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Tollit J, Wray J. Adverse and positive experiences in childhood and improving cardiovascular health - A challenge for us all. Int J Cardiol 2024; 415:132367. [PMID: 39025134 DOI: 10.1016/j.ijcard.2024.132367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Jennifer Tollit
- Institute of Cardiovascular Science, University College London, UK; Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | - Jo Wray
- Institute of Cardiovascular Science, University College London, UK; Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Blackwell CK, Cella D, Mansolf M. Intergenerational transmission of adverse and positive childhood experiences and associations with child well-being. CHILD ABUSE & NEGLECT 2024; 157:107050. [PMID: 39303434 DOI: 10.1016/j.chiabu.2024.107050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 07/31/2024] [Accepted: 09/11/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Parental adverse childhood experiences (ACEs) contribute to offspring adversity and poor health outcomes, but little is known about whether and to what extent parental positive childhood experiences (PCEs) influence offspring positive experiences and well-being. OBJECTIVE To investigate the association between parent and child ACEs and PCEs and their impact on child well-being and psychopathology. PARTICIPANTS AND SETTING A national sample of n = 1016 US parents of 1-5-year-olds completed online surveys in September 2019. METHODS Mediation analysis in a path modeling framework was used with stratified probability weights for generalizability to the US population. RESULTS Each additional parent PCE equated to 0.32 (95 % CI: 0.20, 0.45) increase in child PCEs and each additional parent ACE equated to 0.18 (95 % CI: 0.06, 0.31) increase in child PCEs and 0.13 (95 % CI: 0.08, 0.18) increase in child ACEs. In turn, an increase in 1 child PCE was associated with 0.10-0.16 SD increase in well-being and 0.06-0.10 decrease in psychopathology, and each additional child ACE equated to 0.10-0.18 SD increase in psychopathology. CONCLUSIONS Results support the intergenerational transmission of PCEs and ACEs, advancing understanding of the role that parent PCEs play in promoting child PCEs and fostering child well-being. Findings underscore the importance of extending clinical surveillance of ACEs to include PCEs in pediatric and adult healthcare settings. Dual-generation programs that address the negative consequences of parental ACEs may be able to increase their impact by adding a parallel emphasis on PCEs and providing parents with tools to foster PCEs in their children.
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Affiliation(s)
- Courtney K Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Maxwell Mansolf
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
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Guo S, Wijesuriya R, O'Connor M, Moreno-Betancur M, Goldfeld S, Burgner D, Liu R, Priest N. The effects of adverse and positive experiences on cardiovascular health in Australian children. Int J Cardiol 2024; 411:132262. [PMID: 38878872 DOI: 10.1016/j.ijcard.2024.132262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/01/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Limited evidence suggests that positive experiences in childhood may promote cardiovascular health, providing additional opportunities for prevention and early intervention. This study aimed to examine the effects of adverse and positive experiences on cardiovascular health in late childhood. METHODS Data sources: Longitudinal Study of Australian Children (N = 1874). EXPOSURES Adverse and positive experiences assessed repeatedly (age 0-11 years). OUTCOMES Cardiovascular health (high versus low or moderate) quantified by four health behaviors (diet, physical activity, cigarette smoking, and sleep) and four health factors (body mass index, non-high-density lipoprotein, blood pressure, and blood glucose) (age 11-12 years) as per the American Heart Association's Life's Essential 8 metrics. ANALYSES Separate generalized linear models with log-Poisson links were used to estimate the effects of adverse and positive experiences on cardiovascular health, adjusting for confounders. RESULTS Children exposed to multiple adverse experiences (≥ 2) were less likely to have high cardiovascular health (RR = 0.82, 95% CI = 0.67 to 1.02) than those not exposed. Children exposed to multiple positive experiences (≥ 2) were more likely to have high cardiovascular health (RR = 1.14, 95% CI = 0.94 to 1.38) than those not exposed. Stratified analyses suggested that exposure to multiple positive experiences might buffer the detrimental effects of multiple adverse experiences on cardiovascular health. CONCLUSIONS Both adverse and positive experiences were found to be modestly associated with cardiovascular health in Australian children. Future research and practice should not only consider addressing childhood adversity but also use a strengths-based approach to promoting positive experiences to improve cardiovascular health.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
| | - Rushani Wijesuriya
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Meredith O'Connor
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Melbourne Children's LifeCourse Initiative, Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Education, University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - David Burgner
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Inflammatory Origins Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of General Medicine, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, Australia
| | - Richard Liu
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Naomi Priest
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; The Centre for Social Policy Research, Australian National University, Canberra, Australia; Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Coronado H, Bonilla GS, Shircliff K, Sims I, Flood E, Cooley JL, Cummings C. Considering the associations of adverse and positive childhood experiences with health behaviors and outcomes among emerging adults. J Exp Child Psychol 2024; 244:105932. [PMID: 38718679 DOI: 10.1016/j.jecp.2024.105932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 06/10/2024]
Abstract
Childhood is a sensitive period of development during which early life experiences can facilitate either positive or negative health trajectories across subsequent developmental periods. Previous research has established strong links between adverse childhood experiences (ACEs) and adverse health outcomes (e.g., sleep-related problems, pain, substance use). Despite this, less is known about positive childhood experiences (PCEs) and how they may buffer the effects of ACEs on health outcomes. The current study investigated whether PCEs moderate the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference) in a sample of at-risk emerging adults. Participants (N = 165) were undergraduate college students (18-25 years of age) who reported frequent alcohol and/or cannabis use (≥3 times in the past week). A significant positive association was found between ACEs and cannabis use. There were also significant negative associations found between PCEs and pain interference and intensity. PCEs did not moderate any of the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference). Findings suggest that PCEs may be unlikely to serve as a strong enough protective factor during early life to decrease risk for suboptimal health and health behaviors during emerging adulthood among individuals who report a greater accumulation of ACEs. Longitudinal research is needed to identify additional related risk and protective factors during early life to further support health and health behavior during this transitional period of development and beyond.
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Affiliation(s)
- Haley Coronado
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - Gisel Suarez Bonilla
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - Katherine Shircliff
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - Imani Sims
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - Ella Flood
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - John L Cooley
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA
| | - Caroline Cummings
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79423, USA.
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Cain SM, Rooney EA, Cacace S, Post A, Russell K, Rasmussen S, Baker JC, Cramer RJ. Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis. BMC Public Health 2024; 24:2052. [PMID: 39080601 PMCID: PMC11290251 DOI: 10.1186/s12889-024-19448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 07/11/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat). METHOD Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence. RESULTS Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs. CONCLUSIONS Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.
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Affiliation(s)
- Shannon M Cain
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Emily A Rooney
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Samantha Cacace
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Abigail Post
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA
| | - Kirsten Russell
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G11QE, UK
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive 1st Floor, Columbus, OH, 43210, USA
| | - Robert J Cramer
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
- Violence Prevention Center, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28227, USA.
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Cordoba DJ, Levin ER, Ramachandran U, Lima D, Shearman N, Willis D, Srinivasavaradan D, Jimenez ME. Parents' Perspectives on Early Relational Health: A Qualitative Study. J Dev Behav Pediatr 2024; 45:e334-e340. [PMID: 39023850 DOI: 10.1097/dbp.0000000000001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/25/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE The American Academy of Pediatrics endorses a paradigm shift toward promoting early relational health (ERH) in pediatrics. Pediatric clinicians have a unique opportunity to promote ERH, yet little work has sought parents' perspectives on how clinicians can do so effectively. We sought to understand diverse parents' perspectives on ERH and the role of pediatric clinicians in supporting it. METHODS We conducted virtual focus groups using a guide prepared with input from community partners and parent advisors. We purposively sampled a diverse group of parents of children aged ≤7 years. Focus groups were recorded and transcribed verbatim. We analyzed data as it was collected and identified themes using an inductive and iterative process. RESULTS Thirty-seven parents participated in 8 focus groups (median parent age: 36.0 years; 43.2% Asian, 18.9% Black/African-American; 32.4% Hispanic/Latino; 78.4% mothers). We identified 3 organizing themes: (1) Time, attention, and open communication with children lay a foundation for ERH; (2) Pediatric clinicians have an opportunity to promote ERH, but disconnected parent-clinician relationships are a major barrier; and (3) Enhanced communication and careful attention to child development and family well-being represent key opportunities to strengthen parent-clinician relationships. CONCLUSION Parents identified time, attention, and open communication as essential to ERH. Although participants expressed openness to clinicians addressing ERH, such work is contingent on strong parent-clinician relationships. Policymakers and clinicians seeking to address ERH in pediatric settings must also be prepared to address potential barriers through strategies like providing adequate time to facilitate relationship-building and careful attention to address this critical topic.
