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Zheng L, Liu P, Li X, Yan S, Qiu Y, Xu Y, Yang Y, Chen L, Li G. Association between adverse childhood experiences and mortality: A systematic review and meta-analysis. Psychiatry Res 2025; 343:116275. [PMID: 39608195 DOI: 10.1016/j.psychres.2024.116275] [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: 05/04/2024] [Revised: 10/28/2024] [Accepted: 11/17/2024] [Indexed: 11/30/2024]
Abstract
Adverse childhood experiences represent a critical public health concern that warrants urgent attention and cannot be overlooked. The evidence regarding the relationship between adverse childhood experiences and mortality has been insufficient and inconsistent. To address this gap, we conducted a systematic review and meta-analysis to explore the association between adverse childhood experiences, including their subtypes, and various mortality outcomes. We systematically searched PubMed, Web of Science, EMBASE, CINAHL, and the Cochrane Library from inception to 9 March 2024. Ultimately, 49 studies were included. Among them, 46 studies involving 24,276,424 participants investigated the association between adverse childhood experiences and mortality. The results showed adverse childhood experiences were significantly associated with overall mortality (OR, 1.64; 95 % CI, 1.51 to 1.78; P < 0.001), external cause mortality (OR, 1.91; 95 % CI, 1.7 to 2.15; P < 0.001), and internal cause mortality (OR, 1.3; 95 % CI, 1.17 to 1.44; P < 0.001). Among women and men, the effect sizes were 1.39 (95 %CI, 1.25 to 1.54; P < 0.001) and 1.4 (95 %CI, 1.22 to 1.6; P < 0.001), respectively. Increased mortality risk was also observed for those exposed to maltreatment (OR, 1.95; 95 %CI, 1.65 to 2.3; P < 0.001), household dysfunction (OR, 1.36; 95 %CI, 1.22 to 1.51; P < 0.001), low socioeconomic status (OR, 1.25; 95 %CI, 1.09 to 1.43; P = 0.002), or out-of-home care (OR, 2.87; 95 %CI, 2.12 to 3.9; P < 0.001). Gender differences were not statistically significant, except for minor variations within the low socioeconomic status. This study underscores the profound impact of adverse childhood experiences on mortality risk, highlighting the need for targeted public health interventions and policies.
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Affiliation(s)
| | - Peiqi Liu
- Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xin Li
- School of Nursing, Jilin University, Changchun, China
| | - Shoumeng Yan
- School of Nursing, Jilin University, Changchun, China.
| | - Yiming Qiu
- School of Nursing, Jilin University, Changchun, China
| | - Yiran Xu
- School of Nursing, Jilin University, Changchun, China
| | - Yali Yang
- School of Nursing, Jilin University, Changchun, China
| | - Li Chen
- School of Nursing, Jilin University, Changchun, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China.
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, China.
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Kreshpaj B, Elsenburg LK, Andersen SH, De Vries TR, Thielen K, Rod NH. Association between childhood adversity and use of the health, social, and justice systems in Denmark (DANLIFE): a nationwide cohort study. Lancet Public Health 2024:S2468-2667(24)00242-1. [PMID: 39681123 DOI: 10.1016/s2468-2667(24)00242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 10/02/2024] [Accepted: 10/10/2024] [Indexed: 12/18/2024]
Abstract
BACKGROUND Childhood adversities can negatively affect health and social outcomes. We aimed to assess the association between adversity in childhood and use of public services in early adulthood across three systems: health, social welfare, and justice. METHODS We used Danish nationwide registry data on individuals born between 1980 and 1991 and followed up between 1998 and 2021. We evaluated annual exposure to adversity during childhood (age 0-16 years) across three dimensions-material deprivation, loss or threat of loss within the family, and family dynamics-and used this to divide individuals into five trajectory groups: low adversity, early-life material deprivation, persistent material deprivation, loss or threat of loss, and high adversity. We defined high-intensity users of each public service system as those above the 90th percentile in terms of hospital visits (health system) and weeks of social welfare use (social welfare system), and whether or not they were convicted for a crime (justice system) during early adulthood (age 18-40 years). We analysed the proportion of high-intensity users of each public service system across the childhood adversity trajectory groups. Logistic regression was used to assess whether the risk of becoming a high-intensity user differed by trajectory group relative to the low-adversity group, with adjustment for sex, parental education, parental origin, and maternal age at time of birth. FINDINGS Of the 567 035 individuals in the cohort, 273 616 (48·3%) were in the low-adversity group, 128 238 (22·6%) were in the early-life material deprivation group, 100 959 (17·8%) were in the persistent material deprivation group, 43 826 (7·7%) were in the loss or threat of loss group, and 20 396 (3·6%) were in the high-adversity group. Childhood adversity was associated with a markedly higher risk of belonging to the high-intensity user group across all three public service systems. Specifically, low proportions of the low-adversity group became high-intensity users of the health system (19 675 [7·2%]), social welfare system (13 681 [5·0%]), and justice system (38 198 [14·0%]). By comparison, those in the high-adversity group were significantly more likely to become high-intensity users of the health system (4685 [23·0%]; adjusted odds ratio 2·81 [95% CI 2·71-2·93]), social welfare system (8158 [40·0%]; 8·88 [8·50-9·27]), and justice system (8681 [42·6%]; 3·62 [3·50-3·75]). INTERPRETATION There were long-term effects of childhood adversities across three public service systems, with an association of high-intensity users among individuals who experienced childhood adversity. Systemic inequalities already present in childhood need to be addressed, with prioritisation of equitable resource allocation for those most in need of assistance. FUNDING Rockwool Foundation.
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Affiliation(s)
- Bertina Kreshpaj
- Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Leonie K Elsenburg
- Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Tjeerd Rudmer De Vries
- Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Karsten Thielen
- Department of Occupational and Social Medicine, University Hospital of Holbæk, Holbæk, Denmark
| | - Naja Hulvej Rod
- Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Schroeder K, Sinko L, Ibrahim J, Sarwer DB. Supporting student learning and development through trauma-informed campuses. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:3681-3689. [PMID: 36977341 PMCID: PMC10533736 DOI: 10.1080/07448481.2023.2187647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/29/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Many students come to higher education with a history of trauma. College life may also expose students to traumatizing events. While the past decade has witnessed greater discussion of trauma-informed frameworks, it has not regularly been applied to the college environment. We advance the concept of a trauma-informed campus, where administrators, faculty, staff, and students from diverse disciplines create an environment that recognizes the widespread nature of trauma, integrates knowledge about trauma into practices and procedures, and minimizes further re-traumatization for all community members. A trauma-informed campus is prepared for students' past or future traumatic experiences, while also recognizing and responding to structural and historical harms. In addition, it recognizes the role of the surrounding community challenges, particularly how violence, substance use, hunger, poverty, and housing insecurity may contribute to further trauma or negatively impact healing. We use an ecological model to frame and shape the construct of trauma-informed campuses.
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Affiliation(s)
- Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Laura Sinko
- Department of Nursing, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Jennifer Ibrahim
- Department of Academic Affairs and Department of Health Services Administration and Policy, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - David B Sarwer
- Temple University Center for Obesity Research and Education and Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
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Buchanan M, Newton-Howes G, Cunningham R, McLeod GFH, Boden JM. The role of social support in reducing the long-term burden of cumulative childhood adversity on adulthood internalising disorder. Soc Psychiatry Psychiatr Epidemiol 2024; 59:2165-2175. [PMID: 38687359 PMCID: PMC11522040 DOI: 10.1007/s00127-024-02674-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Previous research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood. METHODS The Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members' birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support. RESULTS Results indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0 .98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) = .98 (0.97, 0.99), p < 001). CONCLUSION The findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA.
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Affiliation(s)
- Mary Buchanan
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Geraldine F H McLeod
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Li J, Pei H, Yan X, Wei Y, Chen G, Pei L. Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China. J Nutr Health Aging 2024; 28:100400. [PMID: 39437579 DOI: 10.1016/j.jnha.2024.100400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 10/11/2024] [Accepted: 10/13/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation METHODS: Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011-2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation. RESULTS Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21-1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18-1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55-0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01-1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02-1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction <0.05), while participants with lower ACEs scores (1 and 2) and high social participation were associated with an increased probability of transition from frail to pre-frail (HR = 1.26, 95%CI: 1.04-1.89 and HR = 1.15, 95%CI: 1.08-1.69). CONCLUSIONS High ACEs scores were associated with an increased likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation.
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Affiliation(s)
- Jiajia Li
- Institute of Population Research, Peking University, Beijing, China
| | - Heming Pei
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Xiaojin Yan
- Institute of Population Research, Peking University, Beijing, China
| | - Yue Wei
- Institute of Population Research, Peking University, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, China.
| | - Lijun Pei
- Institute of Population Research, Peking University, Beijing, China.
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Hunt ET, Brazendale K, Kelder SH, Lanza KL, Mantey DS, Cristol B, Crouch EL, Schroeder K, Hoelscher DM. Sleep, Screen Behaviors, and Adverse Childhood Experiences: A Cross-Sectional Study of U.S. Children and Adolescents. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:1169-1176. [PMID: 39686934 PMCID: PMC11646242 DOI: 10.1007/s40653-024-00653-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2024] [Indexed: 12/18/2024]
Abstract
To examine the associations between adverse childhood experiences (ACEs) and children's obesogenic behaviors (meeting recommendations for sleep duration and screen time) in a representative sample of U.S. children and adolescents. This study assessed data from the 2019-2020 National Survey of Children's Health. Separate multinomial logistic regressions examined the likelihood of failing to meet sleep and screen time recommendations given individual and cumulative ACE scores. 15,581 children (48% female, 32% non-White) experienced one ACE, representing 32% of the analyzed sample. Parents reported financial hardship as the most prevalent ACE (48%). After adjusting for child race/ethnicity, sex of the child, highest education in the household, and child age, we found that participants with four or more ACEs were (1) age-specific sleep recommendations compared with participants with zero ACEs (OR 1.96; 95%CI = 1.64-2.35), and (2) more likely to fall short of meeting screen use recommendations compared with participants with zero ACEs (OR 1.61; 95%CI = 1.26-2.07). U.S. children and adolescents who have experienced four or more ACEs are significantly more likely to fall short of sleep and screen time recommendations compared to their counterparts who experienced zero ACEs. Given the strong associations between ACEs and health outcomes in adulthood, screening for ACEs may better inform practitioners when attempting to improve youth health outcomes.
