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Park J, Song M, Cho A, Yang H, Lee H. Adverse childhood experiences of Korean mothers with young children: a latent class analysis. Eur J Psychotraumatol 2024; 15:2372994. [PMID: 38984740 PMCID: PMC11238651 DOI: 10.1080/20008066.2024.2372994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/17/2024] [Indexed: 07/11/2024] Open
Abstract
Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs.Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified.Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups.Results: The participants were classified into two subgroups: the 'high-ACEs group' and the 'low-ACEs group'. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group.Conclusion: The findings highlight the significant role of ACEs on the formation of an individual's psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.
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Affiliation(s)
- Jeongok Park
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - MinKyoung Song
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Ahyoung Cho
- Education of Counseling, Konkuk University, Gwangjin-gu, Seoul, South Korea
| | - HaYeJin Yang
- Yonsei University College of Nursing, Seodaemun-gu, Seoul, South Korea
| | - Hyojin Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seodaemun-gu, Seoul, South Korea
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Moreland AD, Rancher C, Davies F, Bottomley J, Galea S, Abba-Aji M, Abdalla SM, Schmidt MG, Vena JE, Kilpatrick DG. Posttraumatic Stress Disorder Among Adults in Communities With Mass Violence Incidents. JAMA Netw Open 2024; 7:e2423539. [PMID: 39058488 PMCID: PMC11282439 DOI: 10.1001/jamanetworkopen.2024.23539] [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: 01/03/2024] [Accepted: 05/15/2024] [Indexed: 07/28/2024] Open
Abstract
Importance Mass violence incidents (MVIs) are prevalent in the US and can have profound and long-lasting psychological consequences on direct survivors, but their outcomes among the broader communities where the MVI occurred are unknown. Objective To investigate the prevalence of and factors associated with past-year and current posttraumatic stress disorder (PTSD) among adults in communities that experienced an MVI. Design, Setting, and Participants This cross-sectional survey was completed between February and September 2020 with a household probability sample of adults from 6 communities that had experienced an MVI between 2015 and 2019: Dayton, Ohio; El Paso, Texas; Parkland, Florida; Pittsburgh, Pennsylvania; San Bernadino, California; and Virginia Beach, Virginia. Address-based sampling was used to identify randomly selected households, mail invitations, and select 1 adult per household to complete a self-administered paper or online survey. Data analysis was performed from September to November 2023. Main Outcomes and Measures The primary outcome was presumptive diagnostic-level past-year PTSD and current (past month) PTSD determined using American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) PTSD criteria. Results A total of 6867 adults aged 18 years or older accessed the website with a description of the study and consent materials. Of these, 5991 (87.2%) agreed to participate and completed the survey, 343 (6.3%) partially completed the survey, and 443 (6.5%) did not meet eligibility criteria or refused to participate. Most of the 5991 respondents were female (3825 individuals [53.5%]) and had a mean (SD) age of 45.56 (17.58) years. A total of 1261 of 5931 individuals (21.0%) reported high exposure to the MVI (either they or a close friend and/or family member was on site during the shooting). Nearly one-quarter (23.7%; 1417 of 5977 participants reporting PTSD) met presumptive DSM-5 diagnostic criteria for past-year PTSD, with 8.9% (530 participants) meeting the criteria for current PTSD. Regression analyses found that being female (odds ratio, 2.32; 95% CI, 2.01-2.68) and having a history of both physical or sexual assault and other potentially traumatic events (odds ratio, 9.68; 95% CI, 7.48-12.52) were associated with the greatest risk of past-year PTSD. Conclusions and Relevance In this survey study of 5991 participants, presumptive PTSD was quite prevalent long after the MVI among adults in communities that have experienced an MVI, suggesting that MVIs have persistent and pervasive public health impacts on communities, particularly among those with prior exposure to physical or sexual assault and other potentially traumatic events. Focusing exclusively on direct exposure to MVIs is not sufficient. Incorporating these findings into screening should improve efforts to identify the individuals most in need of prevention or mental health service after MVIs.
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Affiliation(s)
- Angela D. Moreland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Caitlin Rancher
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Faraday Davies
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Jamison Bottomley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Sandro Galea
- School of Public Health, Boston University, Boston, Massachusetts
| | | | - Salma M. Abdalla
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Michael G. Schmidt
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Dean G. Kilpatrick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
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Yu J, Haynie DL, Gilman SE. Patterns of Adverse Childhood Experiences and Neurocognitive Development. JAMA Pediatr 2024; 178:678-687. [PMID: 38805237 PMCID: PMC11134279 DOI: 10.1001/jamapediatrics.2024.1318] [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: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 05/29/2024]
Abstract
Importance Early life adversity is associated with higher risk of many adult health problems, including mental illness, substance abuse, suicide attempt, and chronic diseases. Many previous studies investigated adversities one at a time or investigated the health toll associated with the cumulative number of adversities. Objective To examine the co-occurrence of adversities among children and how specific patterns of adversities are associated with neurocognitive development. Design, Setting, and Participants This cohort study used data from the Collaborative Perinatal Project (CPP), which enrolled a national sample of women during pregnancy and followed their offspring to ages 7 to 8 years, between 1959 and 1974. The CPP was a community-based study conducted in 12 US medical centers. The CPP sample was ascertained through prenatal clinics and is diverse with respect to race and socioeconomic status. Data analysis was performed from August 2023 to March 2024. Exposures A latent class analysis was conducted of 12 adverse childhood experiences that occurred between birth and 7 years to identify common patterns of childhood adversities. Main Outcomes and Measures Five neurocognitive tests were used to measure children's visual-motor, sensory-motor, auditory-vocal, intelligence quotient, and academic skills. Results The analysis sample included 49 853 offspring (25 226 boys [50.6%]); 24 436 children (49.0%) had low probability of experiencing any adversity, whereas the remaining half were classified into 5 groups reflecting distinct patterns of childhood adversities: parental harshness and neglect, 1625 children (3.3%); parental separation and poverty, 8731 children (17.5%); family instability, 3655 children (7.3%); family loss, instability, and poverty, 1505 children (3.0%); and crowded housing and poverty, 9901 children (19.9%). Children in 4 of these groups had lower neurocognitive scores than children with a low probability of experiencing adversity, with standardized mean differences ranging from -0.07 (95% CI, -0.11 to -0.03) to -0.86 (95% CI, -1.06 to -0.65). Conclusions and Relevance These findings suggest that adverse childhood experiences are associated with deficits in children's neurocognitive functions. It is important to understand the complexity in children's exposure to adversity and the resulting developmental consequences, as well as the underlying mechanisms, to help support children exposed to adversity and foster healthier and resilient trajectories of development.
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Affiliation(s)
- Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L. Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Haczkewicz KM, Shahid S, Finnegan HA, Moninn C, Cameron CD, Gallant NL. Adverse childhood experiences (ACEs), resilience, and outcomes in older adulthood: A scoping review. CHILD ABUSE & NEGLECT 2024:106864. [PMID: 38926006 DOI: 10.1016/j.chiabu.2024.106864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 05/05/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Previous research has demonstrated a dose-response relationship between exposure to adverse childhood experiences (ACEs) and adverse outcomes in adulthood. Despite widely known associations, previous reviews have primarily focused on outcomes in younger and middle-aged adults exposed to ACEs to the exclusion of older adults and do not consider the potential role of resilience for understanding outcomes in older adulthood. OBJECTIVE The present scoping review aimed to examine the extent and nature of existing literature on the influence of ACEs and resilience on the cognitive, physical, mental, and social health outcomes among older adults. METHODS We conducted a search of five electronic databases (CINAHL, MEDLINE, PsycINFO, AgeLine, Scopus) using the following keywords: adversity, resilience, aging, and older adults. We limited our inclusion criteria to works published in English or French after 1998 as Felitti et al. published the first study describing ACEs in this year. RESULTS Of the 4926 studies screened, 27 studies met the inclusion criteria. Overall, results from the included studies indicated that exposure to adversity during childhood was associated with worse outcomes in older adulthood. Additionally, we found that resilience and resiliency-related factors (e.g., problem-focused coping strategies) mitigated or reduced harms associated with ACEs to improve outcomes in older adulthood. CONCLUSIONS Exposure to ACEs is associated with reduced functioning in later adulthood. Findings from this review indicate a need for further exploration into the role of ACEs, and the potential effects of resilience, on health outcomes in older adults to develop better individual- and population-level interventions for this group.
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Affiliation(s)
- Kelsey M Haczkewicz
- Department of Psychology and Centre on Aging and Health, University of Regina, 3737 Wascana Parkway, S4S 0A2, Canada
| | - Sheza Shahid
- Department of Psychology, University of Regina, 3737 Wascana Parkway, S4S 0A2, Canada
| | - Heather A Finnegan
- Department of Clinical Health Psychology, University of Manitoba (Bannatyne Campus), 771 Bannatyne Avenue, Canada
| | - Caroline Moninn
- Neil John Maclean Health Sciences Library, University of Manitoba, 727 McDermot Ave, R3E 3P5, Canada
| | - Courtney D Cameron
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Natasha L Gallant
- Department of Psychology and Centre on Aging and Health, University of Regina, 3737 Wascana Parkway, S4S 0A2, Canada.
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Pan EJ, Liu JC, Zha AC, Seballos SS, Falcone T, Phelan M, Weleff J. Adverse Childhood Experiences (ACEs) in Unhoused Children Increase Odds of Psychiatric Illness, Physical Illness, and Psychiatric Admission. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:363-372. [PMID: 38938936 PMCID: PMC11199423 DOI: 10.1007/s40653-023-00608-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 06/29/2024]
Abstract
Unhoused children and adolescents have high rates of adverse childhood experiences (ACEs). The objective of this study was to characterize a large cohort of unhoused children and investigate rates of psychiatric diagnoses, medical diagnoses, and utilization of emergency department (ED) resources depending on the presence of additional documented ACEs. A retrospective cohort of all unhoused children who presented to the ED of a large Midwestern health system from January 2014 to July 2019 were included. Unhoused status was determined by address field or ICD-10 code for homelessness (Z59.0). Demographics and ED visits were extracted from the electronic health record. Past medical history, ACEs, chief complaint (CC), length of stay (LOS), imaging, and labs were extracted by chart review. T-tests, chi square tests, and Fisher's exact tests were completed for each sub-analysis. Unhoused children with at least one additional ACE had higher odds of the following psychiatric disorders: depression (OR = 5.2, 95% CI = 3.4- 7.9), anxiety (OR = 3.4, 95% CI = 32.1-5.5), behavioral disorder (OR = 7.2, 95% CI = 35.1- 10.4), psychoses (OR = 6.0, 1.9-18.4), bipolar disorder (OR = 19.8, 95% CI = 34.6-84.9), suicidal ideation (OR = 8.0, 95% CI = 34.8-13.4), post-traumatic stress disorder (OR = 10.1, 95% CI = 35.4-18.6), and attention deficit hyperactive disorder (OR = 4.1, 3.0-5.7). Patients with additional documented ACEs were also more likely to have a prior psychiatric admission (p < 0.001). Unhoused children and adolescents with exposure to additional documented ACEs are more likely to have some serious psychiatric and medical diagnoses compared to other unhoused children.
