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Ma N, Ji X, Shi Y, Wang Q, Wu J, Cui X, Niu W. Adverse childhood experiences and mental health disorder in China: A nationwide study from CHARLS. J Affect Disord 2024; 355:22-30. [PMID: 38548193 DOI: 10.1016/j.jad.2024.03.110] [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: 09/30/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES Mental health disorder is highly prevalent worldwide, and factors attributable to its development have not been fully understood. We aimed to explore the association of adverse childhood experiences (ACEs) with mental health disorder using data from the China Health and Retirement Longitudinal Study (CHARLS). METHODS CHARLS is an ongoing nationwide survey enrolling 17,708 residents aged ≥45 years in China. Total 20 ACE indicators were extracted. Unmeasured confounding and potential mediation were assessed, and effect-size estimates are expressed as odds ratio (OR) with 95 % confidence interval (CI). RESULTS Of 10,961 assessable participants with complete information, 3652 were reported to have mental health disorder. The risk for mental health disorder was increased by 20.7 % for participants with one to less than four events of ACEs (OR: 1.207, 95 % CI: 0.711 to 2.049), and this number reached 102.7 % for participants with four or more events (OR: 2.027, 95 % CI: 1.196 to 3.436) relative to those with no ACE. In subgroup analyses, between-group risk estimates differed significantly for residence, marital status, personal asset, life satisfaction, and living standard. The E-value of 2.35 for ACEs of 4 or more events indicated the low likelihood of unmeasured confounders. In mediation analyses, the proportion eliminated was 5.1 % for continuous ACEs and 6.1 % for categorical ACEs (both P < 0.001). DISCUSSION Our findings indicate that ACEs, especially with four or more events, can predict the significant risk of mental health disorder, underscoring the necessity of screening mental illness based on ACEs to reduce the resultant morbidity and mortality in China.
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Affiliation(s)
- Ning Ma
- Graduate School, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Xiaoxiao Ji
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yixin Shi
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Qiong Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Wu
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China.
| | - Xia Cui
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.
| | - Wenquan Niu
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China.
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Ravichandran S, Sood R, Das I, Dong T, Figueroa JD, Yang J, Finger N, Vaughan A, Vora P, Selvaraj K, Labus JS, Gupta A. Early life adversity impacts alterations in brain structure and food addiction in individuals with high BMI. Sci Rep 2024; 14:13141. [PMID: 38849441 PMCID: PMC11161480 DOI: 10.1038/s41598-024-63414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
Obesity and food addiction are associated with distinct brain signatures related to reward processing, and early life adversity (ELA) also increases alterations in these same reward regions. However, the neural mechanisms underlying the effect of early life adversity on food addiction are unknown. Therefore, the aim of this study was to examine the interactions between ELA, food addiction, and brain morphometry in individuals with obesity. 114 participants with high body mass index (BMI) underwent structural MRIs, and completed several questionnaires (e.g., Yale Food Addiction Scale (YFAS), Brief Resilience Scale (BRS), Early Traumatic Inventory (ETI)). Freesurfer 6 was applied to generate the morphometry of brain regions. A multivariate pattern analysis was used to derive brain morphometry patterns associated with food addiction. General linear modeling and mediation analyses were conducted to examine the effects of ELA and resilience on food addiction in individuals with obesity. Statistical significance was determined at a level of p < 0.05. High levels of ELA showed a strong association between reward control brain signatures and food addiction (p = 0.03). Resilience positively mediated the effect of ELA on food addiction (B = 0.02, p = 0.038). Our findings suggest that food addiction is associated with brain signatures in motivation and reward processing regions indicative of dopaminergic dysregulation and inhibition of cognitive control regions. These mechanistic variabilities along with early life adversity suggest increased vulnerability to develop food addiction and obesity in adulthood, which can buffer by the neuroprotective effects of resilience, highlighting the value of incorporating cognitive appraisal into obesity therapeutic regimens.
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Affiliation(s)
- Soumya Ravichandran
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
- UC San Diego School of Medicine, University of California, San Diego, USA
| | - Riya Sood
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Isha Das
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Tien Dong
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- Goodman Luskin Microbiome Center, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Johnny D Figueroa
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, USA
| | - Jennifer Yang
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- Goodman Luskin Microbiome Center, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Nicholas Finger
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Allison Vaughan
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Priten Vora
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Katie Selvaraj
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Jennifer S Labus
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA
- Goodman Luskin Microbiome Center, University of California, Los Angeles, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA.
- Goodman Luskin Microbiome Center, University of California, Los Angeles, USA.
