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Turgeon J, Racine N, McDonald S, Tough S, Madigan S. Maternal adverse childhood experiences, child resilience factors, and child mental health problems: A multi-wave study. CHILD ABUSE & NEGLECT 2024; 154:106927. [PMID: 38970861 DOI: 10.1016/j.chiabu.2024.106927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. OBJECTIVES The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. PARTICIPANTS AND SETTING The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. METHODS Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. RESULTS Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (β = 0.174, p = .02) and depression (β = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (β = -0.29, p = .02, β = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. CONCLUSIONS Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.
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Affiliation(s)
- Jessica Turgeon
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Nicole Racine
- University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON K1H 5B, Canada
| | - Sheila McDonald
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Suzanne Tough
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. N.W. Calgary, AB, Canada.
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Akinyemi AA, Jones A, Sweeting JA, Holman EA. Parental Preconception Adversity and Offspring Mental Health in African Americans and Native Americans in the United States: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1911-1924. [PMID: 37776310 PMCID: PMC11155212 DOI: 10.1177/15248380231200464] [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: 10/02/2023]
Abstract
This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web of Science were searched for studies that included at least two generations of AAs or NAs from the same family, measured parental preconception adversity and their offspring's mental health, and examined the association between these variables. Over 3,200 articles were screened, and 18 articles representing 13 unique studies were included in this review. Among the studies with samples that included AAs (n = 12, 92%), 10 (83%) reported a significant association between parental preconception adversity and adverse offspring mental health. The only study with a sample of NAs (n = 1, 8%) also reported a significant association between these variables. Although the literature suggests that parental preconception adversity is associated with offspring mental health among AAs and NAs, it must be interpreted in the context of the small number of studies on this topic and the less-than-ideal samples utilized-just one study included a sample of NAs and several studies (n = 6, 46%) used multi-ethnic/racial samples without testing for ethnic/racial disparities in their results. A more rigorous body of literature on this topic is needed as it may help explain an important factor underlying ethnic/racial mental health disparities, with important implications for interventions and policy.
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Affiliation(s)
| | - Adrianna Jones
- Department of Psychology, Miami University, Oxford, OH, USA
| | - Josiah A. Sweeting
- Department of Psychological Science, University of California, Irvine, USA
| | - E. Alison Holman
- Department of Psychological Science, University of California, Irvine, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine
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Sloss IM, Smith J, Sebben S, Wade M, Prime H, Browne DT. Family functioning in the context of current and historical stressors: Exploring the buffering role of social support. CHILD ABUSE & NEGLECT 2024:106711. [PMID: 38388324 DOI: 10.1016/j.chiabu.2024.106711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) can be passed onto future generations through complex biopsychosocial mechanisms. However, social support in caregivers who have experienced adversity may lead to adaptation. Most research on the intergenerational consequences of ACEs has focused on mental health in subsequent generations, while overlooking family functioning as an outcome. OBJECTIVE This pre-registered study addresses this gap by examining a hypothesized association between caregiver ACEs and caregiver-perceived family functioning, and the moderating role of social support. It was expected that high levels of social support would attenuate the association between caregiver ACEs and family functioning, controlling for contemporaneous stressors in the context of the COVID-19 pandemic. PARTICIPANTS AND SETTING Data come from a multinational non-clinical sample (n = 310). METHODS Caregivers completed self-report measures to assess caregiver ACEs, social support, COVID stressors, and family dysfunction. RESULTS Multiple regression analyses revealed that the ACEs-by-social support interaction was not significant. Exploratory analyses revealed a significant three-way interaction between COVID stressors, ACEs, and social support (b = 0.001, SE < 0.001, p = .008). For lower adversity, social support protected against the association between COVID stressors and family dysfunction; however, for higher adversity, social support was only protective when COVID stressors were low. CONCLUSIONS Social support is protective against concurrent stressors during the pandemic in relation to family functioning, though this buffering depends on historical levels of adversity. Findings are interpreted through a trauma-informed lens and provide support for family-focused interventions and policies to mitigate the impact of stress on caregivers with high ACEs.