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Affiliation(s)
- Eric J. Pan
- Department of Psychiatry & Behavioral Neurosciences, Northwestern University, Chicago, IL USA
| | - Jessica C. Liu
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Alexander C. Zha
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH USA
| | - Spencer S. Seballos
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic, Cleveland, OH USA
| | - Tatiana Falcone
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH USA
| | - Michael Phelan
- Emergency Services Institute, Cleveland Clinic, Cleveland, OH USA
| | - Jeremy Weleff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
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Miedema SS, Stamatakis C, Tracy A, Hegle J, Kamagate MF, McOwen J, Augusto A, Manuel P, Coomer R, Kambona C, Ramphalla P, Niolon P, Patel P, Annor FB. Patterns of adverse childhood experiences and their associations with mental distress, substance use and sexual risk behaviors in Sub-Saharan Africa. CHILD ABUSE & NEGLECT 2024; 150:106494. [PMID: 37806930 PMCID: PMC11264303 DOI: 10.1016/j.chiabu.2023.106494] [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: 03/10/2023] [Revised: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Multiple adverse childhood experiences (ACEs) are associated with poor sexual and mental health outcomes in low- and middle-income countries (LMICs). Less well understood is how discrete and gendered clustering of ACEs may influence health. OBJECTIVE To assess how multiple ACEs co-occur and how dominant patterns of co-occurrence are associated with mental distress, substance use, and sexual risk behaviors among young women and men in Sub-Saharan Africa. PARTICIPANTS AND SETTING We used pooled data of young men and women aged 19-24 from comparable, nationally representative Violence Against Children and Youth Surveys (VACS) conducted in Cote d'Ivoire, Kenya, Lesotho, Mozambique, and Namibia (nf = 7183; nm = 2207). METHODS We estimated sex-disaggregated latent classes of six ACEs among young women and men. We ran Bolck-Croon-Hagenaars (BCH) distal outcome analysis to test the sex-stratified relationships between ACEs latent classes and health outcomes. RESULTS A six class solution best fit the female data. Classes included witnessing violence and experiencing physical violence (PV); experiencing PV; high ACEs; witnessing community violence; orphanhood; and low ACEs exposure. Among males, the best-fitting three-class solution included experiencing PV and witnessing community violence; high ACEs; and low ACEs exposure. Membership in the high ACEs class was associated with mental distress among females and males, and substance use among males. No differences in sexual risk behavior were identified by class membership among either females or males. CONCLUSIONS Discrete clusters of co-occurring ACEs are associated with elevated odds of mental distress among females, and mental distress and substance use among males. Preventing ACEs may improve mental health among young women and men in LMICs in Sub-Saharan Africa.
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Affiliation(s)
- Stephanie Spaid Miedema
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Caroline Stamatakis
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Rwanda
| | | | - Jennifer Hegle
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jordan McOwen
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | | | - Pedro Manuel
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | | | | | - Phyllis Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pragna Patel
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Romm KF, Berg CJ. Patterns of Adverse Childhood Experiences and Problematic Health Outcomes Among US Young Adults: A Latent Class Analysis. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:191-200. [PMID: 38258814 DOI: 10.1177/29767342231218081] [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] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) predict problematic health outcomes (eg, substance use, mental health) among young adults; whether specific ACEs are differentially associated with specific substance use and mental health symptoms is understudied. METHODS Latent class analysis (LCA) identified classes of ACEs among 2209 US young adults (Mage = 24.69, range: 18-34; 57.4% female; 30.9% sexual minority; 35.8% racial/ethnic minority) in a 2-year study (2018-2020). Multivariable logistic regressions examined ACEs (reported in 2019) in relation to 2020 reports of current (past 30-day) substance use (ie, tobacco use; cannabis use and hazardous use; alcohol use and binge drinking) and mental health (ie, ≥moderate depression and anxiety symptoms), controlling for sociodemographics (ie, age, gender, race, ethnicity, sexual orientation, education). RESULTS Overall, 65.4% reported ≥1 ACE (M = 2.09, SD = 2.30); 34.8%, 39.1%, and 71.1% current tobacco, cannabis, and alcohol use; 39.1% and 15.3% hazardous cannabis use and binge drinking; and 24.2% and 34.5% ≥moderate depression and anxiety symptoms, respectively. LCA yielded 4 classes: Low ACEs (referent; 55.6%), Poor family health and divorce (16.3%), Parental abuse (16.0%), and High ACEs (12.1%). High ACEs (vs Low ACEs) was associated with each adverse substance use and mental health outcome except alcohol use. Poor family health and divorce was associated with tobacco use, cannabis use, and both mental health outcomes. Parental abuse was associated with tobacco use, cannabis use, hazardous cannabis use, and both mental health outcomes. CONCLUSIONS Health promotion interventions for young adults must assess ACEs, given that certain types of ACEs may be associated with distinct substance use and mental health outcomes.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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Wang X, Jiang L, Barry L, Zhang X, Vasilenko SA, Heath RD. A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges. TRAUMA, VIOLENCE & ABUSE 2024; 25:1695-1708. [PMID: 37594222 DOI: 10.1177/15248380231192922] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.
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Silke C, Heary C, Bunting B, Devaney C, Groarke A, Major E, Durcan M, O'Brien C, Brady B. Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022. J Affect Disord 2024; 349:234-243. [PMID: 38163570 DOI: 10.1016/j.jad.2023.12.065] [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: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022). METHODS Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277). RESULTS Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide. LIMITATIONS These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings. DISCUSSION Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Ireland.
| | | | | | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Ireland
| | | | - Emmet Major
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Ireland
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Beeler S, Gerrish O, Aldred BG, Asher BlackDeer A. Histories of violence among clients seeking substance use disorder treatment: a systematic mapping review. Front Psychiatry 2024; 15:1307641. [PMID: 38505794 PMCID: PMC10948608 DOI: 10.3389/fpsyt.2024.1307641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction There is a limited literature base regarding the intersection of drug and alcohol treatment, violence, and trauma. While research substantiates that exposure to violence and trauma impacts the propensity to misuse substances, the conceptualization in clinical trials and practice has largely been narrow and gendered, referring only to intimate partner or domestic violence. Our systematic mapping review explored a more inclusive and expansive review of survivors of and perpetrators of violence and trauma (e.g., intimate partner violence, sexual assault, stalking, child abuse, political and community violence, criminal violence, micro violence, structural violence, and oppression) to establish: 1) the types of treatment settings included in intervention studies, 2) the common indicators of success or common outcomes recorded, and 3) understanding who is seeking treatment for drug and alcohol use with histories of violence. Methods A systematic mapping review was conducted to identify any peer-reviewed articles published from 2011 to 2022. The Web of Science database was searched using a broad set of Boolean search terms related to violence, substance use disorders, and treatment. Over 8,800 records were identified from the systematic review with a total of 48 articles meeting inclusion criteria. Results Most studies in this review included populations reporting perpetration of violence (n=23, 48%) versus participants reporting survival of trauma/violence (n=17, 35%). Results also indicated female identifying populations (n=19; 40%) were predominantly served, were treated in the US (n=33; 69%) and seen in an outpatient setting (n=24; 50%). Authors also were attentive to studies that included sexual and gender minorities and discovered only three studies (6%) explicitly acknowledging inclusion of transgender participants or participants in relationship with partners of the same sex; three more studies (6%) were focused on participants with histories of or engaging in sex work. Discussion This review outlines treatment and research implications directly situated in the gap of service delivery found in this review. Specifically, the results elucidate the impact on minoritized and excluded identities based on gender, sexual preference, criminal legal status and directions for research and treatment to increase inclusion, representation, and equity across research and treatment settings.
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Affiliation(s)
- Sara Beeler
- Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, United States
| | - Olivia Gerrish
- Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, United States
| | - B. Grantham Aldred
- University Library, University of Illinois Chicago, Chicago, IL, United States
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Decrop R, Nowalis S, Yannon M, McGraw J, Docherty M. Unveiling hidden dimensions: A novel bifactor approach to unraveling adverse childhood experiences. CHILD ABUSE & NEGLECT 2024; 147:106599. [PMID: 38113570 DOI: 10.1016/j.chiabu.2023.106599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/25/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with diverse negative health outcomes and are commonly screened for in primary care, research, and clinical practice. However, more research is needed surrounding the conceptualization, measurement, and application of ACEs measures. OBJECTIVE This study examines the bifactor structure and internal reliability of a short, practical, and commonly used ACEs questionnaire and assesses how the factor structure is associated with correlates of ACEs. PARTICIPANTS AND SETTING Data from Utah's 2020 Behavioral Risk Factor Surveillance System, a telephone survey assessing the prevalence of health-related behaviors among a sample of adults in Utah (N = 8978, Mage = 51.5, SD = 19.4, Range = 18-99; 50 % female, 87.1 % White) was analyzed. METHODS Exploratory and confirmatory factor analyses were conducted to determine the best-fitting factor structure and examined correlations between the identified factors and poor health and substance use with structural equation modeling. RESULTS A three-factor bifactor model best fit the data and its components had associations of different direction and magnitude with outcomes (bifactor: health β = 0.83, p < .001, substance use β = 0.14, p = .025; household hardship: health ß = -0.49, p < .001, substance use ß = 0.23, p < .001; general abuse: health ß = -0.63, p < .001, substance use ß = 0.18, p = .036; sexual abuse: health ß = -0.25, p < .001). CONCLUSIONS Results highlight the importance of using a bifactor approach to examine and score ACEs measures rather than a traditional total sum score method.
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Affiliation(s)
- Romain Decrop
- Department of Psychology, Bowling Green State University, 822 E Merry Ave. 0000-0002-5128-1135, Bowling Green, OH 43403, USA.
| | - Sarah Nowalis
- Department of Psychology, Bowling Green State University, 822 E Merry Ave. 0000-0002-5128-1135, Bowling Green, OH 43403, USA.
| | - Miranda Yannon
- Department of Psychology, Bowling Green State University, 822 E Merry Ave. 0000-0002-5128-1135, Bowling Green, OH 43403, USA.
| | - James McGraw
- Department of Psychology, Bowling Green State University, 822 E Merry Ave. 0000-0002-5128-1135, Bowling Green, OH 43403, USA.
| | - Meagan Docherty
- Department of Psychology, Bowling Green State University, 822 E Merry Ave. 0000-0002-5128-1135, Bowling Green, OH 43403, USA.
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12
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Gissandaner TD, Littlefield AK, Schmidt AT, Victor SE, Kim S, Morrow AJ, Borrego J. Caregiver adverse childhood experiences and preschool externalizing problems: The role of factors that contribute to caregiver resilience. CHILD ABUSE & NEGLECT 2024; 147:106526. [PMID: 37952291 PMCID: PMC10841980 DOI: 10.1016/j.chiabu.2023.106526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Preschool children with externalizing problems are at risk for short- and long-term difficulties and preschool externalizing problems (PEP) are influenced by several caregiver factors. One such factor is caregiver adverse childhood experiences (ACEs). Researchers have investigated how caregiver ACEs are related to PEP by identifying risk factors to account for this association. However, research on caregiver factors associated with fewer PEP is limited. Particularly, factors that contribute to caregiver resilience may be adaptive caregiver characteristics that negatively relate to PEP, even when adjusting for caregiver ACEs. OBJECTIVE The present study sought to address a gap in the literature by examining the impact of different types of factors that contribute to caregiver resilience (e.g., caregiver social-ecological factors or caregiver positive childhood experiences) as promotive factors of lower PEP. PARTICIPANTS AND SETTING Participants included 125 caregiver-child dyads recruited from the community. METHOD Participating caregivers completed measures of their own and their child's demographic information, caregiver ACEs, caregiver social-ecological factors, caregiver positive childhood experiences, and PEP. RESULTS Overall, positive caregiver childhood experiences (r = -0.25, p < .01), and not caregiver social-ecological factors (r = -0.13, p = .15), demonstrated a significant negative association with PEP. However, this relation became statistically non-significant when adjusting for caregiver ACEs (β = -0.12, p = .20). CONCLUSIONS Given the association between caregiver ACEs and PEP, this study highlights the importance of assessing a caregiver's ACEs, specifically when working with caregivers seeking parent training for disruptive child behaviors. There should be a continued focus on ecological and family strengths and differential impacts as they relate to PEP.
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Affiliation(s)
- Tre D Gissandaner
- Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, United States of America.