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, The Obesity and Ingestive Behavior Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, Center for Health Sciences 42-210, Los Angeles, CA, 90095, USA.
- David Geffen School of Medicine, University of California, Los Angeles, USA.
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Camacho-Téllez V, Castro MN, Wainsztein AE, Goldberg X, De Pino G, Costanzo EY, Cardoner N, Menchón JM, Soriano-Mas C, Guinjoan SM, Villarreal MF. Childhood adversity modulates structural brain changes in borderline personality but not in major depression disorder. Psychiatry Res Neuroimaging 2024; 340:111803. [PMID: 38460393 DOI: 10.1016/j.pscychresns.2024.111803] [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: 07/08/2023] [Revised: 11/24/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
Adverse childhood experiences (ACEs) negatively affect the function and structure of emotion brain circuits, increasing the risk of various psychiatric disorders. It is unclear if ACEs show disorder specificity with respect to their effects on brain structure. We aimed to investigate whether the structural brain effects of ACEs differ between patients with major depression (MDD) and borderline personality disorder (BPD). These disorders share many symptoms but likely have different etiologies. To achieve our goal, we obtained structural 3T-MRI images from 20 healthy controls (HC), 19 MDD patients, and 18 BPD patients, and measured cortical thickness and subcortical gray matter volumes. We utilized the Adverse Childhood Experiences (ACE) questionnaire to quantify self-reported exposure to childhood trauma. Our findings suggest that individuals with MDD exhibit a smaller cortical thickness when compared to those with BPD. However, ACEs showed a significantly affected relationship with cortical thickness in BPD but not in MDD. ACEs were found to be associated with thinning in cortical regions involved in emotional behavior in BPD, whereas HC showed an opposite association. Our results suggest a potential mechanism of ACE effects on psychopathology involving changes in brain structure. These findings highlight the importance of early detection and intervention strategies.
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Affiliation(s)
- Vicente Camacho-Téllez
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina
| | - Mariana N Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina.
| | - Agustina E Wainsztein
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Ximena Goldberg
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Gabriela De Pino
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Laboratorio de Neuroimágenes, Departamento de Imágenes, Fleni, Argentina; Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Argentina
| | - Elsa Y Costanzo
- Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Narcís Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José M Menchón
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, USA; Department of Psychiatry, Health Sciences Center, Oklahoma University, and Oxley College, Tulsa University, Tulsa, Oklahoma, USA
| | - Mirta F Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Física, Facultad de Ciencias Exactas y Naturales, UBA, Argentina
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Cánepa ET, Berardino BG. Epigenetic mechanisms linking early-life adversities and mental health. Biochem J 2024; 481:615-642. [PMID: 38722301 DOI: 10.1042/bcj20230306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/15/2024]
Abstract
Early-life adversities, whether prenatal or postnatal exposure, have been linked to adverse mental health outcomes later in life increasing the risk of several psychiatric disorders. Research on its neurobiological consequences demonstrated an association between exposure to adversities and persistent alterations in the structure, function, and connectivity of the brain. Consistent evidence supports the idea that regulation of gene expression through epigenetic mechanisms are involved in embedding the impact of early-life experiences in the genome and mediate between social environments and later behavioral phenotypes. In addition, studies from rodent models and humans suggest that these experiences and the acquired risk factors can be transmitted through epigenetic mechanisms to offspring and the following generations potentially contributing to a cycle of disease or disease risk. However, one of the important aspects of epigenetic mechanisms, unlike genetic sequences that are fixed and unchangeable, is that although the epigenetic markings are long-lasting, they are nevertheless potentially reversible. In this review, we summarize our current understanding of the epigenetic mechanisms involved in the mental health consequences derived from early-life exposure to malnutrition, maltreatment and poverty, adversities with huge and pervasive impact on mental health. We also discuss the evidence about transgenerational epigenetic inheritance in mammals and experimental data suggesting that suitable social and pharmacological interventions could reverse adverse epigenetic modifications induced by early-life negative social experiences. In this regard, these studies must be accompanied by efforts to determine the causes that promote these adversities and that result in health inequity in the population.
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Affiliation(s)
- Eduardo T Cánepa
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Bruno G Berardino
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
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5
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Buchanan M, Newton-Howes G, Cunningham R, McLeod GFH, Boden JM. The role of social support in reducing the long-term burden of cumulative childhood adversity on adulthood internalising disorder. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02674-6. [PMID: 38687359 DOI: 10.1007/s00127-024-02674-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Previous research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood. METHODS The Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members' birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support. RESULTS Results indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0 .98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) = .98 (0.97, 0.99), p < 001). CONCLUSION The findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA.