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Affiliation(s)
- Imogen M Sloss
- Department of Psychology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Jackson Smith
- Department of Psychology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Sofia Sebben
- Department of Psychology, Federal University of Rio Grande do Sul, Farroupilha, Porto Alegre, RS 90010-150, Brazil
| | - Mark Wade
- Applied Psychology and Human Development, University of Toronto, 252 Bloor St W, Toronto, ON M5S 1V6, Canada
| | - Heather Prime
- Department of Psychology, York University, 4700 Keele St, North York, ON M3J 1P3, Canada
| | - Dillon T Browne
- Department of Psychology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
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Boering A, Groenman AP, van Dam L, Overbeek G. Effectiveness, working mechanisms, and implementation of youth-initiated mentoring for juvenile delinquents: a multiple-methods study protocol. HEALTH & JUSTICE 2024; 12:5. [PMID: 38355837 PMCID: PMC10868063 DOI: 10.1186/s40352-024-00258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND The societal costs associated with juvenile delinquency and reoffending are high, emphasising the need for effective prevention strategies. A promising approach is Youth-Initiated Mentoring (YIM). In YIM, professionals support youths in selecting a non-parental adult from within their social network as their mentor. However, until now, little (quasi-)experimental research has been conducted on YIM in the field of juvenile delinquency. We will examine the effectiveness, working mechanisms, and implementation of YIM as a selective prevention strategy for juvenile delinquents. METHODS This multiple-methods study consists of a quasi-experimental trial and a qualitative study. In the quasi-experimental trial, we aim to include 300 juvenile offenders referred to Halt, a Dutch juvenile justice system organisation which offers youths a diversion program. In the Netherlands, all juvenile offenders between 12 and 18 years old are referred to Halt, where they must complete the Halt intervention. Youths will be non-randomly assigned to region-matched non-YIM-trained and YIM-trained Halt professionals implementing Care as Usual (CAU, i.e., the Halt intervention) or CAU plus YIM, respectively. Despite non-random allocation, this approach may yield comparable conditions regarding (1) the characteristics of professionals delivering the intervention and (2) case type and severity. Youth and caregiver(s) self-report data will be collected at pre-and post-test and a 6-month follow-up and complemented with official Halt records data. Multilevel analyses will test whether youths following CAU plus YIM show a stronger increase in resilience factors and a stronger decline in the need for formal support and delinquency than youths following CAU. In the qualitative study, we will organise focus group interviews with YIM-trained professionals to explore boosters and barriers experienced by professionals during the implementation of YIM. DISCUSSION The proposed study will help identify the effectiveness of YIM in strengthening resilience factors and possibly decreasing juvenile delinquency. In addition, it may offer insights into how and for whom YIM works. Finally, this study can help strengthen the implementation of YIM in the future. TRIAL REGISTRATION ClinicalTrials.Gov (# NCT05555472). Registered 7 September 2022. https://www. CLINICALTRIALS gov/ct2/show/NCT05555472?cond=Youth+Initiated+Mentoring&draw=2&rank=1 .
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Affiliation(s)
- Angelique Boering
- Research Institute Child Development and Education, Preventive Youth Care Programme Group, University of Amsterdam, Nieuwe Achtergracht 127, 1018WS, Amsterdam, the Netherlands.
| | - Annabeth P Groenman
- Research Institute Child Development and Education, Preventive Youth Care Programme Group, University of Amsterdam, Nieuwe Achtergracht 127, 1018WS, Amsterdam, the Netherlands
| | - Levi van Dam
- Research Institute Child Development and Education, Preventive Youth Care Programme Group, University of Amsterdam, Nieuwe Achtergracht 127, 1018WS, Amsterdam, the Netherlands
- Dutch YIM Foundation, Amersfoort, the Netherlands
- Levvel Academic Centre for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Geertjan Overbeek
- Research Institute Child Development and Education, Preventive Youth Care Programme Group, University of Amsterdam, Nieuwe Achtergracht 127, 1018WS, Amsterdam, the Netherlands
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Skov H, Glackin EB, Drury SS, Lockman J, Gray SAO. Pre-COVID respiratory sinus arrhythmia moderates associations between COVID-19 stress and child externalizing behaviors: Testing neurobiological stress theories. Dev Psychopathol 2024:1-12. [PMID: 38273710 DOI: 10.1017/s0954579423001682] [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] [Indexed: 01/27/2024]
Abstract
Exposure to stress related to the COVID-19 pandemic contributes to psychopathology risk, yet not all children are negatively impacted. The current study examined a parasympathetic biomarker of stress sensitivity, respiratory sinus arrhythmia (RSA), as a moderator of the effects of exposure to pandemic stress on child internalizing and externalizing behaviors in a sample of children experiencing economic marginalization. Three to five years pre-pandemic, when children were preschool-aged, RSA during baseline and a challenging parent-child interaction were collected. Mid-pandemic, between November 2020 and March 2021, children's exposure to pandemic stress and internalizing and externalizing behaviors were collected. Results demonstrated that children who, pre-pandemic, demonstrated blunted parasympathetic reactivity (i.e., no change in RSA relative to baseline) during the dyadic challenge exhibited elevated risk for externalizing behaviors mid-pandemic. Further, this risk was greatest for children exposed to high and moderate levels of pandemic stress. Consistent with diathesis stress and polyvagal frameworks, these conditional effects suggest that blunted parasympathetic reactivity in response to stress in early childhood may escalate the development of externalizing behaviors following stress exposure at school age.