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX 79409, United States of America
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX 79409, United States of America
| | - Sarah E Victor
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX 79409, United States of America
| | - Shinye Kim
- Department of Counseling Psychology, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, WI 53706, United States of America
| | - Amber J Morrow
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX 79409, United States of America
| | - Joaquín Borrego
- School of Graduate Psychology, Pacific University, Oregon, 190 SE 8th Ave, Hillsboro, OR 97123, United States of America
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13
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Gehris JS, Oyeyemi AL, Baishya ML, Roth SC, Stoutenberg M. The role of physical activity in the relationship between exposure to community violence and mental health: A systematic review. Prev Med Rep 2023; 36:102509. [PMID: 38116284 PMCID: PMC10728451 DOI: 10.1016/j.pmedr.2023.102509] [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: 08/08/2023] [Revised: 10/28/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Community violence is a global public health problem that is associated with mental health disorders. Physical activity can enhance mental health and may play an important role in the relationship between exposure to community violence and mental health. We systematically reviewed the literature to better understand the potential role of physical activity in this relationship. In this review, we searched the databases PubMed, Embase, Web of Science, Cochrane Central, PsycInfo, and SPORTdiscus, and conducted a grey literature search of one clinical trials registry and four organizations' websites. The review included quantitative observational studies, intervention studies, and qualitative studies published by November 30, 2022 and that involved generally healthy individuals across the lifespan. Eligible studies included measures of community violence, mental health, and physical activity. Five studies met the inclusion criteria for the review. Four studies were conducted in high-income countries, only two minority populations were represented in the studies, and none of the studies included older adults or children. Studies defined and measured community violence, mental health, and physical activity in different ways. In most studies, physical activity was not a primary focus but assessed as one item within a larger construct. The role of physical activity was examined differently across the studies and only one study found a significant role (mediator) of physical activity. This review revealed that few studies have specifically examined physical activity's role in the relationship between exposure to community violence and mental health. Further research is needed involving low-income countries, diverse minority populations, and children.
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Affiliation(s)
- Jeffrey S. Gehris
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, 1800 North Broad Street, 251 Pearson Hall, Philadelphia, PA 19122, USA
| | - Adewale L. Oyeyemi
- College of Health Solutions, Arizona State University, 425 North 5th Street, Arizona Biomedical Collaborative, Room 234, Phoenix, AZ 85004, USA
| | - Mona L. Baishya
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19130, USA
| | - Stephanie C. Roth
- Biomedical & Research Services Librarian, Temple University Health Sciences Library, 3500 N. Broad Street, Philadelphia, PA 19140, USA
| | - Mark Stoutenberg
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, 1800 North Broad Street, 237 Pearson Hall, Philadelphia, PA 19122, USA
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Lam-Hine T, Riddell CA, Bradshaw PT, Omi M, Allen AM. Racial differences in associations between adverse childhood experiences and physical, mental, and behavioral health. SSM Popul Health 2023; 24:101524. [PMID: 37860706 PMCID: PMC10583167 DOI: 10.1016/j.ssmph.2023.101524] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/30/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose Adverse childhood experiences (ACEs) are associated with poor adulthood health. Multiracial people have elevated mean ACEs scores and risk of several outcomes. We aimed to determine whether this group should be targeted for prevention efforts. Methods We analyzed three waves (1994-2009) of the National Longitudinal Study of Adolescent to Adult Health (n = 12,372) in 2023, estimating associations between four or more ACEs and physical (metabolic syndrome, hypertension, asthma), mental (anxiety, depression), and behavioral (suicidal ideation, drug use) outcomes. We estimated adjusted risk ratios for each outcome in modified Poisson models interacting race and ACEs. We used the interaction contrast to estimate race-specific excess cases per 1000 relative to Multiracial participants. Results Excess case estimates of asthma were smaller for White (-123 cases, 95% CI: -251, -4), Black (-141, 95% CI: -285, -6), and Asian (-169, 95% CI: -334, -7) participants compared to Multiracial participants. Black (-100, 95% CI: -189, -10), Asian (-163, 95% CI: -247, -79) and Indigenous (-144, 95% CI: -252, -42) participants had fewer excess cases of and weaker relative scale association with anxiety compared to Multiracial participants. Conclusions Adjusted associations with asthma and anxiety appear stronger for Multiracial people. Existing ACEs prevention strategies should be tailored to support Multiracial youth and families.
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Affiliation(s)
- Tracy Lam-Hine
- Stanford University School of Medicine, Division of Epidemiology & Population Health, 1701 Page Mill Road, Palo Alto, CA, USA
| | - Corinne A. Riddell
- University of California Berkeley School of Public Health, Division of Biostatistics, 2121 Berkeley Way West, Berkeley, CA, USA
- University of California Berkeley School of Public Health, Division of Epidemiology, 2121 Berkeley Way West, Berkeley, CA, USA
| | - Patrick T. Bradshaw
- University of California Berkeley School of Public Health, Division of Epidemiology, 2121 Berkeley Way West, Berkeley, CA, USA
| | - Michael Omi
- University of California Berkeley Department of Ethnic Studies, 506 Social Science Building, Berkeley, CA, USA
| | - Amani M. Allen
- University of California Berkeley School of Public Health, Division of Epidemiology, 2121 Berkeley Way West, Berkeley, CA, USA
- University of California Berkeley School of Public Health, Division of Community Health Sciences, 2121 Berkeley Way West, Berkeley, CA, USA
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15
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Li SM, Zhang C, Bi K, Chen MS. Longitudinal impacts of adverse childhood experiences on multidimensional health outcomes: Predicting trajectories in mental, physical, and behavioral health. CHILD ABUSE & NEGLECT 2023:106543. [PMID: 37980177 DOI: 10.1016/j.chiabu.2023.106543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/16/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) elevate the risk of poor health later in life. OBJECTIVE This study aims to provide a more comprehensive investigation of the multidimensional health risks associated with ACEs, to address a gap in the understanding of their longitudinal impact on mental, physical, and behavioral health domains. PARTICIPANTS AND SETTING This study included 6, 504 participants (51.61 % females) from the National Longitudinal Study of Adolescent to Adult Health (1994-2018). METHODS We utilized latent class growth analysis to identify trajectories from adolescence to adulthood in three health domains: depression (Mental Health, MH), self-report physical health (SRH), and binge drinking frequency (BDF). Binary logistic regression was then used to assess the unique contributions of different types of ACEs to these longitudinal health trajectories. RESULTS Three to four trajectories were identified for MH (consistently low, decreasing, increasing), SRH (consistently low, decreasing, increasing, consistently high), and BDF (consistently low, decreasing, moderate). Regression results showed that experience of emotional abuse and witnessed community violence elevated the risk associated with unfavorable trajectories in the mental health and behavioral health domains, respectively. CONCLUSIONS Individual ACEs differentially predicted mental, physical, and behavioral health trajectories, potentially through various pathways. Prevention of ACEs could mitigate health risks for adolescents and young adults across these domains.
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Affiliation(s)
- Simon M Li
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States.
| | - Chengmian Zhang
- Center of Student Mental Health, Wuhan, Institute of Design and Science, Wuhan, China
| | - Kaiwen Bi
- Department of Social Work and Social Administration, University of Hong Kong, Pok Fu Lam, Hong Kong, China.
| | - Mark Shuquan Chen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
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16
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Liu C, Zhang M, Ma C, Fu M, Guo J, Zhen C, Zhang B. Childhood abuse as a mediator of the relationship between early family socio-economic status and geriatric depression: A population-based study in China. Heliyon 2023; 9:e22021. [PMID: 38034775 PMCID: PMC10682629 DOI: 10.1016/j.heliyon.2023.e22021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Previous studies have suggested that childhood socioeconomic status (SES) is linked to geriatric depressive symptoms in many developed countries. However, the potential pathways of the relationship between childhood SES and geriatric depressive symptoms need to be further explored. This study aimed to assess the mediating effect of being abused during childhood on the association between childhood SES and geriatric depressive symptoms, using evidence from a longitudinal study in China. The study cohort included 8137 individuals. Childhood abuse was defined as experiences related to parental violence, sibling abuse, school violence, community violence, and parental quarrel. Results indicated poor childhood SES was associated significantly with geriatric depressive symptoms. The indirect effect of poor childhood SES to high geriatric depressive risk through community violence, sibling abuse, school violence, and parental quarrel were 0.02, 0.01, 0.02, and 0.01, respectively. Our findings shed new light on the literature regarding the impact of childhood SES on elderly depressive symptoms. Furthermore, childhood SES demonstrated a significant correlation with geriatric depressive symptoms through bullying behaviors. The findings highlight the need to promote both childhood social welfare and psychological well-being within the elderly population.
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Affiliation(s)
- Chengcheng Liu
- The School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, PR China
| | - Mingyu Zhang
- School of Public Health, Peking University, Beijing, 100191, PR China
| | - Chongyue Ma
- School of Accounting, Henan University of Economics and Law, PR China
| | - Mingqi Fu
- School of Public Management, Central South University, Wuhan, 430079, PR China
| | - Jing Guo
- School of Public Health, Peking University, Beijing, 100191, PR China
- Health Policy and Technology Assessment Center, Peking University Health Science Center, Beijing, PR China
| | - Cheng Zhen
- Center For the History of Medicine, School of Health Humanities, Peking University Health Science Center, Beijing, PR China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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17
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Tran NM, Mann S, Cortez MG, Harrell B, Nettuno L. Adverse childhood experiences (ACEs) and mental health by gender identity in the United States, 2019-2021. Prev Med 2023; 175:107705. [PMID: 37722459 DOI: 10.1016/j.ypmed.2023.107705] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To estimate the prevalence of adverse childhood experiences (ACEs) and their association with mental health outcomes in adulthood by gender identity. METHODS Data come from 2019 to 2021 US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, among 17 states collecting gender identity and ACEs. We estimated the prevalence of ACEs and used Poisson family regression to estimate the association between ACEs and mental health stratified by gender identity. Mental health was assessed as current frequent mental distress and lifetime depression diagnosis. RESULTS The sample included n = 141,615 adults, 556 of whom identified as gender minority (including transgender or gender non-binary). Gender minority respondents were 18% more likely [95% CI 8% to 29%, p < 0.01] to be exposed to 3 or more ACEs relative to cisgender respondents. Among respondents exposed to 3 or more ACEs, gender minority adults were 25% [95% CI 10% to 43%, p < 0.01] more likely to report current frequent mental distress and 26% [95% CI 14% to 40%, p < 0.01] more likely to report a lifetime depression diagnosis than their cisgender peers. CONCLUSION Using population-level data, we identified higher prevalence of ACEs among gender minority adults than cisgender adults, and greater associations of ACEs and adverse mental health in adulthood. The prevalence of current and lifetime adverse mental health outcomes increased with higher levels of ACE exposure among cisgender and gender minority respondents. Action by stakeholders at the community, health system, and legislative levels are needed to improve gender minority population health.
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Affiliation(s)
- Nathaniel M Tran
- Department of Health Policy, Vanderbilt University, 2525 West End Avenue, Suite 1250, Nashville, TN 37027, USA; Vanderbilt LGBTQ+ Policy Lab, Vanderbilt University, 2201 West End Avenue, 340 Buttrick Hall, Nashville, TN 37240, USA.
| | - Samuel Mann
- RAND Corporation, 1200 S Hayes St, Arlington, VA 22202, USA
| | - Manuel G Cortez
- Department of Pharmaceutical Services, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Benjamin Harrell
- Department of Economics, Trinity University, 1 Trinity Pl, San Antonio, TX 78212, USA
| | - Laura Nettuno
- Vanderbilt LGBTQ+ Policy Lab, Vanderbilt University, 2201 West End Avenue, 340 Buttrick Hall, Nashville, TN 37240, USA; Department of Economics, Vanderbilt University, 2201 West End Avenue, 415 Calhoun Hall, Nashville, TN 37240, USA
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18
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Orendain N, Anderson A, Galván A, Bookheimer S, Chung PJ. A data-driven approach to categorizing early life adversity exposure in the ABCD Study. BMC Med Res Methodol 2023; 23:164. [PMID: 37420169 PMCID: PMC10327383 DOI: 10.1186/s12874-023-01983-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Adversity occurring during development is associated with detrimental health and quality of life outcomes, not just following exposure but throughout the lifespan. Despite increased research, there exists both overlapping and distinct definitions of early life adversity exposure captured by over 30 different empirically validated tools. A data-driven approach to defining and cataloging exposure is needed to better understand associated outcomes and advance the field. METHODS We utilized baseline data on 11,566 youth enrolled in the ABCD Study to catalog youth and caregiver-reported early life adversity exposure captured across 14 different measures. We employed an exploratory factor analysis to identify the factor domains of early life adversity exposure and conducted a series of regression analyses to examine its association with problematic behavioral outcomes. RESULTS The exploratory factor analysis yielded a 6-factor solution corresponding to the following distinct domains: 1) physical and sexual violence; 2) parental psychopathology; 3) neighborhood threat; 4) prenatal substance exposure; 5) scarcity; and 6) household dysfunction. The prevalence of exposure among 9-and 10-year-old youth was largely driven by the incidence of parental psychopathology. Sociodemographic characteristics significantly differed between youth with adversity exposure and controls, depicting a higher incidence of exposure among racial and ethnic minoritized youth, and among those identifying with low socioeconomic status. Adversity exposure was significantly associated with greater problematic behaviors and largely driven by the incidence of parental psychopathology, household dysfunction and neighborhood threat. Certain types of early life adversity exposure were more significantly associated with internalizing as opposed to externalizing problematic behaviors. CONCLUSIONS We recommend a data-driven approach to define and catalog early life adversity exposure and suggest the incorporation of more versus less data to capture the nuances of exposure, e.g., type, age of onset, frequency, duration. The broad categorizations of early life adversity exposure into two domains, such as abuse and neglect, or threat and deprivation, fail to account for the routine co-occurrence of exposures and the duality of some forms of adversity. The development and use of a data-driven definition of early life adversity exposure is a crucial step to lessening barriers to evidence-based treatments and interventions for youth.