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Affiliation(s)
- David J Cordoba
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Erica R Levin
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Daniel Lima
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - David Willis
- Center for the Study of Social Policy, Washington, DC
| | | | - Manuel E Jimenez
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
- Children's Specialized Hospital, New Brunswick, NJ
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Qiu X, Robert AL, McAlaine K, Quan L, Mangano J, Weisskopf MG. Early-life participation in cognitively stimulating activities and risk of depression and anxiety in late life. Psychol Med 2024; 54:962-970. [PMID: 37706289 PMCID: PMC10937330 DOI: 10.1017/s0033291723002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Early-life stressful experiences are associated with increased risk of adverse psychological outcomes in later life. However, much less is known about associations between early-life positive experiences, such as participation in cognitively stimulating activities, and late-life mental health. We investigated whether greater engagement in cognitively stimulating activities in early life is associated with lower risk of depression and anxiety in late life. METHODS We surveyed former participants of the St. Louis Baby Tooth study, between 22 June 2021 and 25 March 2022 to collect information on participants' current depression/anxiety symptoms and their early-life activities (N = 2187 responded). A composite activity score was created to represent the early-life activity level by averaging the frequency of self-reported participation in common cognitively stimulating activities in participants' early life (age 6, 12, 18), each rated on a 1 (least frequent) to 5 (most frequent) point scale. Depression/anxiety symptoms were measured by Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Screener (GAD-7). We used logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) of outcome risk associated with frequency of early-life activity. RESULTS Each one-point increase in the early-life composite cognitive activity score was associated with an OR of 0.54 (95% CI 0.38-0.77) for late-life depression and an OR of 0.94 (95% CI 0.61-1.43) for late-life anxiety, adjusting for age, sex, race, parental education, childhood family structure, and socioeconomic status. CONCLUSIONS More frequent participation in cognitively stimulating activities during early life was associated with reduced risk of late-life depression.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Andrea L. Robert
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Kaleigh McAlaine
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Luwei Quan
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Joseph Mangano
- Metals and Metal Mixtures, Cognitive Aging, Remediation and Exposure Sources (MEMCARE) Harvard Radiation and Public Health Project, Inc
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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Seya MKS, Matthews S, Zhu L, Brown C, Lefevre A, Agathis N, Chiang LF, Annor FB, McOwen J, Augusto A, Manuel P, Kamagate MF, Nobah MT, Coomer R, Kambona C, Low A. Parenting-related positive childhood experiences, adverse childhood experiences, and mental health-Four sub-Saharan African countries. CHILD ABUSE & NEGLECT 2024; 150:106493. [PMID: 37839988 PMCID: PMC11264190 DOI: 10.1016/j.chiabu.2023.106493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with poor mental health outcomes and risk-taking behaviors. Positive childhood experiences (PCEs) may mitigate these negative impacts. OBJECTIVE This study 1) assessed the associations between ACEs and negative health outcomes and risk-taking behaviors among young adults, and 2) evaluated whether - and which - PCEs moderate the association between ACEs and these outcomes in sub-Saharan Africa. METHODS This multi-country analysis combined cross-sectional representative survey data from young adults, ages 18-24 years, from the 2019 Kenya, 2018 Lesotho, 2019 Mozambique, and 2019 Namibia Violence Against Children and Youth Surveys. The association between experiencing any ACEs and each health outcome was assessed using Wald's chi-square tests. Multivariable logistic regression analyses assessed the association between each PCE and each outcome of interest. RESULTS Females who experienced any ACEs had higher odds of experiencing moderate to severe mental distress (aOR = 2.7, 95%CI: 1.9, 3.9). Males who experienced any ACEs had higher odds of experiencing suicidal/self-harm behaviors (aOR = 6.7, 95%CI: 2.8, 16.0) and substance use (aOR = 2.5, 95%CI: 1.4, 4.2). In females, strong mother-child relationship was protective against moderate to severe mental distress (aOR = 0.7, 95%CI: 0.6, 0.9), suicidal/self-harm behaviors (aOR = 0.6, 95%CI: 0.4, 0.9), and substance use (aOR = 0.6, 95%CI: 0.4, 0.9). For males, a strong mother-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.5, 95%CI: 0.2, 0.9), and a strong father-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.4, 95%CI: 0.2, 0.7) and substance use (aOR = 0.6, 95%CI: 0.4, 0.8). CONCLUSIONS Strong parenting programs may likely play an important role in improving the psychosocial health of young adults.
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Affiliation(s)
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Adrienne Lefevre
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Nickolas Agathis
- Division of Global HIV and Tuberculosis, Center for Global Health Centers for Disease Control and Prevention, GA, USA
| | - Laura F Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Marie-Therese Nobah
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
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Şanli ME, Çiçek İ, Yıldırım M, Çeri V. Positive childhood experiences as predictors of anxiety and depression in a large sample from Turkey. Acta Psychol (Amst) 2024; 243:104170. [PMID: 38301406 DOI: 10.1016/j.actpsy.2024.104170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Positive childhood experiences positively influence one's adult life, while the absence of such positive experiences can potentially yield mental health problems throughout the lifespan. OBJECTIVE This study aimed to investigate the role of positive childhood experiences on depression and anxiety levels. PARTICIPANTS AND SETTING 3090 (2059 women) young adults participated in this research. They ranged in age between 18 and 68 years (M = 28.78, SD = 9.44) and completed the self-report measures including the Positive Childhood Experiences Scale, Beck Depression and Anxiety Scales and Personal Information Forms. METHOD A cross-sectional research design was used to collect the data through social media platforms. We conducted a regression analysis to examine how positive childhood experiences contribute to depression and anxiety. RESULTS The results of correlation analysis indicated that positive childhood experiences were significantly negatively related to depression and anxiety. Regression analysis revealed that positive childhood experiences explained a significant amount of variance in the prediction of depression (10 %) and anxiety (8 %) after controlling for demographic factors. CONCLUSIONS The results suggest that the frequency of positive experiences lived during childhood might significantly reduce anxiety and depression, and positive childhood experiences might positively affect them.
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Affiliation(s)
| | - İlhan Çiçek
- Health College, Batman University, Batman, Turkey
| | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Ağrı, Turkey; Department of Social and Educational Sciences, Lebanese American University, Beirut, Lebanon.
| | - Veysi Çeri
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Antalya Bilim University, Antalya, Turkey
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Suglia SF, April-Sanders AK. Considering Social Context to Understand Childhood Adversities and Cardiovascular Health. Circ Cardiovasc Qual Outcomes 2024; 17:e010661. [PMID: 38258574 PMCID: PMC11086681 DOI: 10.1161/circoutcomes.123.010661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (S.F.S.)
| | - Ayana K April-Sanders
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ (A.K.A.-S.)
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Ortiz R, Kershaw KN, Zhao S, Kline D, Brock G, Jaffee S, Golden SH, Ogedegbe G, Carroll J, Seeman TE, Joseph JJ. Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Circ Cardiovasc Qual Outcomes 2024; 17:e009794. [PMID: 38258561 DOI: 10.1161/circoutcomes.122.009794] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND This study aimed to quantify the association between childhood family environment and longitudinal cardiovascular health (CVH) in adult CARDIA (Coronary Artery Risk Development in Young Adults) Study participants. We further investigated whether the association differs by adult income. METHODS We applied the CVH framework from the American Heart Association including metrics for smoking, cholesterol, blood pressure, glucose, body mass index, physical activity, and diet. CVH scores (range, 0-14) were calculated at years 0, 7, and 20 of the study. Risky Family environment (range, 7-28) was assessed at year 15 retrospectively, for childhood experiences of abuse, caregiver warmth, and family or household challenges. Complete case ordinal logistic regression and mixed models associated risky family (exposure) with CVH (outcome), adjusting for age, sex, race, and alcohol use. RESULTS The sample (n=2074) had a mean age of 25.3 (±3.5) years and 56% females at baseline. The median risky family was 10 with ideal CVH (≥12) met by 288 individuals at baseline (28.4%) and 165 (16.3%) at year 20. Longitudinally, for every 1-unit greater risky family, the odds of attaining high CVH (≥10) decreased by 3.6% (OR, 0.9645 [95% CI, 0.94-0.98]). Each unit greater child abuse and caregiver warmth score corresponded to 12.8% lower and 11.7% higher odds of ideal CVH (≥10), respectively (OR, 0.872 [95% CI, 0.77-0.99]; OR, 1.1165 [95% CI, 1.01-1.24]), across all 20 years of follow-up. Stratified analyses by income in adulthood demonstrated associations between risky family environment and CVH remained significant for those of the highest adult income (>$74k), but not the lowest (<$35k). CONCLUSIONS Although risky family environmental factors in childhood increase the odds of poor longitudinal adult CVH, caregiver warmth may increase the odds of CVH, and socioeconomic attainment in adulthood may contextualize the level of risk. Toward a paradigm of primordial prevention of cardiovascular disease, childhood exposures and economic opportunity may play a crucial role in CVH across the life course.
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Affiliation(s)
- Robin Ortiz
- Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine (R.O.)
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (K.N.K.)
| | - Songzhu Zhao
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (D.K.)
| | - Guy Brock
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - Sara Jaffee
- Department of Psychology, The University of Pennsylvania, Philadelphia (S.J.)
| | - Sherita H Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.H.G.)
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
- Department of Medicine, New York University, Grossman School of Medicine (G.O.)
| | - Judith Carroll
- The University of California, Los Angeles, David Geffen School of Medicine, Jane and Terri Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences (J.C.)
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (T.E.S.)
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus (J.J.J.)
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12
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Nguyen TNM, Disabato DJ, Gunstad J, Delahanty DL, George R, Muakkassa F, Mallat AF, Coifman KG. Can the positive buffer the negative? Testing the impact of protective childhood experiences on adjustment in adults following trauma exposure. ANXIETY, STRESS, AND COPING 2024; 37:60-76. [PMID: 37012026 PMCID: PMC10545812 DOI: 10.1080/10615806.2023.2193888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND It is unclear if protective childhood experiences (PCEs), like emotional support and economic stability, exert influence on adulthood adjustment. Prior research suggests PCEs can promote childhood resilience through increased social connection. In contrast, research has demonstrated potential life-long negative impacts of adverse childhood experiences (ACEs) on psychological health. This study examined the role of PCEs and ACEs in psychological symptoms following potentially traumatic events (PTE) in adults. METHODS Participants (N = 128) were adults admitted to two Level 1 Trauma Centers following violence, motor-vehicle crashes, or other accidents. Participants reported childhood experiences and completed assessments of depression, PTSD, and social support at one, four, and nine months post-PTE. RESULTS Structural Equation Modeling was used to simultaneously model PCEs and ACEs as predictors of psychological symptoms over time, with potential mediation through social support. PCEs overall did not directly affect psychological symptoms nor indirectly through social support. However, the emotional support component of PCEs had an indirect effect on psychological symptoms at baseline through social support. ACEs predicted greater psychological symptoms at baseline and over time. CONCLUSION PCEs consisting of childhood emotional support indirectly promote adjustment in adults after PTEs through initial social support, while ACEs exert direct effects on psychological symptoms.