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Affiliation(s)
- Ethan T. Hunt
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL USA
| | - Steven H. Kelder
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
| | - Kevin L. Lanza
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
| | - Dale S. Mantey
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
| | - Benjamin Cristol
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
| | - Elizabeth L. Crouch
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC USA
| | - Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA USA
| | - Deanna M. Hoelscher
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, 1616 Guadalupe St. Suite 6.316C, Austin, TX 78701 USA
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Madigan S, Thiemann R, Deneault AA, Fearon RMP, Racine N, Park J, Lunney CA, Dimitropoulos G, Jenkins S, Williamson T, Neville RD. Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024:2826097. [PMID: 39527072 PMCID: PMC11555579 DOI: 10.1001/jamapediatrics.2024.4385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/21/2024] [Indexed: 11/16/2024]
Abstract
Importance Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability. Objective To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates. Design, Setting, and Participants Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024. Main Outcomes and Measures ACEs. Results The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90). Conclusions In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Raela Thiemann
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | | | - R. M. Pasco Fearon
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Julianna Park
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Carole A. Lunney
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Gina Dimitropoulos
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Serena Jenkins
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Tyler Williamson
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ross D. Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Pezzoli P, Pingault JB, Eley TC, McCrory E, Viding E. Causal and common risk pathways linking childhood maltreatment to later intimate partner violence victimization. Mol Psychiatry 2024:10.1038/s41380-024-02813-0. [PMID: 39488656 DOI: 10.1038/s41380-024-02813-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 10/22/2024] [Accepted: 10/24/2024] [Indexed: 11/04/2024]
Abstract
Childhood maltreatment and intimate partner violence (IPV) victimization are major psychiatric risk factors. Maltreatment substantially increases the likelihood of subsequent IPV victimization, but what drives this association is poorly understood. We analyzed retrospective self-reports of maltreatment and IPV victimization in 12,794 participants (58% women, 42% men) from the Twins Early Development Study at ages 21 and 26 using quantitative genetic methods. We estimated the etiological influences common to maltreatment and IPV, and the effect of maltreatment on IPV beyond such common influences. Participants who reported childhood maltreatment ( ~ 7% of the sample) were 3 times more likely than their peers to also report IPV victimization at age 21, 4 times more likely at 26. The association between maltreatment and IPV was mostly due to environmental influences shared by co-twins (42-43%) and genetic influences (30-33%), as well as nonshared environmental influences (25-27%). The association between maltreatment and IPV was similar for women and men, but its etiology partly differed by sex. Maltreatment had a moderate effect on IPV in phenotypic models (β = 0.25-0.30), decreasing to a small-to-moderate range in causally informative models accounting for their common etiology (β = 0.15-0.21). Risk factors common to maltreatment and IPV victimization are largely familial in origin, environmental and genetic. Even considering common risk factors, experiencing maltreatment may be causally related to subsequent IPV victimization. Interventions promoting safe intimate relationships among young adults exposed to maltreatment are warranted and should address family-level environmental risk and individual-level risk shaped by genetics.
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Affiliation(s)
- Patrizia Pezzoli
- Division of Psychology and Language Sciences, University College London (UCL), London, UK.
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London (UCL), London, UK
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Thalia C Eley
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London (UCL), London, UK
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London (UCL), London, UK
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Stewart-Tufescu A, Fortier J, Salmon S, Taillieu TL, Garces-Davila I, Afifi TO. Examining adolescents' experiences of distress when participating in research on well-being and early life adversity. CHILD ABUSE & NEGLECT 2024:107099. [PMID: 39482185 DOI: 10.1016/j.chiabu.2024.107099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 09/20/2024] [Accepted: 10/10/2024] [Indexed: 11/03/2024]
Abstract
RATIONALE Most child well-being and childhood adversity research is informed by proxy informants such as parents or teachers rather than children and youth. This may be due to concerns about perceived sensitivity, challenges accessing and engaging with children in research, ethical considerations, and apprehensions about causing undue harm and distress. This study aimed to understand adolescents' identification of, and reactions to, questions in the context of participating in a survey of well-being and adversity. OBJECTIVES The aim of this study was to enhance our understanding of how adolescents identify and respond to potentially upsetting questions about well-being and life experiences, including childhood adversity. METHOD Data were from 1002 adolescent respondents aged 14 to 17 years. The Well-being and Experiences (WE) survey assessed several domains of life, including general health and well-being and early life adversity. Data were analyzed using descriptive statistics, logistic regression models, and thematic analysis approaches. RESULTS Few adolescent respondents reported feeling upset when completing the survey (11.2 %). Among those who reported feeling upset, 92.0 % indicated that it was still important to ask those upsetting questions, and only two respondents (1.8 %) thought upsetting questions should be removed. Ten themes emerged from the adolescents' reflections on self-reported upsetting questions, including identity and life satisfaction, motivation, mental health, and school; childhood adversity was not primarily identified. CONCLUSIONS Findings indicate that conducting research on well-being and childhood adversity directly with adolescents is feasible and minimally distressing. Future research should consider how to engage youth directly in research to understand better the scope and outcomes associated with childhood adversity.
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Affiliation(s)
- Ashley Stewart-Tufescu
- Faculty of Social Work and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
| | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
| | - Tamara L Taillieu
- Department of Community Health Sciences and Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
| | - Isabel Garces-Davila
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
| | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
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Smout E, Buechner H, Lynch R, Dalton L, Rapa E. Investigating child-facing practitioners' understanding of adversity and its impact on children's development and service provision. Heliyon 2024; 10:e38908. [PMID: 39640774 PMCID: PMC11620144 DOI: 10.1016/j.heliyon.2024.e38908] [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: 01/10/2024] [Revised: 09/19/2024] [Accepted: 10/02/2024] [Indexed: 12/07/2024] Open
Abstract
Adversity during childhood is a common risk factor for poorer outcomes across physical, mental, and social health. Despite growing evidence and policy around preventing adversity and its sequalae, the incidence of adversity in childhood remains high. Child-facing practitioners (CfPs) may be well-placed to identify adversity and address its impact on children. This study investigated the understanding of adversity and current practice of CfPs working in the Education system, Healthcare and Social Care in England. An anonymous online survey was completed by 113 CfPs between April and June 2022. Data were analysed using descriptive statistics. Participating CfPs' reported using a range of assessment tools and direct observation, but there was a lack of consistency in the extent to which different types of adversity were explored in assessments. CfPs working in the Education system and Healthcare reported only liaising with Social Care services when a current worker was known to be involved with the family, or to make a referral. Indeed, a quarter of respondents from the Education system and Healthcare only considered early life experiences when capacity allowed. Over half of the CfPs in this survey 'did not know' or 'did not agree' that public services offer interventions to support families experiencing domestic abuse, parental mental health difficulties and addiction, or the impact of these adversities on children's wellbeing. The study highlights that CfPs could benefit from further training about the prevalence and impact of adversity to inform service delivery. A review of CfPs' routine assessments is needed to ensure that children's exposure to adversity is routinely identified; this will facilitate families to access appropriate support to mitigate the impact of such experiences.
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Affiliation(s)
- Emily Smout
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Hadassah Buechner
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Rosie Lynch
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
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Fatima R, Saleem J, Ishaq M, Khan HZ, Javaid Bukhari GM, Naz M, Fatima A, Abdi G, Jain M. Effects of adverse childhood experiences on university students' ability to lead healthy lives: an exploratory qualitative study in Lahore, Pakistan. BMC Public Health 2024; 24:2897. [PMID: 39434086 PMCID: PMC11492790 DOI: 10.1186/s12889-024-20391-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 10/14/2024] [Indexed: 10/23/2024] Open
Abstract
BACKGROUND Adverse Childhood Experiences are a significant global public health concern as these experiences have adverse effects on all the health determinants. METHODS The interpretive phenomenological research design was used to explore the implications of adverse childhood experiences on the adult life of university students. An interpretive thematic analysis method was employed to analyze this study. RESULTS Five major themes emerged after a comprehensive review of the information obtained from the interviews with the ten selected participants. These were (1) Chronic health struggles (2) Mental health disorders (3) Emotional and social difficulties (4) Paranoia and distrust and (5) Academic and professional under-performance. CONCLUSION This study concludes that adverse childhood experiences have long-lasting negative effects on university students' health and behaviour, preventing them from leading healthy lives and excelling academically and professionally.
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Affiliation(s)
- Rabia Fatima
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Javeria Saleem
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Ishaq
- Department of Sociology, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Humera Zaib Khan
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | | | - Mahwish Naz
- Ghazi Khan Medical College, Dera Ghazi Khan, Punjab, Pakistan
| | - Aneela Fatima
- Pakistan council of scientific & industrial Research, Islamabad, Pakistan
| | - Gholamreza Abdi
- Department of Biotechnology, Persian Gulf Research Institute, Persian Gulf University, Bushehr, 75169, Iran.
| | - Mukul Jain
- Cell and Developmental Biology Laboratory, Research and Development Cell, Parul University, Vadodara, Gujarat, India
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara, Gujarat, India
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Loveday S, White N, Constable L, Gates A, Sanci L, Goldfeld S, Hiscock H. Lessons Learned From the Implementation of an Integrated Health and Social Care Child and Family Hub - a Case Study. Int J Integr Care 2024; 24:9. [PMID: 39552790 PMCID: PMC11568806 DOI: 10.5334/ijic.8631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 11/07/2024] [Indexed: 11/19/2024] Open
Abstract
Introduction Childhood adversity is associated with poor physical and mental health outcomes across the lifespan. Integration of health and social care may provide a solution to childhood adversity through practices of better detection and response. There is growing interest in the creation of child and family hubs that integrate health and social care but little literature that describes the development process. Description We aimed to evaluate and describe the implementation of a co-designed health and social care child and family hub in Victoria, Australia. Rapid ethnographic methodology was used to iterate the hub components. Practitioners and researchers co-created solutions to barriers identified during implementation. Discussion There were five key learnings: (i) Practice change takes time and intensive coaching, (ii) Lived experience is a powerful motivator for practice change, (iii) Integration of services requires more than co-location to break down silos, (iv) Reflective practice is a key driver of practice change, and (v) Using real time data enabled rapid implementation change and directly informed the development of solutions. Conclusions Maintaining and developing practice change during implementation requires time and access to a broad range of data to enable iteration and the development of solutions.
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Affiliation(s)
- Sarah Loveday
- Department of Paediatrics, University of Melbourne, Australia
- Health Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Natalie White
- Policy and Equity, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Centre for Community Child Health, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Leanne Constable
- Health Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | | | - Lena Sanci
- Department of General Practice, University of Melbourne, Australia
| | - Sharon Goldfeld
- Department of Paediatrics, University of Melbourne, Australia
- Policy and Equity, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Centre for Community Child Health, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Australia
- Health Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Centre for Community Child Health, The Royal Children’s Hospital, Melbourne, Victoria, Australia
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Bornscheuer L, Gauffin K, Almquist YB. Mapping resilience: a scoping review on mediators and moderators of childhood adversity with a focus on gender patterns. BMJ Open 2024; 14:e080259. [PMID: 39313285 PMCID: PMC11429260 DOI: 10.1136/bmjopen-2023-080259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Childhood adversity is associated with a host of negative health and socioeconomic outcomes far into adulthood. The process of avoiding such outcomes is often referred to as resilience. Mapping resilience comprehensively and across contexts is highly relevant to public health, as it is a step towards understanding environments and interventions that contribute to preventing or reversing negative outcomes after early adverse experiences. OBJECTIVES This review scoped out the literature on resilience factors in relation to adulthood outcomes as diverse as mental health and educational attainment. Our aim was to understand where there is untapped research potential, by examining the current evidence base on resilience factors in terms of (a) resources that can buffer the impact of childhood adversity and (b) the pathways linking adversity to long-term outcomes. Furthermore, we aimed to identify gender patterns in these resources and pathways, which has not been a primary interest of reviews on resilience to date, and which can add to our understanding of the different ways in which resilience may unfold. ELIGIBILITY CRITERIA Studies had to include an adversity experienced in childhood, an outcome considered indicative of resilience in adulthood, and at least one putative resilience factor, which had to be approached via mediation or moderation analysis. We considered cohort, case-control and cross-sectional studies. SOURCES OF EVIDENCE We searched PubMed, Scopus and PsycINFO and included original, peer-reviewed articles published before 20 July 2023 in English, German, French, Spanish, Dutch and Swedish. CHARTING METHODS All three authors collaborated on the extraction of information relevant to answering the research questions. The results were visually and narratively summarised. RESULTS We included 102 studies. Traditionally anchored in the field of psychology, the resilience literature focuses heavily on individual-level resilience factors. Gender was considered in approximately 22% of included studies and was always limited to comparisons between men and women. There is no evidence that childhood adversity impacts men and women differently in the long term, but there is some evidence for gender differences in resilience factors. CONCLUSIONS There is untapped potential in resilience research. By considering structural-level factors simultaneously with individual-level factors, and including gender as one of the elements that shape resilience, we can map resilience as a heterogeneous, multilevel process from a public health perspective. This would complement the extensive existing literature on individual-level factors and help reframe resilience as a concept that can be intervened on at a structural level, and that is subject to societal norms and forces, such as gender. There is a lack of quantitative studies including transgender and gender-non-conforming persons.
