1
|
Zhang X, Liu Q, Wang X, Vasilenko SA. Unpacking the Impact of Early Adverse Childhood Experiences on Early Onset of Sexual Intercourse Among an Urban Birth Cohort of Early Adolescents. J Adolesc Health 2023; 73:1110-1116. [PMID: 37676194 PMCID: PMC10842965 DOI: 10.1016/j.jadohealth.2023.07.010] [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: 02/16/2023] [Revised: 06/17/2023] [Accepted: 07/03/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Early adverse childhood experiences (ACEs) predict early onset of sexual intercourse. However, patterns of ACEs identified using latent class analysis (LCA) and their links to early sexual intercourse have been less examined. In this study, we apply LCA to identify ACEs profiles at age five and to examine whether these profiles differentially predict adolescents' sexual initiation. METHODS We analyzed data obtained from the Future of Families and Child Wellbeing Study for 3,185 participants (male = 1,638; female = 1,547). This included parental/caregivers' reports of 10 types of ACEs when participants were on average at age five and youth self-report data on sexual intercourse before or at age 15. We used LCA to classify the participants into subgroups and multinomial logistic regressions to examine differences in early sexual initiation among the ACEs subgroups. RESULTS LCA showed evidence of four classes for both genders: low adversity (51.8%), socioeconomic adversity (32.0%), family dysfunction (12.0%), and abuse (4.2%). We found class membership differences in early sexual intercourse in all three adversity classes compared to the low adversity group. Pairwise comparison tests further revealed that adolescents in the family dysfunction class had lesser odds of engaging in early sexual intercourse than their counterparts in the socioeconomic adversity and abuse classes. DISCUSSION Our findings suggest that LCA could help identify meaningful and distinctive child adversity patterns while accounting for the co-occurrence of ACEs. This is particularly helpful in evaluating who might be at greatest health risk which can further inform more effective and targeted interventions.
Collapse
Affiliation(s)
- Xiaoyan Zhang
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, California.
| | - Qingyang Liu
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, New York
| | - Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, New York
| | - Sara A Vasilenko
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, New York
| |
Collapse
|
2
|
Sheerin KM, Brodell R, Huey SJ, Kemp KA. Applying ecological systems theory to juvenile legal system interventions outcomes research: a measurement framework. Front Psychol 2023; 14:1177568. [PMID: 37425162 PMCID: PMC10327555 DOI: 10.3389/fpsyg.2023.1177568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths' lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths' social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework.
Collapse
Affiliation(s)
- Kaitlin M. Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| | - Regina Brodell
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Stanley J. Huey
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A. Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| |
Collapse
|
3
|
Liang Y, Wu R, Huang Q, Liu Z. Sex Differences in Patterns of Childhood Traumatic Experiences in Chinese Rural-To-Urban Migrant Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040734. [PMID: 37189983 DOI: 10.3390/children10040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Children and adolescents are likely to be exposed to various types of childhood traumatic experiences (CTEs) with gender-specific patterns. Rural-to-urban migrant children have been demonstrated a greater risk of CTE exposure than local children. However, no study has investigated sex differences in the patterns of CTEs and predictive factors among Chinese children. METHODS A large-scale questionnaire survey of rural-to-urban migrant children (N = 16,140) was conducted among primary and junior high schools in Beijing. Childhood trauma history, including interpersonal violence, vicarious trauma, accidents and injuries was measured. Demographic variables and social support were also examined. Latent class analysis (LCA) was utilized to examine patterns of childhood trauma, and logistic regression was used to examine predictors. RESULTS Four classes of CTEs were found among both boys and girls, labeled low trauma exposure, vicarious trauma exposure, domestic violence exposure, and multiple trauma exposure. The possibility of various CTEs in the four CTE patterns was higher among boys than girls. Sex differences also manifested in predictors of childhood trauma patterns. CONCLUSIONS Our findings shed light on sex differences in CTE patterns and predictive factors in Chinese rural-to-urban migrant children, suggesting that trauma history should be considered along with sex, and sex-specific prevention and treatment programs should be developed.
Collapse
Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Ruiyao Wu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Qi Huang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| |
Collapse
|
4
|
Xu H, Zhang X, Wang J, Xie Y, Zhang Y, Xu S, Wan Y, Tao F. Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences. Child Adolesc Psychiatry Ment Health 2023; 17:26. [PMID: 36803389 PMCID: PMC9940075 DOI: 10.1186/s13034-023-00575-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
PURPOSE Adolescents exposed to adverse childhood experiences (ACEs) are at increased risk for health-compromising behaviors. However, few studies have investigated how ACEs correlate with patterns of health risk behaviors (HRBs) during adolescence, a crucial developmental period. The aim was to extend the current knowledge about the relationship between ACEs and HRB patterns among adolescents, and to explore gender differences. METHODS A multi-centered population-based survey was conducted in 24 middle schools in three provinces across China between 2020 and 2021. A total of 16,853 adolescents effectively completed anonymous questionnaires covering exposure to eight ACE categories and 11 HRBs. Clusters were identified using latent class analysis. Logistic regression models were utilized to test the association between them. RESULTS There were four classes of HRB patterns: "Low all" (58.35%), "Unhealthy lifestyle" (18.23%), "Self-harm" (18.42%), and "High all" (5.0%). There were significant differences between HRB patterns in terms of the different numbers and types of ACEs in three logistic regression models. Specifically, compared to "Low all," different types of ACEs were positively associated with the three other HRB patterns, and there were significant trends toward increase in the three latent classes of HRBs with higher ACEs. In general, females with ACEs had a higher risk of "High all" except sexual abuse than males. CONCLUSION Our study comprehensively considers the association between ACEs and aggregation categories of HRBs. The results support efforts to improve clinical healthcare, and future work may explore protective factors based on individual, family, and peer education to mitigate the negative trajectory of ACEs.
Collapse
Affiliation(s)
- Huiqiong Xu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Xinyu Zhang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Jiaojiao Wang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Yang Xie
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Yi Zhang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Shaojun Xu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032 Anhui China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China.
| |
Collapse
|
5
|
Alto ME, Warmingham JM, Handley ED, Manly JT, Cicchetti D, Toth SL. The Association Between Patterns of Trauma Exposure, Family Dysfunction, and Psychopathology Among Adolescent Females With Depressive Symptoms From Low-Income Contexts. CHILD MALTREATMENT 2023; 28:130-140. [PMID: 34989275 PMCID: PMC9256854 DOI: 10.1177/10775595211050303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Distinguishing profiles of trauma exposure among low-income adolescent females with depressive symptoms is important for understanding comorbidity, family relationships, and treatment. Specifically, child maltreatment is essential to examine in comparison to other traumas. Participants included 170 adolescent females (65.3% Black; 21.2% White; 13.5% other race; 14.1% Latina/x) with depressive symptoms and their primary caregiver from low-income families. Latent class analysis (LCA) identified three trauma classes. Probabilities of endorsing different subtypes of maltreatment (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse), number of subtypes of maltreatment, and non-maltreatment traumas (accident, experiencing or witnessing physical assault, death or injury of loved one, medical trauma) varied among groups. Higher levels of family dysfunction and traumatic stress symptoms were reported in both classes with maltreatment exposure as compared to the class with only non-maltreatment trauma exposure. Findings have implications for family-focused interventions for maltreated adolescent females with depressive symptoms from low-income contexts.
Collapse
Affiliation(s)
- Michelle E Alto
- Mt. Hope Family Center, 6927University of Rochester, Rochester, NY, USA
| | | | | | - Jody Todd Manly
- Mt. Hope Family Center, 6927University of Rochester, Rochester, NY, USA
| | | | - Sheree L Toth
- Mt. Hope Family Center, 6927University of Rochester, Rochester, NY, USA
| |
Collapse
|
6
|
Ling H, Meng F, Yan Y, Feng H, Zhang J, Zhang L, Yuan S. Why Is Maternal Control Harmful? The Relation between Maternal Control, Insecure Attachment and Antisocial Personality Disorder Features in Chinese College Students: A Sequential Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710900. [PMID: 36078615 PMCID: PMC9518312 DOI: 10.3390/ijerph191710900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous work has indicated that a negative parenting style is associated with antisocial personality disorder features in Chinese college students, yet few studies have explored the unique role of negative mothering in children's antisocial personality disorder. METHODS The current study mainly examined the sequential mediation effect of parental antipathy and neglect (PAN) and mother negative loving (a form of insecure attachment) in the association between mother control and adulthood antisocial personality disorder features (ASPD features) in the framework of attachment theory and cognitive-behavioral theory. A community sample of 1547 Chinese college students filled in the Parental Bonding Instrument, the Childhood Experience of Care and Abuse Questionnaire, the Adult Attachment Questionnaire and the Personality Diagnostic Questionnaire-4+. RESULTS A sequential mediation model analysis showed that maternal control significantly predicted PAN, mother negative loving, as well as ASPD features. CONCLUSIONS Mother control and mother negative loving appear to advance on the development and exacerbation of ASPD features in college students.
Collapse
Affiliation(s)
- Hui Ling
- Department of Psychology, Hunan Normal University, Changsha 410081, China
| | - Fanfei Meng
- School of Preschool Education, Changsha Normal University, Changsha 410100, China
| | - Yaqin Yan
- Department of Psychology, Hunan Normal University, Changsha 410081, China
- Department of Student Affairs, Hunan First Normal University, Changsha 410205, China
| | - Hong Feng
- Hunan Wenjin Research Institute of Education, Changsha 410013, China
| | - Jianren Zhang
- Department of Psychology, Hunan Normal University, Changsha 410081, China
- Cognition & Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha 410081, China
| | - Linrui Zhang
- Department of Psychology, University of Toronto Scarborough, Toronto, ON M4Y 1M7, Canada
| | - Siyang Yuan
- School of Dentistry, University of Dundee, Dundee DD1 4HN, UK
| |
Collapse
|
7
|
Pammenter A, Woodford ELE, Harris DA. Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences. CHILD ABUSE & NEGLECT 2022; 129:105678. [PMID: 35675724 DOI: 10.1016/j.chiabu.2022.105678] [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: 09/17/2021] [Revised: 03/28/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
This study examines the differential childhood adversities experienced by two samples of Australian adolescents involved in the juvenile justice system: male youth who had been adjudicated for sexual offences and their counterparts who had been adjudicated for nonsexual violence. The sample is comprised of clients referred to a service that explicitly prioritises cases identified to be high risk, high need, and living in rural or remote areas. Male youth who had committed a sexual offence were more likely than their counterparts to have experienced emotional and sexual abuse and neglect in their childhoods. Alternatively, the childhoods of the comparison group were marked by characteristics of more general household dysfunction. Potential explanations for these findings are provided. The onset of sexual offending is presented as a possible consequence of poor attachment and emotional dysregulation and the impact of vicarious violence, and a chaotic family life are considered in the development of subsequent nonsexual violence. The implications of these findings for both clinical practice and future research are discussed.