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Affiliation(s)
- Natalia Orendain
- Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | - Ariana Anderson
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Adriana Galván
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Susan Bookheimer
- Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Paul J Chung
- Departments of Pediatrics and Health Policy & Management, University of California, Los Angeles, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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19
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Lam-Hine T, Riddell CA, Bradshaw PT, Omi M, Allen AM. Racial Differences in Associations Between Adverse Childhood Experiences and Physical, Mental, and Behavioral Health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.02.23290905. [PMID: 37333236 PMCID: PMC10274984 DOI: 10.1101/2023.06.02.23290905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Introduction Adverse childhood experiences (ACEs) are associated with poor adulthood health, with individuals experiencing multiple ACEs at greatest risk. Multiracial people have high mean ACEs scores and elevated risk of several outcomes, but are infrequently the focus of health equity research. This study aimed to determine whether this group should be targeted for prevention efforts. Methods We analyzed Waves 1 (1994-95), 3 (2001-02), and 4 (2008-09) of the National Longitudinal Study of Adolescent to Adult Health (n = 12,372) in 2023, estimating associations between four or more ACEs and physical (metabolic syndrome, hypertension, asthma), mental (anxiety, depression), and behavioral (suicidal ideation, drug use) outcomes. We estimated risk ratios for each outcome in modified Poisson models with a race × ACEs interaction, adjusted for hypothesized confounders of the ACE-outcome relationships. We used the interaction contrast to estimate excess cases per 1,000 individuals for each group relative to Multiracial participants. Results Excess case estimates of asthma were significantly smaller for White (-123 cases, 95% CI: -251, -4), Black (-141, 95% CI: -285, -6), and Asian (-169, 95% CI: -334, -7) participants compared to Multiracial participants. Black (-100, 95% CI: -189, -10), Asian (-163, 95% CI: -247, -79) and Indigenous (-144, 95% CI: -252, -42) participants had significantly fewer excess cases of and weaker (p < 0.001) relative scale association with anxiety compared to Multiracial participants. Conclusions Adjusted associations between ACEs and asthma or anxiety appear stronger for Multiracial people than other groups. ACEs are universally harmful but may contribute disproportionately to morbidity in this population.
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Affiliation(s)
- Tracy Lam-Hine
- Stanford University School of Medicine, Division of Epidemiology & Population Health, Palo Alto, CA
| | - Corinne A Riddell
- University of California Berkeley School of Public Health, Division of Biostatistics and Division of Epidemiology, Berkeley, CA
| | - Patrick T Bradshaw
- University of California Berkeley School of Public Health, Division of Epidemiology, Berkeley, CA
| | - Michael Omi
- University of California Berkeley Department of Ethnic Studies, Berkeley, CA
| | - Amani M Allen
- University of California Berkeley School of Public Health, Division of Community Health Sciences and Division of Epidemiology, Berkeley, CA
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20
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Tan M, Mao P. Type and dose-response effect of adverse childhood experiences in predicting depression: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023; 139:106091. [PMID: 36787671 DOI: 10.1016/j.chiabu.2023.106091] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Researchers have documented that adverse childhood experiences (ACEs) are associated with adverse long-term consequences for mental health, including increased risk for depression. However, the type and dose-response effects of ACE on depression risk need further exploration. OBJECTIVE We aimed to synthesize the evidence on the relationship between ACEs measured by ACE International Questionnaire (ACE-IQ) and depression in type and quantity. PARTICIPANTS AND SETTING Individuals with ACEs. METHODS A systematic search was carried out of all published articles, up to November 2022, in eight electronic databases. Fixed- and random-effect models and dose-response were used. RESULTS Exposure to ACEs, including household dysfunction, was associated with a higher risk of depression (ORs ranged from 1.34 to 3.17). The numbers of ACE acted as a nonlinear predictor of depression. CONCLUSIONS These analyses provided important evidence that ACEs, regardless of type or quantity, may be a risk factor for depression development. Prevention of ACEs and interventions for supporting those affected by ACEs are necessary.
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Affiliation(s)
- Minghui Tan
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Ping Mao
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha 410013, China; Key Laboratory of Nursing of Hunan Province, Changsha 410013, China.
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21
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Aksoy D, Simões C, Favre CA. Exposure to Intimate-Partner Violence and Resilience Trajectories of Adolescents: A Two-Wave Longitudinal Latent Transition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095676. [PMID: 37174193 PMCID: PMC10177968 DOI: 10.3390/ijerph20095676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
Despite the serious emotional and social consequences of adolescents' exposure to intimate-partner violence (IPV) and the high prevalence of this exposure, few analyses have focused on person-centered models or considered psychological IPV. Studies that address exposure to violence tend to focus on physical IPV. Therefore, in this study, we examine (across two waves) the trajectories of resilience among adolescents who have witnessed psychological IPV by conducting a latent transition analysis and predicting class membership through socio-demographic and individual-level protective factors. Using a sample of 879 (T1, fall 2020) and 770 (T2, spring 2022) adolescent Swiss students with mean ages of 11.74 (SD = 0.64) and 13.77 (SD = 0.53), we identified four distinct time-invariant resilience classes: comorbid-frustrated, internalizing-frustrated, comorbid-satisfied, and resilient. The classes characterized by some level of psychopathological symptoms and basic psychological-needs frustration were the most stable over time. Furthermore, we found the four typical resilience trajectories: recovery, chronic, delayed, and improving. Gender, socioeconomic background, and protective factors showed a significant prediction of class membership in wave 1, highlighting the importance of increasing sensitivity to psychological-IPV exposure on the one hand, and reinforcing the relevance of prevention in schools regarding the promotion of protective factors on the other.
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Affiliation(s)
- Dilan Aksoy
- Department of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, 5210 Windisch, Switzerland
| | - Celeste Simões
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Lisbon, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Céline Anne Favre
- Department of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, 5210 Windisch, Switzerland
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22
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Lee H, Park A. The Influence of Adverse Childhood Experiences on Suicidal Behaviors in South Korea: The Mediating Effects of Depressive Symptoms and Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231162658. [PMID: 37057336 DOI: 10.1177/08862605231162658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study examines the relationship between patterns of adverse childhood experiences (ACEs) and suicidal behaviors. It investigates the role of depressive symptoms as an underlying mechanism between patterns of ACEs and suicidal behaviors in South Korea. Data came from the 2012 Korean General Social Survey (KGSS), a nationally representative sample in South Korea (N = 1,048). The dependent variables included two suicidal behaviors: suicidal thoughts and a suicide plan or attempt. The independent variable was the patterns of ACEs identified using ten binary indicators of childhood adversity. The mediating variable of depressive symptoms was measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Covariates were also included to control for socio-demographic characteristics: age, gender, education, and household income. This study conducted a latent class analysis (LCA) to classify different patterns of ACEs and then employed path analysis to examine mediating effects of depressive symptoms in the relationship between ACEs and suicidal behavior. Among the results, three latent classes of ACEs were identified-child maltreatment, child maltreatment and family dysfunction, and low ACEs. The child maltreatment and child maltreatment and family dysfunction classes were more likely to have suicidal thoughts and to plan or attempt suicide compared to the low ACEs class. Path analysis also showed significant indirect pathways from ACEs exposure to suicidal behaviors through depressive symptoms. This evidence corroborates previous research that shows family dysfunction and child maltreatment as detrimental factors leading to depressive symptoms and suicidal behaviors. Practitioners and policy-makers should therefore consider childhood life experiences when assessing suicidal behaviors in health prevention and intervention strategies.
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Affiliation(s)
- Haenim Lee
- Dongguk University, Jung-gu, Seoul, Republic of Korea
| | - Aely Park
- Sunchon National University, Suncheon, Republic of Korea
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23
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Borg BA, Rabinak CA, Marusak HA. Violence Exposure and Mental Health Consequences Among Urban Youth. CURRENT PSYCHOLOGY 2023; 42:8176-8185. [PMID: 38107483 PMCID: PMC10722903 DOI: 10.1007/s12144-021-02141-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/27/2022]
Abstract
Urban residents are disproportionately affected by violence exposure and mental health consequences as compared to non-urban residents. The present study examined the prevalence of violence exposure and associated mental health consequences among urban and non-urban youth. Urban participants were drawn from Detroit, Michigan, a city that has led the nation for most of the last decade as one of the most violent big cities in the U.S. Participants included 32 Detroit youth and 32 youth recruited from the surrounding non-urban areas, matched on age (M=10.4±2.8 years) and sex (49% male). Youth completed validated measures of violence exposure, anxiety, and depression symptoms. Urban youth reported more violence exposures than their non-urban counterparts, including hearing gunshots (69% vs. 19%, respectively), witnessing a shooting (24% vs. 6%), and witnessing an arrest (58% vs. 27%). Overall, greater violence exposure was associated with more anxiety symptoms, particularly among urban youth. Although violence exposure was not associated with depressive symptoms overall, urban youth reported significantly higher depressive symptoms than non-urban youth. Exposure to specific violence types, particularly hearing gunshots, was associated with higher anxiety and depressive symptoms among urban but not non-urban youth. Being beat up predicted depressive symptoms among non-urban but not urban youth. Household income and community distress did not predict mental health outcomes. Taken together, urban youth have more exposure to violence, particularly firearm violence, and associated mental health problems than their non-urban counterparts. Targeted community-wide initiatives to prevent violence and identify exposed youth are needed to improve mental health in at-risk communities.
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Affiliation(s)
- Breanna A. Borg
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University
| | - Christine A. Rabinak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University
- Translational Neuroscience Program, School of Medicine, Wayne State University
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University
| | - Hilary A. Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University
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24
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Wiss DA, Prelip ML, Upchurch DM, von Ehrenstein OS, Tomiyama AJ, Gorbach PM, Shoptaw SJ. Association between Childhood Maltreatment and Depressive and Anxiety Symptoms among Men Who Have Sex with Men in Los Angeles. J Urban Health 2023; 100:327-340. [PMID: 36826734 PMCID: PMC9951846 DOI: 10.1007/s11524-023-00719-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/25/2023]
Abstract
Adverse childhood experiences (ACEs) have been associated with poor mental health outcomes in adulthood. Childhood maltreatment is related to both depressive and anxiety symptoms. Our objective was to investigate these associations among low-income, mostly Black and Latino men who have sex with men (MSM), as these may be a particularly vulnerable population group. Data come from a longitudinal study of MSM with varied substance use behaviors (n = 321) collected between August 2014 and April 2022. Cumulative, childhood maltreatment ACEs, and the single ACE of childhood sexual abuse were investigated as potential predictors of self-reported depressive and anxiety symptoms in mixed-effects logistic and ordinal regression models. There was no evidence of a dose-response relationship between the number of ACEs and the predicted probability of depressive and anxiety symptoms. Compared to MSM reporting fewer than five ACEs, those with five or more ACEs had approximately double the odds ratio of reporting depressive (OR = 1.93; 95% CI: 1.04-3.60) and anxiety symptoms (OR = 2.21; 95% CI: 1.05-4.68). The dimension of childhood maltreatment had a more robust prediction of depressive symptoms than the dimension of household dysfunction across all models. The association between childhood sexual abuse history and depressive symptoms remained after adjustment for the other nine ACEs (OR = 2.27; 95% CI: 1.11-4.68). The ordinal logistic model suggested that cumulative ACEs more than triple the odds of being in a higher anxiety category (OR = 3.12; 95% CI: 1.58-6.14), with associations reported for childhood maltreatment ACEs (OR = 1.31; 95% CI: 1.06-1.66) and childhood sexual abuse (OR = 1.93; 95% CI: 0.89-4.21). Childhood maltreatment ACEs, particularly childhood sexual abuse, are salient predictors of depressive and anxiety symptoms among adult urban MSM. Mitigating the impact of childhood maltreatment requires understanding the additional burden of social distress often faced by MSM throughout the life course.