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Affiliation(s)
- Lisa Bornscheuer
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Karl Gauffin
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ylva B Almquist
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Huang YY, Zhang WS, Jiang CQ, Zhu F, Jin YL, Au Yeung SL, Wang J, Cheng KK, Lam TH, Xu L. Childhood socio-economic disadvantages versus adverse care experiences: Mediation and moderation impacts on late-life depressive symptoms. Eur Psychiatry 2024; 67:e47. [PMID: 39189516 PMCID: PMC11441342 DOI: 10.1192/j.eurpsy.2024.1760] [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: 01/16/2024] [Revised: 04/04/2024] [Accepted: 04/20/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Whether material deprivation-related childhood socio-economic disadvantages (CSD) and care-related adverse childhood experiences (ACE) have different impacts on depressive symptoms in middle-aged and older people is unclear. METHODS In the Guangzhou Biobank Cohort Study, CSD and ACE were assessed by 7 and 5 culturally sensitive questions, respectively, on 8,716 participants aged 50+. Depressive symptoms were measured by 15-item Geriatric Depression Scale (GDS). Multivariable linear regression, stratification analyses, and mediation analyses were done. RESULTS Higher CSD and ACE scores were associated with higher GDS score in dose-response manner (P for trend <0.001). Participants with one point increment in CSD and ACE had higher GDS score by 0.11 (95% confidence interval [CI], 0.09-0.14) and 0.41 (95% CI, 0.35-0.47), respectively. The association of CSD with GDS score was significant in women only (P for sex interaction <0.001; women: β (95% CI)=0.14 (0.11-0.17), men: 0.04 (-0.01 to 0.08)). The association between ACE and GDS score was stronger in participants with high social deprivation index (SDI) (P for interaction = 0.01; low SDI: β (95% CI)=0.36 (0.29-0.43), high SDI: 0.64 (0.48-0.80)). The proportion of association of CSD and ACE scores with GDS score mediated via education was 20.11% and 2.28%. CONCLUSIONS CSD and ACE were associated with late-life depressive symptoms with dose-response patterns, especially in women and those with low adulthood socio-economic status. Education was a major mediator for CSD but not ACE. Eliminating ACE should be a top priority.
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Affiliation(s)
- Ying Yue Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People’s Hospital, Guangzhou, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Chao Qiang Jiang
- Guangzhou Twelfth People’s Hospital, Guangzhou, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Feng Zhu
- Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Shiu Lun Au Yeung
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- Guangzhou Twelfth People’s Hospital, Guangzhou, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Greater Bay Area Public Health Research Collaboration, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Greater Bay Area Public Health Research Collaboration, China
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Amiri S, Mahmood N, Yusuf R, Ghenimi N, Javaid SF, Khan MAB. Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1015. [PMID: 39201949 PMCID: PMC11352292 DOI: 10.3390/children11081015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024]
Abstract
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, and morbid obesity; (2) Methods: Three databases were searched: Web of Science, PubMed, and Scopus. Manual searches were conducted using Google Scholar and ResearchGate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between ACEs and BMI. A random-effects model was used to combine the ORs and CIs across studies; (3) Results: This meta-analysis included 71 studies. The pooled ORs for the relationship between ACEs and obesity was 1.42 (95% CI: 1.24-1.63, Z = 4.96, p < 0.001), indicating a significant association. ACEs showed a positive association with overweight (OR = 1.16, 95% CI: 1.06-1.27, Z = 3.24, p = 0.001). Specifically, ACEs ≥ 4 were strongly associated with obesity (OR = 2.06, 95% CI: 1.27-3.36, Z = 2.90, p = 0.004). Sexual abuse was also found to be significantly associated with obesity (OR = 1.46, 95% CI: 1.29-1.65, Z = 5.98, p < 0.001); (4) Conclusion: This study finds that individuals who have experienced ACEs are more likely to have a higher BMI in adulthood. Therefore, ACEs should be considered a factor associated with abnormal BMI.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran 17166, Iran;
| | - Nailah Mahmood
- Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Rahemeen Yusuf
- Emirates Center for Happiness Research, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Nadirah Ghenimi
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates;
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
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Yuan R, Adlimoghaddam A, Zhu Y, Han X, Bartke A. Early Life Interventions: Impact on Aging and Longevity. Aging Dis 2024:AD.202.0516. [PMID: 39325935 DOI: 10.14336/ad.202.0516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 07/05/2024] [Indexed: 09/28/2024] Open
Abstract
Across mammals, lifespans vary remarkably, spanning over a hundredfold difference. Comparative studies consistently reveal a strong inverse relationship between developmental pace and lifespan, hinting at the potential for early-life interventions (ELIs) to influence aging and lifespan trajectories. Focusing on postnatal interventions in mice, this review explores how ELIs influence development, lifespan, and the underlying mechanisms. Previous ELI studies have employed a diverse array of approaches, including dietary modifications, manipulations of the somatotropic axis, and various chemical treatments. Notably, these interventions have demonstrated significant impacts on aging and lifespan in mice. The underlying mechanisms likely involve pathways related to mitochondrial function, mTOR and AMPK signaling, cellular senescence, and epigenetic alterations. Interestingly, ELI studies may serve as valuable models for investigating the complex regulatory mechanisms of development and aging, particularly regarding the interplay among somatic growth, sexual maturation, and lifespan. In addition, prior research has highlighted the intricacies of experimental design and data interpretation. Factors such as timing, sex-specific effects, administration methods, and animal husbandry practices must be carefully considered to ensure the reliability and reproducibility of results, as well as rigorous interpretation. Addressing these factors is essential for advancing our understanding of how development, aging, and lifespan are regulated, potentially opening avenues for interventions that promote healthy aging.
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Affiliation(s)
- Rong Yuan
- Division of Geriatrics Research, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
- Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
| | - Aida Adlimoghaddam
- Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
- Department of Neurology, Center for Alzheimer's Research and Treatment, Neuroscience Institute, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
| | - Yun Zhu
- Division of Geriatrics Research, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
| | - Xiuqi Han
- Division of Geriatrics Research, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
- Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
| | - Andrzej Bartke
- Division of Geriatrics Research, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL 62702, USA
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McGovern R, Balogun-Katung A, Artis B, Bareham B, Spencer L, Alderson H, Brown E, Brown J, Lingam R, McArdle P, Newham JJ, Wojciechowska A, Rankin J, Redgate S, Thomason P, Kaner E. The Effectiveness of Preventative Interventions to Reduce Mental Health Problems in at-risk Children and Young People: A Systematic Review of Reviews. JOURNAL OF PREVENTION (2022) 2024; 45:651-684. [PMID: 38884876 PMCID: PMC11271346 DOI: 10.1007/s10935-024-00785-z] [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] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
Mental health problems are the leading cause of childhood disability worldwide, resulting in poor outcomes for children and young people that persist into adulthood. It is essential that those young people most at risk of developing mental health problems receive effective preventative interventions. Whilst there have been a number of systematic reviews which have examined the effectiveness of secondary prevention interventions for specific groups of children and young people, or to address identified mental health concerns, no review has engaged with the breadth of this literature. We conducted a systematic review of systematic reviews to map this complex field of secondary preventative interventions and identify effective interventions to prevent mental health problems in children and adolescents aged 3-17 years. The review protocol was registered on PROSPERO. We searched five electronic databases from inception to February 2023. The certainty of the evidence was appraised using the AMSTAR 2. We included 49 unique systematic reviews each including between 2 and 249 (mean 34) unique studies; the majority of which were reviews which included only or mostly randomised controlled trials (70%). The reviews examined selective interventions (defined as interventions which are delivered to sub-group populations of young people at increased risk of mental health problems) (n = 22), indicated interventions (defined as interventions which target young people who are found to have pre-clinical symptoms) (n = 15) or a synthesis of both (n = 12). The certainty of the evidence in the reviews was rated as high, (n = 12) moderate (n = 5), low (n = 9) and critically low (n = 23). We found evidence to support both selective and indicated interventions in a range of populations and settings, with most of this evidence available for children and young people in their mid-years (6-10 years) and early adolescence (11-13 years). There was a large body of evidence suggesting that resilience enhancing, cognitive behaviour therapy-based and psychoeducational interventions for children who experience adversity, or those with subclinical externalising problems may offer promise. Early selective interventions for a subpopulation of children and young people who have experienced adversity which combines risk reduction and resilience enhancing approaches directed at children and their families may be effective at reducing mental health problems.
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Affiliation(s)
- R McGovern
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Artis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Bareham
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - E Brown
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - J Brown
- Children's Social Care, Newcastle City Council, Newcastle upon Tyne, UK
| | - R Lingam
- Population Child Health Research Group, School of Women and Children's Health, University New South Wales, Sydney, Australia
| | - P McArdle
- Child and Adolescent Mental Health Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - A Wojciechowska
- Disabilities Integrated Team at the Tees, Esk and Wear Valleys, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - S Redgate
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - P Thomason
- Children's Social Care, Gateshead Council, Tyne and Wear, UK
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
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Turgeon J, Racine N, McDonald S, Tough S, Madigan S. Maternal adverse childhood experiences, child resilience factors, and child mental health problems: A multi-wave study. CHILD ABUSE & NEGLECT 2024; 154:106927. [PMID: 38970861 DOI: 10.1016/j.chiabu.2024.106927] [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: 04/09/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. OBJECTIVES The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. PARTICIPANTS AND SETTING The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. METHODS Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. RESULTS Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (β = 0.174, p = .02) and depression (β = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (β = -0.29, p = .02, β = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. CONCLUSIONS Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.
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Affiliation(s)
- Jessica Turgeon
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Nicole Racine
- University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON K1H 5B, Canada
| | - Sheila McDonald
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Suzanne Tough
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. N.W. Calgary, AB, Canada.
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Liu Y, Qiu H, Tang F, Huang Z, Gao Y, Wang Y, Wang S, Zhang Y. Association of adverse childhood experiences with poor health condition among middle-aged and elderly adults in the United States: A nationally retrospective cohort study. Psychiatry Res 2024; 338:115977. [PMID: 38823165 DOI: 10.1016/j.psychres.2024.115977] [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: 12/20/2023] [Revised: 04/27/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND The specific effects of adverse childhood experiences (ACEs) in adulthood and senectitude were less known. We aim to examine the relationship between early ACEs and overall health condition as well as specific dimensions in the middle-aged and elderly population. METHODS In the 2019-2021 Behavioral Risk Factor Surveillance System Study, robust Poisson regression models were used to estimate the relationship between ACE exposure and current health status among adults aged 45 ≥ years. RESULTS Of the 195,472 participants, 53.8 % were female and the mean age was 65.0 years. Compared to populations without ACE, ACE exposures were more significantly associated with depression (PR: 2.03, 95 %CI: 1.94-2.21), frequent mental health (PR: 1.85, 95 %CI: 1.74-1.97) and subject cognitive decline (PR: 1.99, 95 %CI:1.85-2.14) than with physical health (PR: 1.37, 95 %CI: 1.32-1.44), with dose-response patterns. The association with mental disorder was especially significant among the elderly population. CONCLUSION Early ACEs are associated with adverse health outcomes that persist into later life, particularly mental disorders and cognitive decline. Poor mental health may indirectly influence associations with ACEs and cognitive decline as well as physical health. Our findings emphasize the importance of lifelong psychological screening and support for the ACE-exposed middle-aged and elderly population.
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Affiliation(s)
- Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Hongbin Qiu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Fan Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Zemin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Yi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Ye Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education; State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin, China
| | - Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education; State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China.