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Affiliation(s)
- Tam N M Nguyen
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - David J Disabato
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - John Gunstad
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - Douglas L Delahanty
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
| | - Richard George
- Department of Trauma, Summa Health Systems - Akron Campus, Akron, OH, USA
- Department of Surgery, Northeast Ohio Medical University, Rootstown, OH, USA
| | | | - Ali F Mallat
- Cleveland Clinic, Akron General Hospital, Akron, OH, USA
| | - Karin G Coifman
- Departments of Psychological Science and Public Health, Kent State University, Kent, OH, USA
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13
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La Charite J, Khan M, Dudovitz R, Nuckols T, Sastry N, Huang C, Lei Y, Schickedanz A. Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study. SSM Popul Health 2023; 24:101558. [PMID: 38034480 PMCID: PMC10685007 DOI: 10.1016/j.ssmph.2023.101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Background Positive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure. Methods We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures. Results The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure. Conclusion Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.
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Affiliation(s)
- Jaime La Charite
- Department of General Internal Medicine, University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mariam Khan
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
- Fielding School of Public Health at University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA
| | - Rebecca Dudovitz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
| | - Teryl Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, 8700 Beverly Blvd Ste 113 Los Angeles, California, 90048, USA
| | - Narayan Sastry
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Cher Huang
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Yvonne Lei
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
| | - Adam Schickedanz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
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14
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Yoon C, Joseph T, Moussa G, Voss T, Ledoux T, Johnston C. Associations of positive childhood experiences with binge-eating disorder characteristics and intuitive eating among college students. Appetite 2023; 191:107073. [PMID: 37802219 DOI: 10.1016/j.appet.2023.107073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/08/2023]
Abstract
Childhood experiences encompass both adverse and positive childhood events. Adverse childhood experiences are positively associated with binge-eating disorder characteristics and inversely associated with intuitive eating in adults. However, to what extent positive childhood experiences (PCEs) are associated with binge-eating disorder characteristics and intuitive eating remains unclear. This study examined the associations of cumulative and individual PCEs with binge-eating disorder characteristics and intuitive eating among college students. Data were collected from 828 college students in 2022 (54.5% female, Mage 20.9 ± 2.6 years). PCEs were assessed using the Benevolent Childhood Experiences scale. Binge-eating disorder characteristics were assessed with the Questionnaire on Eating and Weight Patterns-5. Intuitive eating was assessed with the Intuitive Eating Scale-2. Associations of PCEs with binge-eating disorder characteristics and intuitive eating were examined using modified Poisson regressions and linear regressions. PCEs were cumulatively associated with binge-eating disorder characteristics and intuitive eating (p for trend <.05). College students in the low PCEs category (0-4 PCEs) had 1.37-1.92 times the prevalence of binge-eating disorder characteristics and had 3.89 points lower intuitive eating score than those in the high PCEs category (9-10 PCEs). Among the individual PCEs, intrapersonal PCE (i.e., feeling comfortable with oneself during childhood) was associated with both a lower prevalence of binge-eating disorder characteristics (aPR = 0.56-0.76) and a higher score of intuitive eating (adjusted β = 1.87, 95% CI = 1.28-2.46) after adjustment for sociodemographic variables. Findings from this study suggest that PCEs may play a role in eating behaviors of college students. Future studies with nationally representative samples should prospectively examine associations of PCEs with binge-eating disorder characteristics and intuitive eating and explore the underlying mechanisms of the associations between PCEs and eating behaviors.
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Affiliation(s)
- Cynthia Yoon
- Department of Health and Human Performance, University of Houston, Houston, TX, 77204, USA.
| | - Temperance Joseph
- School of Public Health, The University of Texas Health Sciences Center at Houston, Houston, TX, 77030, USA
| | - Genesis Moussa
- Department of Health and Human Performance, University of Houston, Houston, TX, 77204, USA
| | - Trenton Voss
- Department of Health and Human Performance, University of Houston, Houston, TX, 77204, USA
| | - Tracey Ledoux
- Department of Health and Human Performance, University of Houston, Houston, TX, 77204, USA
| | - Craig Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX, 77204, USA
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15
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Han D, Dieujuste N, Doom JR, Narayan AJ. A systematic review of positive childhood experiences and adult outcomes: Promotive and protective processes for resilience in the context of childhood adversity. CHILD ABUSE & NEGLECT 2023; 144:106346. [PMID: 37473619 PMCID: PMC10528145 DOI: 10.1016/j.chiabu.2023.106346] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Research on positive childhood experiences (PCEs) as counterparts to childhood adversity has surged in the last five years. A systematic review of the additive and interactive effects of childhood adversity and PCEs across adult outcomes is needed that contextualizes the long-term correlates of childhood experiences within a developmental perspective. OBJECTIVE The current review synthesizes the empirical evidence for PCEs as resilience factors for a range of adult outcomes. METHODS Articles published until May 2023 were systematically identified according to PRISMA Guidelines through PubMed and PsycINFO databases and references of included articles. Then, 131 records were screened, and 58 studies were included. RESULTS Higher levels of PCEs were significantly but modestly associated with lower levels of childhood adversity. Higher levels of PCEs were associated with outcomes reflecting mental health, psychosocial functioning, physical health and health behaviors, and psychosocial stress. Most studies found direct, promotive effects of PCEs for more favorable outcomes. Few studies found significant interaction effects between childhood adversity and PCEs on outcomes, suggesting that PCEs may more frequently directly promote positive outcomes rather than moderate the effects of adversity on outcomes. CONCLUSIONS Individuals' childhood adversity and PCEs are somewhat independent sets of experiences; many individuals experience both, and the presence of one does not preclude the other. PCEs predict more favorable outcomes independent of childhood adversity more often than they interact with and moderate the effects of adversity on outcomes. Although the literature base is steadily growing, more research on PCEs in diverse and international samples is needed.
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Affiliation(s)
- Deborah Han
- University of Denver, 2155 S. Race St., Denver, CO, United States, 80210.
| | - Nathalie Dieujuste
- University of Denver, 2155 S. Race St., Denver, CO, United States, 80210.
| | - Jenalee R Doom
- University of Denver, 2155 S. Race St., Denver, CO, United States, 80210.
| | - Angela J Narayan
- University of Denver, 2155 S. Race St., Denver, CO, United States, 80210.
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16
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Adjaye-Gbewonyo D, Ng AE, Jackson CL, Johnson DA. The perceived neighborhood walking environment and self-reported sleep health in a nationally representative sample of the United States. Health Place 2023; 83:103066. [PMID: 37385129 DOI: 10.1016/j.healthplace.2023.103066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 07/01/2023]
Abstract
Neighborhood environment can influence sleep health; yet, there is a lack of data on specific environment features in nationally representative samples. We used the 2020 National Health Interview Survey to determine associations between perceived built and social environment factors related to pedestrian access (walking paths, sidewalks), amenities (shops, transit stops, entertainment/services, places to relax), and unsafe walking conditions (traffic, crime) and self-reported sleep duration and disturbances. Places to relax and pedestrian access were associated with better sleep health while unsafe walking conditions were associated with worse sleep health. Access to amenities (shops, transit stops, entertainment venues) had null associations with sleep health.
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Affiliation(s)
- Dzifa Adjaye-Gbewonyo
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD, 20782, USA.
| | - Amanda E Ng
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD, 20782, USA.
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 T.W. Alexander Drive, Research Triangle Park, NC, 27709, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, 6707 Democracy Blvd Ste 800, Bethesda, MD, 20892, USA.
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA.
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17
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Mueller KC, Cavitt J, Carey MT. Future orientation in justice-involved youth: The effects of adverse and positive childhood experiences, and being dual-status. CHILD ABUSE & NEGLECT 2023; 141:106230. [PMID: 37167659 DOI: 10.1016/j.chiabu.2023.106230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/23/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Justice-involved youth face diverse challenges and are likely to experience more adverse childhood experiences (ACEs) and fewer positive childhood experiences (PCEs), which can have implications for their orientation toward their future. Future orientation is thought to influence behavior, but little is known about how it is shaped. While future orientation and its correlates likely matter for all justice-involved youth, the recently recognized subcategory of Dual Status Youths (DSYs) might be especially sensitive to influences on future orientation. OBJECTIVE This study explores the effects of cumulative adverse childhood experiences (ACEs), cumulative positive childhood experiences (PCEs), and DSY classification on the likelihood of having a positive orientation toward the future. PARTICIPANTS AND SETTING The researchers analyze a sample of 3604 justice-involved youth on probation in a large metropolitan area in Texas. METHOD The sample includes juveniles who received the full Positive Achievement Change Tool (PACT) risk/needs assessment. The analytical plan included t-tests and two logistic regression analyses. RESULTS Findings were that DSY are exposed to more ACEs and fewer PCEs than non-dual status justice-involved youth. Results indicated that a greater number of PCEs is associated with future orientation, but DSY status and ACEs are not. CONCLUSIONS Juvenile justice programming must strive to cultivate PCEs in justice-involved youth prior to the completion of their probation supervision.