Collapse
|
8
|
MacLochlainn J, Mallett J, Kirby K, McFadden P. Stressful Events and Adolescent Psychopathology: A Person-Centred Approach to Expanding Adverse Childhood Experience Categories. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:327-340. [PMID: 35600522 PMCID: PMC9120305 DOI: 10.1007/s40653-021-00392-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 06/15/2023]
Abstract
Stress from cumulative adverse childhood experiences (ACEs) can pose a serious risk of experiencing anxiety, depression, and other mood disorders in adolescence. However, there is a paucity of research identifying specific profiles or combinations of exposure to other forms of stressful life events and their impact on adolescent psychopathology. This study attempted a conceptual expansion of the ACE checklist by examining these stressful events. The study used cross-sectional data from a modified version of the CASE Study survey where 864 adolescents (56% female, n = 480), aged from 11 - 18 years were recruited from four post-primary schools in the North-West region of NI. Latent class analysis of the 20-item stressful events checklist revealed 3 distinct risk classes: a low-risk class (53.5%), at-risk class (42.7%), and an immediate-risk class (3.8%). Results showed those at most risk of adolescent psychopathology had the highest probability of encountering interpersonal relationship issues, experiencing family dysfunction, and having close friends experiencing psychological difficulties. Findings indicate that the original ten ACE categories may be too narrow in focus and do not capture the wide range of childhood adversity. Expanding the ACE checklist to include other stressful events is discussed as these may also be antecedents to psychopathologic responses.
Collapse
Affiliation(s)
- Justin MacLochlainn
- School of Psychology, Ulster University, Room H259, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - John Mallett
- School of Psychology, Ulster University, Room H259, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - Karen Kirby
- School of Psychology, Ulster University, Room H245, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - Paula McFadden
- School of Applied Social and Policy Sc, Institute for Research in Social Sciences, Magee campus, Room MF211, Derry, BT48 7JL Northern Ireland
| |
Collapse
|
9
|
Profiles of adverse childhood experiences and protective resources on high-risk behaviors and physical and mental disorders: Findings from a national survey. J Affect Disord 2022; 303:24-30. [PMID: 35120966 DOI: 10.1016/j.jad.2022.01.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACE) vary across culture and their heterogenous impact on health outcomes is understudied. The present population-based study determined latent classes of adverse childhood experiences, examined socio-demographic variations between identified classes, and elucidated the interactions between class membership and protective resources (i.e., positive mental health and perceived social support) on high-risk behaviors (i.e., smoking, binge drinking, and suicidality), chronic physical disorders, and mental disorders. METHODS A total of 4441 adult Singapore residents were recruited from the community. Lifetime mental disorders and suicidality were assessed on structured clinical interviews by trained interviewers, while chronic physical disorders, smoking, binge drinking, ACE, perceived social support, and positive mental health were self-reported. RESULTS Latent class analysis identified three distinct profiles; a multiple adversities class endorsing elevated levels of abuse and violence (6.1%), an emotionally neglected and bullied class (7.6%), and a low adversities class (86.2%). The multiple adversities class was associated with younger age, female gender, lower education status, more high-risk behaviors (e.g. binge drinking and suicidality), and physical/mental disorders. A three-way interaction was observed between ACE profiles, social support, and positive mental health on suicidality; high social support and positive mental health reduced the risk of suicidality in the multiple adversities class. LIMITATIONS Results may not be generalizable beyond the Singapore population due to cultural factors. CONCLUSIONS Clinical assessment should adopt a person-centered approach to identify profiles of ACE and determine their interactions with protective resources on high-risk behaviors and physical/mental disorders; patient-tailored treatment may subsequently build upon these profiles.
Collapse
|
10
|
Travers Á, McDonagh T, McLafferty M, Armour C, Cunningham T, Hansen M. Adverse experiences and mental health problems in perpetrators of intimate partner violence in Northern Ireland: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 125:105455. [PMID: 35078089 DOI: 10.1016/j.chiabu.2021.105455] [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: 07/20/2021] [Revised: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Trauma and adverse experiences among perpetrators of intimate partner violence (IPV) have been associated with more serious patterns of offending. OBJECTIVE To examine 1) how traumatic and adverse experiences cluster together and co-occur among IPV perpetrators, and 2) whether different patterns of trauma exposure are associated with specific mental health problems. PARTICIPANTS AND SETTING The sample consisted of 405 convicted IPV perpetrators from Northern Ireland. METHODS Data was collected between 2018 and 2019. Latent class analysis identified typologies of exposure to traumatic and adverse experiences. A series of binary logistic regression analyses explored associations between the identified classes and five categories of probable mental health problems. RESULTS Three adversity classes were identified: a baseline class (59.2%), characterised by relatively low levels of exposure to most types of adversity; a 'childhood adversity' class (32.9%), with high levels of childhood adversity; and a 'community violence and disadvantage' class (7.9%), which had high probabilities of endorsing adversities related to economic hardship and community violence. Regression analyses showed that the childhood adversity class was significantly associated with increased likelihood of all categories of mental health problems, except for neurodevelopmental disorders (ORs = 1.77-3.25). The community violence and disadvantage class was significantly associated with probable mood and anxiety disorder (ORs 3.92 and 8.42, respectively). CONCLUSIONS Different patterns of exposure to adversities were associated with distinct mental health problems in the present sample. Early intervention to prevent poly-victimisation, the clustering of adversities in childhood and the resulting accumulation of risk may be a useful component of preventive responses for IPV in Northern Ireland.
Collapse
Affiliation(s)
- Áine Travers
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Tracey McDonagh
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Margaret McLafferty
- School of Biomedical Science, Ulster University, Magee Campus, Londonderry BT48 7JL, United Kingdom of Great Britain and Northern Ireland.
| | - Cherie Armour
- Centre for Stress, Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, University Rd, Belfast BT7 1NN, United Kingdom of Great Britain and Northern Ireland.
| | - Twylla Cunningham
- Psychology Department, Probation Board for Northern Ireland, 80-90 North St, Belfast BT1 1LD, United Kingdom of Great Britain and Northern Ireland.
| | - Maj Hansen
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| |
Collapse
|
11
|
deSteiguer AJ, Frazier EA, Gelman DJ, Hedrick MA, Micalizzi L. Adverse Childhood Experiences and Mental Health in an Adolescent Partial Hospital Program. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:452-462. [PMID: 36465480 PMCID: PMC9718448 DOI: 10.1080/23794925.2021.1986869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Childhood adversity has been associated with myriad physical, emotional, and mental health symptoms across the lifespan, including higher risk for substance abuse, depression, suicidal ideation, and premature mortality. The current study evaluates the association between cumulative adverse childhood experiences and mental health distress at admission and discharge in an adolescent partial hospital program. Data were collected from 157 adolescents through clinical assessments administered during admission and discharge procedures (Youth Outcomes Questionnaire Self-Report (YOQ-SR), Treatment Support Measure (TSM), and Center for Youth Wellness Adverse Childhood Experiences Questionnaire Teen (CYW ACE-Q Teen)). Regression analyses were conducted to assess how cumulative ACEs predict admission mental health distress (Intrapersonal Distress, Critical Items, and Total Score) as well as mental health distress at discharge, above and beyond other clinically relevant factors. While ACEs significantly predicted overall distress at admission (p = .026), there were no other significant associations between ACEs and outcomes at admission, nor ACEs and any outcomes at discharge. This suggests experiences of adversity may not hinder or influence outcomes over the course of treatment in this setting. Experiences of adversity were highly endorsed in this sample; thus, further understanding of experiences of trauma and resilience in acute treatment settings is a critical area for future research to improve interventions for adolescents.
Collapse
Affiliation(s)
| | - Elisabeth A. Frazier
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA;,Department of Psychiatry and Human Behavior, Brown University, USA
| | | | - Molly A. Hedrick
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA
| | - Lauren Micalizzi
- Brown University, Providence, Rhode Island, USA;,Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USA
| |
Collapse
|
12
|
McLaughlin KA, Sheridan MA, Humphreys KL, Belsky J, Ellis BJ. The Value of Dimensional Models of Early Experience: Thinking Clearly About Concepts and Categories. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:1463-1472. [PMID: 34491864 PMCID: PMC8563369 DOI: 10.1177/1745691621992346] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We review the three prevailing approaches-specificity, cumulative risk, and dimensional models-to conceptualizing the developmental consequences of early-life adversity and address fundamental problems with the characterization of these frameworks in a recent Perspectives on Psychological Science piece by Smith and Pollak. We respond to concerns raised by Smith and Pollak about dimensional models of early experience and highlight the value of these models for studying the developmental consequences of early-life adversity. Basic dimensions of adversity proposed in existing models include threat/harshness, deprivation, and unpredictability. These models identify core dimensions of early experience that cut across the categorical exposures that have been the focus of specificity and cumulative risk approaches (e.g., abuse, institutional rearing, chronic poverty); delineate aspects of early experience that are likely to influence brain and behavioral development; afford hypotheses about adaptive and maladaptive responses to different dimensions of adversity; and articulate specific mechanisms through which these dimensions exert their influences, conceptualizing experience-driven plasticity within an evolutionary-developmental framework. In doing so, dimensional models advance specific falsifiable hypotheses, grounded in neurodevelopmental and evolutionary principles, that are supported by accumulating evidence and provide fertile ground for empirical studies on early-life adversity.