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20
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Loveday S, Chen L, Constable LN, Kabir A, White N, Goldfeld S, Sanci L, Hiscock H. Opening Pandora's box - key facilitators of practice change in detecting and responding to childhood adversity - a practitioner perspective. BMC Pediatr 2024; 24:461. [PMID: 39026201 PMCID: PMC11256471 DOI: 10.1186/s12887-024-04918-5] [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: 04/16/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Childhood adversities worsen physical and mental health across the lifespan. Health and social care practitioners play a key role in identifying and responding to childhood adversity, however, may be reluctant to do so due to a perceived lack of services to refer to, time pressures and a deficit of training and confidence. We aimed to (1) quantify changes in practitioner comfort and confidence to identify and respond to childhood adversity following a multimodal intervention within an integrated child and family health and social care hub and (2) to understand barriers and facilitators of practice change. METHODS Hub practitioners were surveyed about their competence and comfort to directly ask about and confidence to respond to adversity at baseline and then at six and twelve months post training. Interviews were undertaken to explore practitioner barriers and enablers of practice change. Interviews were recorded, transcribed verbatim, and analysed using reflexive thematic analysis. The theoretical domains framework was used to identify the key drivers of practice change. RESULTS Fifteen of 18 practitioners completed all three surveys and 70% reported increased competence and comfort to directly ask, and confidence to respond across a range of adversities over the 12-month intervention. Twenty-one practitioners completed interviews. Six themes were identified as either facilitators or barriers to practice change. Facilitator themes included (1) connection matters, (2) knowledge provides assurance, (3) confidence in ability and (4) choosing change. Barrier themes were (1) never enough time and (2) opening Pandora's box. Following analysis, key drivers of practice change were 'social influence', 'belief in capability', 'knowledge' and 'behaviour regulation' while barriers to practice change were 'environmental context and resources' and 'emotion'. CONCLUSIONS Practitioners reported improved confidence in identifying and responding to adversity through a multimodal intervention delivered in an integrated Child and Family Hub. Changing practice requires more than just education and training. Opportunities for social connection and coaching to improve self-confidence and perceived competence are needed to overcome the fear of opening Pandora's box.
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Affiliation(s)
- Sarah Loveday
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Lingling Chen
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Leanne N Constable
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ashraful Kabir
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Natalie White
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Parkville, VIC, Australia
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
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21
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Ruge J, Ehlers MR, Kastrinogiannis A, Klingelhöfer-Jens M, Koppold A, Abend R, Lonsdorf TB. How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms. eLife 2024; 13:e92700. [PMID: 39012794 PMCID: PMC11251725 DOI: 10.7554/elife.92700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 06/26/2024] [Indexed: 07/18/2024] Open
Abstract
Adverse childhood experiences (ACEs) are a major risk factor for the development of multiple psychopathological conditions, but the mechanisms underlying this link are poorly understood. Associative learning encompasses key mechanisms through which individuals learn to link important environmental inputs to emotional and behavioral responses. ACEs may impact the normative maturation of associative learning processes, resulting in their enduring maladaptive expression manifesting in psychopathology. In this review, we lay out a systematic and methodological overview and integration of the available evidence of the proposed association between ACEs and threat and reward learning processes. We summarize results from a systematic literature search (following PRISMA guidelines) which yielded a total of 81 articles (threat: n=38, reward: n=43). Across the threat and reward learning fields, behaviorally, we observed a converging pattern of aberrant learning in individuals with a history of ACEs, independent of other sample characteristics, specific ACE types, and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by diminished responding to conditioned threat cues. Furthermore, attenuated reward learning manifested in reduced accuracy and learning rate in tasks involving acquisition of reward contingencies. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization across both fields. We conclude that blunted threat and reward learning may represent a mechanistic route by which ACEs may become physiologically and neurobiologically embedded and ultimately confer greater risk for psychopathology. In closing, we discuss potentially fruitful future directions for the research field, including methodological and ACE assessment considerations.
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Affiliation(s)
- Julia Ruge
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
| | | | - Alexandros Kastrinogiannis
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Maren Klingelhöfer-Jens
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- University of BielefeldBielefeldGermany
| | - Alina Koppold
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
| | | | - Tina B Lonsdorf
- University Medical Center Hamburg-Eppendorf, Institute for Systems NeuroscienceHamburgGermany
- University of BielefeldBielefeldGermany
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22
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Gautschi J, Lätsch D. The effectiveness of interventions to prevent and reduce child maltreatment in high-income countries: An umbrella review. CHILD ABUSE & NEGLECT 2024; 153:106845. [PMID: 38761720 DOI: 10.1016/j.chiabu.2024.106845] [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: 01/23/2024] [Revised: 04/24/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND In recent decades, many interventions targeting the occurrence (primary prevention) or the recurrence (secondary prevention) of child abuse and neglect have been tested. Findings have been synthesized in several meta-analyses and systematic reviews. However, the range of interventions addressed in these studies is very broad, and an integrative assessment of this large spectrum is lacking. OBJECTIVE Focusing on high-income countries, we ask (i) what is known about the effectiveness of interventions to prevent or reduce child abuse and neglect and (ii) how robust this evidence is. METHODS A systematic review of systematic reviews, called an umbrella review, was conducted. Ten databases on OvidSP and Web of Science were searched up until April 2023. Narrative synthesis was used to document the publications' findings. RESULTS 44 publications were included in the umbrella review. We did not find that any type of intervention had a clear, consistent, and robust track record of preventing or reducing the occurrence of child abuse and neglect. Rather, publications examining the effectiveness of interventions in all areas frequently reported non-existent, small or inconsistent effects. However, positive effects for particular interventions in specific settings did emerge. Research methodologies showed several and often severe problems. CONCLUSIONS We suggest several measures to improve the quality of research and call on practitioners to be persistent in developing more effective interventions.
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Affiliation(s)
- Joel Gautschi
- Zurich University of Applied Sciences ZHAW, School of Social Work, Institute of Childhood, Youth, and Family, Pfingstweidstrasse 96, CH-8037 Zürich, Switzerland.
| | - David Lätsch
- Zurich University of Applied Sciences ZHAW, School of Social Work, Institute of Childhood, Youth, and Family, Pfingstweidstrasse 96, CH-8037 Zürich, Switzerland.
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23
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Horváth D, Kovács-Tóth B, Oláh B, Fekete Z. Trends in the dose-response relationship between adverse childhood experiences and maladaptive metacognitive beliefs: A cross-sectional study. Compr Psychiatry 2024; 132:152489. [PMID: 38663341 DOI: 10.1016/j.comppsych.2024.152489] [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: 02/03/2024] [Revised: 03/20/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Since the publication of the major research on adverse childhood experiences (ACE) at the turn of the millennium, our knowledge about the prevalence and physical and mental consequences of childhood adversities has increased substantially. In parallel, research on metacognition, which plays an important role in understanding our mental functioning, has also been on the rise. Although the adverse effects of ACEs on mental processes and the role of metacognitive deficits in the development of mental disorders are widely known, hardly any research into the interaction between these two areas has been conducted; this is what triggered our investigation. METHODS Our research was carried out as a cross-sectional study on a sample of 304 members of the general population. We measured ACEs with the 10-item Adverse Childhood Experiences Questionnaire and maladaptive metacognitions-positive and negative metacognitive beliefs, cognitive confidence, cognitive self-consciousness, and need to control thoughts- using the Meta-Cognitions Questionnaire. The closeness of the relationship between the ACE score and metacognitions was measured using Pearson's linear correlation coefficient, while the association of ACE accumulation with metacognitive beliefs was assessed using generalized linear models. RESULTS The most common ACE in our sample turned out to be emotional neglect (44.74%). All the examined maladaptive metacognitive beliefs correlate mildly to moderately with the number of suffered ACEs (r = 0.13-0.34), with an increase in the ACE score leading to a rise in the salience of maladaptive metacognitive beliefs. Moreover, a dose-response relationship was seen between increases in ACE scores and the overall values of metacognition, negative metacognitive beliefs, and the maladaptive metacognitive belief of the need to control thoughts. CONCLUSIONS Our results suggest that the more ACEs were experienced in childhood, the more pronounced the dysfunctional metacognitive beliefs are. Therefore, our findings emphasize the importance of further research into the topic.
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Affiliation(s)
- Dorottya Horváth
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, Hungary, 22. Móricz Zs. blvd., Debrecen 4032, Hungary.
| | - Beáta Kovács-Tóth
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, Hungary, 22. Móricz Zs. blvd., Debrecen 4032, Hungary.
| | - Barnabás Oláh
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, Hungary, 22. Móricz Zs. blvd., Debrecen 4032, Hungary.
| | - Zita Fekete
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, Hungary, 22. Móricz Zs. blvd., Debrecen 4032, Hungary.
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24
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Silva C, Moreira P, Moreira DS, Rafael F, Rodrigues A, Leite Â, Lopes S, Moreira D. Impact of Adverse Childhood Experiences in Young Adults and Adults: A Systematic Literature Review. Pediatr Rep 2024; 16:461-481. [PMID: 38921705 PMCID: PMC11206640 DOI: 10.3390/pediatric16020040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Investigations have shown the different impacts that ACEs have on an individual's adult life, on both physical and mental health, but they have not yet shown the issue of the influence of ACEs on adults and young adults. Objective/Participants and Setting: This systematic review, performed according to the PRISMA norms and guidelines, intended to understand the most frequent outcomes of adverse childhood experiences in the life of young adults and adults. METHODS Studies were identified through multiple literature search databases at EBSCOhost, Web of Science, and PubMed April 2023, and a total of 279 studies, published between 1999 and 2002, were excluded, 256 because of multiple factors: being duplicates, showing statistical analysis with correlations only, being systematic reviews or case studies, comprising individuals under the age of 18, and not meeting the intended theme; ultimately, we selected for the review a total of 23 studies. RESULTS AND CONCLUSIONS The impacts of the various articles are subdivided into three main themes: antisocial and criminal behaviour; sexual Behaviour and intimate partner violence; and attachment, quality of life, and therapeutic alliance.
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Affiliation(s)
- Candy Silva
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
| | - Patrícia Moreira
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
| | - Diana Sá Moreira
- Institute of Psychology and Neuropsychology of Porto—IPNP Health, 4100-136 Porto, Portugal;
| | - Filipa Rafael
- School of Education, The Polytechnic Institute of Oporto (IPP), 4200-465 Porto, Portugal;
| | - Anabela Rodrigues
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
| | - Ângela Leite
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
| | - Sílvia Lopes
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Diana Moreira
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 1649-023 Braga, Portugal; (C.S.); (P.M.); (A.R.); (Â.L.)
- Institute of Psychology and Neuropsychology of Porto—IPNP Health, 4100-136 Porto, Portugal;
- Centro de Solidariedade de Braga/Projecto Homem, R. do Alcaide 31, 4700-024 Braga, Portugal
- Observatory Permanent Violence and Crime (OPVC), FP-I3ID, University Fernando Pessoa, 4249-004 Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences and CPUP—Center for Psychology at University of Porto, 4200-135 Porto, Portugal
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25
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Patrizia P, Pingault JB, Eley TC, McCrory E, Viding E. Causal and common risk pathways linking childhood maltreatment to later intimate partner violence victimization. RESEARCH SQUARE 2024:rs.3.rs-4409798. [PMID: 38883746 PMCID: PMC11177992 DOI: 10.21203/rs.3.rs-4409798/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Childhood maltreatment and intimate partner violence (IPV) victimization are major psychiatric risk factors. Maltreatment substantially increases the likelihood of subsequent IPV victimization, but what drives this association is poorly understood. We analyzed retrospective self-reports of maltreatment and IPV in 12794 participants (58% women, 42% men) from the Twins Early Development Study at ages 21 and 26 using quantitative genetic methods. We estimated the etiological influences common to maltreatment and IPV, and the direct causal effect of maltreatment on IPV beyond such common influences. Participants exposed to maltreatment (~7% of the sample) were 3 times more likely to experience IPV victimization than their peers at age 21, 4 times more likely at 26. The association between maltreatment and IPV was mostly due to environmental influences shared by co-twins (42-43%) and genetic influences (30-33%). The association between maltreatment and IPV was similar for women and men, but its etiology partly differed by sex. Maltreatment had a moderate-to-large effect on IPV in phenotypic models (β = 0.23-0.34), decreasing to a small-to-moderate range in causal models accounting for their common etiology (β = 0.15-0.21). Risk factors common to maltreatment and IPV victimization are largely familial in origin, environmental and genetic. Even considering common risk factors, experiencing maltreatment is causally related to subsequent IPV victimization. Interventions promoting safe intimate relationships among young adults exposed to maltreatment are warranted and should address family-level environmental risk and individual-level risk shaped by genetics.