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Affiliation(s)
- Hilary Skov
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Erin B Glackin
- Department of Psychology, Tulane University School of Science and Engineering, New Orleans, LA, USA
| | - Stacy S Drury
- Department of Psychiatry and Behavioral Science, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jeffrey Lockman
- Department of Psychology, Tulane University School of Science and Engineering, New Orleans, LA, USA
| | - Sarah A O Gray
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Department of Psychology, Tulane University School of Science and Engineering, New Orleans, LA, USA
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Kazemian N, Zhou T, Chalasani N, Narayan A, Cedeño Laurent JG, Olvera Alvarez HA, Pakpour S. Long-Term Impact of Childhood Adversity on the Gut Microbiome of Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:68. [PMID: 38248533 PMCID: PMC10815413 DOI: 10.3390/ijerph21010068] [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: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Adverse childhood experiences (ACEs) encompass negative, stressful, and potentially traumatic events during childhood, impacting physical and mental health outcomes in adulthood. Limited studies suggest ACEs can have short-term effects on children's gut microbiomes and adult cognitive performance under stress. Nevertheless, the long-term effects of ACEs experienced during adulthood remain unexplored. Thus, this study aimed to assess the long-term effects of ACEs on the gut microbiota of adult nursing students. We employed a multidimensional approach, combining 16S rRNA sequencing, bioinformatics tools, and machine learning to predict functional capabilities. High-ACE individuals had an increased abundance of Butyricimonas spp. and Prevotella spp. and decreased levels of Clostridiales, and Lachnospira spp. Prevotella abundance correlated negatively with L-glutamate and L-glutamine biosynthesis, potentially impacting intestinal tissue integrity. While nursing students with high ACE reported increased depression, evidence for a direct gut microbiota-depression relationship was inconclusive. High-ACE individuals also experienced a higher prevalence of diarrhea. These findings highlight the long-lasting impact of ACEs on the gut microbiota and its functions in adulthood, particularly among nursing students. Further research is warranted to develop targeted interventions and strategies for healthcare professionals, optimizing overall health outcomes.
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Affiliation(s)
- Negin Kazemian
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| | - Tony Zhou
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Naveen Chalasani
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Apurva Narayan
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
- Department of Computer Science, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
- Department of Electrical and Computer Engineering, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
| | - Jose Guillermo Cedeño Laurent
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | | | - Sepideh Pakpour
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
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Grafft N, Lo B, Easton SD, Pineros-Leano M, Davison KK. Maternal and Paternal Adverse Childhood Experiences (ACEs) and Offspring Health and Wellbeing: A Scoping Review. Matern Child Health J 2024; 28:52-66. [PMID: 37914980 DOI: 10.1007/s10995-023-03825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are common, often co-occur, and are associated with poor health outcomes across the life course. Emerging research has emphasized the lasting consequences of ACEs across generations, suggesting parental ACEs are associated with poor physical and mental health outcomes in children. However, the individual effects of fathers' ACEs and pathways of transmission remain unclear. A scoping review was conducted to summarize the current knowledgebase of the intergenerational consequences of parental ACEs on offspring health, clarify pathways of transmission, understand how ACEs are operationalized in the intergenerational literature, and identify gaps in knowledge. METHODS Six electronic databases were searched for articles published in English from 1995 to 2022 relating to the long-term consequences of parental ACEs on offspring physical and mental health. Articles underwent title, abstract, and full-text review by two investigators. Content analysis was performed to integrate findings across the included studies. RESULTS The search yielded 14,542 unique articles; 49 met the inclusion criteria. Thirty-six articles focused exclusively on mothers, one solely on fathers, and 12 included both mothers and fathers in their analyses. Six studies used an expanded definition of ACEs. Both direct and indirect associations between parental ACEs and poor offspring outcomes were identified, primarily through biological and psychosocial pathways. CONCLUSIONS Findings underscore the importance and oversight of fathers and the need to solidify a unified definition and measure of ACEs. This review identified modifiable protective factors (social support, father involvement) and pathways of transmission (parental mental health, parenting); both having important implications for intervention development.
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Affiliation(s)
- Natalie Grafft
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 20467, USA.
| | - Brian Lo
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 20467, USA
| | - Scott D Easton
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 20467, USA
| | - Maria Pineros-Leano
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 20467, USA
| | - Kirsten K Davison
- Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA, 20467, USA
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McCollum DC, Teeters JB, Moskal KR, Woodward MJ. Does Social Support Moderate the Association between Adverse Childhood Experiences and Substance-Related Problems? Subst Use Misuse 2023; 59:269-277. [PMID: 37853713 DOI: 10.1080/10826084.2023.2269570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: More than half of individuals in the United States have had adverse childhood experiences (ACEs), which can result in physical and mental distress. ACEs has been linked with greater likelihood of harmful alcohol and drug use. Research has found that protective factors, such as social support, may potentially buffer against harmful substance use engagement among those who have experienced ACEs. The purpose of this study was to examine associations between perceived social support, ACEs, and alcohol and cannabis-related problems. Moreover, this study aimed to examine if specific domains of perceived social support (family, friends, and significant other) moderated the relationship between ACEs and alcohol and cannabis-related problems. Method: Validated measures of ACEs, perceived social support, and alcohol and cannabis problems were collected in a sample of 401 emerging adults via Prolific Academic (an online data collection platform). Results: Overall perceived social support and domains such as perceived family and friend social support moderated the relationship between ACEs and alcohol-related problems but not ACEs and cannabis-related problems. The association between ACEs and alcohol-related problems was strongest at low levels of perceived family and friend social support. Perceived social support was not associated with cannabis-related problems. Conclusions: Lack of social support is a potential risk factor for alcohol-related problems among emerging adults. Bolstering perceived social support from family and friends among those who have experienced ACEs may be beneficial in intervention and treatment efforts aiming to reduce harmful substance use in this population.