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Affiliation(s)
- David A Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA.
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Steven J Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, 10880 Wilshire Blvd, Los Angeles, CA, 90024, USA
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Silke C, Brady B, Devaney C, O'Brien C, Durcan M, Bunting B, Heary C. Youth Suicide and Self-Harm: Latent Class Profiles of Adversity and the Moderating Roles of Perceived Support and Sense of Safety. J Youth Adolesc 2023; 52:1255-1271. [PMID: 36964434 PMCID: PMC10121538 DOI: 10.1007/s10964-023-01762-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023]
Abstract
Research suggests that exposure to adversity can lead to an increased risk of experiencing suicidal and self-injurious thoughts or behaviours, but few studies have examined whether different patterns of adversity are differentially associated with youth suicide/self-harm. The current study aims to explore the relationship between exposure to adversity across various social domains and youth self-harm and suicidality, using a person centred approach, and examines whether access to social support and a sense of safety across home, peer or school settings buffer the relationship between adversity and self-harm/suicidality. Secondary data analyses were carried out on cross-sectional self-report data collected from 4848 (Mage=15.78, SD = 0.59; 50% female) adolescents who participated in the Irish Planet Youth survey. Latent Class Analyses identified four distinct profiles of adversity; low-adversity (n = 2043, 42%); peer-adversity (n = 972, 20%); parental-adversity (n = 1189, 25%); and multiple-adversity (n = 644, 13%). Findings from logistic moderated regressions indicated that there were significant differences in self-harm and suicidality across the adversity classes. Although parental support and perceived safety at school were negatively associated with suicidality and self-harm outcomes, no significant moderation effects were observed. These findings suggest that youth who experience adversity across multiple social domains are more likely to report suicidal and self-harm thoughts and behaviours, and should be key targets for intervention/prevention efforts. While parental support and school safety may act as significant compensatory factors, further work is needed to identify the social resources that can offset the risk imposed by youth's adverse experiences.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland.
| | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | | | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Caroline Heary
- School of Psychology, University of Galway, Galway, Ireland
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26
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Desch J, Mansuri F, Tran D, Schwartz SW, Bakour C. The association between adverse childhood experiences and depression trajectories in the Add Health study. CHILD ABUSE & NEGLECT 2023; 137:106034. [PMID: 36706612 DOI: 10.1016/j.chiabu.2023.106034] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are potentially traumatic experiences that occur before age 18. ACEs are linked to depression in adulthood, but little is known about the association between ACEs and depression trajectories across the lifespan. OBJECTIVE To examine the association between specific types of ACEs, cumulative ACE scores, and depression trajectories from adolescence to adulthood. PARTICIPANTS AND SETTING Waves 1-4 of the National Longitudinal Study of Adolescent to Adult Health (N = 12,888), spanning ages 12 years to 43 years. METHODS We constructed trajectories of depression scores using a modified 9-item Center for Epidemiologic Studies Depression Scale (CES-D-9). We used weighted logistic regression to calculate odds ratios and confidence intervals for each ACE and ACE score and depression trajectories after adjusting for confounders. RESULTS We found 75.3 % experienced at least one ACE and 14.7 % experienced 4+ ACEs. We identified three CES-D-9 trajectories: consistently low (Group 1), decreasing (Group 2), and increasing (Group 3) depression scores. All types of abuse, neglect, and community violence were significantly associated with trajectory Groups 2 and 3 vs 1 (p < .05). Foster home placement, poverty, and parental incarceration were associated with Group 2 vs 1. ACE scores showed a dose-response association with Group 3 vs 1 [aORs for 1ACE = 1.43 (0.93-2.20); 2-3ACEs = 1.97 (1.30-3.00); 4+ACEs = 3.08 (1.86-5.09)], and Group 2 vs 1 [aORs for 1ACE = 1.26 (0.87-1.83); 2-3ACEs = 1.93 (1.36-2.74); 4+ACES = 2.70 (1.90-3.84)]. CONCLUSIONS ACEs can have a lasting impact on depression through adulthood, highlighting the need to mitigate their impact to prevent depression-associated morbidity and mortality.
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Affiliation(s)
- Jill Desch
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Fahad Mansuri
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Dieu Tran
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Skai W Schwartz
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Chighaf Bakour
- College of Public Health, University of South Florida, Tampa, FL, USA.
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27
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Contextualizing Adverse Childhood Experiences: The Intersections of Individual and Community Adversity. J Youth Adolesc 2023; 52:570-584. [PMID: 36445650 DOI: 10.1007/s10964-022-01713-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022]
Abstract
Adverse Childhood Experiences (ACEs) are traumatic childhood events that can undermine youth development, and are linked to chronic health problems, mental illness, and risk-taking behaviors in adulthood. ACEs are preventable, yet effective response strategies require comprehensive conceptualization and measurement of adversity. Although typically measured as individual experiences in the family and home (e.g., abuse, neglect), adversity also exists outside the home, in the many contexts in which youth development unfolds (e.g., communities, neighborhoods). Yet, such contexts and experiences are often absent in ACEs research. Using data from a nationally representative youth sample, this study addresses that gap, advancing a measure that contextualizes individual-level ACEs within social and structural domains of community-level adversity. Among 13,267 youth (mean age = 15.25 [range 12-18]; 51% female; 71% White; 13% Black; 10% Hispanic; 3% Asian; 2% American Indian/Multiracial), 61% and 73% were exposed to at least one individual and community ACE, respectively, while 15% of youth reported severe individual ACE exposure (≥3 ACEs) and 20% were exposed to severe (≥3) community ACEs. All ACE exposures were associated with problem behaviors later in adolescence, but youth reporting both severe individual and community ACEs were especially at high risk for later violence, delinquency, and other health-risk behaviors. These findings highlight that community adversity exacerbates the damaging effects of individual/family adversity and thus should be addressed in efforts to prevent ACEs and reduce their long-term harm.
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28
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Kim Y, Park A, Murphy J. Patterns of Adverse Childhood Experiences and Mental Health: Evidence From College Students in Korea. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3011-3029. [PMID: 35584536 DOI: 10.1177/08862605221102487] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adverse childhood experiences (ACEs) are concerning exposures that may have detrimental effects on mental health. Much of the prior evidence on ACEs comes from the U.S and western developed countries. In light of the limited knowledge of ACEs in other social contexts and the interconnection among adversities, this study aims to identify distinct patterns of co-occurring ACEs and examines the associations between those adversities and mental health in South Korea. We used data from a national sample of Korean college students recruited via non-probability quota sampling in 2019 (N = 1037). The dependent variables included three measures of mental health assessed by the Brief Symptom Inventory depression symptoms, anxiety symptoms, and somatization symptoms. The independent variable was the patterns of ACEs identified using 14 indicators of childhood adversity. We conducted a Latent Class Analysis with a distal outcome, using the Bolck, Croons, and Hagenaars method. The analysis found four patterns of ACEs: extreme adversity (8%), family violence (20.3%), economic adversity (10.4%), and low adversity (61.3%). The extreme adversity group exhibited multiple exposures, including interpersonal violence in home environments, economic hardship, and bullying victimization by peers. The results suggest that the extreme adversity and family violence groups showed significantly worse mental health symptoms than the economic adversity and low adversity groups. Also, the extreme adversity group reported significantly higher levels of depression symptoms and somatization symptoms than the family violence group. This study expands the current understanding of ACEs and their harmful effects on mental health in young adulthood specific to Korea while comparing them with other social contexts. Researchers and practitioners should recognize the co-occurrence of child adversities, rather than overestimating sole adversity, to develop effective strategies for promoting mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Aely Park
- Department of Social Welfare, 65380Sunchon National University, Suncheon, South Korea
| | - Jennifer Murphy
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
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29
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Miedema SS, Le VD, Chiang L, Ngann T, Shortt JW. Adverse Childhood Experiences and Intimate Partner Violence Among Youth in Cambodia: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1446-NP1472. [PMID: 35471130 PMCID: PMC10263171 DOI: 10.1177/08862605221090573] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adverse childhood experiences (ACEs) are a global public health problem, including in low- and middle-income country settings, and are associated with increased risk of intimate partner violence (IPV) during young adulthood. However, current measurement of ACEs may underestimate sequelae of different combinations, or classes, of ACEs and mask class-specific associations with adult exposure to IPV. We used data among ever-partnered young women and men aged 18-24 years from the Cambodia Violence Against Children Survey (Nw = 369; Nm = 298). Participants retrospectively reported on seven ACEs and lifetime physical and/or sexual IPV victimization and perpetration. Latent classes comprised of ACEs were used as predictors of physical and/or sexual IPV perpetration and victimization, controlling for household wealth. Identified latent classes for women were "Low ACEs" (60%), "Community Violence and Physical Abuse" (23%), and "Physical, Sexual and Emotional Abuse" (17%). Latent classes for men were "Low ACEs" (48%) and "Household and Community Violence" (52%). Among women, those in the Physical, Sexual and Emotional Abuse class were more likely to experience and perpetrate physical and/or sexual IPV in their romantic relationships compared to the reference group (Low ACEs). Women in the Community Violence and Physical Abuse class were more likely to perpetrate physical and/or sexual IPV, but not experience IPV, compared to women in the Low ACEs class. Among men, those in the Household and Community Violence class were more likely to perpetrate physical and/or sexual IPV against a partner, compared to men in the Low ACEs class. Overall, patterns of ACEs were differently associated with IPV outcomes among young women and men in Cambodia. National violence prevention efforts might consider how different combinations of childhood experiences shape risk of young adulthood IPV and tailor interventions accordingly to work with youth disproportionately affected by varied combinations of ACEs.
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Affiliation(s)
- Stephanie S. Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi Donna Le
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chiang
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thanak Ngann
- Gender and Development for Cambodia (GAD/C), Phnom Penh, Cambodia
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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30
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Mumford EA, Copp J, MacLean K. Childhood Adversity, Emotional Well-Being, Loneliness, and Optimism: a National Study. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:137-149. [PMID: 36466586 PMCID: PMC9684794 DOI: 10.1007/s42844-022-00084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 05/05/2023]
Abstract
Optimism and loneliness, which reflect the expected inverse associations with excess morbidity and mortality, are theoretically and empirically associated with early adversities and offer potential avenues for clinical support. The current study first estimates latent classes of adverse childhood experiences and, second, assesses the role of these experiences on later reports of optimism and loneliness in late adolescence and emerging adulthood, and the role of emotional regulation and common mental disorders. Surveys were conducted in a longitudinal household sample of adolescents recruited in 2013 (average age of 20 at wave 6 follow-ups). The analytic sample included 1177 female and male respondents representative of their age group in the USA at baseline. Latent classes were estimated based on 10 indicators of childhood adversity. Respondents were assigned to classes using posterior probabilities of latent class membership, and class membership was used to predict psychological outcomes in multivariable models. Three latent classes of childhood adversity were identified in the current sample, representing low childhood adversity (81.5%), higher probability of family dysfunction with lower levels of interpersonal abuse (13.4%), and high adversity including higher probabilities of parental discord and violence as well as child abuse (5.1%). Both classes of respondents who faced greater childhood adversity were more likely to report greater loneliness and lower optimism in emerging adulthood. Results were attenuated by measures of emotional well-being. Addressing adolescent loneliness and supporting optimistic outlooks in emerging adulthood are two pathways with potential benefits to reduce mental and physical morbidities.