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Affiliation(s)
- Kyle Curtis Mueller
- Research Analyst at Harris County Juvenile Probation Department (HCJPD), United States of America.
| | - Joslyn Cavitt
- Research Analyst at Harris County Juvenile Probation Department (HCJPD), United States of America; University of Houston, Department of Psychology, Graduate Research Assistant, United States of America
| | - Marcus Tyler Carey
- Assistant Professor of Criminal Justice at Texas A&M International University, Laredo, TX, United States of America
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18
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Teas E, Marceau K, Friedman E. Life-course social connectedness: Comparing data-driven and theoretical classifications as predictors of functional limitations in adulthood. ADVANCES IN LIFE COURSE RESEARCH 2023; 55:100529. [PMID: 36942641 PMCID: PMC10115127 DOI: 10.1016/j.alcr.2023.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/16/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
A life course perspective on social relationships highlights the importance of specific relationships at specific times in life, but analyses that account for life course trajectories in social relationships are rare. This study compares theoretical and data-driven approaches to classifying life course relationships, including multiple dimensions of social connectedness at different time points across the life course. We examine each approach's ability to predict later-life functional limitations, given that functional impairment is prevalent among middle-aged and older adults. Data were from three waves of the Midlife in the United States (MIDUS) study (n = 6909). Relationship variables (parental affection, parental discipline, social support, social strain, and positive relations with others) were from wave 1 or wave 2. Functional limitations were measured at wave 3. Results showed that the data-driven approach had more predictive power than the theoretical approach. Additionally, results suggested that including only positive relationship features was nearly as robust as including both positive and negative relationship features. Overall, the data-driven approach outperformed the theoretical approach and revealed relationship trajectories consistent with life course cumulative processes.
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Affiliation(s)
- Elizabeth Teas
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47907, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN 47907, USA.
| | - Kristine Marceau
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47907, USA
| | - Elliot Friedman
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47907, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN 47907, USA
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19
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Long DA, Waak M, Doherty NN, Dow BL. Brain-Directed Care: Why Neuroscience Principles Direct PICU Management beyond the ABCs. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121938. [PMID: 36553381 PMCID: PMC9776953 DOI: 10.3390/children9121938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Major advances in pediatric intensive care (PICU) have led to increased child survival. However, the long-term outcomes among these children following PICU discharge are a concern. Most children admitted to PICU are under five years of age, and the stressors of critical illness and necessary interventions can affect their ability to meet crucial developmental milestones. Understanding the neuroscience of brain development and vulnerability can inform PICU clinicians of new ways to enhance and support the care of these most vulnerable children and families. This review paper first explores the evidence-based neuroscience principles of brain development and vulnerability and the impact of illness and care on children's brains and ultimately wellbeing. Implications for clinical practice and training are further discussed to help optimize brain health in children who are experiencing and surviving a critical illness or injury.
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Affiliation(s)
- Debbie A. Long
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
- Correspondence: ; Tel.: +61-7-3138-3834
| | - Michaela Waak
- Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
| | - Nicola N. Doherty
- Regional Trauma Network, SPPG, DOH, Belfast BT2 8BS, Northern Ireland, UK
- School of Psychology, Faculty of Life and Health Sciences, Coleraine Campus, Ulster University, Coleraine BT52 1SA, Northern Ireland, UK
| | - Belinda L. Dow
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
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20
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Priest N, Guo S, Gondek D, Lacey RE, Burgner D, Downes M, Slopen N, Goldfeld S, Moreno-Betancur M, Kerr JA, Cahill S, Wake M, Juonala M, Lycett K, O'Connor M. The effect of adverse and positive experiences on inflammatory markers in Australian and UK children. Brain Behav Immun Health 2022; 26:100550. [PMID: 36420372 PMCID: PMC9677086 DOI: 10.1016/j.bbih.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Background The relationship between childhood adversity and inflammation is well-established. Examination of positive experiences can provide a more complete understanding of intervention opportunities. We investigated associations of adverse and positive experiences, and their intersection, with inflammation in children and adolescents. Methods Data sources: Longitudinal Study of Australian Children (LSAC; N = 1237) and Avon Longitudinal Study of Parents and Children (ALSPAC; N = 3488). Exposures: Adverse and positive experiences assessed repeatedly (LSAC: 0-11 years; ALSPAC: 0-15 years). Outcomes: Inflammation quantified by high sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA) (LSAC: 11-12 years; ALSPAC: 15.5 years). Analyses: Linear regression on the log-transformed outcomes estimated the relative difference in inflammatory markers with adverse/positive experiences, adjusting for socio-demographics and concurrent positive/adverse experiences, respectively. Results Most associations were in the expected direction but differed in magnitude by exposure, outcome and cohort. Across both cohorts, adverse experiences were associated with up to 7.3% higher hsCRP (95% CI: -18.6%, 33.2%) and up to 2.0% higher GlycA (95% CI: 0.5%, 3.5%); while positive experiences were associated with up to 22.1% lower hsCRP (95% CI: -49.0%, 4.7%) and 1.3% lower GlycA (95% CI: -2.7%, 0.2%). In LSAC, the beneficial effect of positive experiences on inflammation was more pronounced among those with fewer concurrent adverse experiences. Conclusion Across two cohorts, we found small but directionally consistent associations between adverse experiences and higher inflammation, and positive experiences and lower inflammation, particularly for GlycA. Future research should give further consideration to positive experiences to complement the current focus on adversity and inform the design and evaluation of early life interventions.
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Affiliation(s)
- Naomi Priest
- ANU Centre for Social Research & Methods, The Australian National University, Canberra, Australia
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Dawid Gondek
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca E. Lacey
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - David Burgner
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Inflammatory Origins Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of General Medicine, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, Monash University, Melbourne, Australia
| | - Marnie Downes
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Jessica A. Kerr
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Stephanie Cahill
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Melissa Wake
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics & the Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Markus Juonala
- Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Kate Lycett
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Centre for Social & Early Emotional Development, Deakin University, Burwood, Australia
| | - Meredith O'Connor
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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21
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Yu Z, Wang L, Chen W, Zhang J, Bettencourt AF. Positive Childhood Experiences Associate with Adult Flourishing Amidst Adversity: A Cross Sectional Survey Study with a National Sample of Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14956. [PMID: 36429674 PMCID: PMC9690672 DOI: 10.3390/ijerph192214956] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to examine the prevalence of PCEs among young adults in Mainland China and the extent to which the cumulative number of PCEs moderates the associations between ACEs and flourishing in adulthood. Between August and November 2020, we used convenience and snowball sampling to recruit 9468 young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China to participate in a survey, which included measures on flourishing, exposure to ACEs and PCEs, and demographic characteristics. Approximately 92% of participants reported experiencing seven to nine PCEs, with harmonious family relationships (96.9%), feeling supported by friends (96.8%) and being treated fairly at school (96.3%) being the most common PCEs reported. Results of the multiple regression indicated that the cumulative number of PCEs statistically significantly moderated the relation between the cumulative number of ACEs and flourishing (interaction term b = -0.060 [-0.071, -0.049], p < 0.001, adjusted R2 = 0.183); as the number of ACEs increased up through eight ACEs, decreases in flourishing were smaller among those with higher numbers of PCEs. PCEs are common among young adults from Mainland China and serve a potential buffering effect against exposure to ACEs.
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Affiliation(s)
- Zhiyuan Yu
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Wenyi Chen
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Juan Zhang
- International Peace Maternity and Children Hospital of China Welfare Institution, Departments of Nursing, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Amie F. Bettencourt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
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Boehm JK, Qureshi F, Kubzansky LD. Psychological Well-Being in Childhood and Cardiometabolic Risk in Middle Adulthood: Findings From the 1958 British Birth Cohort. Psychol Sci 2022; 33:1199-1211. [PMID: 35771978 PMCID: PMC9807774 DOI: 10.1177/09567976221075608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn's r = .82-.91), which were combined into a standardized overall score (Cronbach's α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for total cardiometabolic risk. Regressions indicated that children with greater psychological well-being had lower cardiometabolic risk (b = -0.14, 95% confidence interval [CI] = [-0.28, -0.006]): specifically, healthier total cholesterol (b = -0.04, 95% CI = [-0.07, -0.003]) and triglycerides (b = -0.06, 95% CI = [-0.09, -0.02]). Childhood psychological well-being may promote adulthood cardiometabolic health.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology, Chapman University,Julia K. Boehm, Chapman University, Department of Psychology
| | - Farah Qureshi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health,Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health,Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health
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Guo S, O'Connor M, Mensah F, Olsson CA, Goldfeld S, Lacey RE, Slopen N, Thurber KA, Priest N. Measuring Positive Childhood Experiences: Testing the Structural and Predictive Validity of the Health Outcomes From Positive Experiences (HOPE) Framework. Acad Pediatr 2022; 22:942-951. [PMID: 34801761 DOI: 10.1016/j.acap.2021.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Positive childhood experiences (PCEs), that occur within secure and nurturing social environments, are fundamental to healthy physical, social-emotional, and cognitive development. However, reliable measures of these experiences are not yet widely available. We used data from the Longitudinal Study of Australian Children (LSAC) to empirically represent and psychometrically evaluate 3 primary domains of PCEs defined within the Health Outcomes from Positive Experiences (HOPE) framework, specifically: 1) nurturing and supportive relationships; 2) safe and protective environments and; 3) constructive social engagement and connectedness. METHODS LSAC is a nationally representative cohort that has followed young Australians from birth since 2004. LSAC data were used to represent the 3 primary HOPE-PCEs domains (birth to 11 years) across 4 inter-related PCEs constructs: 1) positive parenting, 2) trusting and supportive relationships, 3) supportive neighborhood and home learning environments, and 4) social engagement and enjoyment. Confirmatory factor analysis was used to test the proposed 4-factor structure. Predictive validity was examined through associations with mental health problems and academic difficulties at 14 to 15 years. RESULTS The 4-factor structure was supported by empirical data at each time point. Higher exposure to PCEs across each domain was associated with lower reporting of mental health problems (β = -0.20 to -2.05) and academic difficulties (β = -0.01 to -0.13) in adolescence. CONCLUSIONS The 4 LSAC-based HOPE-PCEs have sufficient internal coherence and predictive validity to offer a potentially useful way of conceptualizing and measuring PCEs in future cohort studies and intervention trials aiming to enhance the understanding of, and mitigate the negative impacts of, adverse childhood experiences.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (S Guo, S Goldfeld, and N Priest), Melbourne, Australia; Department of Pediatrics, University of Melbourne (S Guo, M O'Connor, F Mensah, and S Goldfeld), Melbourne, Australia
| | - Meredith O'Connor
- Department of Pediatrics, University of Melbourne (S Guo, M O'Connor, F Mensah, and S Goldfeld), Melbourne, Australia; Melbourne Children's LifeCourse Initiative, Murdoch Children's Research Institute (M O'Connor), Melbourne, Australia
| | - Fiona Mensah
- Department of Pediatrics, University of Melbourne (S Guo, M O'Connor, F Mensah, and S Goldfeld), Melbourne, Australia; Intergenerational Health, Murdoch Children's Research Institute (F Mensah), Melbourne, Australia
| | - Craig A Olsson
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital (CA Olsson), Melbourne, Australia; Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University (CA Olsson), Geelong, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (S Guo, S Goldfeld, and N Priest), Melbourne, Australia; Department of Pediatrics, University of Melbourne (S Guo, M O'Connor, F Mensah, and S Goldfeld), Melbourne, Australia
| | - Rebecca E Lacey
- Research Department of Epidemiology and Public Health, University College London (RE Lacey), London, United Kingdom
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (N Slopen), Boston, Mass
| | - Katherine A Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University (KA Thurber), Canberra, Australia
| | - Naomi Priest
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital (S Guo, S Goldfeld, and N Priest), Melbourne, Australia; Centre for Social Research & Methods, The Australian National University (N Priest), Canberra, Australia.