Collapse
Affiliation(s)
| | - Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | - Jay Belsky
- Department of Human Ecology, University of California at Davis
| | - Bruce J. Ellis
- Departments of Psychology and Anthropology, University of Utah
| |
Collapse
|
13
|
Brown M, Worrell C, Pariante CM. Inflammation and early life stress: An updated review of childhood trauma and inflammatory markers in adulthood. Pharmacol Biochem Behav 2021; 211:173291. [PMID: 34695507 DOI: 10.1016/j.pbb.2021.173291] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
Inflammation, as a neurobiological consequence of childhood trauma, has frequently been reported across research, however, recent investigations suggest this relationship may be dependent on specificities such as type of trauma, type of inflammatory marker, and additional mediatory variables - such as body mass index (BMI), age, and sex. As an updated version of a previous review by Baumeister et al., the current review comprised a search of PubMed, which identified 37 articles that collectively assessed 4 inflammatory markers (CRP, IL-6, TNFα and IL-1β). A review of the studies revealed predominantly non-significant associations between childhood trauma and elevated levels of all inflammatory markers in adulthood. However, in line with previous research, discrepancies in significance arose when considering type of trauma, type of inflammatory marker, and additional variables. Compared to neglect, abuse showed greater significant associations with elevated inflammatory markers in adulthood, though this was dependent on the individual subtypes (emotional, physical or sexual). Mediation analyses reported BMI as a significant mediator, though, when controlled for, no significant differences were found. Sex differences were reported but investigations were sparse. Future research should investigate the mediatory role of sex differences in the inflammatory effects of childhood trauma. Many studies in the review were restricted by use of the same trauma measure - the Childhood Trauma Questionnaire. To assess greater variety of trauma types, future studies should utilize other standardized measures to explore these avenues.
Collapse
Affiliation(s)
- Mollie Brown
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Courtney Worrell
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Carmine M Pariante
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| |
Collapse
|
14
|
Langevin R, Hébert M, Wallace A. The intersection of intimate partner violence and childhood sexual abuse in mother-child dyads. CHILD ABUSE & NEGLECT 2021; 120:105218. [PMID: 34303162 DOI: 10.1016/j.chiabu.2021.105218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/04/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) and intimate partner violence (IPV) have been associated with negative consequences for adult victims and their children including a risk of revictimization and intergenerational continuity. OBJECTIVES The aim of this study was to document correlates of intergenerational cumulative trauma profiles in mother-child dyads. PARTICIPANTS AND SETTING A sample of 997 sexually abused children (mean age = 7.61 years; 79.1% girls) and their mothers was recruited. METHODS Latent Class Analysis (LCA) was used to identify classes of cumulative trauma among dyads. Classes were compared on validated measures of psychological functioning for both members of the dyads. RESULTS Four distinct classes emerged: CSA Only (43.3%), Intergenerational CSA with Psychological IPV (14.2%), Physical and Psychological IPV with Low Child Exposure (24.0%) and Intergenerational Polyvictimization (18.5%). Comparisons generally revealed lower distress in CSA Only dyads, and higher levels of psychological difficulties in the two most victimized groups. However, the dose-response pattern was not as clear as expected, as the two most victimized groups did not differ in terms of psychological functioning. CONCLUSIONS This study shows that higher levels of intergenerational cumulative trauma are associated with increased psychological symptoms in mothers and more dissociation in their sexually abused children. Interventions should be adapted to the specific needs of families to prevent lasting intergenerational difficulties in trauma exposed individuals.
Collapse
Affiliation(s)
- Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, Canada.
| | - Martine Hébert
- Canada Research Chair in Interpersonal Trauma and Resilience, Département de sexologie, Université du Québec à Montréal, Canada
| | - Aimée Wallace
- Canada Research Chair in Interpersonal Trauma and Resilience, Département de sexologie, Université du Québec à Montréal, Canada
| |
Collapse
|
15
|
Davis JP, Tucker JS, Stein BD, D'Amico EJ. Longitudinal effects of adverse childhood experiences on substance use transition patterns during young adulthood. CHILD ABUSE & NEGLECT 2021; 120:105201. [PMID: 34245974 PMCID: PMC8384697 DOI: 10.1016/j.chiabu.2021.105201] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/10/2021] [Accepted: 06/27/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Few studies have investigated how adverse childhood experiences are associated with substance use patterns during young adulthood, a crucial developmental period. OBJECTIVE The objective of this study was to extend current knowledge on the association between adverse childhood experiences and patterns of substance use among young adults. We also sought to understand how current mental health status and biological sex influences these patterns. PARTICIPANTS AND SETTING The current study utilized wave 8-wave 11 data of a longitudinal cohort study (N = 2880). METHODS We used latent transition analysis (LTA) to understand stability and transition patterns of substance use across participants who reported adverse childhood experiences (ACEs+) versus those who did not (ACEs-). Latent class regression was used to assess contemporaneous effects of mental health and sex on classes over time. RESULTS Both groups had similar patterns of substance use emerge at each timepoint: High all; Binge, tobacco, cannabis; and Steady/increasing binge drinking. ACEs+ had a higher proportion of youth in the High all class and much higher stability in this class, compared to the ACEs- group. Those in the ACES+ group were less likely to transition out of a riskier class. Mental health and sex showed differential effects across ACEs groups. CONCLUSION Results point to increased risk of polysubstance use, including opioids and prescription medications, among those who reported adverse childhood events. Future work may explore protective, malleable, factors that may confer reduced risk of long-term polysubstance use.
Collapse
Affiliation(s)
- Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California, United States of America.
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America
| | - Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, United States of America
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America
| |
Collapse
|
16
|
Chen AJ, Chen WT, Wang IA, Wang N, Chen WJ, Chen CY. Association between childhood negative life events with alcohol expectancies in early adolescence: Cumulative risk and latent class approaches. Drug Alcohol Depend 2021; 226:108853. [PMID: 34225224 DOI: 10.1016/j.drugalcdep.2021.108853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/22/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The present study aims to investigate the effects of childhood negative life events (NLEs) on alcohol expectancies (AEs) in early adolescence through cumulative risk and latent class approaches. METHODS Data were obtained from a prospective cohort of 945 sixth graders (age 11-12) ascertained from 17 elementary schools in northern Taiwan (response rate = 61.0 %wt); subsequent assessments were conducted during eighth grade (n = 775, follow-up rate [FR] = 82.6 %wt). Information concerning socio-demographics, 14 NLEs, alcohol-related experience, and four-domain AEs was collected by self-administered questionnaires at childhood and follow-up. Latent class and multivariate analyses were used to evaluate the association estimates. RESULTS Nearly one half of children had experienced at least one NLE in sixth grade, with one-tenth experiencing four or more NLEs. Three latent classes of NLEs were identified: "lesser experience (68.1 %wt)," "stressed relationship (27.6 %wt)," and "family instability (4.3 %wt)." The observed NLE-associated increase in AEs was relatively stronger in the cumulative approach: children experiencing four or more NLEs (βwt = 1.27, 95 % CI = 0.27-2.27) and in the "stressed relationship" NLE class appeared to develop greater AEs (βwt = 0.86, 95 % CI = 0.30-1.42). Moreover, such NLE-associated increase was especially salient in the AE domains regarding "global positive transformation" and "promoting relaxation or tension reduction". CONCLUSIONS Our results provide insight into which experiences of multiple and "stressed relationship" negative life events arising from the family context in childhood may shape endorsed alcohol expectancies in adolescence, and implied that such effects may not uniformly operate across AE domain.
Collapse
Affiliation(s)
- An-Jou Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
| | - Wan-Ting Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - I-An Wang
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Nadia Wang
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
17
|
Tomlinson TA, Mears DP, Turanovic JJ, Stewart EA. Forcible Rape and Adolescent Friendship Networks. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:4111-4136. [PMID: 30027792 DOI: 10.1177/0886260518787807] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Studies have found that sexual victimization can adversely affect an adolescent's psychological well-being, physical health, and behavior. Little is known, however, about how friendships are influenced by such victimization. Drawing on research on sexual violence and the salience of peers among adolescents, the current study extends prior work by examining the effects of forcible rape on adolescent social networks. Using a subsample of females from the National Longitudinal Study of Adolescent to Adult Health (N = 4,386), the study employs multivariate regression analyses to estimate the effects of youth forcible rape on the popularity, centrality, and density of adolescent friendship networks and to determine whether depression and attachment to others (e.g., to friends and to school) mediate these effects. The analyses indicated that forcible rape was associated with a decrease in the popularity and centrality of females within their friendship networks; however, no effect on the density of these networks was identified. In addition, forcible rape effects on popularity and centrality were partially mediated by depression and social attachments. The results suggest that forcible rape may adversely affect adolescent females' levels of popularity and centrality within their friendship networks. Combined with prior research, the results indicate that the harmful effects of rape have the potential to extend across diverse domains, including social relationships. This possibility suggests that services and assistance to female adolescents may be useful in navigating these relationships after victimization. It suggests, too, that potential benefits that may arise from interventions that educate adolescents-victims and nonvictims alike-about the challenges that victims of sexual violence experience.
Collapse
|
18
|
Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: How COVID-19 school closures inhibit the reporting of child maltreatment. JOURNAL OF PUBLIC ECONOMICS 2020; 190:104258. [PMID: 32863462 PMCID: PMC7441889 DOI: 10.1016/j.jpubeco.2020.104258] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 05/18/2023]
Abstract
To combat the spread of COVID-19, many primary and secondary schools in the United States canceled classes and moved instruction online. This study examines an unexplored consequence of COVID-19 school closures: the broken link between child maltreatment victims and the number one source of reported maltreatment allegations-school personnel. Using current, county-level data from Florida, we estimate a counterfactual distribution of child maltreatment allegations for March and April 2020, the first two months in which Florida schools closed. While one would expect the financial, mental, and physical stress due to COVID-19 to result in additional child maltreatment cases, we find that the actual number of reported allegations was approximately 15,000 lower (27%) than expected for these two months. We leverage a detailed dataset of school district staffing and spending to show that the observed decline in allegations was largely driven by school closures. Finally, we discuss policy implications of our findings for the debate surrounding school reopenings and suggest a number of responses that may mitigate this hidden cost of school closures.