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Affiliation(s)
- Elizabeth A. Mumford
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814 USA
| | - Jennifer Copp
- Florida State University, 314B Criminology & Criminal Justice Building, 112 S. Copeland Street, Tallahassee, FL 32306-1273 USA
| | - Kai MacLean
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814 USA
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31
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Wang X, Heath RD, Majewski D, Blake C. Adverse childhood experiences and child behavioral health trajectory from early childhood to adolescence: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 134:105879. [PMID: 36115324 DOI: 10.1016/j.chiabu.2022.105879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly influence child development. Different patterns of ACEs among boys and girls may be associated with different developmental trajectories. OBJECTIVE This study aimed to identify patterns of ACEs at age three and tested the associations of these patterns with child behavioral health problems from age three to age fifteen. PARTICIPANTS AND SETTING This study used data (N = 4898) from the Fragile Families Child Wellbeing Study. METHODS First, this study conducted latent class analysis (LCA) across ten indicators of ACEs at age 3. LCA was conducted separately for boys and girls. Second, class membership was tested for associations with child internalizing symptoms and externalizing behaviors (ages three, five, nine, and fifteen years). RESULTS LCA identified five classes of ACEs for girls: low ACEs, parental separation, financial difficulty, chaotic home, and child maltreatment. LCA for boys, however, identified a six-class solution, in which there was a physical abuse-only class, while also a sixth high ACEs class that included both physical and emotional abuse. Classes with the most ACEs often had the highest symptomology (internalizing symptoms ranging from 0.24 to 0.56; externalizing ranging from 0.36 to 1.00; ps < .05). However, differences in behavioral health were detected depending on the patterns of ACES. At ages nine and fifteen, the financial difficulty group also had high symptomatology (internalizing symptoms ranging from 0.23 to 0.43; externalizing from 0.23 to 0.46; ps < .05). CONCLUSIONS Findings provide implications including the need to examine ACEs heterogeneity and address financial difficulty as a substantial ACE.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| | - Ryan D Heath
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Daniel Majewski
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Corinne Blake
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
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32
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Craig JM, Wolff KT, Baglivio MT. Clustering of adverse and positive childhood experiences: The nature and correlates of risk and protective factors. CHILD ABUSE & NEGLECT 2022; 134:105878. [PMID: 36115326 DOI: 10.1016/j.chiabu.2022.105878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the increased attention paid to the separate effects of cumulative stress and protection on offending, the extent to which distinct clusters of risk and protective factors exist and have unique effects on justice-related outcomes is under-studied. OBJECTIVE The current study examines for unique clustering of Adverse Childhood Experiences (ACE) and Positive Childhood Experiences (PCE) and the extent to which they predict juvenile recidivism. PARTICIPANTS AND SETTING The sample consists of a cohort of youth adjudicated delinquent in Florida who received a community-based sanction. METHODS The study first utilized latent-class analysis to identify distinct classes based upon the youths' ACE and PCE exposures. Next, two sets of regression models were estimated; the first investigated correlates of class membership and the second assessed whether class membership predicted recidivism. RESULTS Seven distinct classes of ACE/PCE clusters were found, composing 9.9 % to 20.5 % of the sample each. Relative to the class with low ACE and low PCE, those with low ACEs and high PCE evidenced 27.5 % lower rearrest rates, as did the Moderate Risk/Moderate Protection group. CONCLUSIONS Not only do distinct groupings of ACE and PCE exposures exist, but these groups have different likelihoods of future offending, where a youth's cumulative protection appears to be more important than their risk level. This has important policy implications as it offers further support for the use of strength-based treatment approaches.
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Affiliation(s)
- Jessica M Craig
- Criminal Justice, University of North Texas, United States of America.
| | - Kevin T Wolff
- Criminal Justice, John Jay College of Criminal Justice, United States of America.
| | - Michael T Baglivio
- Research & Development, Youth Opportunity Investments, United States of America.
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33
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Alvarez C, Sabina C, Brockie T, Perrin N, Sanchez-Roman MJ, Escobar-Acosta L, Vrany E, Cooper LA, Hill-Briggs F. Patterns of Adverse Childhood Experiences, Social Problem-Solving, and Mental Health Among Latina Immigrants. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22401-NP22427. [PMID: 35098761 DOI: 10.1177/08862605211072159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Researchers have established the long-term negative impact of adverse childhood experiences (ACEs) on mental health. Evidence also shows that different types of ACEs often co-occur and that ACEs profiles have differential impact on mental health. However, this prior research has often omitted first-generation Latino immigrants-a growing segment of the population, with potentially higher risk for ACEs, decreased access to mental health services, and increased risk for remaining in poor mental health. In this study, we conducted a cluster analysis using a sample of 336 Latina immigrant to examine: (1) patterns of ACEs, and (2) the mediating role of social problem-solving in the association between ACEs and mental health (depression, anxiety, and post-traumatic stress disorder symptoms [PTSD]) and life satisfaction. We identified 5 clusters: (a) Global ACEs (n = 52, 15.5%), (b) Community Violence and Physical Abuse (n = 80, 23.8%), (c) Physical and Emotional Abuse (n = 72, 21.4%), (d) Household Dysfunction with Physical and Emotional Abuse (n = 56, 16.7%), and (e) Low ACEs (n = 76, 22.6%). The clusters differed by social problem-solving, chronic life burden, mental health, and life satisfaction. Compared to the Low Abuse cluster, the Community Violence and Physical Abuse, and Global ACEs clusters were significantly more likely to have higher depression, anxiety, and PTSD symptoms. Social problem-solving was independently associated with all mental health variables and life satisfaction, and mediated the association between ACEs and depression and anxiety for those in the Community Violence and Physical Abuse cluster. Our study sheds light on how ACEs are experienced by Latina immigrants. Social problem-solving also emerged as a significant determinant of mental health and life satisfaction, and may be a point of intervention for improving mental health in this population.
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Affiliation(s)
- Carmen Alvarez
- 1466Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Chiara Sabina
- University of Delaware Women & Gender Studies, Newark, DE, USA
| | - Teresa Brockie
- 1466Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Nancy Perrin
- 1466Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | - Elizabeth Vrany
- Department of Medicine, Division of General Internal Medicine, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa A Cooper
- 1466Johns Hopkins University School of Nursing, Baltimore, MD, USA
- Department of Medicine, Division of General Internal Medicine, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Felicia Hill-Briggs
- Department of Medicine, Division of General Internal Medicine, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Lopez-Tamayo R, Suarez L, Simpson D, Volpe K. The Impact of Adverse Childhood Experiences and Community Violence Exposure on a Sample of Anxious, Treatment-Seeking Children. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1081-1093. [PMID: 36439664 PMCID: PMC9684382 DOI: 10.1007/s40653-022-00447-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 06/16/2023]
Abstract
Screening for adverse childhood experiences (ACEs) can help prevent and reduce adverse outcomes on child development, including increased risk for anxiety disorders. Emerging studies strongly support the inclusion of community-level adversities in ACE screeners to consider diverse contexts and populations. Recent studies suggest that community violence exposure (CVE) may have a distinct impact on youth mental health. Although recent studies have examined the association between ACEs, CVE, and mental health in primary care settings, this association has not been examined on treatment-seeking children in urban mental health settings. The present study employs a mediation model using the PROCESS macro to examine community violence exposure mediating the effect on the association between ACEs and somatic symptoms (SS) on a sample of anxious treatment-seeking children. A total of 98 participants (Mage = 11.7, SD = 3.79, 51.6% males, 54.1% ethnic minority children) who sought services at a specialized anxiety clinic completed self-report measures. Results indicated that exposure to ACEs is associated with endorsement of somatic symptoms as a result of reporting hearing, witnessing, or experiencing CVE. Evidence of mediation was found in a statistically significant indirect effect of ACEs on SS through CREV (Effect = .17, 95% CI = .069-.294). These findings support recent evidence that CVE is a distinct ACE as it contributes to toxic stress similar to individual-level ACEs. The use of a comprehensive ACE screening that includes CVE is warranted, particularly when working with culturally and socioeconomically diverse populations, as it would better capture a broader range of adversities across demographic groups.
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Affiliation(s)
- Roberto Lopez-Tamayo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois USA
| | - Liza Suarez
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois USA
| | | | - Kelley Volpe
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois USA
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Chen C, Sun Y, Liu B, Zhang X, Song Y. The Latent Class Analysis of Adverse Childhood Experiences among Chinese Children and Early Adolescents in Rural Areas and Their Association with Depression and Suicidal Ideation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16031. [PMID: 36498106 PMCID: PMC9738574 DOI: 10.3390/ijerph192316031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Exposure to adverse childhood experiences (ACEs) is a global public health concern that is detrimental to the psychological outcomes of Chinese children in rural areas due to the lack of public awareness of ACEs and mental health resources. The objective of this study was to identify the patterns of ACEs and the impact of ACE patterns on depression and suicidal ideation among 4683 students (mean age = 10.08 years, SD = 0.99; 48.17% female students) from 63 elementary schools in rural areas in Guizhou Province, China. Latent class analysis was conducted to identify the best class pattern. A three-step approach was undertaken to explore the association between the class patterns and demographic covariates and depression and suicidal thoughts. An overall three-class pattern of ACEs was identified, which was: (1) high ACEs, (2) high verbal abuse and emotional neglect and low household dysfunction, and (3) low ACEs. The results also showed that children in the high ACEs class tended to show higher depression rates and more frequent suicidal ideation across the three groups. Being female and younger and having a lower socioeconomic status were risk factors. Our study identified a class pattern that was not found in previous research, which is high verbal abuse and emotional neglect and low household dysfunction.
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Affiliation(s)
- Chun Chen
- School of Humanities and Social Sciences, Chinese University of Hong Kong-Shenzhen, Shenzhen 518172, China
| | - Yu Sun
- Department of Education Policy Studies, Pennsylvania State University, State College, PA 16801, USA
| | - Boyuan Liu
- Department of Sociology, Tsinghua University, Beijing 100184, China
- China Development Research Foundation, Beijing 100011, China
| | - Xiao Zhang
- China Institute for Educational Finance Research, Peking University, Beijing 100871, China
| | - Yingquan Song
- China Institute for Educational Finance Research, Peking University, Beijing 100871, China
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36
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Ekezie W, Maxwell A, Byron M, Czyznikowska B, Osman I, Moylan K, Gong S, Pareek M. Health Communication and Inequalities in Primary Care Access during the COVID-19 Pandemic among Ethnic Minorities in the United Kingdom: Lived Experiences and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15166. [PMID: 36429886 PMCID: PMC9690007 DOI: 10.3390/ijerph192215166] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 05/20/2023]
Abstract
Health Communication is critical in the context of public health and this was highlighted during the COVID-19 pandemic. Ethnic minority groups were significantly impacted during the pandemic; however, communication and information available to them were reported to be insufficient. This study explored the health information communication amongst ethnic communities in relation to their experiences with primary health care services during the COVID-19 pandemic. The research used qualitative methodology using focus groups and semi-structured interviews with community members and leaders from three ethnic minority communities (African-Caribbean, Somali and South Asian) in Leicester, United Kingdom. The interviews were audio recorded, transcribed, and open-coded. Rigour was determined through methodological coherence, appropriate and sufficient sampling, and iterative data collection and analysis. Six focus groups and interviews were conducted with 42 participants. Four overarching themes were identified related to health communication, experiences, services and community recommendations to improve primary care communication. To address primary care inequalities effectively and improve future health communication strategies, experiences from the pandemic should be reflected upon, and positive initiatives infused into the healthcare strategies, especially for ethnic minority communities.