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Affiliation(s)
- Pezzoli Patrizia
- Division of Psychology and Language Sciences, University College London (UCL)
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London (UCL)
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Thalia C Eley
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London (UCL)
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London (UCL)
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26
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Banerjee A. Disparities by Social Determinants of Health: Links Between Long COVID and Cardiovascular Disease. Can J Cardiol 2024; 40:1123-1134. [PMID: 38428523 DOI: 10.1016/j.cjca.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
Long COVID has been defined by the World Health Organisation as "continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation." Cardiovascular disease is implicated as a risk factor, concomitant condition, and consequence of long COVID. As well as heterogeneity in definition, presentation, and likely underlying pathophysiology of long COVID, disparities by social determinants of health, extensively studied and described in cardiovascular disease, have been observed in 3 ways. First, underlying long-term conditions, such as cardiovascular disease and its risk factors, are associated with incidence and severity of long COVID, and previously described socioeconomic disparities in these factors are important in exacerbating disparities in long COVID. Second, socioeconomic disparities in management of COVID-19 may themselves lead to distal disparities in long COVID. Third, there are socioeconomic disparities in the way that long COVID is diagnosed, managed, and prevented. Together, factors such as age, sex, deprivation, and ethnicity have far-reaching implications in this new postviral syndrome across its management spectrum. There are similarities and differences compared with disparities for cardiovascular disease. Some of these disparities are in fact, inequalities, that is, rather than simply observed variations, they represent injustices with costs to individuals, communities, and economies. This review of current literature considers opportunities to prevent or at least attenuate these socioeconomic disparities in long COVID and cardiovascular disease, with special challenges for research, clinical practice, public health, and policy in a new disease which is evolving.
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Affiliation(s)
- Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom; Department of Cardiology, Barts Health NHS Trust, London, United Kingdom.
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27
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Hu Y, Wang Y, Zhao Z, Zhao B. Reconsidering gas as clean energy: Switching to electricity for household cooking to reduce NO 2-attributed disease burden. ECO-ENVIRONMENT & HEALTH 2024; 3:174-182. [PMID: 38638171 PMCID: PMC11021829 DOI: 10.1016/j.eehl.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 04/20/2024]
Abstract
Nitrogen dioxide (NO2) is a prevalent air pollutant in urban areas, originating from outdoor sources, household gas consumption, and secondhand smoke. The limited evaluation of the disease burden attributable to NO2, encompassing different health effects and contributions from various sources, impedes our understanding from a public health perspective. Based on modeled NO2 exposure concentrations, their exposure-response relationships with lung cancer, chronic obstructive pulmonary disease, and diabetes mellitus, and baseline disability-adjusted life years (DALYs), we estimated that 1,675 (655-2,624) thousand DALYs were attributable to NO2 in urban China in 2019 [138 (54-216) billion Chinese yuan (CNY) economic losses]. The transition from gas to electricity for household cooking was estimated to reduce the attributable economic losses by 35%. This reduction falls within the range of reductions achieved when outdoor air meets the World Health Organization interim target 3 and air quality guidelines for annual NO2, highlighting the significance of raising awareness of gas as a polluting household energy for cooking. These findings align with global sustainable development initiatives, providing a sustainable solution to promote public health while potentially mitigating climate change.
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Affiliation(s)
- Ying Hu
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Ye Wang
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai 200433, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200433, China
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200433, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing 100084, China
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28
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Ahn S, Kim S, Zhang H, Dobalian A, Slavich GM. Lifetime adversity predicts depression, anxiety, and cognitive impairment in a nationally representative sample of older adults in the United States. J Clin Psychol 2024; 80:1031-1049. [PMID: 38294127 PMCID: PMC11216061 DOI: 10.1002/jclp.23642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/28/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Although life stress and adversity are well-known risk factors for mental health problems and cognitive impairment among older adults, limited research has comprehensively examined the impact of both childhood and adulthood adversity on psychiatric and cognitive impairment symptoms over a prolonged period. To address this issue, we investigated how lifetime adversity exposure is related to symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the United States. METHOD We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3496 individuals (59.9% female), aged ≥64 years old (Mage = 76.0 ± 7.6 years in 2016). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities, and later-life depression, anxiety, and cognitive impairment. RESULTS Many participants experienced a significant early life (38%) or adulthood (79%) stressor. Moreover, experiencing one childhood adversity (vs. none) was associated with a 17.4% increased risk of adulthood adversity. Finally, as hypothesized, childhood adversity exposure was related to experiencing more depression and anxiety symptoms in later life, whereas adulthood stressor exposure predicted more cognitive impairment as well as more depression and anxiety symptoms. DISCUSSION These findings demonstrate significant associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help healthcare professionals and policymakers identify individuals who could potentially benefit from interventions designed to reduce stress and enhance resilience.
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Affiliation(s)
- SangNam Ahn
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
- Center for Population Health and Aging, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Seonghoon Kim
- School of Economics, Singapore Management University, Singapore, Singapore
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Aram Dobalian
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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29
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Hughes K, Bellis MA, Cresswell K, Hill R, Ford K, Hopkins JC. Examining relationships between adverse childhood experiences and coping during the cost-of-living crisis using a national cross-sectional survey in Wales, UK. BMJ Open 2024; 14:e081924. [PMID: 38692715 PMCID: PMC11086514 DOI: 10.1136/bmjopen-2023-081924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect individuals' resilience to stressors and their vulnerability to mental, physical and social harms. This study explored associations between ACEs, financial coping during the cost-of-living crisis and perceived impacts on health and well-being. DESIGN National cross-sectional face-to-face survey. Recruitment used a random quota sample of households stratified by health region and deprivation quintile. SETTING Households in Wales, UK. PARTICIPANTS 1880 Welsh residents aged ≥18 years. MEASURES Outcome variables were perceived inability to cope financially during the cost-of-living crisis; rising costs of living causing substantial distress and anxiety; and self-reported negative impact of rising costs of living on mental health, physical health, family relationships, local levels of antisocial behaviour and violence, and community support. Nine ACEs were measured retrospectively. Socioeconomic and demographic variables included low household income, economic inactivity, residential deprivation and activity limitation. RESULTS The prevalence of all outcomes increased strongly with ACE count. Perceived inability to cope financially during the cost-of-living crisis increased from 14.0% with 0 ACEs to 51.5% with 4+ ACEs. Relationships with ACEs remained after controlling for socioeconomic and demographic factors. Those with 4+ ACEs (vs 0 ACEs) were over three times more likely to perceive they would be unable to cope financially and, correspondingly, almost three times more likely to report substantial distress and anxiety and over three times more likely to report negative impacts on mental health, physical health and family relationships. CONCLUSIONS Socioeconomically deprived populations are recognised to be disproportionately impacted by rising costs of living. Our study identifies a history of ACEs as an additional vulnerability that can affect all socioeconomic groups. Definitions of vulnerability during crises and communications with services on who is most likely to be impacted should consider childhood adversity and history of trauma.
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Affiliation(s)
- Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Katie Cresswell
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Rebecca Hill
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - Kat Ford
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Joanne C Hopkins
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
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Parker CH, Minnis H, Ougrin D. Editorial perspective: protective factors following cumulative childhood adversity. BJPsych Open 2024; 10:e92. [PMID: 38650053 PMCID: PMC11060067 DOI: 10.1192/bjo.2024.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 04/25/2024] Open
Abstract
Adverse childhood experiences can have a significant impact on adult psychosocial outcomes. However, negative outcomes are not inevitable, and protective factors can interrupt the realisation of negative developmental trajectories and result in positive adaptation in spite of childhood adversity. Interventions that promote social support, encourage education and academic achievement, and address specific personality and dispositional factors are likely to beneficial for those with experience of childhood adversity. Holistic assessment that considers both neurodevelopmental conditions and trauma symptoms is also important for promoting resilience and avoiding assumptions that mental and behavioural problems in children with cumulative adversity are purely 'social'.
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Affiliation(s)
- Camilla H. Parker
- East London NHS Foundation Trust, London, UK; and Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - Helen Minnis
- Institute of Health and Wellbeing, Academic CAMHS, West Glasgow Ambulatory Care Hospital, University of Glasgow, UK
| | - Dennis Ougrin
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK
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Amene EW, Annor FB, Gilbert LK, McOwen J, Augusto A, Manuel P, N'gouanma Nobah MTV, Massetti GM. Prevalence of Adverse Childhood Experiences in sub-Saharan Africa: A multicountry analysis of the Violence Against Children and Youth Surveys (VACS). CHILD ABUSE & NEGLECT 2024; 150:106353. [PMID: 37482505 PMCID: PMC11330677 DOI: 10.1016/j.chiabu.2023.106353] [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] [Received: 04/11/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Adverse Childhood Experiences are traumatic events early in life and have been associated with significant negative health outcomes. OBJECTIVE To estimate the prevalence of ACEs in five low- and middle-income sub-Saharan African countries. PARTICIPANTS AND SETTING Nationally representative data from the Cote d'Ivoire (2018), Kenya (2019), Lesotho (2018), Mozambique (2019), and Namibia (2019) Violence Against Children and Youth Surveys (VACS) were used. Analyses were restricted to youth ages 18-24 years (n = 8766 females and 2732 males). METHODS VACS data were analyzed to generate sex-stratified weighted prevalence of individual ACEs (including sexual, physical, and emotional violence; witnessing interparental violence and violence in the community; and orphanhood) and aggregate ACEs (total ACEs; 0, 1-2, and 3 or more), for each country and combined. RESULTS The most common type of ACEs among both females and males was witnessing physical violence (males: 55.0 % [95 % CI: 51.1-58.8] and females: 37.2 % [95 % CI = 34.3-40.1]) followed by experiencing physical violence (males: 49.7 % [95 % CI = 45.5-53.9] and in females: 36.5 % [95 % CI = 33.8-39.2]). Prevalence of sexual violence was significantly higher in females than in males (16.0 % [95 % CI = 13.9-18.2] vs 8.3 % [95 % CI = 7.0-9.8]; p < 0.001). About 72 % of females and 82 % of males have experienced at least one form of ACE with 20 % of females and 24.2 % of males experiencing 3 or more ACEs. CONCLUSION This study demonstrated that majority of the children in countries in sub-Saharan Africa have experienced multiple ACEs in their lifetime. Understanding the extent of the problem will help design early interventions to reduce childhood exposure to ACEs or mitigate against the harmful impact of ACEs.