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Affiliation(s)
- Diamonde C McCollum
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Katie R Moskal
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Matthew J Woodward
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
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Zhang L, Mersky JP, Gruber AMH, Kim JY. Intergenerational Transmission of Parental Adverse Childhood Experiences and Children's Outcomes: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3251-3264. [PMID: 36205317 DOI: 10.1177/15248380221126186] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adverse childhood experiences (ACEs) are among the leading environmental causes of morbidity and mortality. Extending research on within-generation effects, more recent scholarship has explored between-generation consequences of ACEs. Despite growing interest in the intergenerational effects of parents' ACEs on children's outcomes, this line of scholarship has yet to be coalesced into a comprehensive review. The current study is a scoping review on the intergenerational transmission of parental ACEs and children's outcomes. Ten databases such as PubMed, APA PsycArticles, and Social Work Abstracts were searched. To be included, empirical studies must have been published in English and analyzed associations between a cumulative measure of at least four parental ACEs and children's outcomes. Sixty-eight studies qualified for the review and, among these, 60 were published in the most recent 5 years (2018-2022). Fifty-one studies had sample sizes smaller than 500, and 55 focused on the effect of maternal ACEs. Nearly all studies demonstrated that parental ACEs could affect children's outcomes directly or indirectly via mechanisms like maternal mental health problems or parenting-related factors. By scoping the extant literature, this review advances the knowledge base regarding the intergenerational impacts of parental childhood trauma and children's outcomes. It also reveals methodological limitations that should be addressed in future research to strengthen causal inferences along with practical implications for interventions that aim to interrupt the intergenerational transmission of trauma.
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Meijer L, Franz MR, Deković M, van Ee E, Finkenauer C, Kleber RJ, van de Putte EM, Thomaes K. Towards a more comprehensive understanding of PTSD and parenting. Compr Psychiatry 2023; 127:152423. [PMID: 37722204 DOI: 10.1016/j.comppsych.2023.152423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The impact of post-traumatic stress disorder (PTSD) on parenting and the parent-child relationship has been well-documented in the scientific literature. However, some conceptual and methodological challenges within this research field remain. PROCEDURE We reflect on a number of challenges that we identified while examining the literature in preparation of an individual participant data meta-analysis on the relationships between PTSD and parenting. FINDINGS We address 1) the presence of 'trauma-islands'; 2) the need for transdiagnostic theoretical frameworks for mechanisms between PTSD and parenting; 3) the lack of developmental perspectives; 4) the overuse of self-reported retrospective measures; 5) the need to study more diverse samples and cultural contexts; and 6) the lack of research on resilience and post-traumatic growth in parenting. Based on these reflections, we offer suggestions on strategies for responding to these challenges through: 1) welcoming open science; 2) working towards shared theoretical frameworks; 3) doing more longitudinal research 4) expanding the methodological palette; 5) centering lived experience; and 6) taking systemic inequality into account. CONCLUSION With this commentary, we aim to open a discussion on next steps towards a more comprehensive understanding of the association between PTSD and parenting, and inspire collaborative research.
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Affiliation(s)
- Laurien Meijer
- Sinai Centrum Arkin Mental Health Care, Amstelveen, Laan van de Helende Meesters 2, 1186 AM Amstelveen, the Netherlands; Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, 3584 CH Utrecht, the Netherlands.
| | - Molly R Franz
- Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States
| | - Maja Deković
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - Elisa van Ee
- Psychotraumacentrum Zuid Nederland, Den Bosch, Bethaniestraat 10, 5211 LJ 's Hertogenbosch, the Netherlands; Behavioural Science Institute, Radboud University, Thomas Van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, 3584 CH Utrecht, the Netherlands
| | - Rolf J Kleber
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - Elise M van de Putte
- Wilhelmina Children's Hospital / University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, the Netherlands
| | - Kathleen Thomaes
- Department of Psychiatry, Amsterdam University Medical Centre/VUmc, Laan van de Helende Meesters 2, 1186 AM Amstelveen, the Netherlands
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Racine N, Deneault AA, Thiemann R, Turgeon J, Zhu J, Cooke J, Madigan S. Intergenerational transmission of parent adverse childhood experiences to child outcomes: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023:106479. [PMID: 37821290 DOI: 10.1016/j.chiabu.2023.106479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The current meta-analytic review provides a comprehensive synthesis of studies examining parent exposure to ACEs and the developmental and mental health outcomes of their children. PARTICIPANTS AND SETTING Eligible studies up to August 2021 were identified through comprehensive database searches in PsycINFO, MEDLINE, and Embase. Studies that were included examined the intergenerational effects of parent ACEs on child development (i.e., cognitive, language, motor, social difficulties, and early social-emotional development) or mental health (i.e., internalizing problems, externalizing problems) outcomes. METHODS Data were extracted by two coders using a standardized extraction protocol. A multi-level meta-analytic approach was used to derive pooled effect sizes and test for moderators. RESULTS A total of 52 studies were included in the meta-analysis. Parent ACEs were positively associated with child mental health problems (r=0.17, 95% CI [0.12, 0.21], p<.001), child externalizing difficulties (r=0.20, 95% CI [0.15, 0.26], p<.001), and child internalizing difficulties (r=0.17, 95% CI [0.11, 0.22], p<.001). There were no significant sociodemographic (i.e., child age, parent age, income level, child sex, or racial/ethnic minority status) or methodological (i.e., study type or quality) moderators of these associations. Preliminary evidence suggests that parent ACEs were not associated with offspring developmental outcomes, such as cognitive or language skills. CONCLUSIONS Results suggest that parent ACEs are associated with some, but not all child outcomes. Additional research focused on the mechanisms of transmission are needed to inform policies and practices related to the intergenerational transmission of ACEs.