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Affiliation(s)
- Winifred Ekezie
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester LE5 4PW, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
| | - Akilah Maxwell
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Margaret Byron
- School of Geography, Geology and the Environment, University of Leicester, Leicester LE1 7RH, UK
| | - Barbara Czyznikowska
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
| | - Idil Osman
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Katie Moylan
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Sarah Gong
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester LE3 9QP, UK
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Johnson D, Browne DT, Meade RD, Prime H, Wade M. Latent Classes of Adverse and Benevolent Childhood Experiences in a Multinational Sample of Parents and Their Relation to Parent, Child, and Family Functioning during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13581. [PMID: 36294161 PMCID: PMC9603677 DOI: 10.3390/ijerph192013581] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Adverse Childhood Experiences (ACEs) are known to contribute to later mental health. Conversely, Benevolent Childhood Experiences (BCEs) may buffer against mental health difficulties. The importance of ACEs and BCEs for mental health of both parents and children may be most obvious during periods of stress, with potential consequences for functioning of the family. Subgroups of ACEs and BCEs in parents during the COVID-19 pandemic were investigated and validated in relation to indices of parent, child, and family well-being. In May 2020, ACEs/BCEs were assessed in 547 parents of 5-18-year-old children from the U.K., U.S., Canada, and Australia. Subgroups of parents with varying levels of ACEs and BCEs were identified via latent class analysis. The subgroups were validated by examining associations between class membership and indices of parent and child mental health and family well-being. Four latent classes were identified: low-ACEs/high-BCEs, moderate-ACEs/high-BCEs, moderate-ACEs/low-BCEs, and high-ACEs/moderate-BCEs. Regardless of the extent of BCEs, there was an increased risk of parent and child mental health difficulties and family dysfunction among those reporting moderate-to-high levels of ACEs. Parents' history of adversity may influence the mental health of their family. These findings highlight the importance of public health interventions for preventing early-life adversity.
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Affiliation(s)
- Dylan Johnson
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1V6, Canada
| | - Dillon T. Browne
- Centre for Mental Health Research and Treatment, Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Robert D. Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Heather Prime
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
| | - Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1V6, Canada
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Redican E, Hyland P, Cloitre M, McBride O, Karatzias T, Murphy J, Bunting L, Shevlin M. Prevalence and predictors of ICD-11 posttraumatic stress disorder and complex PTSD in young people. Acta Psychiatr Scand 2022; 146:110-125. [PMID: 35503737 PMCID: PMC9540630 DOI: 10.1111/acps.13442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The prevalence, construct validity, risk factors and psychopathological correlates associated with ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as measured by the International Trauma Questionnaire for Children and Adolescents (ITQ-CA) were assessed in a sample of young people from Northern Ireland. METHOD Participants were trauma-exposed 11-19-year-olds (N = 507) who participated in the Northern Ireland Youth Wellbeing Prevalence Survey (YWS-NI, 2020). Factor mixture modelling (FMM) was used to test the latent structure of the ITQ-CA. Risk-factors and psychopathological correlates associated with latent class membership, and ICD-11diagnostic status, were also investigated. RESULTS More participants met the ITQ-CA criteria for CPTSD (3.4%, n = 44) than PTSD (1.5%, n = 19). A second-order FMM comprising a 'partial-PTSD class', a 'CPTSD class', a 'DSO class' and a 'low symptom endorsement class' was the best-fitting model. Younger age and cumulative trauma were risk factors for all trauma classes. Female gender and two or more violent traumas were significant predictors of the 'PTSD' and 'CPTSD' classes, while single sexual trauma was a significant predictor of the 'DSO' and 'CPTSD' classes. Two or more sexual traumas was a unique predictor of 'CPTSD class', while two or more vicarious traumas was a unique predictor of 'DSO class'. The 'CPTSD' class displayed the most notable comorbidity. CONCLUSIONS Findings indicate that CPTSD may be more prevalent than PTSD in children and young people. Support for the ICD-11 conceptualisation of CPTSD as representing a unique diagnostic construct was supported using FMM, with findings indicating trauma symptom class-specific risk profiles.
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Affiliation(s)
- Enya Redican
- School of PsychologyUlster UniversityColeraineUK
| | - Philip Hyland
- Department of PsychologyMaynooth UniversityMaynoothIreland
| | - Marylene Cloitre
- National Center for PTSDVerterans Affairs Palo Alto Health Care SystemPalo AltoCaliforniaUSA
| | - Orla McBride
- School of PsychologyUlster UniversityColeraineUK
| | - Thanos Karatzias
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Jamie Murphy
- School of PsychologyUlster UniversityColeraineUK
| | - Lisa Bunting
- School of Social Sciences, Education and Social WorkQueen's UniversityBelfastUK
| | - Mark Shevlin
- School of PsychologyUlster UniversityColeraineUK
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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Yuan M, Qin F, Xu C, Fang Y. Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study. BMJ Open 2022; 12:e060477. [PMID: 35688592 PMCID: PMC9189840 DOI: 10.1136/bmjopen-2021-060477] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To identify the heterogeneity of adverse childhood experiences (ACEs) as well as their association with cognitive function in an elderly Chinese population. DESIGN A retrospective cohort study. PARTICIPANTS The data were from the latest wave of the China Health and Retirement Longitudinal Study and a total of 7222 participants aged ≥60 were included. PRIMARY AND SECONDARY OUTCOME MEASURES Latent class analysis was used to identify the classes characterised by 11 types of ACEs. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined by education-specific threshold MMSE scores. Logistic models were constructed to examine the relationship between ACE classes and cognitive impairment. Several childhood and adulthood confounding factors were considered. RESULTS Three ACE latent classes were identified. Of them, 76.09% were in the 'Low ACEs' class, 15.43% were in the 'Household dysfunction' class and 8.49% were in the 'Child maltreatment' class. The people in the 'Low ACEs' class seemed to have better childhood family financial situations and higher education levels. The population in the 'Household dysfunction' class tended to live in rural areas and have a higher proportion of men, whereas people in the 'Child maltreatment' class showed a significantly higher proportion of women and higher levels of chronic diseases. 'Child maltreatment' was related to a higher risk of cognitive impairment (OR=1.37, 95% CI: 1.12 to 1.68), while the risk of 'Household dysfunction' was not significantly different from that of the 'Low ACEs' participants (OR=1.06, 95% CI: 0.90 to 1.26). CONCLUSIONS The findings supported differences in cognitive function in elderly Chinese people exposed to different types of ACEs.
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Affiliation(s)
- Manqiong Yuan
- School of Public Health, Xiamen University, Xiamen, China
- School of Public Health, Xiamen University, Xiamen, China
| | - Fengzhi Qin
- School of Public Health, Xiamen University, Xiamen, China
| | - Chuanhai Xu
- School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, China
- School of Public Health, Xiamen University, Xiamen, China
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Ballard J, Turner L, Cuca YP, Lobo B, Dawson-Rose CS. Trauma-Informed Home Visiting Models in Public Health Nursing: An Evidence-Based Approach. Am J Public Health 2022; 112:S298-S305. [PMID: 35679545 PMCID: PMC9184900 DOI: 10.2105/ajph.2022.306737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/04/2022]
Abstract
Traumatic experiences can have significant health effects, particularly when they are experienced during childhood. Structural determinants of health including environmental disasters and limited access to mental health services and affordable housing can contribute additional stress for parents with a personal history of childhood adversity. These factors can directly affect their children, contributing to intergenerational trauma. Pregnant people and families with young children are often referred to public health nursing maternal and child home visiting (HV) programs when there are concerns about historical or evolving childhood trauma. The strict eligibility and participation requirements of existing evidence-based maternal and child HV programs can exclude families that have experienced or are experiencing childhood trauma and its effects and can limit innovation by public health nurses, a hallmark of the field. Therefore, we advocate and describe the implementation of the Trauma Informed Approach in Public Health Nursing (TIA PHN) model, which incorporates a trauma-informed approach into a traditional maternal and child HV program in 3 California counties. TIA PHN, which began enrollment in March 2021, involves public health nurses and community health workers and integrates program evaluations in pursuit of evidence-based status. (Am J Public Health. 2022;112(S3):S298-S305. https://doi.org/10.2105/AJPH.2022.306737).
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Affiliation(s)
- Julianne Ballard
- Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco
| | - Laura Turner
- Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco
| | - Yvette P Cuca
- Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco
| | - Brittany Lobo
- Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco
| | - Carol S Dawson-Rose
- Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco
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Kalebic N, Argent S, Austin H, Bramley L, O'Connor G, Hoskins C, Willis A, Withecomb J, Forrester A, Morgan P, Taylor PJ. The all-Wales forensic adolescent consultation and treatment service (FACTS): A 5-year referral cohort study. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:159-174. [PMID: 35709314 DOI: 10.1002/cbm.2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND FACTS is a Wales-wide mental health service for 10-17-year-olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely consultation-liaison service, it differs from other UK services in the field. AIMS To describe a complete cohort of referrals to FACTS 2013-2017 with service exit by June 2018. METHODS Clinical, social and offending data were extracted from FACTS records. RESULTS 80 young people completed a FACTS episode, averaging nearly a year (309 days; range 13-859 days). Mostly boys (65, 81%) of mean age 15.4 years (range 9-18), two-thirds (n = 53) had three or more referral reasons, one invariably being threatened/actual harm to others; only half were criminal-justice involved. Half (41, 51%) were committing sexually harmful acts. Half were self-harming (41, 51%). All but seven had had at least one adverse childhood experience (ACE), nearly half (35, 44%) four or more. Nevertheless, post-traumatic stress disorder (PTSD) was rarely diagnosed (7, 9%); just over one-quarter (23, 29%) had no diagnosis at all. Correspondence analyses endorsed two distinct Attention deficit hyperactivity disorder groups, distinguished by presence/absence of evidenced brain damage or dysfunction. Suicide-related behaviours clustered with the other diagnoses, flashbacks and psychotic symptoms with no diagnosis. Change in home circumstances during a FACTS episode was slight. CONCLUSIONS The complexity of presenting problems and service involvement evidences need for FACTS. The extent of persistently harmful sexual behaviours is a novel finding, suggesting need for more expert input for this at other service levels. Rarity of PTSD diagnoses was surprising given the extent of ACEs. This raises concerns that services focus on disorder signs rather than the child's inner life. Given the extent of problems, minimal change may be a positive outcome - especially when remaining in the community. Further development of this service should include explicit case-by-case goals and indicative outcome markers.
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Affiliation(s)
| | - Sarah Argent
- Cardiff University, Cardiff, UK
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
| | | | | | - Gwen O'Connor
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
| | | | | | - Julie Withecomb
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
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Weiler LM, Lee SK, Zhang J, Ausherbauer K, Schwartz SEO, Kanchewa SS, Taussig HN. Mentoring Children in Foster Care: Examining Relationship Histories as Moderators of Intervention Impact on Children's Mental Health and Trauma Symptoms. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:100-113. [PMID: 34312883 PMCID: PMC8789940 DOI: 10.1002/ajcp.12549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Mentoring-based interventions show promise among children in foster care, but previous research suggests that some benefit more than others. Because children in foster care experience relationship disruptions that could affect mentoring effectiveness, we examined whether children's relational histories at baseline (i.e., relationship quality with birth parents, relationship quality with foster parents, caregiver instability, and previous mentoring experience) moderated the impact of a mentoring intervention on children's mental health, trauma symptoms, and quality of life. Participants included 426 racially and ethnically diverse children (age: 9-11; 52% male) who participated in a randomized controlled trial of the Fostering Healthy Futures program (FHF), a 9-month one-to-one mentoring and skills group intervention. Results showed that relationship quality with foster parents and prior mentoring experience did not moderate intervention impact. Relationship quality with birth parents and caregiver instability pre-program, however, moderated the effect on some outcomes. The impact on quality of life was stronger for children with weaker birth parent relationships and fewer caregiver changes. Likewise, the impact on trauma symptoms was stronger for those with fewer caregiver changes. Overall, FHF seems to positively impact children with varied relational histories, yet some may derive more benefits - particularly those with fewer caregiver changes pre-program.