Collapse
Affiliation(s)
- E Jason Baron
- Ford School of Public Policy, University of Michigan, United States of America
| | - Ezra G Goldstein
- Department of Economics, Florida State University, United States of America
| | - Cullen T Wallace
- Department of Economics and Finance, Georgia College & State University, United States of America
| |
Collapse
|
19
|
Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: How COVID-19 school closures inhibit the reporting of child maltreatment. JOURNAL OF PUBLIC ECONOMICS 2020. [PMID: 32863462 DOI: 10.2139/ssrn.3601399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
To combat the spread of COVID-19, many primary and secondary schools in the United States canceled classes and moved instruction online. This study examines an unexplored consequence of COVID-19 school closures: the broken link between child maltreatment victims and the number one source of reported maltreatment allegations-school personnel. Using current, county-level data from Florida, we estimate a counterfactual distribution of child maltreatment allegations for March and April 2020, the first two months in which Florida schools closed. While one would expect the financial, mental, and physical stress due to COVID-19 to result in additional child maltreatment cases, we find that the actual number of reported allegations was approximately 15,000 lower (27%) than expected for these two months. We leverage a detailed dataset of school district staffing and spending to show that the observed decline in allegations was largely driven by school closures. Finally, we discuss policy implications of our findings for the debate surrounding school reopenings and suggest a number of responses that may mitigate this hidden cost of school closures.
Collapse
Affiliation(s)
- E Jason Baron
- Ford School of Public Policy, University of Michigan, United States of America
| | - Ezra G Goldstein
- Department of Economics, Florida State University, United States of America
| | - Cullen T Wallace
- Department of Economics and Finance, Georgia College & State University, United States of America
| |
Collapse
|
20
|
Liang Y, Zhou Y, Ruzek JI, Liu Z. Patterns of childhood trauma and psychopathology among Chinese rural-to-urban migrant children. CHILD ABUSE & NEGLECT 2020; 108:104691. [PMID: 32854057 DOI: 10.1016/j.chiabu.2020.104691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to childhood trauma can cause psychopathology and negative psychosocial outcomes across the lifespan. Rural-to-urban migrant children are commonly exposed to traumatic experiences (TEs). However, no study has comprehensively examined patterns of childhood trauma in Chinese culture. The current study aimed to examine patterns of childhood trauma exposure among Chinese rural-to-urban migrant children. METHODS A large-scale (N = 15,890) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Childhood TEs, including accidents and injuries, interpersonal violence, and vicarious trauma, as well as demographics and internalizing and externalizing behaviors, were measured. RESULTS Four patterns of childhood trauma were found: low trauma exposure (60.4%), vicarious trauma exposure (23.9%), domestic violence exposure (10.5%), and multiple trauma exposure (5.3%). Age, gender, parents' marital status, father's education level, family support and peer support differentiated the four TE patterns. Both internalizing and externalizing behaviors were more severe in patterns with more types of TEs. CONCLUSIONS Our findings provide a better understanding of childhood trauma in Chinese culture and the relationship between TEs and mental health. Clinicians and policy makers should tailor prevention and treatment programs according to different patterns of victimization.
Collapse
Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Josef I Ruzek
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China.
| |
Collapse
|
21
|
Charak R, Vang ML, Shevlin M, Ben-Ezra M, Karatzias T, Hyland P. Lifetime Interpersonal Victimization Profiles and Mental Health Problems in a Nationally Representative Panel of Trauma-Exposed Adults From the United Kingdom. J Trauma Stress 2020; 33:654-664. [PMID: 32516511 DOI: 10.1002/jts.22527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 11/08/2022]
Abstract
Traumatic event exposure has been associated with negative psychological outcomes. There is, however, a dearth of research on revictimization. The current study examined patterns of lifetime interpersonal victimization based on six types of childhood maltreatment, physical and sexual assault, and assault with a weapon during adulthood via latent class analysis (LCA), with gender as covariate. Using a three-step approach, we assessed differences across the latent classes in symptoms and diagnosis of depression, anxiety, and DSM-5 posttraumatic stress disorder (PTSD). A trauma-exposed adult sample representative of the United Kingdom population (N = 1,051) was recruited online through a research panel. The mean participant age 47.18 years (SD = 15.00, range: 18-90 years; 68.4% female). The LCA identified five classes: lifetime polyvictimization (8.3%; 69.5% female), sexual revictimization (13.7%; 96.5% female), physical revictimization (12.5%; 1.5% male), childhood trauma (25.9%; 85.6% female), and limited victimization (39.7%; 40.3% female). Compared to the other classes, the polyvictimization class, followed by the childhood trauma class, demonstrated the highest scores on anxiety, depression, and posttraumatic stress symptoms. The polyvictimization class had nearly a nine- to 33-fold increase in risk of depression, OR = 9.48, 95% CI [3.34, 26.87]; anxiety, OR = 12.10, 95% CI [5.36, 27.36]; and PTSD diagnoses, OR = 33.63, 95% CI [16.35, 69.43], compared to the limited victimization class. The findings facilitate the identification of individuals at risk for revictimization and indicate that evidence-based clinical interventions should be targeted toward those with exposure to revictimization and childhood trauma exposure to alleviate mental health challenges.
Collapse
Affiliation(s)
- Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | | | - Mark Shevlin
- School of Psychology and Psychology Research Institute, Ulster University, Coleraine, Northern Ireland
| | | | - Thanos Karatzias
- Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| |
Collapse
|
22
|
Putnam FW, Amaya-Jackson L, Putnam KT, Briggs EC. Synergistic adversities and behavioral problems in traumatized children and adolescents. CHILD ABUSE & NEGLECT 2020; 106:104492. [PMID: 32447141 DOI: 10.1016/j.chiabu.2020.104492] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study investigated synergy of commonly co-occurring pairs of childhood traumas/adversities to determine: 1) if synergistic pairings differ by gender and/or age grouping; and 2) if some traumas/adversities were more synergistically reactive. METHODS A sample of 10,355 clinic-referred youth (1.5-18 years) from the National Child Traumatic Stress Network Core Data Set was divided by gender and categorized into salient age groups (1.5-5 years, 6-12 years, and 13-18 years). Attributable Proportion (AP), a biomedically relevant metric, was calculated to assess additive synergy for behavior problems on the CBCL. RESULTS Overall, only four pairs of adversities were synergistic. Three involved sexual abuse with physical abuse, parental loss, and domestic violence. When the sample was analyzed by Gender X Age group, however, a more complicated picture emerges. Twelve of the twenty-one possible pairings (57 %) show additive synergy in one or more categories. The mean AP accounted for approximately 40 % of outcome variance. Males had more synergistic pairings (16) than females (7). The average synergistic effect was higher for males (42 % of variance) than females (36 % of variance). The vast majority of synergy occurs in the 6-12 and 13-18 age groups. Sexual abuse was the most synergistically reactive trauma, pairing most frequently (16) followed by physical abuse (10) or neglect (9). CONCLUSION Sexual abuse was malignantly synergistic, frequently pairing with other adversities, followed by physical abuse, neglect, and domestic violence. The findings underscore that all ACEs are not equal in their contributions to commonly assessed outcomes. The findings also have considerable implications for prevention, intervention, and future research.
Collapse
Affiliation(s)
- Frank W Putnam
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, United States
| | - Lisa Amaya-Jackson
- UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC, United States
| | - Karen T Putnam
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, United States
| | - Ernestine C Briggs
- UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC, United States.
| |
Collapse
|
23
|
Kazemitabar M, Moghadamzadeh A, Habibi M, Hakimzadeh R, Garcia D. School health assessment tools: a systematic review of measurement in primary schools. PeerJ 2020; 8:e9459. [PMID: 32742780 PMCID: PMC7380271 DOI: 10.7717/peerj.9459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/09/2020] [Indexed: 12/02/2022] Open
Abstract
Background This systematic review aimed to investigate the psychometric properties of the school health’s assessment tools in primary schools through COSMIN Risk of Bias checklist. We examined the studies that have addressed the measurement properties of school-health instruments to give a clear overview of the quality of all available tools measuring school health in primary schools. This systematic review was registered in PROPERO with the Registration ID: CRD42020158158. Method Databases of EBSCOhost, PubMed, ProQuest, Wily, PROSPERO, and OpenGrey were systematically searched without any time limitation to find all full-text English journal articles studied at least one of the COSMIN checklist measurement properties of a school-health assessment tool in primary schools. The instruments should be constructed based on a school health model. The eligible studies were assessed by COSMIN Risk of Bias checklist to report their quality of methodology for each measurement property and for the whole study by rating high, moderate or low quality. Results At the final screening just seven studies remained for review. Four studies were tool development, three of them were rated as “adequate” and the other study as “very good”; five studies examined the content validity, three of them were appraised as “very good”, and the two remaining as “inadequate”. All seven studies measured structural validity, three of them were evaluated as “very good”, three other were scored as “adequate”, and the last study as “inadequate”. All the seven studies investigated the internal consistency, five of them were assessed as “very good”, one was rated as “doubtful”, and the last one as “inadequate”. Just one study examined the cross-cultural validity and was rated as “adequate”. Finally, all seven studies measured reliability, two of them were rated as “very good” and the rest five studies were appraised as “doubtful”. All rating was based on COSMIN checklist criteria for quality of measurement properties assessment. Conclusion The number of studies addressing school health assessment tools was very low and therefore not sufficient. Hence, there is a serious need to investigate the psychometric properties of the available instruments measuring school health at primary schools. Moreover, the studies included in the present systematic review did not fulfill all the criteria of the COSMIN checklist for assessing measurement properties. We suggest that future studies consider these criteria for measuring psychometric properties and developing school health assessment tools.