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Matjasko JL, Herbst JH, Estefan LF. Preventing Adverse Childhood Experiences: The Role of Etiological, Evaluation, and Implementation Research. Am J Prev Med 2022; 62:S6-S15. [PMID: 35597583 PMCID: PMC9215220 DOI: 10.1016/j.amepre.2021.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Research on adverse childhood experiences is a vital part of the data-to-action link and the development of evidence-based public health and violence prevention practice. Etiological research helps to elucidate the key risk and protective factors for adverse childhood experiences and outcome research examines the consequences of exposure to them. Evaluation research is critical to building the evidence base for strategies that are likely to have a significant impact on preventing and reducing adverse experiences during childhood. Implementation research efforts inform the movement and scale-up of evidence-based findings to public health practice. The Centers for Disease Control and Prevention's Division of Violence Prevention located in the National Center for Injury Prevention and Control is investing in a number of research initiatives that are designed to advance what is known about the causes and consequences of adverse childhood experiences (i.e., etiological research), the strategies that are effective at reducing and preventing them (i.e., evaluation research), and how to best adapt and scale effective strategies (i.e., implementation research). This article complements the other articles in this Special Supplement by briefly providing a review of reviews for each of these areas and highlighting recent research investments and strategic directions by the Centers for Disease Control and Prevention in the area of child abuse and neglect and adverse childhood experience prevention. Research investments are critical to advancing the evidence base on the prevention of adverse childhood experiences and to ensure safe, stable, and nurturing relationships and environments so that all children can live to their fullest potential.
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Affiliation(s)
- Jennifer L Matjasko
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jeffrey H Herbst
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Alizadeh G, Gholipour K, Azami-Aghdash S, Dehnavieh R, JafarAbadi MA, Azmin M, Khodayari-Zarnaq R. Social, Economic, Technological, and Environmental Factors Affecting Cardiovascular Diseases: A Systematic Review and Thematic Analysis. Int J Prev Med 2022; 13:78. [PMID: 35706860 PMCID: PMC9188896 DOI: 10.4103/ijpvm.ijpvm_105_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
Background Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD. Methods Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data. Results A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster. Conclusions Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.
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Affiliation(s)
- Gisoo Alizadeh
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Gholipour
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Dehnavieh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Asghari JafarAbadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Hou H, Zhang C, Tang J, Wang J, Xu J, Zhou Q, Yan W, Gao X, Wang W. Childhood Experiences and Psychological Distress: Can Benevolent Childhood Experiences Counteract the Negative Effects of Adverse Childhood Experiences? Front Psychol 2022; 13:800871. [PMID: 35282200 PMCID: PMC8914177 DOI: 10.3389/fpsyg.2022.800871] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Childhood experiences can exert a huge impact on adult psychological conditions. Previous studies have confirmed the effects of adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) on psychological distress (e.g., stress, depression, and suicidal ideation) separately, but few studies explored a combined effect of ACEs and BCEs on psychological distress. The aim of this study was to explore a combined effect of ACEs and BCEs on psychological distress among Chinese undergraduates. Methods Participants were undergraduates aged 17–24 years (N = 1,816) and completed a self-reported questionnaire. A series of regression analyses were conducted to examine the association between childhood experiences and psychological distress. Results A total of 65.7% of undergraduates had BCEs, 27.1% of undergraduates had ACEs, and 12.9% of undergraduates had ACEs and BCEs simultaneously. Logistic regression analysis indicated that undergraduates who experienced high ACEs were more likely to have a high risk of psychological distress [odds ratio (ORs) = 1.46, 1.84, and 3.15 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively], while undergraduates who experienced High BCEs were less likely to have psychological distress (ORs = 0.33, 0.22, and 0.32 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively) compared with Low-Both group. The combined effect of ACEs and BCEs (High-Both group) could also play as a protective factor in uncertainty stress (OR = 0.56) and depressive symptoms (OR = 0.47). Conclusion Our findings suggested that ACEs and BCEs could not only predict the psychological distress independently, but also BCEs could counteract the negative effect of ACEs in psychological problems. There is an even greater need to identify and support the victims of ACEs and to increase BCEs in early childhood.
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Affiliation(s)
- Hao Hou
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Caochen Zhang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jiaqi Xu
- School of Medical Technology, Xuzhou Medical University, Xuzhou, China
| | - Qin Zhou
- The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wenjun Yan
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiuyin Gao
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Wei Wang,
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27
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Lifetime Trauma and Cardiovascular Health in Latinas. Nurs Res 2022; 71:66-74. [PMID: 34644271 PMCID: PMC8732306 DOI: 10.1097/nnr.0000000000000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care. OBJECTIVE The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women. METHODS Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. RESULTS The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. DISCUSSION Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.
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Pei Y, Wang J, Tang J, Yan N, Luo Y, Xie Y, Zhou Q, Zhang C, Wang W. Network connectivity between benevolent childhood experiences and uncertainty stress among Chinese university students. Front Psychiatry 2022; 13:1007369. [PMID: 36386984 PMCID: PMC9665163 DOI: 10.3389/fpsyt.2022.1007369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/17/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore the association between benevolent childhood experiences (BCEs) and uncertainty stress among Chinese university students by network analysis. METHODS A total of 1,830 university students from three Chinese cities were recruited. Respondents' BCEs and uncertainty stress were self-reported using online questionnaire. The structure of the BCEs-uncertainty stress and related centrality indicators were examined for this sample. RESULTS The overall network model showed that "no ways to suit the important changes in life" was the most influential, followed by "all things are not going well," "feel that there is nothing to do," and "worry about the future." And in this network, the most influential bridge symptom was "having a positive self-concept." CONCLUSION The central symptoms of the BCEs-uncertainty stress network should be prioritized as targets in interventions and prevention efforts to reduce uncertainty stress among Chinese university students. Improving university students' positive self-concept is important to alleviate the level of uncertainty stress among Chinese university students.
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Affiliation(s)
- Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Na Yan
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yunjiao Luo
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yaofei Xie
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Qin Zhou
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Caiyi Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China.,Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, China.,Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
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Bertele S, Heitland I, Fraccarollo D, Stapel B, Bauersachs J, Westhoff-Bleck M, Kahl KG. Behavioral pathway to a broken heart: The link between adverse childhood experiences, depression, physical exercise and cardiovascular health. Front Psychiatry 2022; 13:1002143. [PMID: 36304562 PMCID: PMC9595725 DOI: 10.3389/fpsyt.2022.1002143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIM Adverse childhood experiences (ACEs) are a major risk factor for unfavorable behavioral, mental and health outcomes later in life. However, the precise pathway via which ACEs convey these risks, in particular regarding health outcomes such as cardiovascular disease, remains unknown. Here, we combined psychiatric and cardiac methods to investigate the pathway via which childhood adversities may lead to adult adverse cardiovascular health, with a focus on epicardial adipose tissue (EAT) as a risk marker. METHODS 210 adult congenital heart disease outpatients (mean age 35.5 y, 43% female) completed a thorough cardiac and psychiatric evaluation. Psychiatric measurements included an expert interview, the childhood trauma questionnaire (CTQ), Beck's depression inventory II (BDI-II), quality of life and the global scale of functioning, amongst others. All patients completed a full cardiac workup including EAT assessment using echocardiography. We then computed bootstrapping mediation models using ACEs as a predictor, depression and physical activity as mediators and EAT as dependent variable in PROCESS. RESULTS CTQ scores had a significant indirect effect on EAT via a serial mediation of BDI and physical activity [a*b2*d = 0.0260, 95% BCa CI [0.0047, 0.0619]]. CONCLUSION Using mediation analyses, we show that adverse childhood events are linked to increased depressive symptoms, which are linked to decreased physical activity, which in turn are linked to a higher amount of epicardial adipose tissue. While other pathways most certainly exist and replication is needed, this suggests a meaningful pathway via which ACEs lead to adverse cardiovascular health, with several potential targets for health interventions across time.