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Affiliation(s)
- Nicole Racine
- University of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
| | - Audrey-Ann Deneault
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
| | | | - Jessica Turgeon
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
| | | | | | - Sheri Madigan
- University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
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12
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Edwards KM, Waterman EA, Mullet N, Herrington R, Cornelius S, Hopfauf S, Trujillo P, Wheeler LA, Deusch AR. Indigenous Cultural Identity Protects Against Intergenerational Transmission of ACEs Among Indigenous Caregivers and Their Children. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01795-z. [PMID: 37697145 DOI: 10.1007/s40615-023-01795-z] [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: 06/11/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Arielle R Deusch
- Avera Research Institute, Sioux Falls, USA
- University of South Dakota, Vermillion, USA
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13
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Kim AW, Rieder AD, Cooper-Vince CE, Kakuhikire B, Baguma C, Satinsky EN, Perkins JM, Kiconco A, Namara EB, Rasmussen JD, Ashaba S, Bangsberg DR, Tsai AC, Puffer ES. Maternal adverse childhood experiences, child mental health, and the mediating effect of maternal depression: A cross-sectional, population-based study in rural, southwestern Uganda. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:19-31. [PMID: 37212482 PMCID: PMC10524293 DOI: 10.1002/ajpa.24758] [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: 07/01/2022] [Revised: 02/09/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health. METHODS Data come from a population-based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. Survey data were analyzed using causal mediation and moderated-mediation analysis. RESULTS Among 218 mother-child pairs, 61 mothers (28%) and 47 children (22%) showed symptoms meeting cutoffs for clinically significant psychological distress. In multivariable linear regression models, maternal ACEs had a statistically significant association with severity of child conduct problems, peer problems, and total child difficulty scores. Maternal depression mediated the relationship between maternal ACEs and conduct problems, peer problems, and total difficulty, but this mediating effect was not moderated by maternal group membership. CONCLUSIONS Maternal depression may act as a potential mechanism linking maternal childhood adversity with poor child mental health in the next generation. Within a context of elevated rates of psychiatric morbidity, high prevalence of childhood adversity, and limited healthcare and economic infrastructures across Uganda, these results emphasize the prioritization of social services and mental health resources for rural Ugandan families.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amber D Rieder
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Jessica M Perkins
- Peabody College, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Institute of Global Health, Nashville, Tennessee, USA
| | - Allen Kiconco
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | - David R Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- Oregon Health and Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Alexander C Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Eve S Puffer
- Duke Global Health Institute, Durham, North Carolina, USA
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14
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Meijer L, Finkenauer C, Blankers M, de Gee A, Kramer J, Shields-Zeeman L, Thomaes K. Study protocol: development and randomized controlled trial of a preventive blended care parenting intervention for parents with PTSD. BMC Psychiatry 2023; 23:102. [PMID: 36765312 PMCID: PMC9921412 DOI: 10.1186/s12888-023-04548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Children of parents with post-traumatic stress disorder (PTSD) are at increased risk of adverse psychological outcomes. An important risk mechanism is impaired parental functioning, including negative parenting behavior, perceived incompetence, and lack of social support. Several parenting interventions for trauma-exposed parents and parents with psychiatric disorders exist, but none have specifically targeted parents with PTSD. Our objective is to evaluate the effectiveness of a blended care preventive parenting intervention for parents with PTSD. METHODS The intervention was adapted from an existing online intervention, KopOpOuders Self-Help. In co-creation with parents with PTSD and partners, the intervention was adapted into KopOpOuders-PTSD, by adding PTSD-specific content and three in-person-sessions with a mental health prevention professional. Effectiveness will be tested in a randomized controlled trial among N = 142 parents being treated for PTSD at Arkin Mental Health Care (control condition: treatment as usual, n = 71; intervention condition: treatment as usual + intervention, n = 71). Online questionnaires at pretest, posttest, and three-month follow-up and ecological momentary assessment at pretest and posttest will be used. Intervention effects on primary (parenting behavior) and secondary outcomes (perceived parenting competence, parental social support, parenting stress, child overall psychological problems and PTSD symptoms) will be analyzed using generalized linear mixed modeling. We will also analyze possible moderation effects of parental PTSD symptoms at pretest on primary and secondary outcomes. DISCUSSION This study protocol describes the randomized controlled trial of KopOpOuders-PTSD, a blended care preventive parenting intervention for parents with PTSD. Findings can contribute to understanding of the effectiveness of parenting support in clinical practice for PTSD. TRIAL REGISTRATION This protocol (Version 1) was registered on 11-02-2022 at ClinicalTrials.gov under identification number NCT05237999.
