perpetration) for both males and females, with few differences in the patterns of associations by sex. These findings are an important step in better understanding the types of peer-to-peer sexual violence that adolescents experience and risk factors for both male and female youth.

The association between child exposure to intimate partner violence (IPV) and perpetration of IPV in adulthood-A systematic review

Increasingly recognized as a distinct form of childhood maltreatment, children's exposure to intimate partner violence (IPV) has been shown to be associated with an array of negative psychosocial outcomes, including elevated risk for additional violence over the life course. Although studies have identified child exposure to IPV as a predictor of IPV perpetration in adulthood, no review has critically evaluated the methodology of this quantitative work. The present study examines the association between childhood exposure to IPV and the perpetration of IPV in adulthood based on a systematic review of the literature from inception to January 4, 2016. Databases searched included Medline, Embase, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, Sociological Abstracts and ERIC. Database searches were complemented with backward and forward citation chaining. Studies were critically appraised using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of 5601 articles identified by the search, 19 studies were included for data extraction. Sixteen of these studies found that child exposure to IPV was significantly and positively associated with adult IPV perpetration; three studies reported null findings. The methodological quality of the studies was low. Work thus far has tended to focus on child exposure to physical IPV and the perpetration of physical IPV within heterosexual contexts. In addition, measures of child exposure to IPV vary in their classification of what exposure entails. We critically discuss the strengths and limitations of the existing evidence and the theoretical frameworks informing this work.

Adverse life events increase risk for postpartum psychiatric episodes: A population-based epidemiologic study

BACKGROUND

Trauma histories may increase risk of perinatal psychiatric episodes. We designed an epidemiological population-based cohort study to explore if adverse childhood experiences (ACE) in girls increases risk of later postpartum psychiatric episodes.

METHODS

Using Danish registers, we identified women born in Denmark between January 1980 and December 1998 (129,439 childbirths). Exposure variables were ACE between ages 0 and 15 including: (1) family disruption, (2) parental somatic illness, (3) parental labor market exclusion, (4) parental criminality, (5) parental death, (6) placement in out-of-home care, (7) parental psychopathology excluding substance use, and (8) parental substance use disorder. Primary outcome was first occurrence of in- or outpatient contact 0-6 months postpartum at a psychiatric treatment facility with any psychiatric diagnoses, ICD-10, F00-F99 (N = 651). We conducted survival analyses using Cox proportional hazard regressions of postpartum psychiatric episodes.

RESULTS

Approximately 52% of the sample experienced ACE, significantly increasing risk of any postpartum psychiatric diagnosis. Highest risks were observed among women who experienced out-of-home placement, hazard ratio (HR) 2.57 (95% CI: 1.90-3.48). Women experiencing two adverse life events had higher risks of postpartum psychiatric diagnosis HR: 1.88 (95% CI: 1.51-2.36), compared to those with one ACE, HR: 1.24 (95% CI: 1.03-49) and no ACE, HR: 1.00 (reference group).

CONCLUSIONS

ACE primarily due to parental psychopathology and disability contributes to increased risk of postpartum psychiatric episodes; and greater numbers of ACE increases risk for postpartum psychiatric illness with an observed dose-response effect. Future work should explore genetic and environmental factors that increase risk and/or confer resilience.

Physical and Psychological Abuse among Seropositive African American MSM 50 Aged Years and Older

Little is known about abuse experienced among African American men who have sex with men (MSM) who are 50 years and older. A series of focus groups were conducted to examine perspectives of seropositive African American MSM age 50 years and older who reported experiencing some form of psychological or physical abuse. Thirty African American MSM were divided into four focus groups and four themes emerged: "Fear Being Gay," "No One Else to Love Me," "Nowhere to Turn," and "Sexual Risk & Control." The data suggest there is a need to develop culturally tailored interventions for this population.

Disrupted Executive Function and Aggression in Individuals With a History of Adverse Childhood Experiences: An Event-Related Potential Study

Here, we explored the functional and neural mechanisms underlying aggression related to adverse childhood experiences. We assessed behavioral performance and event-related potentials during a go/no-go and N-back paradigm. The participants were 15 individuals with adverse childhood experiences and high aggression (ACE + HA), 13 individuals with high aggression (HA), and 14 individuals with low aggression and no adverse childhood experiences (control group). The P2 latency (initial perceptual processing) was longer in the ACE + HA group for the go trials. The HA group had a larger N2 (response inhibition) than controls for the no-go trials. Error-related negativity (error processing) in the ACE + HA and HA groups was smaller than that of controls for false alarm go trials. Lastly, the ACE + HA group had shorter error-related negativity latencies than controls for false alarm trials. Overall, our results reveal the neural correlates of executive function in aggressive individuals with ACEs.