Collapse
Affiliation(s)
- Maryam Kazemitabar
- Department of Curriculum and Instruction, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Ali Moghadamzadeh
- Department of Curriculum and Instruction, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Mojtaba Habibi
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Rezvan Hakimzadeh
- Department of Curriculum and Instruction, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Blekinge Center of Competence, Region Blekinge, Karlskrona, Sweden.,Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden.,Network for Well-Being, Sweden
| |
Collapse
|
24
|
Leblanc NM, Alexander K, Carter S, Crean H, Ingram L, Kobie J, McMahon J. The Effects of Trauma, Violence, and Stress on Sexual Health Outcomes Among Female Clinic Clients in a Small Northeastern U.S. Urban Center. ACTA ACUST UNITED AC 2020; 1:132-142. [PMID: 32617533 PMCID: PMC7325490 DOI: 10.1089/whr.2019.0027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: Threats to sexual health can emerge across one's life span and are influenced by individual and interpersonal experiences, as well as certain environmental exposures. Although previous research has recognized the importance of ecological frameworks to understand the complexity of health and behaviors in marginalized communities, there continues to be a dearth of research that truly utilizes this perspective to gain insight into the multifaceted factors that can concurrently influence threats to sexual health among women. Methods: A sample of 279 ethnoracially diverse women were recruited from a U.S. northeastern small urban center health clinic to participate in a parent study on trauma and immunity. A hierarchical block analysis was conducted to investigate associations between women's experiences of trauma, stress and violence (i.e., childhood trauma (CHT), intimate partner violence (IPV), neighborhood stressors), and sexual health outcomes and behaviors (i.e., lifetime sexually transmitted infection [STI] diagnosis, concurrent partnerships, and lifetime sex trading). Results: In the full hierarchical model, IPV and life stress trauma were associated with lifetime sex trading and partner concurrency. Also in the full model, sexual CHT was associated with lifetime STI acquisition and partner concurrency, while emotional CHT was associated with lifetime sex trading. Lastly, as neighborhood disorder increased, so did the number of lifetime sex trading partners. Conclusion: Sexual health assessments in clinical and community settings require a holistic, comprehensive, and meaningful approach to inform person-centered health promotion intervention. Prevention and treatment interventions require a focus on parents and families, and should assist adolescents and young adults to adopt therapies for healing from these experiences of trauma, violence, and stress. Interventions to enhance sexual health promotion must also include the following: advocacy for safe environments, social policy that addresses lifelong impacts of CHT, and fiscal policy that addresses economic vulnerability among women and threatens sexual health. Further recommendations are discussed.
Collapse
Affiliation(s)
- Natalie M Leblanc
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Kamila Alexander
- Department of Community Public Health Nursing, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Hugh Crean
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | | | - James Kobie
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James McMahon
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
25
|
Miller KM, Briggs HE, Elkins J, Kim I, Mowbray O. Physical Abuse and Adolescent Sexual Behaviors: Moderating Effects of Mental Health Disorders and Substance Use. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:55-62. [PMID: 32318228 PMCID: PMC7163811 DOI: 10.1007/s40653-018-0221-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of the current study was to examine the direct effects of child physical abuse on sexual behaviors and whether mental health problems and substance use moderated the associations between exposure to child physical abuse and sexual behavioral practices among adolescents who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A). The data show statistically significant relationships between physical abuse and risky sexual behaviors for youth who met the clinical criteria for lifetime Posttraumatic Stress Disorder (PTSD) and reported marijuana use. Data from future studies can inform sexual health practice development with adolescents and emerging adults with a history of physical abuse, marijuana use/abuse and PTSD. These findings underscore the importance of exploring presence of symptoms associated with PTSD and marijuana use as part of a comprehensive biopsychosocial assessment for physically abused adolescents and emerging adults to determine if they are engaging in risky sexual behaviors.
Collapse
Affiliation(s)
- Keva M. Miller
- School of Social Work, Portland State University, 1800 SW 6th Ave., Portland, OR 97201 USA
| | | | - Jennifer Elkins
- School of Social Work, University of Georgia, Athens, GA USA
| | - Irang Kim
- School of Social Work, University of Georgia, Athens, GA USA
- Department of Social Work, Northwestern State University of Louisiana, Natchitoches, LA USA
| | - Orion Mowbray
- School of Social Work, University of Georgia, Athens, GA USA
| |
Collapse
|
26
|
Sengoelge M, Johnson-Singh CM, Mittendorfer-Rutz E, Vaez M, Saboonchi F. Identifying subgroups of refugees from Syria resettled in Sweden based on multiple trauma exposures: A latent class analysis of trauma history and mental health outcomes. J Psychosom Res 2019; 125:109814. [PMID: 31470254 DOI: 10.1016/j.jpsychores.2019.109814] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/01/2019] [Accepted: 08/14/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Many refugees have been subjected to pre-migratory trauma. Evidence is needed to address the heterogeneity within refugee populations in regard to patterns of multiple trauma exposures. This study identified subgroups within a refugee population displaying different profiles of multiple trauma exposures and assessed sociodemographic predictors and differences in mental health symptom severity across these classes. METHODS Study population consisted of 1215 refugees from Syria resettled in Sweden. Latent class analysis 3-step method for modelling predictors and outcomes and a class-specific weighted multigroup approach were used to identify classes of refugees using self-reported data on violent and non-violent trauma exposures, sociodemographic variables and symptom severity scores for depression, anxiety and PTSD. RESULTS Three classes were identified: class 1 'multiple violent and non-violent trauma' (39.3%, n = 546); class 2 'witnessing violence and multiple non-violent trauma' (40.8%, n = 569); and class 3 'low multiple non-violent trauma' (20.1%, n = 281). Trauma exposure and gender significantly predicted class membership. Male gender and highest severity of mental ill health defined class 1. Female gender predicted higher mental ill health within classes 1 and 2. Across all three classes living with a partner was associated with lower severity of mental ill health regardless of trauma exposure classes. CONCLUSIONS There are distinct patterns within refugee populations concerning exposure to multiple trauma. Violence is a primary marker for higher likelihood of multiple trauma exposures and severity of mental health. Gender predisposes individuals to trauma exposure and its outcomes differentially.
Collapse
Affiliation(s)
- Mathilde Sengoelge
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden.
| | - Charisse M Johnson-Singh
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marjan Vaez
- Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Saboonchi
- Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
27
|
A Meta-Analysis of Parenting Practices and Child Psychosocial Outcomes in Trauma-Informed Parenting Interventions after Violence Exposure. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:927-938. [PMID: 30136246 DOI: 10.1007/s11121-018-0943-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Over half of all youth are exposed to violence, which a growing body of literature suggests is associated with a broad range of negative developmental outcomes over the life course. However, best practices for supporting parenting are not widely applied to parents with children exposed to violence-related trauma. This meta-analyses seeks to synthesize the literature base of trauma-informed parenting interventions to better understand their potential impact on parenting and child outcomes. Specifically, 21 trauma-informed parenting interventions were identified that quantitatively assessed intervention effects on parenting and child outcomes. Six meta-analyses were conducted to assess intervention effects on (1) positive parenting practices, (2) negative parenting practices, (3) parenting stress, (4) children's internalizing problems, (5) children's externalizing problems, and (6) trauma symptoms, respectively. Moderate to large effect sizes were found for positive parenting practices (d = 0.62) as well as child internalizing problems, externalizing problems, and trauma symptoms (d = 0.48-0.59). Validity tests indicated robust findings for positive parenting and for all child outcomes. Additional moderator analyses support the importance of informed intervention design, showing differential findings by trauma type as well as by duration of the intervention. These findings indicate the value of evidence-based parenting interventions for violence-related trauma and support models of trauma-informed care that situate treatment in the broader social context, particularly the family. Results are discussed with respect to which parenting practices hold the most promise for supporting children exposed to violence-related trauma.
Collapse
|
28
|
Identifying Distinct Latent Classes of Adverse Childhood Experiences Among US Children and Their Relationship with Childhood Internalizing Disorders. Child Psychiatry Hum Dev 2019; 50:668-680. [PMID: 30796680 DOI: 10.1007/s10578-019-00871-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study aimed to determine the relationship between latent classes of adverse childhood experience (ACEs) and internalizing disorders (anxiety and depression) among US children. The 2016 National Survey of Children's Health data for children aged 6-17 was used. Latent class analysis was performed to identify distinct sub-types of ACE exposures and survey-weighted logistic regression models were employed to determine whether these classes were associated with any or comorbid childhood internalizing disorders, after controlling for meaningful covariates. Four latent classes were identified: income hardship, divorce, mental health or substance abuse exposure, and high ACEs overall. Children in three of the four classes were significantly more likely to have any childhood internalizing disorder when compared to children reporting no ACEs, while children in all classes were significantly more likely to have a comorbid history of anxiety and depression. Thus, children exposed to ACEs should receive necessary mental health screenings and treatments.
Collapse
|
29
|
Stein MB, Campbell-Sills L, Ursano RJ, Rosellini AJ, Colpe LJ, He F, Heeringa SG, Nock MK, Sampson NA, Schoenbaum M, Sun X, Jain S, Kessler RC. Childhood Maltreatment and Lifetime Suicidal Behaviors Among New Soldiers in the US Army: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). J Clin Psychiatry 2019; 79:16m10900. [PMID: 28541647 PMCID: PMC6460907 DOI: 10.4088/jcp.16m10900] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/29/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Understanding suicide risk is a priority for the US military. We aimed to estimate associations of childhood maltreatment with pre-enlistment suicidal behaviors in new Army soldiers. METHODS Cross-sectional survey data from 38,237 soldiers reporting for basic training from April 2011 through November 2012 were analyzed. Scales assessing retrospectively reported childhood abuse and neglect were derived and subjected to latent class analysis, which yielded 5 profiles: No Maltreatment, Episodic Emotional Maltreatment, Frequent Emotional/Physical Maltreatment, Episodic Emotional/Sexual Abuse, and Frequent Emotional/Physical/Sexual Maltreatment. Discrete-time survival analysis was used to estimate associations of maltreatment profiles with suicidal behaviors (assessed with a modified Columbia-Suicide Severity Rating Scale), adjusting for sociodemographics and mental disorders. RESULTS Nearly 1 in 5 new soldiers was classified as experiencing childhood maltreatment. Relative to No Maltreatment, all multivariate maltreatment profiles were associated (P values < .001) with elevated odds of lifetime suicidal ideation (adjusted odds ratios [AORs] = 3.10-4.93), plan (AORs = 3.75-10.77), attempt (AORs = 3.60-15.95), and onset of plan among those with ideation (AORs = 1.40-3.10). Several profiles also predicted attempts among those with plans (AORs = 2.01-2.47), and Frequent Emotional/Physical/Sexual Maltreatment predicted unplanned attempts among ideators (AOR = 5.32). Adjustment for mental disorders attenuated but did not eliminate these associations. CONCLUSIONS Childhood maltreatment is strongly associated with suicidal behavior among new soldiers, even after adjusting for intervening mental disorders. Among soldiers with lifetime ideation, certain maltreatment profiles are associated with elevated odds of subsequently planning and/or attempting suicide. Focus on childhood maltreatment might reveal avenues for risk reduction among new soldiers.