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Affiliation(s)
- Sebastian Bertele
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Daniela Fraccarollo
- Department of Cardiology and Angiology, Hanover Medical School, Hanover, Germany
| | - Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hanover Medical School, Hanover, Germany
| | | | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
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Xu Z, Zhang D, Ding H, Zheng X, Lee RCM, Yang Z, Mo PKH, Lee EKP, Wong SYS. Association of positive and adverse childhood experiences with risky behaviours and mental health indicators among Chinese university students in Hong Kong: an exploratory study. Eur J Psychotraumatol 2022; 13:2065429. [PMID: 35646294 PMCID: PMC9135422 DOI: 10.1080/20008198.2022.2065429] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Different childhood experiences may affect adult health differently. OBJECTIVE To explore the association of different types of positive childhood experiences(PCEs) and adverse childhood experiences (ACEs) with risky behaviours and mental health indicators, andhow PCEs and ACEs are associated with health outcomes in the context of each other. METHOD This was an exploratory cross-sectional online survey including 332 university students in Hong Kong. ACEs (abuse and household challenges), PCEs (perceived safety, positive quality of life, and interpersonal support), risky behaviours (smoking, binge drinking, and sexual initiation), and mental health indicators(depression, anxiety, loneliness, self-rated health, multimorbidity, meaning in life, and life satisfaction)were measured. RESULTS The multivariable logistic regression analysis indicated cumulative effects of PCEs in lowered risks of depression, anxiety, loneliness, as well as better self-rated health, life satisfaction, and meaning in life (p < .05), after adjusting for ACEs. Results also indicated that ACEs had an increasing relationship with poorer mental health indicators, such as anxiety, loneliness, and life satisfaction (p < .05), after adjusting for PCEs. There was also an adverse association between having ≥4 ACEs with smoking and binge drinking. In addition, each type of PCE and ACE was significantly associated with one or more risky behaviours and mental health indicators. Stratified results showed that PCEs had stronger associations with mental health indicators in participants with fewer ACEs. Furthermore, ACEs had stronger associations with mental health indicators in participants with more PCEs than in those with fewer PCEs. CONCLUSIONS In this study, PCE was proven to be an independent protective factor against poor mental health after accounting for ACE. ACE was also proven to be an independent risk factor for poor mental health and risky behaviours. These findings suggest a crucial need for the active promotion of PCEs and the prevention of child maltreatment. The results of subtypes and stratifications can be taken into consideration when developing targeted interventions in the future. HIGHLIGHTS PCE is an independent protective factor against poor mental health after accounting for ACE. ACE is an independent risk factor for poor mental health and risky behaviours.PCEs and ACEs have different associations with health outcomes in the context of one another.
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Affiliation(s)
- Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Hanyue Ding
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Xiaoxiang Zheng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Rym Chung-Man Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Zuyao Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Phoenix Kit-Han Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Eric Kam-Pui Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Zhang C, Wang W, Pei Y, Zhang Y, He C, Wang J, Gao X, Hou H. Benevolent Childhood Experiences and Depressive Symptoms Among Chinese Undergraduates: A Moderated Mediation Model Examining the Roles of Uncertainty Stress and Family Relationship. Front Public Health 2021; 9:757466. [PMID: 34976921 PMCID: PMC8716588 DOI: 10.3389/fpubh.2021.757466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The evidence on the association between benevolent childhood experience (BCE) and depressive symptoms in students is complex. This study aims to explore the underlying mediation mechanism of BCE toward depressive symptoms and whether this link was moderated by the family relationship among Chinese undergraduates. Methods: From March 2021 to May 2021, a cross-sectional study was conducted in China, and 1821 undergraduates were recruited in this study. Participants were asked to complete a self-reported electronic questionnaire. The software SPSS PROCESS macro was used to test the mediation and mediated moderated modeling analysis. Results: Mediation analysis indicated that uncertainty stress (US) partly mediated the link between BCE and depressive symptoms (indirect effect = -0.47, 95% bootstrap CI = -0.55, -0.39). The indirect effect of the US accounted for 39.63% of the total variance in depression. Moderation analysis indicated that the association between the US and depressive symptoms was significantly modified by family relationships (interact effect = -0.019, P < 0.001). An integrative moderated mediation analysis indicated that the indirect effect from BCE to depressive symptoms through the US was also moderated by family relationships (interact effect = -0.012, P = 0.014). Conclusion: Uncertainty stress plays a key role in bridging BCE and depressive symptoms while the family relationship can buffer the impact of the US on depressive symptoms among Chinese undergraduates. Enhancing tolerance of uncertainty and improving family relationships are needed to protect undergraduates from depressive symptoms.
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Affiliation(s)
- Caiyi Zhang
- Department of Medical Psychology, Second Clinical College, Xuzhou Medical University, Xuzhou, China
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Ying Zhang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Chenlu He
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiuyin Gao
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Hao Hou
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
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Suglia SF, Appleton AA, Bleil ME, Campo RA, Dube SR, Fagundes CP, Heard-Garris NJ, Johnson SB, Slopen N, Stoney CM, Watamura SE. Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: Implications for future research. Prev Med 2021; 153:106736. [PMID: 34293381 PMCID: PMC8595689 DOI: 10.1016/j.ypmed.2021.106736] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging evidence suggests there may be continuity in ELA's prediction of cardiometabolic risk over the life course. Extant research has primarily relied on a cumulative risk framework to evaluate the relationship between ELA and CVD. In this framework, risk is considered a function of the number of risk factors or adversities that an individual was exposed to across developmental periods. The cumulative risk exposure approach treats developmental periods and types of risk as equivalent and interchangeable. Moreover, cumulative risk models do not lend themselves to investigating the chronicity of adverse exposures or consider individual variation in susceptibility, differential contexts, or adaptive resilience processes, which may modify the impact of ELA on CVD risk. To date, however, alternative models have received comparatively little consideration. Overall, this paper will highlight existing gaps and offer recommendations to address these gaps that would extend our knowledge of the relationship between ELA and CVD development. We focus specifically on the roles of: 1) susceptibility and resilience, 2) timing and developmental context; and 3) variation in risk exposure. We propose to expand current conceptual models to incorporate these factors to better guide research that examines ELA and CVD risk across the life course.
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Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, GA, United States of America.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY, United States of America
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States of America
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Shanta R Dube
- Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - Nia J Heard-Garris
- Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Catherine M Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, CO, United States of America
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Lei MK, Beach SRH, Simons RL, Ye K. The Impact of Harsh Parenting on the Development of Obesity in Adulthood: An Examination of Epigenetic/Gene Expression Mediators Among African American Youth. Front Cardiovasc Med 2021; 8:755458. [PMID: 34805311 PMCID: PMC8602565 DOI: 10.3389/fcvm.2021.755458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022] Open
Abstract
Objective: We examined the association of prospectively assessed harsh parenting during adolescence with body mass index (BMI) in young adulthood among African American youth. We also assessed the role of methylation of obesity-related genes and gene expression markers of obesity as mediators of this association, providing a pathway for the biological embedding of early harsh parenting and its long-term impact on young adult health. Methods: Hypotheses were tested with a sample of 362 African American youth for whom harsh parenting was assessed at ages 10–15, BMI was assessed at age 10 and 29, and both DNA methylation (DNAm) and gene expression of obesity genes were assessed at age 29. Mediational analyses were conducted using bootstrap methods to generate confidence intervals. Results: Controlling for genetic risk for obesity and health-related covariates, harsh parenting across childhood and adolescence was associated with change in BMI (Δ BMI) from ages 10–29. In addition, we found that the indirect effect of harsh parenting on Δ BMI was mediated through obesity-related DNAm and accounted for 45.3% of the total effect. Further, obesity-related DNAm mediated the effect of harsh parenting on gene expression of obesity-related genes (GEOG), and GEOG, in turn, mediated the impact of obesity-related DNAm on ΔBMI. This pathway accounted for 3.4% of the total effect. There were no gender differences in the magnitude of this indirect effect. Conclusions: The results suggest that alterations in methylation and gene expression mediate the impact of harsh parenting on change in obesity from childhood to young adulthood, illustrating plausible biological pathways from harsh parenting to obesity and bolstering the hypothesis that harsh parenting in childhood and adolescence can become biologically embedded and contribute to obesity.
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Affiliation(s)
- Man-Kit Lei
- Department of Sociology, University of Georgia, Athens, GA, United States
| | - Steven R H Beach
- Department of Psychology, Center for Family Research, University of Georgia, Athens, GA, United States
| | - Ronald L Simons
- Department of Sociology, University of Georgia, Athens, GA, United States
| | - Kaixiong Ye
- Department of Genetics, University of Georgia, Athens, GA, United States
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Abstract
Cardiovascular disease risk is evident during childhood for patients with juvenile systemic lupus erythematosus, juvenile dermatomyositis, and juvenile idiopathic arthritis. The American Heart Association defines cardiovascular health as a positive health construct reflecting the sum of protective factors against cardiovascular disease. Disease-related factors such as chronic inflammation and endothelial dysfunction increase cardiovascular disease risk directly and through bidirectional relationships with poor cardiovascular health factors. Pharmacologic and nonpharmacologic interventions to improve cardiovascular health and long-term cardiovascular outcomes in children with rheumatic disease are needed.
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Ko YA, Shen J, Kim JH, Topel M, Mujahid M, Taylor H, Quyyumi A, Sims M, Vaccarino V, Baltrus P, Lewis T. Identifying neighbourhood and individual resilience profiles for cardiovascular health: a cross-sectional study of blacks living in the Atlanta metropolitan area. BMJ Open 2021; 11:e041435. [PMID: 34330849 PMCID: PMC8327812 DOI: 10.1136/bmjopen-2020-041435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To simultaneously examine multiple individual-level neighbourhood perceptions and psychosocial characteristics and their relationships with cardiovascular health (CVH) among blacks. DESIGN Cross-sectional study. SETTING Subjects were recruited between 2016 and 2018 via convenience sampling. PARTICIPANTS 385 Black men and women, age 30-70 living in the Atlanta metropolitan area (Georgia, USA). PRIMARY OUTCOME MEASURE Individual's CVH was summarised as a composite score using American Heart Association's Life's Simple 7 (LS7) metrics. METHODS We implemented unsupervised learning (k-means) and supervised learning (Bayesian Dirichlet process clustering) to identify clusters based on 11 self-reported neighbourhood perception and psychosocial characteristics. We also performed principal component analysis to summarise neighbourhood perceptions and psychosocial variables and assess their associations with LS7 scores. RESULTS K-means and Bayesian clustering resulted in 4 and 5 clusters, respectively. Based on the posterior distributions, higher LS7 scores were associated with better neighbourhood perceptions and psychosocial characteristics, including neighbourhood safety, social cohesion, activities with neighbours, environmental mastery, purpose in life, resilient coping and no depression. Taken together, the first principal components of neighbourhood perceptions and psychosocial characteristics were associated with an increase of 0.07 (95% CI -0.17 to 0.31) and 0.31 (95% CI 0.06 to 0.55) in LS7 score, respectively, after accounting for age, sex, household income and education level. CONCLUSION Both neighbourhood perception and psychosocial domains were related to CVH, but individual psychosocial characteristics appeared to contribute to CVH most. Approaches that acknowledge the importance of factors in both domains may prove most beneficial for enhancing resilience and promoting CVH among black communities.