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Affiliation(s)
- Ermias W Amene
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service Commissioned Corps, United States
| | - Leah K Gilbert
- United States Public Health Service Commissioned Corps, United States; Office of the Chief Operating Officer, Office of Safety, Security and Asset Management, Occupational Health Clinic, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jordan McOwen
- Epidemiology/Surveillance Branch, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Epidemiology/Surveillance Branch, Centers for Disease Control and Prevention, Mozambique
| | | | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Counts NZ, Feinberg ME, Lee JK, Smith JD. Modeling Long-Term Budgetary Impacts of Prevention: An Overview of Meta-analyses of Relationships Between Key Health Outcomes Across the Life-Course. JOURNAL OF PREVENTION (2022) 2024; 45:177-192. [PMID: 38157132 DOI: 10.1007/s10935-023-00744-0] [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] [Accepted: 08/09/2023] [Indexed: 01/03/2024]
Abstract
Budget analysis entities often cannot capture the full downstream impacts of investments in prevention services, programs, and interventions. This study describes and applies an approach to synthesizing existing literature to more fully account for these effects. This study reviewed meta-analyses in PubMed published between Jan 1, 2010 and Dec 31, 2019. The initial search included meta-analyses on the association between health risk factors, including maternal behavioral health, intimate partner violence, child maltreatment, depression, and obesity, with a later health condition. Through a snowball sampling-type approach, the endpoints of the meta-analyses identified became search terms for a subsequent search, until each health risk was connected to one of the ten costliest health conditions. These results were synthesized to create a path model connecting the health risks to the high-cost health conditions in a cascade. Thirty-seven meta-analyses were included. They connected early-life health risk factors with six high-cost health conditions: hypertension, diabetes, asthma and chronic obstructive pulmonary disorder, mental disorders, heart conditions, and trauma-related disorders. If confounders could be controlled for and causality inferred, the cascading associations could be used to more fully account for downstream impacts of preventive interventions. This would support budget analysis entities to better include potential savings from investments in chronic disease prevention and promote greater implementation at scale.
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Affiliation(s)
- Nathaniel Z Counts
- Mental Health America, 500 Montgomery St, Suite 820, Alexandria, VA, 22314, USA.
| | - Mark E Feinberg
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
| | - Jin-Kyung Lee
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
| | - Justin D Smith
- Division of Health System Innovation and Research, Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
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Knipschild R, Hein I, Pieters S, Lindauer R, Bicanic IAE, Staal W, de Jongh A, Klip H. Childhood adversity in a youth psychiatric population: prevalence and associated mental health problems. Eur J Psychotraumatol 2024; 15:2330880. [PMID: 38530708 DOI: 10.1080/20008066.2024.2330880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024] Open
Abstract
Background: Childhood adversity can have lasting negative effects on physical and mental health. This study contributes to the existing literature by describing the prevalence rates and mental health outcomes related to adverse childhood experiences (ACEs) among adolescents registered for mental health care.Methods: Participants in this cross-sectional study were youths (aged 12-18 years) who were referred to outpatient psychiatric departments in the Netherlands. Demographic information was collected from the medical records. The Child Trauma Screening Questionnaire (CTSQ) was used to examine the presence of ACEs and posttraumatic stress symptoms (PTSS). To assess mental health problems, we used the Dutch translation of the Youth Self Report. Descriptive statistics and frequencies were used to calculate prevalence rates across the various ACEs domains. ANOVA and chi-square tests were used to explore the relationship between ACEs and mental health.Results: Of the 1373 participants, 69.1% reported having experienced at least one ACE and 17.1% indicated exposure to four or more ACEs in their lives. Although there was substantial overlap among all ACE categories, the most frequently reported were bullying (49.2%), emotional abuse (17.8%), physical abuse (12.2%), and sexual abuse (10.1%). Female adolescents (72.7%) reported significantly more ACEs than their male counterparts (27.0%). Furthermore, a higher number of ACEs was associated with significantly more self-reported general mental health problems, an elevated prevalence of both mood and post-traumatic stress disorders, and a greater presence of two or more co-existing psychiatric diagnoses (comorbid psychiatric classification).Conclusions: This cross-sectional study on childhood adversity and its association with mental health showed that ACEs are highly prevalent in youth registered for mental health care. This study provides support for a graded and cumulative relationship between childhood adversity and mental health problems.
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Affiliation(s)
- Rik Knipschild
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | - Irma Hein
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sara Pieters
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
- Department of Psychology, Radboud University, Nijmegen, the Netherlands
| | - Ramon Lindauer
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Iva A E Bicanic
- National Psychotrauma Centre for Children and Youth, University Medical Centre Utrecht, Utrecht, Leiden, the Netherlands
| | - Wouter Staal
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands
- Leiden Institution for Brain and Cognition, the Netherlands
| | - Ad de Jongh
- Psychotrauma Expertise Centre (PSYTREC), Bilthoven, the Netherlands
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, the Netherlands
- School of Health Sciences, Salford University, Manchester, UK
- Institute of Health and Society, University of Worcester, Worcester, UK
- School of Psychology, Queen's University, Belfast, Northern Ireland
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
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Huang R, Li Y, Ma C, Ren R, Yuan X, Peng Y, Wang D. Adverse childhood experiences, sarcopenia, and social participation in older adults: a cohort study. BMC Public Health 2024; 24:711. [PMID: 38443827 PMCID: PMC10916056 DOI: 10.1186/s12889-024-18138-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES To examine the relationships between adverse childhood experiences (ACEs) and developing sarcopenia in older adults and the modifying effects of active social participation. METHODS This prospective cohort study used survey data from the China Health and Retirement Longitudinal Study, including baseline surveys from 2011, follow-up data from 2013, follow-up data from 2015, and information on ACEs from the 2014 Life History Survey. Information concerning 10 ACEs, including five threat-related ACEs and five deprivation-related ACEs before 17 years of age was obtained by questionnaires through face-to-face interviews. Sarcopenia status was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm, consisted of low muscle mass, and low muscle strength, or poor physical performance. The relationship between ACEs, social participation, and sarcopenia was evaluated using Cox proportional hazard regression models. RESULTS The study population comprised 6859 older adults in main analyses. Having experienced ≥ 3 ACEs led to an increased 31% risk of developing sarcopenia (hazard ratio [HR]:1.31, 95% confidence interval [CI]:1.10-1.56). Participants having experienced ≥ 2 threat-related ACEs (HR:1.22, 95%CI:1.04-1.43) or deprivation-related ACEs (HR:1.22, 95%CI:1.02-1.46) had a 22% higher risk of developing sarcopenia. Active social participation significantly modified the association between ACEs (p < 0.05), especially threat-related ACEs (p < 0.05), and sarcopenia. CONCLUSIONS ACEs were associated with the development of sarcopenia; however, social participation had a modifying effect. These findings provide insights for early identification of vulnerable groups, advance intervention timing, and highlight the benefits of promoting active social participation among individuals with sarcopenia who have experienced ACEs.
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Affiliation(s)
- Runnian Huang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Yi Li
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Chunhua Ma
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Rui Ren
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Xiaoyue Yuan
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Yang Peng
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China.
| | - Difei Wang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China.
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Wattanatchariya K, Narkpongphun A, Kawilapat S. The relationship between parental adverse childhood experiences and parenting behaviors. Acta Psychol (Amst) 2024; 243:104166. [PMID: 38295656 DOI: 10.1016/j.actpsy.2024.104166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/14/2024] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are strongly related to the development of various health problems. Several previous studies have revealed the link between ACEs, parental mental health, and child psychopathology. However, the direct association between ACEs and parenting behaviors is still understudied. OBJECTIVES To examine the relationship between parental ACEs and parenting, the effect of mental health which possibly mediated parenting behaviors, and the prevalence of ACEs. PARTICIPANTS AND SETTING Data was obtained from 403 parents of 6-18-year-old students in Chiang Mai, Thailand, from January to February 2023. METHODS Relationships among ACEs, depression, anxiety, stress, and parenting behaviors were examined using correlation analysis and path analysis. The direct and indirect effects of potential associated factors on parenting behaviors were also examined. RESULTS Overall, 62.5 % of parents reported at least one ACE. Path analysis revealed significant direct effects of ACEs on poorer mental health in all subscales: depression, anxiety, and stress (β = 0.19, 0.21, 0.18 respectively). ACEs were directly associated with the use of corporal punishment (β = 0.15). Stress also had a positive direct effect on inconsistent discipline (β = 0.18). CONCLUSION ACEs are common in parents and associated with mental health problems. ACEs also affect parenting behaviors via direct and indirect pathways. It is important to detect and provide interventions to parents having a history of ACEs and poor mental health to improve the quality of parenting practices.
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Affiliation(s)
- Kewalin Wattanatchariya
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si, Phum, Muang, Chiang Mai 50200, Thailand.
| | - Assawin Narkpongphun
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si, Phum, Muang, Chiang Mai 50200, Thailand.
| | - Suttipong Kawilapat
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si, Phum, Muang, Chiang Mai 50200, Thailand.
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Racine NM, MacMillan HL, Madigan S. Understanding and addressing adverse childhood experiences in the face of the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2024; 33:945-947. [PMID: 36131164 PMCID: PMC9491654 DOI: 10.1007/s00787-022-02087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Nicole M Racine
- University of Ottawa, 136 Jean-Jacques Lussier, Vanier 4087, Ottawa, ON, K1N 6N5, Canada.
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Wen S, Zhu J, Han X, Li Y, Liu H, Yang H, Hou C, Xu S, Wang J, Hu Y, Qu Y, Liu D, Aspelund T, Fang F, Valdimarsdóttir UA, Song H. Childhood maltreatment and risk of endocrine diseases: an exploration of mediating pathways using sequential mediation analysis. BMC Med 2024; 22:59. [PMID: 38331807 PMCID: PMC10854183 DOI: 10.1186/s12916-024-03271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), including childhood maltreatment, have been linked with increased risk of diabetes and obesity during adulthood. A comprehensive assessment on the associations between childhood maltreatment and all major endocrine diseases, as well as the relative importance of different proposed mechanistic pathways on these associations, is currently lacking. METHODS Based on the UK Biobank, we constructed a cohort including 151,659 participants with self-reported data on childhood maltreatment who were 30 years of age or older on/after January 1, 1985. All participants were followed from the index date (i.e., January 1, 1985, or their 30th birthday, whichever came later) until the first diagnosis of any or specific (12 individual diagnoses and 9 subtypes) endocrine diseases, death, or the end of follow-up (December 31, 2019), whichever occurred first. We used Cox models to examine the association of childhood maltreatment, treated as continuous (i.e., the cumulative number of experienced childhood maltreatment), ordinal (i.e., 0, 1 and ≥ 2), or binary (< 2 and ≥ 2) variable, with any and specific endocrine diseases, adjusted for multiple covariates. We further examined the risk of having multiple endocrine diseases using Linear or Logistic Regression models. Then, sequential mediation analyses were performed to assess the contribution of four possible mechanisms (i.e., suboptimal socioeconomic status (SES), psychological adversities, unfavorable lifestyle, and biological alterations) on the observed associations. RESULTS During an average follow-up of 30.8 years, 20,885 participants received a diagnosis of endocrine diseases. We observed an association between the cumulative number of experienced childhood maltreatment and increased risk of being diagnosed with any endocrine disease (adjusted hazard ratio (HR) = 1.10, 95% confidence interval 1.09-1.12). The HR was 1.26 (1.22-1.30) when comparing individuals ≥ 2 with those with < 2 experienced childhood maltreatment. We further noted the most pronounced associations for type 2 diabetes (1.40 (1.33-1.48)) and hypothalamic-pituitary-adrenal (HPA)-axis-related endocrine diseases (1.38 (1.17-1.62)), and the association was stronger for having multiple endocrine diseases, compared to having one (odds ratio (95% CI) = 1.24 (1.19-1.30), 1.35 (1.27-1.44), and 1.52 (1.52-1.53) for 1, 2, and ≥ 3, respectively). Sequential mediation analyses showed that the association between childhood maltreatment and endocrine diseases was consistently and most distinctly mediated by psychological adversities (15.38 ~ 44.97%), while unfavorable lifestyle (10.86 ~ 25.32%) was additionally noted for type 2 diabetes whereas suboptimal SES (14.42 ~ 39.33%) for HPA-axis-related endocrine diseases. CONCLUSIONS Our study demonstrates that adverse psychological sequel of childhood maltreatment constitutes the main pathway to multiple endocrine diseases, particularly type 2 diabetes and HPA-axis-related endocrine diseases. Therefore, increased access to evidence-based mental health services may also be pivotal in reducing the risk of endocrine diseases among childhood maltreatment-exposed individuals.