Collapse
Affiliation(s)
- Murray B Stein
- Departments of Psychiatry and Family Medicine and Public Health, University of California San Diego (Mail Code 0855), 9500 Gilman Dr, La Jolla, CA 92093-0855.
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- VA San Diego Healthcare System, San Diego, California, USA
| | - Laura Campbell-Sills
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Anthony J Rosellini
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa J Colpe
- National Institute of Mental Health, Bethesda, Maryland, USA
| | - Feng He
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Steven G Heeringa
- University of Michigan, Institute for Social Research, Ann Arbor, Michigan, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Xiaoying Sun
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
30
|
King LS, Humphreys KL, Camacho MC, Gotlib IH. A person-centered approach to the assessment of early life stress: Associations with the volume of stress-sensitive brain regions in early adolescence. Dev Psychopathol 2019; 31:643-655. [PMID: 29716668 PMCID: PMC6214790 DOI: 10.1017/s0954579418000184] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Researchers are becoming increasingly interested in linking specific forms of early life stress (ELS) to specific neurobiological markers, including alterations in the morphology of stress-sensitive brain regions. We used a person-centered, multi-informant approach to investigate the associations of specific constellations of ELS with hippocampal and amygdala volume in a community sample of 211 9- to 13-year-old early adolescents. Further, we compared this approach to a cumulative risk model of ELS, in which ELS was quantified by the total number of stressors reported. Using latent class analysis, we identified three classes of ELS (labeled typical/low, family instability, and direct victimization) that were distinguished by experiences of family instability and victimization. Adolescents in the direct victimization class had significantly smaller hippocampal volume than did adolescents in the typical/low class; ELS classes were not significantly associated with amygdala volume. The cumulative risk model of ELS had a poorer fit than did the person-centered model; moreover, cumulative ELS was not significantly associated with hippocampal or amygdala volume. Our results underscore the utility of taking a person-centered approach to identify alterations in stress-sensitive brain regions based on constellations of ELS, and suggest victimization is specifically associated with hippocampal hypotrophy observed in early adolescence.
Collapse
|
31
|
Associations of specific and multiple types of childhood abuse and neglect with personality pathology among adolescents referred for mental health services. Psychiatry Res 2018; 270:906-914. [PMID: 30551343 DOI: 10.1016/j.psychres.2018.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 10/24/2018] [Accepted: 11/06/2018] [Indexed: 11/24/2022]
Abstract
The present study investigated the unique association between five types of childhood abuse and neglect and 18 lower-order dimensions of personality pathology, and using latent classes analysis (LCA) explored patterns of childhood abuse or neglect experiences. Further differences across latent classes on personality pathology traits, personality disorder symptom count and a diagnosis of personality disorder were examined. Participants were 178 adolescents and young adults (12-22 years; M = 16.02, 65.7% girls; 83% Axis I/II disorder) from the Netherlands referred for mental health services. Emotional abuse was uniquely associated with 11 personality pathology traits; sexual and physical were associated with three and four traits, respectively. LCA yielded three classes, namely, severe maltreatment (class 1), low-moderate emotional maltreatment and sexual abuse (class 2), and least maltreatment (class 3). After controlling for age, gender, presence of any Axis I disorder, multivariate analysis of covariance indicated that classes with more types of maltreatment experiences and higher severity (classes 1 and 2) endorsed more personality pathology traits, personality disorder symptom counts and a diagnosis of a personality disorder than the least maltreatment class. Findings have theoretical and clinical implications entailing the identification of patterns of maltreatment types and related personality pathology traits among youth.
Collapse
|
32
|
Delaney KR, Burke P, DeSocio J, Greenberg CS, Sharp D. Building mental health and caring for vulnerable children: Increasing prevention, access, and equity. Nurs Outlook 2018; 66:590-593. [DOI: 10.1016/j.outlook.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
33
|
Ryan JP, Jacob BA, Gross M, Perron BE, Moore A, Ferguson S. Early Exposure to Child Maltreatment and Academic Outcomes. CHILD MALTREATMENT 2018; 23:365-375. [PMID: 30037281 DOI: 10.1177/1077559518786815] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Early childhood trauma increases the risk of academic difficulties. The purpose of this study was to investigate the prevalence of early contact with child protection services (CPS) and to determine whether early exposure to maltreatment investigations was associated with important academic outcomes. The authors focused specifically on standardized test scores (math and reading), grade retention, and special education status in third grade. The sample was diverse and included all children born between 2000 and 2006 and enrolled in Michigan's public schools ( N = 732,838). By the time these students reached third grade, approximately 18% were associated with a formal CPS investigation. In some school districts, more than 50% of third graders were associated with an investigation. African American and poor students were more likely to be investigated for maltreatment. Children associated with maltreatment investigations scored significantly lower on standardized math and reading tests, were more likely to be identified as needing special education, and were more likely to be held back at least one grade. These findings indicate that involvement with CPS is not an infrequent event in the lives of young children and that within some school districts, maltreatment investigations are the norm. Child welfare and educational systems must collaborate so that the early academic struggles experienced by victims of maltreatment do not mature into more complicated difficulties later in life.
Collapse
Affiliation(s)
- Joseph P Ryan
- 1 School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Brian A Jacob
- 2 Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - Max Gross
- 3 Department of Economics, University of Michigan, Ann Arbor, MI, USA
| | - Brian E Perron
- 1 School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Moore
- 1 School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Sharlyn Ferguson
- 4 School of Education, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
34
|
Barra S, Bessler C, Landolt MA, Aebi M. Patterns of Adverse Childhood Experiences in Juveniles Who Sexually Offended. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2018; 30:803-827. [PMID: 29188752 DOI: 10.1177/1079063217697135] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Juveniles who sexually offended (JSOs) are differentially burdened with adverse childhood experiences (ACEs). The present study used Latent Class Analysis (LCA) to derive subtypes of JSOs according to their patterns of 10 different ACEs. An extensive file analysis of 322 male JSOs ( M = 14.14, SD = 1.94) revealed five subtypes with (a) multiple (9.0%), (b) mainly family related (17.1%), (c) mainly peer related (21.7%), (d) mainly neglectful (18.6%), and (e) little/no (33.5%) ACEs. Differences among ACE subtypes with regard to several offense and victim characteristics (e.g., the use of penetration or violence, the choice of a child, a male, a stranger, or multiple victims) were examined. Whereas no differences were found for the use of physical violence or the choice of male, stranger, or multiple victims, binary logistic regressions revealed associations of the multiple-ACE subtype with the choice of a child victim, the family-ACE subtype with the use of penetration as well as further nonsexual delinquency, the peer-ACE subtype with the use of penetration and the choice of a child victim, and the neglect-subtype with the choice of a child victim. Additional analyses including single ACE categories instead of LCA-derived subtypes supported these results. Findings highlight the need for a comprehensive consideration of ACEs in research and clinical work to understand developmental pathways to juvenile sexual offending.
Collapse
Affiliation(s)
- Steffen Barra
- 1 University Hospital of Psychiatry, Zurich, Switzerland
| | | | - Markus A Landolt
- 2 University of Zurich, Switzerland
- 3 University Children's Hospital Zurich, Switzerland
| | - Marcel Aebi
- 1 University Hospital of Psychiatry, Zurich, Switzerland
- 2 University of Zurich, Switzerland
| |
Collapse
|
35
|
The Effects of Neighborhood Context on Exposure to Adverse Childhood Experiences (ACE) Among Adolescents Involved in the Juvenile Justice System: Latent Classes and Contextual Effects. J Youth Adolesc 2018; 47:2279-2300. [DOI: 10.1007/s10964-018-0887-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/12/2018] [Indexed: 11/25/2022]
|
36
|
Woodhall-Melnik J, Dunn JR, Svenson S, Patterson C, Matheson FI. Men's experiences of early life trauma and pathways into long-term homelessness. CHILD ABUSE & NEGLECT 2018; 80:216-225. [PMID: 29626785 DOI: 10.1016/j.chiabu.2018.03.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 03/16/2018] [Accepted: 03/23/2018] [Indexed: 06/08/2023]
Abstract
Previous studies that have explored the association between childhood trauma and homelessness indicate that traumatic events can lead to survivor distrust of interpersonal relationships and institutions, prolonged homelessness and poor health and social outcomes. The majority of this literature relies on quantitative data and fails to investigate the personal experiences of childhood trauma that are found to impact housing status later in life. Semi-structured, qualitative interviews were conducted with 25 men living in an urban area in Ontario who had spent more than 30 consecutive nights in an emergency shelter over the course of their housing histories. During data analysis, it was observed that all of the men had experienced some form of trauma or neglect in childhood which contributed to their entries into homelessness. Using a case study approach, three entry pathways into long term homelessness are described: 1) youth; 2) emerging or early adulthood; and 3) middle adulthood. Participants are classified into the pathways by the developmental period at which they first entered homelessness. These findings have implications for policy makers and service providers, as key intervention points are identified. Establishing effective interventions that address crises experienced at these points could assist with homelessness prevention across the life course.