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Affiliation(s)
- Laurien Meijer
- Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM, Amstelveen, The Netherlands. .,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands.
| | - Catrin Finkenauer
- grid.5477.10000000120346234Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Matthijs Blankers
- grid.491093.60000 0004 0378 2028Arkin Mental Health Care, Amsterdam, the Netherlands ,grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Anouk de Gee
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jeannet Kramer
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Laura Shields-Zeeman
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Kathleen Thomaes
- grid.491093.60000 0004 0378 2028Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
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15
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Zhang L, Mersky JP, Lee CP. Intergenerational Pathways Linking Mothers' Adverse Childhood Experiences and Children's Social-Emotional Problems. CHILD MALTREATMENT 2023; 28:107-118. [PMID: 35068215 DOI: 10.1177/10775595211067212] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Despite the persistent hypothesis that adverse childhood experiences (ACE) have intergenerational implications, empirical research documenting the effects and the mechanisms of transmission remains underdeveloped. This study examined the intergenerational effects of mothers' adverse childhood experiences on their offspring's social-emotional development and whether the association was mediated by mothers' mental health, adult adversity, and perceptions of paternal involvement. The study sample included 831 mothers (19-49 years old, 47.5% White) with children aged 12-48 months who participated in a longitudinal investigation of low-income families in Wisconsin. ACEs were assessed by home visitors, and two waves of survey data were collected by researchers to assess demographics, mediators, and social-emotional outcomes. A path analysis showed that the association between maternal ACEs and children's social-emotional problems was fully mediated, with postpartum mental health acting as a primary mechanism. Implications for intervention and future research directions are discussed.
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Affiliation(s)
- Lixia Zhang
- Department of Social Work, 2313University of Northern Iowa, Cedar Falls, IA, USA
| | - Joshua P Mersky
- Helen Bader School of Social Welfare, 14751University of Wisconsin-Milwaukee, Chicago, IL, USA
| | - Chienti P Lee
- The Institute for Child and Family Well-Being, 14751University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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16
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Loheide-Niesmann L, Riem MME, Cima M. The impact of maternal childhood maltreatment on child externalizing behaviour and the mediating factors underlying this association: a three-level meta-analysis and systematic review. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02117-0. [PMID: 36463548 DOI: 10.1007/s00787-022-02117-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
Child maltreatment can negatively impact not only survivors but also survivors' children. However, research on the intergenerational effect of maternal childhood maltreatment on child externalizing behaviour has yielded contradictory results and has not yet been systematically synthesised. The current three-level meta-analysis and systematic review aimed to provide a quantitative estimate of the strength of the association between maternal childhood maltreatment and child externalizing behaviour and to summarise research on potential mediating factors of this association. PsycINFO, PubMed, and Embase were searched and 39 studies with 82 effects sizes were included in the meta-analysis. Results revealed a small significant association between maternal childhood maltreatment and child externalizing behaviour (r = 0.16; 95% CI 0.12-0.19; publication bias-adjusted effect size: r = 0.12, 95% CI 0.08-0.16). Maternal mental health, particularly depressive symptoms, maternal parenting and children's maltreatment exposure were the most frequently examined mediators of this association, with relatively robust mediating effects for children's maltreatment exposure and maternal depressive symptoms, but mixed evidence for the mediating role of maternal parenting. This meta-analysis provides evidence for a small but significant association between maternal childhood maltreatment and children's externalizing behaviour, emphasizing the need to develop effective preventive and intervention strategies to minimise the effects of childhood maltreatment on the next generation.
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Affiliation(s)
- Lisa Loheide-Niesmann
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, The Netherlands.
| | - Madelon M E Riem
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, The Netherlands
- Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Maaike Cima
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, The Netherlands
- VIGO, Juvenile Youth Institutions (YouthCarePLUS), Nijmegen, The Netherlands
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17
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Ivanova MY, Achenbach TM, Turner LV. Associations of Parental Depression with Children’s Internalizing and Externalizing Problems: Meta-Analyses of Cross-Sectional and Longitudinal Effects. JOURNAL OF CLINICAL CHILD & ADOLESCENT PSYCHOLOGY 2022; 51:827-849. [DOI: 10.1080/15374416.2022.2127104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Goodman ML, Baker L, Maigallo AK, Elliott A, Keiser P, Raimer-Goodman L. Adverse childhood experiences, adult anxiety and social capital among women in rural Kenya. J Anxiety Disord 2022; 91:102614. [PMID: 35988441 DOI: 10.1016/j.janxdis.2022.102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 10/16/2022]
Abstract
Hundreds of millions of people suffer anxiety disorders globally, demonstrating need for scalable and effective interventions. Adverse childhood experiences contribute to this mental health burden. The stress-buffering hypothesis, which posits social factors moderate prior adversity and subsequent mental health outcomes, provides one theoretical avenue to consider observations that group-based microfinance programs improve social capital. We investigate associations between adverse childhood experiences, generalized anxiety among adults and social capital associated with participation in a group-based microfinance program in rural Kenya. Adult participants (n = 400 women) responded to standardized measures of childhood adversity in June 2018, group-affiliated social capital and generalized anxiety in June 2019. Cumulative adverse childhood experiences predicted higher anxiety, which was statistically moderated by the presence of group-affiliated interpersonal trust. This study is the first to find social capital associated with participation in a group-based microfinance program statistically moderates expected associations between adverse childhood experiences and adult generalized anxiety. Future study should be conducted using a cluster-randomized control design to further assess the potential of this intervention method to ameliorate associations between past adversity and current mental health.