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Affiliation(s)
- Shu Wen
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jianwei Zhu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Han
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Haowen Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Can Hou
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Shishi Xu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Division of Endocrinology & Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Junren Wang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Di Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Sichuan University - Pittsburgh Institute, Sichuan University, Chengdu, China
| | - Thor Aspelund
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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Kirkbride JB, Anglin DM, Colman I, Dykxhoorn J, Jones PB, Patalay P, Pitman A, Soneson E, Steare T, Wright T, Griffiths SL. The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry 2024; 23:58-90. [PMID: 38214615 PMCID: PMC10786006 DOI: 10.1002/wps.21160] [Citation(s) in RCA: 53] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants that cause mental ill health. Relying as far as possible on high-quality evidence, we first map out the literature that supports a causal link between social determinants and later mental health outcomes. Given the breadth of this topic, we focus on the most pervasive social determinants across the life course, and those that are common across major mental disorders. We draw primarily on the available evidence from the Global North, acknowledging that other global contexts will face both similar and unique sets of social determinants that will require equitable attention. Much of our evidence focuses on mental health in groups who are marginalized, and thus often exposed to a multitude of intersecting social risk factors. These groups include refugees, asylum seekers and displaced persons, as well as ethnoracial minoritized groups; lesbian, gay, bisexual, transgender and queer (LGBTQ+) groups; and those living in poverty. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health. Following this, we provide a review of the evidence concerning candidate preventive strategies to intervene on social determinants of mental health. These interventions fall broadly within the scope of universal, selected and indicated primary prevention strategies, but we also briefly review important secondary and tertiary strategies to promote recovery in those with existing mental disorders. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health.
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Affiliation(s)
| | - Deidre M Anglin
- City College, City University of New York, New York, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Praveetha Patalay
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Thomas Steare
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Talen Wright
- Division of Psychiatry, University College London, London, UK
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Tan H, Zhou H, Chen J, Ren H, Guo Y, Jiang X. Association of early life adversity with cardiovascular disease and its potential mechanisms: a narrative review. Front Public Health 2024; 12:1341266. [PMID: 38362223 PMCID: PMC10867864 DOI: 10.3389/fpubh.2024.1341266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Strong epidemiological evidence has shown that early life adversity (ELA) has a profound negative impact on health in adulthood, including an increased risk of cardiovascular disease, the leading cause of death worldwide. Here, we review cohort studies on the effects of ELA on cardiovascular outcomes and the possible underlying mechanisms. In addition, we summarize relevant studies in rodent models of ELA. This review reveals that the prevalence of ELA varies between regions, time periods, and sexes. ELA increases cardiovascular health risk behaviors, susceptibility to mental illnesses, and neuroendocrine and immune system dysfunction in humans. Rodent models of ELA have been developed and show similar cardiovascular outcomes to those in humans but cannot fully replicate all ELA subtypes. Therefore, combining cohort and rodent studies to further investigate the mechanisms underlying the association between ELA and cardiovascular diseases may be a feasible future research strategy.
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Affiliation(s)
- Huiying Tan
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Huiting Zhou
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Jingmei Chen
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Huixia Ren
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Yi Guo
- Department of Neurology, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Xin Jiang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital, Shenzhen, China
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Myroniuk S, Reitsema AM, de Jonge P, Jeronimus BF. Childhood abuse and neglect and profiles of adult emotion dynamics. Dev Psychopathol 2024:1-19. [PMID: 38196323 DOI: 10.1017/s0954579423001530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Childhood maltreatment (CM) is experienced by ∼40% of all children at major personal and societal costs. The divergent associations between emotional, physical, and sexual abuse or neglect in childhood and differences in adult emotional functioning and regulation were examined in terms of daily emotion intensity, variability, instability, inertia, and diversity, reported over 30 days by 290 Dutch aged 19-73. Participants described their abuse/neglect experiences retrospectively using the Childhood Trauma Questionnaire (CTQ). Dissecting CM effects on adult emotion dynamics may inform theories on the ontogenesis and functioning of emotions, on effects of abuse and neglect, to better understand (dys)functional emotional development, and to prevent their adverse sequelae. Structural equation models (SEM) showed that most types of CM were associated with specific patterns of emotion dynamics, and only emotional abuse had no unique effects on the emotional dynamic indices. Emotional neglect was associated with most measures of emotion dynamics (i.e., less intense, variable, unstable, and diverse emotions). Sexual abuse associated with increases and physical neglect decreases in negative affect variability and instability. Physical abuse was associated with inertia but with a small effect size. Social contact frequency did not mediate much of the relationship between CM types and emotion dynamics.
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Affiliation(s)
- S Myroniuk
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - A M Reitsema
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Department of Developmental Psychology, University of Utrecht, Utrecht, The Netherlands
| | - P de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - B F Jeronimus
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
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Elrefaay SMM, Elyzal AS. Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation. J Psychosoc Nurs Ment Health Serv 2024; 62:45-54. [PMID: 37527517 DOI: 10.3928/02793695-20230726-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].
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Bussières A, Hancock MJ, Elklit A, Ferreira ML, Ferreira PH, Stone LS, Wideman TH, Boruff JT, Al Zoubi F, Chaudhry F, Tolentino R, Hartvigsen J. Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2284025. [PMID: 38111090 PMCID: PMC10993817 DOI: 10.1080/20008066.2023.2284025] [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: 05/11/2023] [Accepted: 08/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are lacking.Objectives: This systematic review and meta-analysis aimed to evaluate associations between exposure to ACEs and chronic pain and pain-related disability in adults.Methods: We searched 10 electronic databases from inception to February 2023. We included observational studies assessing associations between direct ACEs (childhood sexual, physical, emotional abuse, or neglect) alone or in combination with indirect ACEs (witnessing domestic violence, household mental illness), and adult chronic pain (≥3 months duration) and pain-related disability (daily activities limited by chronic pain). Pairs of reviewers independently extracted data and assessed study risks of bias. Random-effect models were used to calculate pooled adjusted odds ratios [aOR]. Tau square [T2], 95% prediction intervals [95%PI] and I2 expressed the amount of heterogeneity, and meta-regressions and subgroup meta-analyses investigated sources of heterogeneity (PROSPERO: CRD42020150230).Results: We identified 85 studies including 826,452 adults of which 57 studies were included in meta-analyses. Study quality was generally good or fair (n = 70). The odds of reporting chronic pain in adulthood were significantly higher among individuals exposed to a direct ACE (aOR, 1.45, 95%CI, 1.38-1.53). Individuals reporting childhood physical abuse were significantly more likely to report both chronic pain (aOR, 1.50, 95CI, 1.39-1.64) and pain-related disability (1.46, 95CI, 1.03-2.08) during adulthood. Exposure to any ACEs alone or combined with indirect ACEs significantly increase the odds of adult chronic painful conditions (aOR, 1.53, 95%CI, 1.42-1.65) and pain-related disability (aOR, 1.29; 95%CI, 1.01-1.66). The risk of chronic pain in adulthood significantly increased from one ACE (aOR, 1.29, 95%CI, 1.22-1.37) to four or more ACEs (1.95, 95%CI, 1.73-2.19).Conclusions: Single and cumulative ACEs are significantly associated with reporting of chronic pain and pain-related disability as an adult.
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Affiliation(s)
- André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Mark J. Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern DenmarkOdense, Denmark
| | - Manuela L. Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paulo H. Ferreira
- Musculoskeletal Health, Faculty of Health Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Laura S. Stone
- Faculty of Dentistry, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Timothy H. Wideman
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Jill T. Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Fauzia Chaudhry
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Raymond Tolentino
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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Hudson M, Johnson MI. Hidden family rules: perspective on a dysfunctional paternalistic system and the persistence of pain. FRONTIERS IN PAIN RESEARCH 2023; 4:1303853. [PMID: 38162891 PMCID: PMC10755869 DOI: 10.3389/fpain.2023.1303853] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
This article explores how paternalistic control and power reside within the family system and how this may influence pain and its persistence. Drawing upon clinical case studies and existing literature, this exploration emphasises the role of paternal dysfunction in creating emotional memory images and delves into how this may influence the chronification and treatment resistance of pain (i.e., making pain "sticky"). We argue that a dysfunctional paternalistic family system, often characterised by authoritarian dynamics, emotional neglect, and abuse, results in adverse experiences and emotional memory images that create a fertile ground for the entrenchment and propagation of psychosomatic symptoms, including pain. Further, the paper emphasizes the potential intergenerational effects of such a scenario, where inherited "Family Rules" drive maladaptive coping mechanisms, which contribute to the persistence of psychological and physiological distress across generations. Understanding these complexities offers new perspectives on treating psychological disorders and their physiological ramifications. It also highlights the urgency of addressing dysfunctional familial dynamics in psychotherapeutic interventions for both immediate and long-term psychophysiological health outcomes.
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Affiliation(s)
- Matt Hudson
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, United Kingdom
- Mind Help Limited, Durham, United Kingdom
| | - Mark I. Johnson
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, United Kingdom
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Nurmatov U, Cowley LE, Rodrigues LB, Naughton A, Debelle G, Alfandari R, Lamela D, Otterman G, Jud A, Ntinapogias A, Laajasalo T, Soldino V, Stancheva V, Caenazzo L, Vaughan R, Christian CW, Drabarek K, Kemp AM, Hurt L. Consensus building on definitions and types of child maltreatment to improve recording and surveillance in Europe: protocol for a multi-sectoral, European, electronic Delphi study. BMJ Open 2023; 13:e076517. [PMID: 38086601 PMCID: PMC10729059 DOI: 10.1136/bmjopen-2023-076517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Child maltreatment (CM) is a complex global public health issue with potentially devastating effects on individuals' physical and mental health and well-being throughout the life course. A lack of uniform definitions hinders attempts to identify, measure, respond to, and prevent CM. The aim of this electronic Delphi (e-Delphi) study is to build consensus on definitions and types of CM for use in surveillance and multi-sectoral research in the 34 countries in the Euro-CAN (Multi-Sectoral Responses to Child Abuse and Neglect in Europe) project (COST Action CA19106). METHODS AND ANALYSIS The e-Delphi study will consist of a maximum of three rounds conducted using an online data collection platform. A multi-disciplinary expert panel consisting of researchers, child protection professionals (health and social care), police, legal professionals and adult survivors of CM will be purposefully recruited. We will approach approximately 100 experts, with between 50 and 60 of these anticipated to take part. Participants will rate their agreement with a range of statements relating to operational definitions and types of CM, and free-text comments on each of the statements to give further detail about their responses and areas of uncertainty. Consensus has been defined a priori as ≥70% of the panel agreeing or disagreeing with the statement after the final round. The responses to the open-ended questions will be analysed using a 'codebook' approach to thematic analysis, and used to refine the statements between rounds where no consensus is reached. ETHICS AND DISSEMINATION Ethical approval has been granted from the Cardiff University School of Medicine ethics committee (reference number SMREC22/96). Results will be submitted for publication in a peer-reviewed journal and presented at workshops (including for the participants) and international academic conferences. The Euro-CAN network will also be used to disseminate the results, with results briefings and presentations to key public health and other relevant organisations in the field.