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Affiliation(s)
- Yi-An Ko
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Jenny Shen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeong Hwan Kim
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matthew Topel
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mahasin Mujahid
- Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Herman Taylor
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Arshed Quyyumi
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Viola Vaccarino
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Peter Baltrus
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Tene Lewis
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
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Zhang L, Fang J, Zhang D, Wan Y, Gong C, Su P, Tao F, Sun Y. Poly-victimization and psychopathological symptoms in adolescence: Examining the potential buffering effect of positive childhood experiences. J Affect Disord 2021; 282:1308-1314. [PMID: 33601709 DOI: 10.1016/j.jad.2021.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Childhood maltreatment are well-established risk factors for adolescent psychopathology. Positive childhood experiences (PCEs) known protective factors. However, few studies have simultaneously investigated childhood maltreatment and PCEs in the context of longitudinal study. The aim of this paper was to assess the buffering effect of PCEs in adolescence in the association between chronic childhood maltreatment and psychological symptoms in adolescence. METHODS Data were from an ongoing longitudinal study with 2288 children aged 8.15 y at baseline who were recruited from 3 large elementary schools in China. Participants were followed up for four waves across 6 years. The associations between re-victimization and poly-victimization with adolescent psychopathological symptoms across different PCEs contexts were explored. RESULTS Poly-victimization was highly predictive of depressive symptoms, oppositional defiant disorder and conduct disorder. PCEs may mitigate the negative effect of chronic childhood maltreatment on adolescent psychopathology in a dose-response manner. For adolescents with 4-5 PCEs, psychopathological symptoms score decreased significantly and showed similar level with those low/no-victimization comparison peers. While experiencing multiple PCEs does decrease the risk of psychopathological symptoms, certain PCEs, such as parental warmth and peer support, appear to entailed protective effect on all the three psychopathological symptoms. LIMITATIONS It is not clear whether the patterns of effects would vary across developmental periods. CONCLUSIONS A focus of interventions should be not only on ameliorating childhood maltreatment, but also on expanding the availability of social support related PCEs, which may help inform suitable strategies for providing intervention and support to best help reduce the psychopathology burden for children.
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Affiliation(s)
- Lei Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Jiao Fang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Dandan Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Chun Gong
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Puyu Su
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China.
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Tao T, Shao R, Hu Y. The Effects of Childhood Circumstances on Health in Middle and Later Life: Evidence From China. Front Public Health 2021; 9:642520. [PMID: 33614591 PMCID: PMC7888477 DOI: 10.3389/fpubh.2021.642520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/15/2021] [Indexed: 01/06/2023] Open
Abstract
Background: This study examined the relationship between childhood circumstances and health in middle and later life. We quantified how childhood circumstances contribute to health in later life, both directly and indirectly, through their effects on potential mediators. Methods: This study used three waves of data from the national longitudinal survey of the China Health and Retirement Longitudinal Study (CHARLS). The final model in this study included 7,476 eligible respondents aged 45 years and above. We constructed a simple health status measure based on the first principal component of CHARLS survey responses with 25 health-related information. It is a multi-dimensional measurement that comprehensively reflects the individual's healthy aging. We formulated childhood circumstances factors into five domains: childhood health and nutrition, childhood socioeconomic status, access to health care, parental genetics, and adverse childhood experiences. Ordered logit regression was conducted to analyze the relationship between health in middle and later life and childhood circumstances, with other explanatory variables controlled. Results: Controlling for educational attainment, personal income, and health status in the last wave, adults who experience good childhood health (poor as the base, coefficient 0.448, p < 0.01), and better family financial status (worse as the base, coefficient 0.173, p < 0.01) have significantly better health during their middle and later life, in comparison, being inconvenient to visit a doctor (coefficient −0.178, p < 0.01), and having two or three adverse childhood experiences (0 as the base, coefficient −0.148, p < 0.01) are significantly associated with poorer health. Childhood circumstances appear to act both through a lasting effect of initial health and financial status in childhood and through their impact on achievements in adulthood. Conclusion: Our findings suggest that investments in health during childhood not only contribute to health in later life but also dynamically improve an individual's educational attainment and personal income, as well as other life prospects. All these returns may extend far beyond childhood and continue throughout the lifespan.
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Affiliation(s)
- Tiantian Tao
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Rong Shao
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Yuanjia Hu
- State Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
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Geng F, Zou J, Liang Y, Zhan N, Li S, Wang J. Associations of positive and adverse childhood experiences and adulthood insomnia in a community sample of Chinese adults. Sleep Med 2021; 80:46-51. [PMID: 33550174 DOI: 10.1016/j.sleep.2021.01.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVES Research has documented that adverse childhood experiences (ACEs) are associated with increased adult sleep disturbances, little is known about whether positive childhood experiences (PCEs) influence sleep health in adulthood. This study aimed to examine the associations of ACEs and PCEs with adulthood insomnia, as well as the extent to which PTSD and depressive symptoms mediated these associations. METHODS A sample of 7245 adults in China (male 32.7%; mean age 38.09 years, SD = 7.84, range from 18 to 81) completed self-report questionnaires to assess ACEs, PCEs, PTSD and depressive symptoms. Multiple linear regressions were used to examine the independent and interaction effects of ACEs and PCEs on insomnia. Path analyses were performed to examine the direct and indirect effects of ACEs and PCEs on insomnia. RESULTS After adjustment of demographics, ACEs (β = 0.11, p < 0.001) and PCEs (β = -0.09, p < 0.001) were both independently associated with adulthood insomnia, while the relationship between PCEs and insomnia was weakened but still significant among participants with high levels of ACEs. After controlling for demographics, PTSD and depressive symptoms partially mediated the overall effect of PCEs on insomnia, and fully mediated the relationship between ACEs and insomnia. CONCLUSIONS These data demonstrate that both positive and adverse childhood experiences influence adulthood insomnia. The findings highlight the importance of joint assessment of PCEs and ACEs to prevent and intervene insomnia. Optimizing the early childhood environment may help to foster healthy sleep throughout the life course.
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Affiliation(s)
- Fulei Geng
- School of Psychology, Jiangxi Normal University, Nanchang, China.
| | - Jiaqi Zou
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yingxin Liang
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong
| | - Nalan Zhan
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Shuhan Li
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Jian Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
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Zhan N, Xie D, Zou J, Wang J, Geng F. The validity and reliability of benevolent childhood experiences scale in Chinese community adults. Eur J Psychotraumatol 2021; 12:1945747. [PMID: 34290847 PMCID: PMC8276668 DOI: 10.1080/20008198.2021.1945747] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Several studies have indicated that positive childhood experiences (PCEs) might have important protective effects on adulthood mental health. However, the instruments to assess PCEs are scarce. OBJECTIVE In this study, we assessed the validity and reliability of the Benevolent Childhood Experiences (BCEs) scale, a new instrument of PCEs, in a large sample of Chinese adults. Furthermore, we examined associations of PCEs with symptoms of posttraumatic stress disorder (PTSD) and depression, as well as, prosocial behaviours across different levels of trauma. METHOD Participants were 6929 adults (33% male; mean age 38.04 years, SD = 7.81, ranging from 18 to 81.) recruited from Jiangxi and Hunan provinces in China. Self-administrated questionnaires were used to measure PCEs, childhood trauma, lifetime trauma, PTSD, depression, and prosocial behaviours. Multiple linear regression models were conducted to examine the interdependent and interactive effects of PCEs, lifetime trauma, childhood trauma on symptoms of PTSD and depression and prosocial behaviours. RESULTS In the current sample, the Cronbach's α of the BCEs scale was 0.70. PCEs were not related to lifetime trauma, while modestly associated with childhood trauma, demonstrating excellent discriminant validity. PCEs were negatively correlated with severity of PTSD and depression, while positively correlated with prosocial behaviours, indicating good predictive validity. PCEs, lifetime trauma and childhood trauma were independently associated with severity of PTSD and depression and prosocial behaviours. Moreover, the interaction of PCEs and lifetime trauma negatively predicted severity of PTSD and depression, while the interaction of PCEs and childhood trauma negatively predicted prosocial behaviours. PCEs had a protective effect on PTSD and depression in high level of lifetime trauma, and showed a reduced positive effect on prosocial behaviours in high level of childhood trauma. CONCLUSIONS The Chinese BCEs scale is a reliable and valid instrument. PCEs can buffer adversity and foster positive outcomes in adulthood.