Collapse
Affiliation(s)
- Julia Woodhall-Melnik
- Department of Health, Aging, and Society, McMaster University, 2nd Floor Kenneth Taylor Hall, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada; Centre for Research on Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.
| | - James R Dunn
- Department of Health, Aging, and Society, McMaster University, 2nd Floor Kenneth Taylor Hall, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada; Centre for Research on Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - Stephen Svenson
- Department of Sociology, Wilfrid Laurier University, 75 University Avenue West Waterloo, Ontario, N2L 3C5, Canada
| | - Caroline Patterson
- Department of Medicine, McMaster University, 3rd Floor Michael Degroote Centre for Learning and Discovery, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Flora I Matheson
- Centre for Research on Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Dalla Lana School of Public Health, University of Toronto, 150 College St. Toronto, Ontario, Canada
| |
Collapse
|
37
|
Ford JD, Charak R, Modrowski CA, Kerig PK. PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents. J Trauma Dissociation 2018; 19:325-346. [PMID: 29547076 DOI: 10.1080/15299732.2018.1441354] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12-19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations.
Collapse
Affiliation(s)
- Julian D Ford
- a Department of Psychiatry , University of Connecticut Health Center , Farmington , CT , USA
| | - Ruby Charak
- b Department of Psychological Science , University of Texas Rio Grande Valley , Edinburg , TX , USA
| | - Crosby A Modrowski
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Patricia K Kerig
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| |
Collapse
|
38
|
van Montfort E, Mommersteeg P, Spek V, Kupper N. Latent profiles of early trauma & Type D personality: sex differences in cardiovascular risk markers. Compr Psychiatry 2018; 83:38-45. [PMID: 29549878 DOI: 10.1016/j.comppsych.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/05/2018] [Accepted: 02/24/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Both adverse early life-events and distressed personality are associated with an increased cardiovascular risk. As there is an important link between these psychological factors, we investigated how these might cluster in sex-specific psychological profiles. We further examined the association of these profiles with cardiovascular risk markers. METHOD 446 women (mean age = 49.8 ± 17.9 years) and 431 men (mean age = 49.4 ± 17.5 years) from the Dutch general population completed questionnaires on demographics, adverse early life-events (ETI), Type D personality (DS14), anxiety (GAD-7) and depressive (PHQ-9) symptoms, and traditional cardiovascular risk markers. RESULTS A step-3 latent profile analysis identified three profiles in women (Reference, Type D & trauma, and Type D/no trauma) and four in men (Reference, Type D & trauma, Type D/no trauma, and Physical abuse). In women, the Type D/no trauma was associated with highest levels of emotional symptoms (OR = 2.47; 95% CI: 2.11-2.89), lipid abnormalities (OR = 3.69; 95% CI: 1.47-9.27), and increased levels of alcohol use (OR = 3.63; 95% CI: 1.42-9.30). The Type D & trauma profile was associated with increased levels of emotional symptoms (OR = 2.03; 95% CI: 1.70-2.42), highest levels of smoking (OR = 3.30; 95% CI: 1.21-8.97) and alcohol use (OR = 7.63; 95% CI: 2.86-20.33). Women in both profiles were older as compared to the Reference group (OR = 1.03; 95% CI: 1.01-1.05). In men, the Type D & trauma profile was associated with increased levels of emotional symptoms (OR = 1.11; 95% CI: 1.03-1.20). There were no significant differences between the profiles in lifestyle factors and cardiometabolic factors. CONCLUSIONS In women, the Type D/no trauma profile and the Type D & trauma profile were associated with a specific combination of cardiovascular risk markers. In men, the Type D & trauma profile was associated with an increased level of emotional symptoms.
Collapse
Affiliation(s)
- Eveline van Montfort
- Center of Research on Psychological and Somatic Diseases, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Paula Mommersteeg
- Center of Research on Psychological and Somatic Diseases, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Viola Spek
- Center of Research on Psychological and Somatic Diseases, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Nina Kupper
- Center of Research on Psychological and Somatic Diseases, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands.
| |
Collapse
|
39
|
Ely GE, Hales TW, Jackson DL, Kotting J, Agbemenu K. Access to choice: Examining differences between adolescent and adult abortion fund service recipients. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:695-704. [PMID: 29687508 DOI: 10.1111/hsc.12582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
The results of a study examining differences between U.S. adolescent and adult abortion fund service recipients are presented in this paper. Using existing case data from 2010 to 2015 from the National Network of Abortion Funds (N = 3,288), a secondary data analysis was conducted to determine whether or not the experiences of adolescent (n = 481) and adult abortion patients (n = 2,807) who received financial assistance to help pay for an abortion differed. Fisher's exact tests examined differences in dichotomous variables, and regression examined differences in procedural costs, patient resources and expected travel distances to obtain an abortion. Results show that a greater proportion of adolescents in this data set identified as African American, and that adolescents were more likely to report seeking an abortion due to lack of contraception, and rape, while adult patients were more likely to be seeking an abortion due to contraceptive failure and partner violence. Results are discussed using a trauma-informed framework.
Collapse
Affiliation(s)
- Gretchen E Ely
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, NY
| | - Travis W Hales
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, NY
| | - D Lynn Jackson
- Department of Social Work, Texas Christian University, Ft. Worth, TX
| | | | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, The State University of New York, New York, NY
| |
Collapse
|
40
|
Zhang H, Li J, Yang B, Ji T, Long Z, Xing Q, Shao D, Bai H, Sun J, Cao F. The divergent impact of catechol-O-methyltransferase (COMT) Val 158Met genetic polymorphisms on executive function in adolescents with discrete patterns of childhood adversity. Compr Psychiatry 2018; 81:33-41. [PMID: 29222971 DOI: 10.1016/j.comppsych.2017.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/07/2017] [Accepted: 11/17/2017] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Catechol-O-methyltransferase (COMT) Val158Met functional polymorphisms play a crucial role in the development of executive function (EF), but their effect may be moderated by environmental factors such as childhood adversity. The present study aimed at testing the divergent impact of the COMT Val158Met genotype on EF in non-clinical adolescents with discrete patterns of childhood adversity. METHODS A total of 341 participants completed the Childhood Trauma Questionnaire, the self-reported version of the Behavior Rating Inventory of Executive Function, and self-administered questionnaires on familial function. The participants' COMT Val158Met genotype was determined. Associations among the variables were explored using latent class analysis and general linear models. RESULTS We found that Val/Val homozygotes showed significantly worse performance on behavioral shift, relative to Met allele carriers (F=5.921, p=0.015, Partial η2=0.018). Moreover, three typical patterns of childhood adversity, namely, low childhood adversity (23.5%), childhood neglect (59.8%), and high childhood adversity (16.7%), were found. Both childhood neglect and high childhood adversity had a negative impact on each aspect of EF and on global EF performance. Importantly, these results provided evidence for significant interaction effects, as adolescents with the Val/Val genotype showed inferior behavioral shift performance than Met carriers (F=6.647, p=0.010, Partial η2=0.020) in the presence of high childhood adversity. Furthermore, there were no differences between the genotypes for childhood neglect and low childhood adversity. CONCLUSIONS Overall, this is the first study to show that an interaction between the COMT genotype and childhood adversity affects EF in non-clinical adolescents. These results suggest that the COMT genotype may operate as a susceptibility gene vulnerable to an adverse environment.
Collapse
Affiliation(s)
- Huihui Zhang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Jie Li
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Bei Yang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Tao Ji
- Zaozhuang Vocational College, Zaozhuang, Shandong, PR China
| | - Zhouting Long
- Zaozhuang Vocational College, Zaozhuang, Shandong, PR China
| | - Qiquan Xing
- Zaozhuang Vocational College, Zaozhuang, Shandong, PR China
| | - Di Shao
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Huayu Bai
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Jiwei Sun
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China
| | - Fenglin Cao
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, PR China.
| |
Collapse
|
41
|
Stempel H, Cox-Martin M, Bronsert M, Dickinson LM, Allison MA. Chronic School Absenteeism and the Role of Adverse Childhood Experiences. Acad Pediatr 2017; 17:837-843. [PMID: 28927940 DOI: 10.1016/j.acap.2017.09.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 09/10/2017] [Accepted: 09/15/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-age children. METHODS We conducted a secondary analysis of data from the 2011-2012 National Survey of Children's Health including children 6 to 17 years old. The primary outcome variable was chronic school absenteeism (≥15 days absent in the past year). We examined the association between chronic school absenteeism and ACEs by logistic regression with weighting for individual ACEs, summed ACE score, and latent class analysis of ACEs. RESULTS Among the 58,765 school-age children in the study sample, 2416 (4.1%) experienced chronic school absenteeism. Witnessing or experiencing neighborhood violence was the only individual ACE significantly associated with chronic absenteeism (adjusted odds ratio [aOR] 1.55, 95% confidence interval [CI] 1.20-2.01). Having 1 or more ACE was significantly associated with chronic absenteeism: 1 ACE (aOR 1.35, 95% CI 1.02-1.79), 2 to 3 ACEs (aOR 1.81, 95% CI 1.39-2.36), and ≥4 ACEs (aOR 1.79, 95% CI 1.32-2.43). Three of the latent classes were also associated with chronic absenteeism, and children in these classes had a high probability of endorsing neighborhood violence, family substance use, or having multiple ACEs. CONCLUSIONS ACE exposure was associated with chronic school absenteeism in school-age children. To improve school attendance, along with future graduation rates and long-term health, these findings highlight the need for an interdisciplinary approach to address child adversity that involves pediatricians, mental health providers, schools, and public health partners.
Collapse
Affiliation(s)
- Hilary Stempel
- University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo.
| | - Matthew Cox-Martin
- University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo
| | - Michael Bronsert
- University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo
| | - L Miriam Dickinson
- University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Family Medicine, University of Colorado Denver, Aurora, Colo
| | - Mandy A Allison
- University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo
| |
Collapse
|
42
|
O'Donnell ML, Schaefer I, Varker T, Kartal D, Forbes D, Bryant RA, Silove D, Creamer M, McFarlane A, Malhi G, Felmingham K, Van Hoof M, Hadzi-Pavlovic D, Nickerson A, Steel Z. A systematic review of person-centered approaches to investigating patterns of trauma exposure. Clin Psychol Rev 2017; 57:208-225. [DOI: 10.1016/j.cpr.2017.08.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
|
43
|
Bandoli G, Campbell-Sills L, Kessler RC, Heeringa SG, Nock MK, Rosellini AJ, Sampson NA, Schoenbaum M, Ursano RJ, Stein MB. Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis. Psychol Med 2017; 47:2379-2392. [PMID: 28443533 PMCID: PMC5595661 DOI: 10.1017/s0033291717001064] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers. METHODS The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed. RESULTS Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment. CONCLUSIONS New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.