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Affiliation(s)
- Michael L Goodman
- University of Texas Medical Branch, Galveston, TX 77550, United States; Sodzo International, Houston, TX 77002, United States.
| | - Larissa Baker
- University of Texas Medical Branch, Galveston, TX 77550, United States
| | | | - Aleisha Elliott
- University of Texas Medical Branch, Galveston, TX 77550, United States
| | - Philip Keiser
- University of Texas Medical Branch, Galveston, TX 77550, United States
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19
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Yaun JA, Rogers LW, Marshall A, McCullers JA, Madubuonwu S. Whole Child Well-Child Visits: Implementing ACEs and SDOH Screenings in Primary Care. Clin Pediatr (Phila) 2022; 61:542-550. [PMID: 35499122 PMCID: PMC9315173 DOI: 10.1177/00099228221093279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Adverse childhood experiences (ACEs) and social determinants of health (SDOH) negatively affect health outcomes. This program was developed to screen for ACEs and SDOH in the primary care setting in families with children 9 months to 5 years of age at well-child checks and provide interventions that support families and build resiliency. Programmatic criteria were identified, referral resources were developed, and a database was implemented, with 246 families enrolled in year 1; 56.9% of caregivers reported 1 or more ACEs for their child, 63% of caregivers reported an SDOH need, and 39.4% of caregivers reported both. The average number of ACEs was 0.94. This program was created to address ACEs and SDOH, to empower families, build resiliency, and provide buffers to mitigate and prevent ACEs. It provides a model that can be implemented in a primary care setting while providing wraparound resources, including integrated mental health resources and referrals, to measure the success of these interventions.
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Affiliation(s)
- Jason A. Yaun
- Methodist Le Bonheur Healthcare,
Memphis, TN, USA,Department of Pediatrics, University of
Tennessee Health Science Center, Memphis, TN, USA,Jason A. Yaun, Department of Pediatrics,
University of Tennessee Health Science Center, 49 North Dunlap, Room 162,
Memphis, TN 38103, USA.
| | | | | | - Jonathan A. McCullers
- Methodist Le Bonheur Healthcare,
Memphis, TN, USA,Department of Pediatrics, University of
Tennessee Health Science Center, Memphis, TN, USA
| | - Sandra Madubuonwu
- Methodist Le Bonheur Healthcare,
Memphis, TN, USA,College of Graduate Health Sciences,
University of Tennessee Health Science Center, Memphis, TN, USA
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20
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Gaylord NM, Bland T, Munoz L, Ross R, Olson C. Prevalence and Impact of Adverse Childhood Experiences in an Interdisciplinary, School-Based Pediatric Clinic. J Pediatr Health Care 2022; 36:e1-e10. [PMID: 35227420 DOI: 10.1016/j.pedhc.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/03/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION This study's purpose was to ascertain the prevalence of adverse childhood experiences (ACEs) in a pediatric population and their connection to other health history information. METHOD Using health history data, a retrospective, descriptive study was undertaken with 1,028 children seen at a school-based, interprofessional clinic over 1 academic year. RESULTS Nearly 58% of children had at least one ACE, and 9.5% had four or more, similar to the prevalence of ACEs in adults reported in the original study by Felitti et al. (1998). With increasing ACEs, children had higher rates of intrauterine drug exposure, intensive care on delivery, homelessness, substance abuse, behavioral problems, mental illness, learning difficulties, and weight issues. DISCUSSION Because ACEs are prevalent among children, pediatric providers should use trauma-informed care principles and teach and model a loving and supportive adult presence in children's lives.
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21
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Gray SAO, Moberg SA, Obus EA, Parker V, Rosenblum KL, Muzik M, Zeanah CH, Drury SS. Harnessing Virtual Mom Power: Process and Outcomes of a Pilot Telehealth Adaptation of a Multifamily, Attachment-Based Intervention. JOURNAL OF INFANT, CHILD, AND ADOLESCENT PSYCHOTHERAPY : JICAP 2022; 21:6-18. [PMID: 36686598 PMCID: PMC9853992 DOI: 10.1080/15289168.2022.2045464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective The COVID-19 pandemic and mitigation strategies amplified racial and income-based health disparities, profoundly shifted family life, and altered delivery systems for support services. We report pilot data from a telehealth adaptation of Mom Power, an evidence-based, attachment-informed multifamily preventive intervention (clinicaltrials.gov: de-identified). Method Virtual Mom Power (VMP), adapted for economically marginalized, predominantly Black mothers and their young children (n = 9) was implemented in New Orleans, an early COVID-19 hotspot with an entrenched history of structural racism and trauma. We outline our approach to adaptation of curriculum and service delivery, using a trauma-informed lens. Results Maternal reports of maternal and child functioning from pre to post were consistent with improvements in maternal depressive and posttraumatic stress symptoms and child competence, comparable to outcomes from in-person trials. Feasibility and acceptability data were strong. Discussion Preliminary results and reflections on process suggest that telehealth service delivery of a multifamily preventive intervention, with attention to decreasing barriers to online access and consideration of culture and context, facilitated engagement while maintaining fidelity and effects on intervention targets. Future research using larger samples, randomized controlled design, and multi-method assessment should continue to guide dissemination of reflective, group-based telehealth parenting programs.