The Impact of Childhood Abuse and Current Mental Health on Young Adult Intimate Relationship Functioning

This study examines the association between childhood abuse and intimate relationship quality and attachment security in young adults. Data were drawn from the Ontario Child Health Study, a province-wide community-based survey that collected baseline data in 1983 from 3,294 children (aged 4 to 16 years) and follow-up data in 2000/2001 (then aged 21 to 35 years). The sample comprised 1,885 men and women who had completed questionnaires regarding retrospective accounts of childhood abuse and current relationship status in 2000/2001. Childhood physical and sexual abuse was assessed using the short form of the Childhood Experiences of Violence Questionnaire. It was hypothesized that childhood physical and sexual abuse would be associated with adult intimate relationship functioning, adjusting for childhood family and individual factors, and that these associations would be mediated by participants' current mental health. The analysis for intimate relationship quality showed that current mental health reduced the association between physical abuse and poor relationship quality (beta 0.09 (se 0.02) to 0.08 (0.02)) and between sexual abuse and this outcome to a non-significant level ((beta 0.07 (se 0.03) to 0.05 (0.03)). The analysis for adult attachment security showed that current mental health reduced the association between physical abuse and insecure attachment to a non-significant level (OR 1.33 (95% CI 1.02-1.76) to OR 1.31 (0.98-1.76)) and between sexual abuse and this outcome (OR 1.89 (1.36-2.65) to OR 1.74 (1.19-2.52)). The importance of current mental health functioning in accounting for continuity in intimate relationship functioning from childhood to young adulthood is discussed.

Parents' adverse childhood experiences and mental health screening using home visiting programs: A pilot study

BACKGROUND

Adverse childhood experiences (ACEs) are associated with adult high-risk behaviors and diseases. There is value in screening parents for ACEs given the repercussions parental ACEs may have on parenting behaviors and child development. The primary aim of this study was to assess the feasibility of parental ACE screening in the home setting. A secondary aim was to evaluate whether or not maternal ACEs correlated with maternal mental health measures.

METHODS

Two home visiting programs that support early childhood development and conduct parental mental health screening implemented ACE screening for parents of infants <1 year of age. Descriptive statistics were produced for population surveillance of ACEs as well as standard practice screens for depression, anxiety, substance use, and intimate partner violence. Logistic models were used to examine associations between ACE score and mental health measures.

RESULTS

A total of 110 parents completed the ACE screen. All possible ACE score outcomes were represented (0-10). A trend toward association of positive prenatal maternal depression screen with ACE score was identified (p = .05).

CONCLUSION

This novel prospective home-based screening program for parental ACEs was feasible and identified a trend toward increasing ACE score association with positive prenatal maternal depression screen.

Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors

HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (β = 0.0002; p = 0.012) and sexual abuse (β = 0.0002; p = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (β = 0.0005; p < 0.001) and parental violence (β = -0.0002; p = 0.012). Among men, IPV perpetration fully mediated sexual abuse (β = -0.0005; p = 0.012) and HIV/STIs while among women, IPV perpetration was not a statistically significant mediator. HIV/STI prevention and intervention programs should use a life course approach by addressing adverse childhood events among men and women and consider the sex differences in the roles of psychopathology and sexual behaviors.

Preventing risky behaviours among young adolescents in eastern Democratic Republic of Congo: A qualitative study

This qualitative study explores and describes adolescent risk behaviours, specifically consumption of alcohol and use of violence; the perceived consequences of these behaviours on future well-being and relationships; and collaboratively identifies the essential components of a prevention intervention for risk behaviours (alcohol use, violence) among young adolescents while strengthening the protective individual and relationship factors in post-conflict Democratic Republic of Congo. One-on-one in-depth interviews were conducted with 28 male and female youth, 20 parents/guardians and 20 stakeholders in three rural villages of South Kivu Province. Trained interviewers conducted interviews and participated in daily debriefing. Descriptive qualitative analysis was used to analyse the data. Youth use of violence and alcohol was associated with a range of factors including peer influence, parent behaviours, school enrolment and poverty. The consequences of risk behaviour include damaged family and social bonds, reduced economic and educational productivity and promise. Community-based, multilevel prevention interventions that promote protective factors and reduce youth exposure and vulnerability to risk factors may have immediate and long-term impact on youth health and behaviour. Such a programme could engage youth, adults and local stakeholders in a range of social, educational and economic activities.

Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: results from a nationally representative sample

Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.