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Affiliation(s)
- Ulugbek Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | | | | | | | | | - Diogo Lamela
- Digital Human-Environment Interaction Lab (HEI-LAB), Lusófona University, Porto, Portugal
| | - Gabriel Otterman
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Athanasios Ntinapogias
- Department of Mental Health and Social Welfare, Institute of Child Health, Athens, Greece
| | - Taina Laajasalo
- Competence Cluster for Violence Prevention Work, Special Services Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Virginia Soldino
- University Research Institute of Criminology and Criminal Science, University of Valencia, Valencia, Spain
| | - Vaska Stancheva
- Department of Medical Social Sciences, South-West University Neofit Rilski, Blagoevgrad, Bulgaria
| | - Luciana Caenazzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Rachael Vaughan
- Children's Social Care Research and Development Centre (CASCADE), Cardiff University, Cardiff, UK
| | - Cindy W Christian
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Katarzyna Drabarek
- Empowering Children Foundation, Warszawa, Poland
- Faculty of Psychology, University of Warsaw, Warszawa, Poland
| | - Alison Mary Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Lisa Hurt
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
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McKenna S, O'Reilly D, Maguire A. Childhood contact with social services and risk of suicide or sudden death in young adulthood: identifying hidden risk in a population-wide cohort study. J Epidemiol Community Health 2023; 78:47-53. [PMID: 37821223 PMCID: PMC10715544 DOI: 10.1136/jech-2023-220975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Childhood out-of-home care is associated with premature death in adulthood, in particular death by suicide, accidents and violence. However, little is known about the mortality risk in the much larger population of adults that had contact with social services in childhood but never entered out-of-home care. We determine the association between all tiers of contact with children's social services and risk of suicide and other sudden deaths in young adulthood. METHODS This population-wide, longitudinal, record-linkage study of adults in Northern Ireland born between 1985 and 1997 (n=437 008) followed each individual from age 18 years to July 2021 (maximum age 36 years). Cox regression models estimated the association between level of contact with social services in childhood (no contact; referred but assessed as not in need (NIN); child in need (CIN) and child in care (CIC)) and risk of death by suicide and sudden death in young adulthood. RESULTS Individuals with childhood social care contact (n=51 097) comprised 11.7% of the cohort yet accounted for 35.3% of sudden deaths and 39.7% of suicide deaths. Risk of suicide or sudden death increased stepwise with level of childhood contact and was highest in adults with a history of out-of-home care (suicide HR 8.85 (95% CI 6.83 to 11.4)). Individuals assessed as NIN, and those deemed a CIN, had four times the risk of death by suicide in young adulthood compared with unexposed peers (HR 4.25 (95% CI 3.26 to 5.53) and HR 4.49 (95% CI 3.75 to 5.39), respectively). CONCLUSION Childhood contact with social services is a risk marker for death by suicide and sudden death in young adulthood. Risk is not confined to adults with a history of out-of-home care but extends to the much larger population that had contact with social services but never entered care.
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Affiliation(s)
- Sarah McKenna
- Administrative Data Research Centre Northern Ireland, Queen's University Belfast, Belfast, UK
| | - Dermot O'Reilly
- Administrative Data Research Centre Northern Ireland, Queen's University Belfast, Belfast, UK
| | - Aideen Maguire
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Peterson C, Aslam MV, Niolon PH, Bacon S, Bellis MA, Mercy JA, Florence C. Economic Burden of Health Conditions Associated With Adverse Childhood Experiences Among US Adults. JAMA Netw Open 2023; 6:e2346323. [PMID: 38055277 PMCID: PMC10701608 DOI: 10.1001/jamanetworkopen.2023.46323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Importance Adverse childhood experiences (ACEs) are preventable, potentially traumatic events in childhood, such as experiencing abuse or neglect, witnessing violence, or living in a household with substance use disorder, mental health problems, or instability from parental separation or incarceration. Adults who had ACEs have more harmful risk behaviors and worse health outcomes; the economic burden associated with these issues is uncertain. Objective To estimate the economic burden of ACE-associated health conditions among US adults. Design, Setting, and Participants In this economic evaluation, regression models of cross-sectional survey data from the 2019-2020 Behavioral Risk Factor Surveillance System (BRFSS) and previous studies were used to estimate ACE population-attributable fractions (PAFs) (ie, the fraction of total cases associated with a specific exposure) for selected health outcomes (anxiety, arthritis, asthma, cancer, chronic obstructive pulmonary disease, depression, diabetes, heart disease, kidney disease, stroke, and violence) and risk factors (heavy drinking, illicit drug use, overweight and obesity, and smoking) among the 2019 US adult population. Adverse childhood experience PAFs were used to calculate the proportion of total condition-specific medical spending and lost healthy life-years related to ACEs using Global Burden of Disease Study data. Data analysis was performed from September 10, 2021, to November 29, 2022. Exposure Adverse childhood experiences (age <18 years). Main Outcomes and Measures Monetary valuation of ACE-associated morbidity and mortality using standard US value of statistical life methods and presented in terms of annual and lifetime per affected person and total population estimates at the national and state levels. Results A total of 820 673 adults, representing 255 million individuals, participated in the BRFSS in 2019 and 2020. An estimated 160 million of the total 255 million US adult population (63%) had 1 or more ACE, associated with an annual economic burden of $14.1 trillion ($183 billion in direct medical spending and $13.9 trillion in lost healthy life-years). This was $88 000 per affected adult annually and $2.4 million over their lifetimes. The lifetime economic burden per affected adult was lowest in North Dakota ($1.3 million) and highest in Arkansas ($4.3 million). Twenty-two percent of adults had 4 or more ACEs and comprised 58% of the total economic burden-the estimated per person lifetime economic burden for those adults was $4.0 million. Conclusions and Relevance In this cross-sectional analysis of the US adult population, the economic burden of ACE-related health conditions was substantial. The findings suggest that measuring the economic burden of ACEs can support decision-making about investing in strategies to improve population health.
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Affiliation(s)
- Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria V. Aslam
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Phyllis H. Niolon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Bacon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark A. Bellis
- Centre for Public Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - James A. Mercy
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Curtis Florence
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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La Charite J, Khan M, Dudovitz R, Nuckols T, Sastry N, Huang C, Lei Y, Schickedanz A. Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study. SSM Popul Health 2023; 24:101558. [PMID: 38034480 PMCID: PMC10685007 DOI: 10.1016/j.ssmph.2023.101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Background Positive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure. Methods We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures. Results The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure. Conclusion Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.
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Affiliation(s)
- Jaime La Charite
- Department of General Internal Medicine, University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mariam Khan
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
- Fielding School of Public Health at University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA
| | - Rebecca Dudovitz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
| | - Teryl Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, 8700 Beverly Blvd Ste 113 Los Angeles, California, 90048, USA
| | - Narayan Sastry
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Cher Huang
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Yvonne Lei
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
| | - Adam Schickedanz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
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Hietamäki J, Laajasalo T, Lindgren M, Therman S. Development and initial validation of the THL Adverse Childhood Experiences Questionnaire (ACE-THL). CHILD ABUSE & NEGLECT 2023; 146:106483. [PMID: 37922617 DOI: 10.1016/j.chiabu.2023.106483] [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: 07/04/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The research on adverse childhood experiences (ACEs) has deepened our understanding of the long-lasting and cumulative effects of childhood adversities. However, the instruments measuring ACEs have several shortcomings, including limited item coverage, collapsing of items and response options, simplistic scoring, and inadequate psychometric assessments. OBJECTIVE To design and conduct preliminarily psychometric testing for a brief new self-report instrument-the THL Adverse Childhood Experiences questionnaire (ACE-THL)-with a comprehensive set of clearly formulated items and appropriate response options. METHODS A previously published process model was applied to develop the ACE-THL questionnaire, which was validated by cognitive interviews (N = 20). Interviewers and interviewees completed the questionnaire separately for a cross-informant comparison. In a separate survey panel validation, the respondents filled out the ACE-THL twice, two weeks apart (N = 513, with 426 in the follow-up). Interview data were used to improve item clarity, and test-retest reliability and structural validity were assessed with repeated survey data. RESULTS The final 14-item questionnaire, including 12 ACE items and two items measuring protective experiences, was highly acceptable to the respondents. In the factor analysis of the quantitative data, a sufficiently single-dimensional construct was found, remaining stable in retesting two weeks later. The internal consistency (omega) of the a priori one-dimensional model was 0.89 and 0.90 at baseline and follow-up, respectively. The high test-retest reliability (mean score rank order correlation 0.93) of the ACE-THL indicated that the probed perceptions of childhood experiences are stable. CONCLUSION Based on the initial validation, the 14-item ACE-THL questionnaire is a reliable and valid instrument to measure adverse childhood experiences, as well as protective experiences.
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Affiliation(s)
- Johanna Hietamäki
- Competence Cluster for Violence Prevention Work, Special Services Unit, Finnish Institute for Health and Welfare, Finland; Faculty of Social Sciences and Business Studies, University of Eastern Finland, Finland.
| | - Taina Laajasalo
- Competence Cluster for Violence Prevention Work, Special Services Unit, Finnish Institute for Health and Welfare, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Maija Lindgren
- Mental Health, Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Sebastian Therman
- Mental Health, Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
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Liu N, Liu W, Deng F, Liu Y, Gao X, Fang L, Chen Z, Tang H, Hong S, Pan M, Liu W, Huo X, Guo K, Ruan F, Zhang W, Zhao B, Mo J, Huang C, Su C, Sun C, Zou Z, Li H, Sun Y, Qian H, Zheng X, Zeng X, Guo J, Bu Z, Mandin C, Hänninen O, Ji JS, Weschler LB, Kan H, Zhao Z, Zhang Y. The burden of disease attributable to indoor air pollutants in China from 2000 to 2017. Lancet Planet Health 2023; 7:e900-e911. [PMID: 37940210 DOI: 10.1016/s2542-5196(23)00215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. METHODS We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. FINDINGS From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. INTERPRETATION DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. FUNDING The National Key Research and Development Program of China and the National Natural Science Foundation of China.
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Affiliation(s)
- Ningrui Liu
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Furong Deng
- School of Public Health, Peking University, Beijing, China
| | - Yumeng Liu
- Department of Building Science, Tsinghua University, Beijing, China
| | - Xuehuan Gao
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lin Fang
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Zhuoru Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Hao Tang
- School of Public Health, Fudan University, Shanghai, China
| | - Shijie Hong
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Minyi Pan
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Xinyue Huo
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Kangqi Guo
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Fangfang Ruan
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
| | - Wenlou Zhang
- School of Public Health, Peking University, Beijing, China
| | - Bin Zhao
- Department of Building Science, Tsinghua University, Beijing, China
| | - Jinhan Mo
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chunxiao Su
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Hao Li
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Xiangang Zeng
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
| | - Jianguo Guo
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhongming Bu
- Department of Energy and Environmental System Engineering, Zhejiang University of Science and Technology, Hangzhou, China
| | - Corinne Mandin
- Institute for Radiation Protection and Nuclear Safety, Fontenay-aux-Roses Cedex, Marne-la-Vallée, France
| | - Otto Hänninen
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio, Finland
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | | | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, China.
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai, China.
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China.
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Bürgin D, Clemens V, Witt A, Sachser C, Jud A, Brähler E, Strauß B, Petrowski K, Schmid M, Fegert JM. Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany. CHILD ABUSE & NEGLECT 2023; 144:106382. [PMID: 37527561 DOI: 10.1016/j.chiabu.2023.106382] [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: 07/04/2022] [Revised: 05/17/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. OBJECTIVES Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. METHOD A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. RESULTS Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. CONCLUSIONS This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.
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Affiliation(s)
- David Bürgin
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland.
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Jud
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marc Schmid
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
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