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Affiliation(s)
- Sarah A O Gray
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA.,Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA.,The Brain Institute, Tulane University, New Orleans, LA, USA
| | - Stephanie A Moberg
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | - Elsia A Obus
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | - Victoria Parker
- Department of Psychology, Tulane School of Science & Engineering, 2007 Percival Stern Hall, 6400 Freret St., New Orleans, LA 70118, USA
| | | | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Charles H Zeanah
- Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA
| | - Stacy S Drury
- Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., New Orleans, LA 70112, USA.,The Brain Institute, Tulane University, New Orleans, LA, USA
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22
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Sanchez AL, Jent J, Aggarwal NK, Chavira D, Coxe S, Garcia D, La Roche M, Comer JS. Person-Centered Cultural Assessment Can Improve Child Mental Health Service Engagement and Outcomes. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:1-22. [PMID: 34905434 DOI: 10.1080/15374416.2021.1981340] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessments to include a person-centered evaluation of patient cultural factors, however, controlled studies have not been conducted in the context of children's mental health care. METHODS Participants included families (N = 89; 89% racial/ethnic minority) receiving services for child externalizing problems. Prior to intake, caregivers were randomized to receive either Assessment as Usual (AAU) or AAU augmented with the Cultural Formulation Interview (CFI+AAU), a brief caregiver assessment of cultural factors affecting their child's problems and family help-seeking. RESULTS Implementation data showed strong provider fidelity and clinical utility. Following assessments, CFI+AAU caregivers (relative to AAU caregivers) reported feeling better understood by their provider, and providers reported better understanding CFI+AAU families' values. Caregiver satisfaction was rated highly overall, yet providers reported being more satisfied with the assessment when the CFI was incorporated. Engagement outcomes found CFI+AAU families were significantly more likely than AAU families to subsequently complete the first phase of treatment. Further, among families receiving services in Spanish, CFI+AAU, relative to AAU, was associated with significantly higher treatment attendance, homework completion, and treatment response. CONCLUSIONS The results underscore the utility of incorporating a brief cultural assessment in pretreatment assessments. To improve the cultural responsiveness of services, efforts may do well to promote the uptake of person-centered approaches such as cultural assessment into usual care. Registered at clinicaltrials.gov (NCT03499600).
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Affiliation(s)
- Amanda L Sanchez
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Jason Jent
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | | | - Denise Chavira
- Department of Psychology, University of California Los Angeles
| | - Stefany Coxe
- Center for Children and Families and Department of Psychology, Florida International University
| | - Dainelys Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | - Martin La Roche
- Harvard Medical School, Boston Children's Hospital at Martha Eliot
| | - Jonathan S Comer
- Center for Children and Families and Department of Psychology, Florida International University
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23
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Cooke JE, Racine N, Pador P, Madigan S. Maternal Adverse Childhood Experiences and Child Behavior Problems: A Systematic Review. Pediatrics 2021; 148:peds.2020-044131. [PMID: 34413250 DOI: 10.1542/peds.2020-044131] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT A growing body of research has examined the role of maternal adverse childhood experiences (ACEs) on child behavior problems. OBJECTIVE To summarize the literature examining the association between maternal ACEs and child behavior problems via a systematic review. DATA SOURCES Electronic searches were conducted in Medline, PsycINFO, and Embase (1998-June 2020). Reference lists were reviewed. In total, 3048 records were screened. STUDY SELECTION Studies were included if an association between maternal ACEs and child externalizing (eg, aggression) and/or internalizing (eg, anxiety) problems was reported. In total, 139 full-text articles were reviewed for inclusion. DATA EXTRACTION Data from 16 studies met full inclusion criteria. Studies were synthesized by child externalizing and internalizing outcomes. RESULTS Maternal ACEs were significantly associated with child externalizing problems across all studies (number of studies synthesized per outcome [k] = 11). Significant associations were also found for inattention, hyperactivity, and impulsivity (k = 4), and aggression (k = 2). For internalizing problems (k = 11), significant associations were identified across 8 studies and nonsignificant associations were reported for 3 studies. Maternal ACEs were consistently associated with child anxiety and depression (k = 5). However, inconsistent findings were reported for somatization (k = 2). LIMITATIONS Results are limited to mother-child dyads and questionnaire measures of behavior problems in primarily North American countries. CONCLUSIONS Mothers' ACEs demonstrated largely consistent associations with children's behavior problems. Future research is needed to determine if specific types of maternal ACEs (eg, household dysfunction) are more strongly associated with child behavior problems.
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Affiliation(s)
- Jessica E Cooke
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Nicole Racine
- Department of Psychology, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada .,Alberta Children's Hospital Research Institute, Calgary, Canada
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