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Affiliation(s)
- Lindsey M Weiler
- Department of Family Social Science, University of Minnesota-Twin Cities, St. Paul, MN, USA
- Institute for Translational Research in Children's Mental Health, Minneapolis, MN, USA
| | - Sun-Kyung Lee
- Department of Family Social Science, University of Minnesota-Twin Cities, St. Paul, MN, USA
| | - Jingchen Zhang
- Department of Family Social Science, University of Minnesota-Twin Cities, St. Paul, MN, USA
| | - Kadie Ausherbauer
- Institute for Translational Research in Children's Mental Health, Minneapolis, MN, USA
- Minnesota Trauma Recovery Institute, Minneapolis, MN, USA
| | | | - Stella S Kanchewa
- Department of Psychology, Bellarmine University, Louisville, KY, USA
| | - Heather N Taussig
- Graduate School of Social Work, University of Denver, Denver, CO, USA
- Kempe Center, University of Colorado School of Medicine, Aurora, CO, USA
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Bhandari D, Ozaki A, Suzuki T, Kotera Y, Shrestha S, Horiuchi S, Miyachi T, Tabuchi T. Physical and verbal abuse amid COVID-19: a nationwide cross-sectional survey in Japan. BMJ Open 2022; 12:e054915. [PMID: 35177454 PMCID: PMC8889444 DOI: 10.1136/bmjopen-2021-054915] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The detrimental impacts of abuse on victims' well-being are well documented globally, including Japan. The ongoing COVID-19 pandemic may increase the incidence of abuse in the community, creating an additional burden amid the crisis. However, the incidence of abuse in Japan during COVID-19 remains to be evaluated. Accordingly, our study aimed to assess the incidence of physical and verbal abuse among the general population in Japan and to identify the associated factors of abuse during COVID-19. DESIGN AND SETTING We used the data obtained from a nationwide, cross-sectional internet survey conducted in Japan between August and September 2020. Sampling weights were used to calculate national estimates, and multivariable logistic regression was performed to identify the associated factors for physical and verbal abuse. RESULTS Out of the total 25 482 participants, 965 (3.8 %) reported experiencing physical abuse and 1941 (7.6%) verbal abuse from April 2020 to September 2020. The incidence of physical and verbal abuse was higher among female participants. Participants who lived in areas where the 'state of emergency' was enforced were more likely to suffer from physical abuse. Similarly, vulnerable participants such as those below age 18, with low income, bad family relationships, and disabled people were more likely to experience both physical and verbal abuse. Participants suffering from COVID-19-related symptoms, who had poor health status and widows/divorcees were more likely to be verbally abused. Furthermore, those who did not follow preventive behaviours such as wearing masks in public places, abusing drugs and drinking alcohol in high amounts were also more likely to experience abuse. CONCLUSION The impact of abuse was found disproportionately greater in more vulnerable groups of the population. Pandemic has reinforced the existing social inequalities, which need to be addressed timely to prevent precarious repercussions.
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Affiliation(s)
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Tomoya Suzuki
- Medical Governance Research Institute, Tokyo, Japan
- School of Medicine, Akita University, Akita, Japan
| | - Yasuhiro Kotera
- School of Health Science, University of Nottingham, Nottingham, UK
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Sayaka Horiuchi
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| | - Takashi Miyachi
- Medical Governance Research Institute, Tokyo, Japan
- School of Medicine, Akita University, Akita, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Kim Y, Lee H, Park A. Patterns of adverse childhood experiences and depressive symptoms: self-esteem as a mediating mechanism. Soc Psychiatry Psychiatr Epidemiol 2022; 57:331-341. [PMID: 34191037 PMCID: PMC8243305 DOI: 10.1007/s00127-021-02129-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE There is a growing interest in the co-occurring natures of adverse childhood experiences (ACEs) and unmeasured types of adversity. The current body of knowledge may also lack plausible mechanisms linking ACEs to mental health in young adulthood. This study aims to identify early adversity patterns using expanded ACEs items and investigate the pathway of ACEs and self-esteem to depressive symptoms in young adulthood. METHODS Data were obtained from the National Longitudinal Study of Adolescent and Adult Health, including a nationally representative sample in the U.S. (N = 10,702). We identified the ACEs patterns and estimated the direct and indirect associations between ACEs and depressive symptoms through self-esteem, using a latent class analysis with a distal outcome. RESULTS This study identified four distinct groups of ACEs that include Child Maltreatment, Household Dysfunction, Violence, and Low Adversity. The Child Maltreatment class showed a significantly higher risk of depressive symptoms compared to other ACEs groups. Self-esteem mediated the negative association of child maltreatment with depressive symptoms. The Violence class presented a significantly higher risk of depressive symptoms than Low Adversity, but no mediation of self-esteem was found. CONCLUSION The study highlights the profound consequence of child abuse/neglect and identifies self-esteem as a plausible mediating mechanism. Researchers and practitioners should increase collaboration efforts to prevent early adversity exposures and detrimental effects on mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, PO Box 842027, Richmond, VA 23220 USA
| | - Haenim Lee
- Department of Social Welfare and Counselling, Dongguk University, 30 Pildong-ro 1gil, Jung-gu, Seoul, South Korea 04629
| | - Aely Park
- Department of Social Welfare, Sunchon National University, 255 Jungang-ro, Suncheon, Jeonnam, South Korea 57922
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Association between Self-Reported Childhood Difficulties and Obesity and Health-Related Behaviors in Adulthood-A Cross-Sectional Study among 28,047 Adults from the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031395. [PMID: 35162418 PMCID: PMC8835689 DOI: 10.3390/ijerph19031395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
The aim of the present study was to examine the associations between self-reported childhood difficulties, weight status, and lifestyle behaviors among a representative sample of Norwegian adults. This cross-sectional study included 28,047 adults (>18 years old) living in southern Norway. A self-report questionnaire was used to assess information about the overall quality of the respondents’ childhood retrospectively in addition to current weight status and current lifestyle behaviors. Multivariable logistic regression models adjusted for gender, age, and educational level showed that evaluating childhood as difficult was associated with increased odds of obesity (OR: 1.29; 95% CI; 1.16–1.44) in adulthood. Moreover, a difficult childhood was associated with increased odds of unhealthy lifestyle behaviors in adulthood, including low consumption of fruit and berries (1.21; 1.09–1.34) and fish (1.43; 1.30–1.57), high consumption of sugar-sweetened beverages (1.30; 1.14–1.48), low level of physical activity (1.10; 1.01–1.21), smoking cigarettes (1.78; 1.61–1.97), and using smokeless tobacco (1.20; 1.07–1.36). Overall, results from the present study suggest that experiencing childhood as difficult is associated with an increased risk of obesity and a range of unhealthy lifestyle behaviors in adulthood. Thus, our findings highlight the importance of identifying and providing support to children in difficult life circumstances in addition to customized and targeted public health efforts in adulthood.
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Chen SS, He Y, Xie GD, Chen LR, Zhang TT, Yuan MY, Li YH, Chang JJ, Su PY. Relationships among adverse childhood experience patterns, psychological resilience, self-esteem and depressive symptoms in Chinese adolescents: A serial multiple mediation model. Prev Med 2022; 154:106902. [PMID: 34863811 DOI: 10.1016/j.ypmed.2021.106902] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 11/14/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
Adverse childhood experiences (ACEs) and adolescent depression are both prevalent social problems that can increase the risk of several negative health consequences throughout life. The original definition of ACEs misdirects the focus of intervention efforts for ACEs to only family dysfunction and parenting practices. We used a broader definition of ACEs and a latent class analysis (LCA) model to examine ACE patterns, aiming to overcome the shortcomings of cumulative and single adversity approaches based on the special social context of China. The data were derived from a middle school in Huaibei City of Anhui Province in 2019 and 2020, which was a prospective study involving 1687 junior high school students. At the initial evaluation (T1), ACEs, psychological resilience, self-esteem, and depressive symptoms were assessed by the students. At Time 2 (T2), the depressive symptoms of students were assessed. LCA and mediation analyses were conducted with Mplus version 8.2. The LCA identified the following three heterogeneous ACE classes: "low adversity" (36.4%), "moderate adversity" (44.2%), and "high adversity" (19.4%). The mediation analysis showed that the ACE patterns affected depressive symptoms through the following two mediation paths only in the moderate but not in the high adversity class: self-esteem alone and a path combining psychological resilience and self-esteem. Psychological resilience separately did not mediate the association between ACE patterns and depressive symptoms. To reduce depressive symptoms, interventions for students with ACEs need to improve self-esteem through many channels.
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Affiliation(s)
- Shan-Shan Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yang He
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Guo-Die Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Li-Ru Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ting-Ting Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Meng-Yuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yong-Han Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jun-Jie Chang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No. 81 Meishan Road, Hefei 230032, Anhui, China.
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Panagou C, MacBeth A. Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences. Clin Psychol Psychother 2022; 29:1626-1654. [PMID: 35266603 PMCID: PMC9790303 DOI: 10.1002/cpp.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022]
Abstract
Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.
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Affiliation(s)
- Corinna Panagou
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
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Saadi A, Chibnik L, Valera E. Examining the Association Between Childhood Trauma, Brain Injury, and Neurobehavioral Symptoms Among Survivors of Intimate Partner Violence: A Cross-Sectional Analysis. J Head Trauma Rehabil 2022; 37:24-33. [PMID: 34985031 PMCID: PMC8855533 DOI: 10.1097/htr.0000000000000752] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Understanding factors contributing to neurobehavioral symptom burden among intimate partner violence (IPV) survivors has important implications for prevention, screening, and intervention in this vulnerable population. This study aimed to (1) identify the relationship between childhood trauma and neurobehavioral symptoms among a shelter- and community-based sample of IPV survivors, including investigating the mediating role of posttraumatic stress symptoms and alexithymia in this relationship; (2) assess the association between IPV-related brain injury (BI) severity and neurobehavioral symptoms; and (3) assesses whether physical, emotional, or cognitive domains of neurobehavioral symptom burden show differential associations with childhood trauma or IPV-related BI. SETTING Community sites serving women who had experienced IPV such as domestic violence shelters and transitional housing sites. PARTICIPANTS Women survivors of IPV with and without BI (n = 99), aged 18 to 54 years. DESIGN Retrospective, cross-sectional study design. MEASURES The following self-reported questionnaires were used: Rivermead Post Concussion Questionnaire (RPQ); Childhood Trauma Questionnaire (CTQ); a modified version of the Conflict Tactics Scale; Brain Injury Severity Assessment (BISA); Clinician-Administered PTSD Scale for DSM IV; and Toronto Alexithymia Scale. The final multivariate regression model assessed the association between childhood abuse, BI severity, and neurobehavioral symptoms (as measured by the RPQ) adjusting for age, educational attainment, and abuse in the past year. We created separate models with total neurobehavioral symptom score as an outcome, as well as somatic, emotional, and cognitive symptom scores. We used structural equation modeling to assess whether posttraumatic stress and alexithymia mediated the effect of childhood trauma and neurobehavioral symptoms. RESULTS Childhood trauma was associated with higher levels (P < .01) of overall neurobehavioral symptom burden in women independent of BI and specifically associated with RPQ Emotional and Somatic subscale symptoms (P ≤ .05). BI was positively associated with somatic symptoms in the full sample and cognitive neurobehavioral symptoms in the sample of women with IPV-related BI (P < .05) independent of childhood trauma. Posttraumatic stress symptoms, but not alexithymia, partially mediated the effect of childhood trauma effect on neurobehavioral symptoms. CONCLUSION Childhood trauma and BI should not be overlooked as part of efforts to meet the needs of IPV survivors who may experience a range of emotional, somatic, and cognitive symptoms.
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Affiliation(s)
- Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lori Chibnik
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eve Valera
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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50
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Li S, Wang R, Thomas E, Jiang Z, Jin Z, Li R, Qian Y, Song X, Sun Y, Zhang S, Chen R, Wan Y. Patterns of adverse childhood experiences and depressive symptom trajectories in young adults: A longitudinal study of college students in China. Front Psychiatry 2022; 13:918092. [PMID: 35958653 PMCID: PMC9358020 DOI: 10.3389/fpsyt.2022.918092] [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: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk. OBJECTIVE We aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students. METHODS A school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories. RESULTS We identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05). CONCLUSIONS The findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
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Affiliation(s)
- Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Rui Wang
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Erica Thomas
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Yan Qian
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Xianbing Song
- Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
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