Collapse
Affiliation(s)
- Gretchen Bandoli
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | | | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Steven G. Heeringa
- University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
| | - Matthew K. Nock
- Department of Psychology, Harvard College, Cambridge, MA, USA
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
44
|
El Mhamdi S, Lemieux A, Bouanene I, Ben Salah A, Nakajima M, Ben Salem K, al'Absi M. Gender differences in adverse childhood experiences, collective violence, and the risk for addictive behaviors among university students in Tunisia. Prev Med 2017; 99:99-104. [PMID: 28216378 DOI: 10.1016/j.ypmed.2017.02.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/04/2023]
Abstract
Adverse childhood experiences (ACE) have been linked to a variety of addictive behaviors. The recent adaptation of the ACE measure by the World Health Organization (WHO) allows for the assessment of the negative role of additional adverse experiences, such as extra-familial violence. To date, the relationship between extra-familial violence and addictive behaviors has not been assessed. We report the contribution of ACEs, including the new scales for extra-familial violence, on the risk for mental health problems and addictive behaviors by gender in a sample of young adults in Tunisia. We conducted a cross sectional study in Tunisia during 2014, where we recruited 1200 young university adults who completed the validated Arabic version of the WHO ACE questionnaire in a university setting. Results indicated that intra-familial adversities were associated with increased risk for addictive behaviors, particularly in males. ACEs were also associated with increased risk for mental health problems with women showing more difficulties than men. Exposure to peer, community and collective violence was higher in males than in females and logistic regression confirms that exposure to extra-familial violence increased the risk for addictive behaviors both in male and females by two to three-fold. Mental health problems were associated with peer violence and substance abuse in males, but not in females. Results demonstrate for the first time the contribution of exposure to extra-familial violence on risk for addictive behaviors. Results highlight the need for addressing mental health and addiction in a community with high burden of adversity and violence.
Collapse
Affiliation(s)
- Sana El Mhamdi
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia.
| | - Andrine Lemieux
- Duluth Global Health Institute, University of Minnesota, USA
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | - Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | | | - Kamel Ben Salem
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | - Mustafa al'Absi
- Duluth Global Health Institute, University of Minnesota, USA
| |
Collapse
|
45
|
Thompson R, Lewis T, Neilson EC, English DJ, Litrownik AJ, Margolis B, Proctor L, Dubowitz H. Child Maltreatment and Risky Sexual Behavior. CHILD MALTREATMENT 2017; 22:69-78. [PMID: 27777330 PMCID: PMC6685066 DOI: 10.1177/1077559516674595] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Risky sexual behavior is a serious public health problem. Child sexual abuse is an established risk factor, but other forms of maltreatment appear to elevate risky behavior. The mechanisms by which child maltreatment influence risk are not well understood. This study used data from 859 high-risk youth, followed through age 18. Official reports of each form of maltreatment were coded. At age 16, potential mediators (trauma symptoms and substance use) were assessed. At age 18, risky sexual behavior (more than four partners, unprotected sex, unassertiveness in sexual refusal) was assessed. Neglect significantly predicted unprotected sex. Substance use predicted unprotected sex and four or more partners but did not mediate the effects of maltreatment. Trauma symptoms predicted unprotected sex and mediated effects of emotional maltreatment on unprotected sex and on assertiveness in sexual refusal and the effects of sexual abuse on unprotected sex. Both neglect and emotional maltreatment emerged as important factors in risky sexual behavior. Trauma symptoms appear to be an important pathway by which maltreatment confers risk for risky sexual behavior. Interventions to reduce risky sexual behavior should include assessment and treatment for trauma symptoms and for history of child maltreatment in all its forms.
Collapse
Affiliation(s)
| | - Terri Lewis
- University of Colorado Denver, Aurora, CO, USA
| | | | | | | | | | | | | |
Collapse
|
46
|
Serafini G, Gonda X, Pompili M, Rihmer Z, Amore M, Engel-Yeger B. The relationship between sensory processing patterns, alexithymia, traumatic childhood experiences, and quality of life among patients with unipolar and bipolar disorders. CHILD ABUSE & NEGLECT 2016; 62:39-50. [PMID: 27792883 DOI: 10.1016/j.chiabu.2016.09.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 06/06/2023]
Abstract
Several studies documented the involvement of sensory perception in emotional processes. The long-term consequences of traumatic experiences and alexithymia have been demonstrated as well. However, the role of extreme sensory processing patterns, traumatic childhood experiences, and alexithymia has not been thoroughly examined in major affective disorders. The present study aimed to: (1) compare unipolar/bipolar patients with regard to their sensory processing patterns, alexithymia, childhood traumatic experiences and quality of life; (2) examine the correlations between sensory processing patterns and childhood traumatic experiences; (3) investigate the relative contribution of diagnostic groups (unipolar/bipolar), sensory processing patterns, alexithymia, and childhood traumatic experiences in predicting quality of life. The sample included 336 participants, 197 with unipolar and 139 with bipolar disorder. All participants completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale, Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI)-II, and Short Form 12 Health Survey version 2 (SF-12). Bipolar patients showed significantly higher physical neglect, emotional abuse, and emotional neglect compared with unipolar patients. Both in unipolar and bipolar groups, lower registration of sensory input as well as hypersensitivity correlated with enhanced childhood trauma events. Reduced sensory sensitivity accounted for 11% of the variance in physical health composite score (PCS) of SF-12 whereas reduced depression accounted for 8% of the variance in mental health composite score (MCS). Furthermore, elevated MCS was predicted by depression, physical and emotional neglect. Sensory processing patterns and childhood traumatic experiences may specifically characterize individuals with major affective disorders and play a role in the prediction of their quality of life.
Collapse
Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Semmelweis University, Hungary
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant'Andrea Hospital, University of Rome, Rome, Italy
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| |
Collapse
|
47
|
Keane CA, Magee CA, Kelly PJ. Is there Complex Trauma Experience typology for Australian's experiencing extreme social disadvantage and low housing stability? CHILD ABUSE & NEGLECT 2016; 61:43-54. [PMID: 27744217 DOI: 10.1016/j.chiabu.2016.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 06/06/2023]
Abstract
Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total sample (N=1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for individuals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness.
Collapse
Affiliation(s)
- Carol A Keane
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia; Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia.
| | - Christopher A Magee
- Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia
| | - Peter J Kelly
- Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
48
|
Abstract
The first part of the series of three articles on posttraumatic stress disorder (PTSD) in Court to appear in the journal reviews the history of the construct of PTSD and its presentation in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013) and the ICD-11 (International Classification of Diseases, 11th Edition; World Health Organization, 2018). There are 20 symptoms of PTSD in the DSM-5. PTSD symptoms are arranged into a four-cluster model, which has received partial support in the literature. Other four-factor models have been found that fit the data even better than that of the DSM-5. There is a five-factor dysphoria model and two six-factor models that have been found to fit better the DSM-5 PTSD symptoms. Finally, research is providing support for a hybrid seven-factor model. An eighth factor on dissociation seems applicable to the minority of people who express the dissociative subtype. At the epidemiological level, individuals can expect trauma exposure to take place about 70% over one's lifetime. Also, traumatic exposure leads to traumatic reactions in about 10% of cases, with PTSD being a primary diagnosis for trauma. Once initiated, PTSD becomes prolonged in about 10% of cases. Polytrauma and comorbidities complicate these prevalence statistics. Moreover, the possibility of malingered PTSD presents confounds. However, the estimate for malingered PTSD varies extensively, from 1 to 50%, so that the estimate is too imprecise for use in court without further research. This first article in the series of three articles appearing in the journal on PTSD in Court concludes with discussion of complications related to comorbidities and heterogeneities, in particular. For example, PTSD and its comorbidities can be expressed in over one quintillion ways. This complexity in its current structure in the DSM-5 speaks to the individual differences involved in its expression.
Collapse
Affiliation(s)
- Gerald Young
- Glendon Campus, York University, Toronto, Ontario, Canada.
| |
Collapse
|
49
|
Abstract
The present review examines the moderating role of ideology on the effects of war, armed conflict, and terrorism on youth. Ideology is an important factor given the central role played by religio-political ideology and nationalism in present-day conflicts. Ideologies or worldviews represent cognitive frameworks that imbue the traumatic situation with meaning and order. Analysis of the pool of studies identified three categories of ideologically based moderating factors, each representing an aspect of social construction of traumatic events, namely, religion, political ideology, and self-concept. The two closely related categories of religion and politico-religious beliefs showed both positive and negative effects on psychological and psychiatric outcomes among youth. The third category of different aspects of self-concept yielded consistently positive moderating effects. The mechanisms by which each category of ideology moderates effects of exposure to war, armed conflict, and terrorism are discussed, and research and clinical implications are presented.
Collapse
Affiliation(s)
- Michelle Slone
- School of Psychological Sciences, Tel Aviv University, PO Box 39040, Tel Aviv, 6997801, Israel.
| | - Lia Shur
- School of Psychological Sciences, Tel Aviv University, PO Box 39040, Tel Aviv, 6997801, Israel
| | - Ayelet Gilady
- School of Psychological Sciences, Tel Aviv University, PO Box 39040, Tel Aviv, 6997801, Israel
| |
Collapse
|
50
|
Shoshani A, Slone M. The Resilience Function of Character Strengths in the Face of War and Protracted Conflict. Front Psychol 2016. [PMID: 26793139 DOI: 10.3389/fpsyg.2015.02006.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13-15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.
Collapse
Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya Herzliya, Israel
| | - Michelle Slone
- School of Psychological Sciences, Tel Aviv University Tel Aviv, Israel
| |
Collapse
|