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Affiliation(s)
- Nalan Zhan
- School of Psychology, Jiangxi Normal University, Nanchang, P.R.China
| | - Dongjie Xie
- Hangzhou College of Preschool Teacher Education, Zhejiang Normal University, Hangzhou, P.R.China
| | - Jiaqi Zou
- School of Psychology, Jiangxi Normal University, Nanchang, P.R.China
| | - Jian Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, P.R.China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, Nanchang, P.R.China
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Caceres BA, Markovic N, Edmondson D, Hughes TL. Sexual Identity, Adverse Life Experiences, and Cardiovascular Health in Women. J Cardiovasc Nurs 2020; 34:380-389. [PMID: 31246631 DOI: 10.1097/jcn.0000000000000588] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Adverse life experiences (ALE; eg, discrimination and sexual abuse) may contribute to cardiovascular disease (CVD) risk in sexual minority women (SMW), but few studies have tested whether ALE explain the association of sexual identity with cardiovascular health (CVH) markers in women. OBJECTIVE The aim of this study was to examine sexual identity differences in CVH among women and the role of ALE. METHODS In the Epidemiologic Study of Risk in Women, we used multinomial logistic regression to assess sexual identity differences (SMW vs heterosexual women [reference group]) in CVH markers (ideal vs poor, intermediate vs poor) using the American Heart Association's Life's Simple 7 metric and the total score. Next, we tested whether the association of sexual identity with the total CVH score was attenuated by traditional CVD risk factors or ALE. RESULTS The sample consisted of 867 women (395 heterosexual, 472 SMW). Sexual minority women were more likely to have experienced discrimination (P < .001) and lifetime sexual abuse (P < .001) than heterosexual women. Sexual minority women were also less likely to meet ideal CVH criteria for current tobacco use (adjusted odds ratio, 0.43; 95% confidence interval, 0.24-0.73) or intermediate CVH criteria for body mass index (adjusted odds ratio, 0.60; 95% confidence interval, 0.40-0.92). Sexual minority women had a lower cumulative CVH score (B [SE] = -0.35 [0.14], P < .01) than heterosexual women. This difference was not explained by traditional CVD risk factors or ALE. CONCLUSIONS Smoking, body mass index, and fasting glucose accounted for much of the CVH disparity due to sexual identity, but those differences were not explained by ALE. Health behavior interventions tailored to SMW should be considered.
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Affiliation(s)
- Billy A Caceres
- Billy A. Caceres, PhD, RN, AGPCNP-BC Postdoctoral Research Fellow, Columbia University School of Nursing, New York, New York. Nina Markovic, PhD Associate Professor, University of Pittsburgh School of Dental Medicine. Donald Edmondson, PhD Associate Professor of Behavioral Medicine (in Medicine and Psychiatry), Columbia University Irving Medical Center. Tonda L. Hughes, PhD, RN, FAAN Henrik H. Bendixen Professor of International Nursing (in Psychiatry), Columbia University School of Nursing, New York, New York
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Boehm JK, Chen Y, Qureshi F, Soo J, Umukoro P, Hernandez R, Lloyd-Jones D, Kubzansky LD. Positive emotions and favorable cardiovascular health: A 20-year longitudinal study. Prev Med 2020; 136:106103. [PMID: 32348855 PMCID: PMC7246158 DOI: 10.1016/j.ypmed.2020.106103] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/07/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period. Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated assessment through 2010. CVH was defined by blood pressure, lipids, body mass index, diabetes, and smoking status. Primary analyses used linear mixed effects models adjusting for potential confounders; secondary analyses stratified by race and sex. Controlling for sociodemographic factors, greater baseline positive emotions were associated with better CVH across time (β = 0.03, 95% confidence interval = 0.007-0.06). However, positive emotions were unrelated to rate of change in CVH across time. Baseline CVH was also associated with greater average positive emotions across time (β = 0.09, 95% confidence interval = 0.02-0.15), but not rate of change. Positive emotions' association with CVH was stronger for women than men, but race did not modify associations. Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.
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Affiliation(s)
- Julia K Boehm
- Department of Psychology, Chapman University, 1 University Drive, Orange, CA 92866, USA.
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Farah Qureshi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Jackie Soo
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Peter Umukoro
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada Street, Urbana, IL 61801, USA.
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, IL 60611, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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Komulainen K, Mittleman MA, Ruohonen S, Laitinen TT, Pahkala K, Elovainio M, Tammelin T, Kähönen M, Juonala M, Keltikangas-Järvinen L, Raitakari O, Pulkki-Råback L, Jokela M. Childhood Psychosocial Environment and Adult Cardiac Health: A Causal Mediation Approach. Am J Prev Med 2019; 57:e195-e202. [PMID: 31753272 DOI: 10.1016/j.amepre.2019.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study used causal mediation analysis to assess the life-course associations of a favorable childhood psychosocial environment with left ventricular mass and diastolic function in adulthood and the extent to which adult health behaviors mediate these associations. METHODS The sample included 880 participants (56% women) from the Young Finns Study with data on the childhood environment from 1980, adult health behaviors (smoking, physical activity, diet, and BMI) from 2001 and an echocardiographic assessment of the left ventricular mass (g/m2.7) and diastolic function (E/e' ratio; higher values indicating a lower diastolic function) from 2011. The associations of the childhood environment with the left ventricular mass and E/e' ratio and mediation pathways through health behaviors were assessed using marginal structural models that were controlled for age, sex, and time-dependent confounding by adult socioeconomic position (measured as educational attainment) via inverse probability weighting. The data were analyzed in 2018-2019. RESULTS The mean age in 2011 was 41 (range 34-49) years. Those above versus below the median childhood score had a 1.28 g/m2.7 lower left ventricular mass (95% CI= -2.63, 0.07) and a 0.18 lower E/e' ratio (95% CI= -0.39, 0.03). There was no evidence for indirect effects from childhood environments to left ventricular outcomes through adult health behaviors after controlling for time-dependent confounding by the adult socioeconomic position (indirect effect β= -0.30, 95% CI= -1.22, 0.63 for left ventricular mass; β= -0.04, 95% CI= -0.18, 0.11 for E/e' ratio). The results after multiple imputation were similar. CONCLUSIONS A favorable childhood environment is associated with more optimal cardiac structure and function in adulthood. After accounting for socioeconomic positions, adult health behaviors explain little of the associations.
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Affiliation(s)
- Kaisla Komulainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Saku Ruohonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Orion Pharma, the Orion Corporation, Espoo, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Crandall A, Miller JR, Cheung A, Novilla LK, Glade R, Novilla MLB, Magnusson BM, Leavitt BL, Barnes MD, Hanson CL. ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. CHILD ABUSE & NEGLECT 2019; 96:104089. [PMID: 31362100 DOI: 10.1016/j.chiabu.2019.104089] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Numerous studies over the past two decades have found a link between adverse childhood experiences (ACEs) and worse adult health outcomes. Less well understood is how advantageous childhood experiences (counter-ACEs) may lead to better adult health, especially in the presence of adversity. OBJECTIVE To examine how counter-ACEs and ACEs affect adult physical and mental health using Resiliency Theory as the theoretical framework. PARTICIPANTS AND SETTING Participants were Amazon mTurk users ages 19-57 years (N = 246; 42% female) who completed an online survey. METHODS We conducted a series of regression analyses to examine how counter-ACEs and ACEs predicted adult health. RESULTS Corresponding to the Compensatory Model of Resiliency Theory, higher counter-ACEs scores were associated with improved adult health and that counter-ACEs neutralized the negative impact of ACEs on adult health. Contrary to the Protective Factors Model, there was a stronger relationship between ACEs and worse adult health among those with above average counter-ACEs scores compared to those with below average counter-ACEs scores. Consistent with the Challenge Model, counter-ACEs had a reduced positive effect on adult health among those with four or more ACEs compared to those with fewer than four ACEs. CONCLUSIONS Overall, the findings suggest that counter-ACEs protect against poor adult health and lead to better adult wellness. When ACEs scores are moderate, counter-ACEs largely neutralize the negative effects of ACEs on adult health. Ultimately, the results demonstrate that a public health approach to promoting positive childhood experiences may promote better lifelong health.
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Affiliation(s)
| | - Jacob R Miller
- Brigham Young University, Department of Public Health, USA
| | - Aaron Cheung
- Brigham Young University, Department of Public Health, USA
| | | | - Rozalyn Glade
- Brigham Young University, Department of Public Health, USA
| | | | | | | | | | - Carl L Hanson
- Brigham Young University, Department of Public Health, USA
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Chen Y, Kubzansky LD, VanderWeele TJ. Parental warmth and flourishing in mid-life. Soc Sci Med 2019; 220:65-72. [PMID: 30396119 PMCID: PMC6309475 DOI: 10.1016/j.socscimed.2018.10.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/18/2018] [Accepted: 10/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study examined the longitudinal association between parental warmth and offspring flourishing in mid-life. We also considered associations between parental warmth and a number of mental health problems and adverse health behavioral outcomes. METHOD Longitudinal data from the Midlife in the United States Study (N = 3,929, mean baseline age = 47.4 years) were analyzed using generalized estimating equations. Parental warmth in childhood was recalled at phase I (1995-1996), while flourishing and other outcomes were self-reported at phase II (2004-2006). Following an approach developed by Keyes, flourishing was operationalized as a combined measure incorporating assessments of three aspects of well-being, including emotional, psychological, and social well-being. RESULTS The results suggest that parental warmth was positively associated with the continuous score of flourishing (B = 0.21, 95% CI = 0.18, 0.25). The association was not specific to any particular component (emotional, psychological, or social well-being) or subdomain of flourishing. Parental warmth was also inversely associated with several adverse health behavior outcomes such as drug use and smoking. CONCLUSIONS Parental warmth in childhood may help promote offspring functioning across multiple domains of well-being in mid-life. The findings help to strengthen the call for a public health focus on the importance of parenting for outcomes beyond childhood and well into adulthood, and suggest the value of targeting parenting practices for prevention and intervention strategies to improve population health and well-being.
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Affiliation(s)
- Ying Chen
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28:1197-1207. [PMID: 30360955 DOI: 10.1016/j.numecd.2018.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. METHODS AND RESULTS We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. CONCLUSION The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
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Affiliation(s)
- Y Peng
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia.
| | - S Cao
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Australia
| | - Z Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Z Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia
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