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Affiliation(s)
- Mary Buchanan
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Geraldine F H McLeod
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Qu G, Shu L, Liu H, Ma S, Han T, Zhang H, Huang C, Wang J, Yang L, Sun Y. Association Between Adverse Childhood Experiences and Academic Performance Among Children and Adolescents: A Global Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024:15248380241246758. [PMID: 38651820 DOI: 10.1177/15248380241246758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
This study was conducted to quantify the association of adverse childhood experiences (ACEs) and the academic performance of children and adolescents. The literature was systematically searched in six electronic databases, and a meta-analysis was conducted. Twenty studies with a total of 1,196,631 children and adolescents from five countries were included. Meta-analysis showed that ACE score was positively associated with poor academic achievement, grade repetition, and special education support. Compared with children and adolescents without any ACE, those with one or more ACE had a significantly higher risk of poor academic achievement (pooled odds ratio [OR]: 1.45, 95% confidence interval [CI] [1.13, 1.85], I2 = 82.6%) and grade repetition (pooled OR: 1.36, 95% CI [1.29, 1.43], I2 = 71.0%). Moreover, all types of ACEs were positively associated with poor academic achievement and grade repetition. In addition, there was a significant dose-response relationship between the ACE score and the risk of poor academic achievement. This study supported that ACE had a significant impact on the academic performance of children and adolescents. Based on these findings, we recommend that early screening of ACEs for children and adolescent is critical and appropriate support and prevention in education should be developed for those with ACEs. Further studies are needed to further explore the long-term effect of ACEs on education and its gender differences.
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Affiliation(s)
| | - Liqin Shu
- Anhui Province Maternity and Child Health Hospital (Affiliated Maternity and Child Health Hospital of Anhui Medical University), Hefei, China
| | | | - Shaodi Ma
- Anhui Medical University, Hefei, China
| | | | | | - Christy Huang
- Touro University Nevada College of Osteopathic Medicine, Henderson, USA
| | - Jun Wang
- Anhui Medical University, Hefei, China
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 DOI: 10.1016/j.chiabu.2024.106701] [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: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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8
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Silke C, Heary C, Bunting B, Devaney C, Groarke A, Major E, Durcan M, O'Brien C, Brady B. Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022. J Affect Disord 2024; 349:234-243. [PMID: 38163570 DOI: 10.1016/j.jad.2023.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022). METHODS Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277). RESULTS Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide. LIMITATIONS These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings. DISCUSSION Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Ireland.
| | | | | | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Ireland
| | | | - Emmet Major
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Ireland
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Abdelhamid S, Kraaijenvanger E, Fischer J, Steinisch M. Assessing adverse childhood experiences in young refugees: a systematic review of available questionnaires. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02367-6. [PMID: 38451312 DOI: 10.1007/s00787-023-02367-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/21/2023] [Indexed: 03/08/2024]
Abstract
Today, various questionnaires are available to assess Adverse Childhood Experiences (ACEs) in children; however, it is uncertain if these questionnaires are comprehensive in addressing adversities of vulnerable subgroups, specifically refugee children. This review's objectives are to (1) identify current ACE questionnaires and determine if they are suitable in assessing refugee children's adversities, and (2) identify those previously used within a refugee population. A systematic literature search was conducted across five databases for articles published since 2010, including studies using an ACE-questionnaire that recognized multiple adversities in healthy children and were published in English. A total of 103 ACE questionnaires were identified in 506 studies. Only 14 of the 103 questionnaires addressed a refugee-specific adversity. Their ability to capture refugee children's experiences was limited: available questionnaires used a maximum of three items to assess refugee-specific adversities, covering only a fraction of forms of adversities relevant to refugee children. Psychometric characteristics were rarely reported. In addition, only two ACE questionnaires were used within a refugee population. With the tools currently available, it is not possible to comprehensively assess the exposure to and severity of the adversities faced by refugee children. The perpetuation of ongoing crises necessitates assessing refugee children's adversities to understand how their wellbeing is affected and to identify children at risk.
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Affiliation(s)
- Shaymaa Abdelhamid
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany.
| | - Eline Kraaijenvanger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Joachim Fischer
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
| | - Maria Steinisch
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of Public Health, Social and Preventive Medicine, Heidelberg University, Alte Brauerei, Röngtenstraße 7, 68167, Mannheim, Germany
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10
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Bravo-Queipo-de-Llano B, Sainz T, Díez Sáez C, Barrios Miras E, Bueno Barriocanal M, Cózar Olmo JA, Fabregas Martori A, Gancedo Baranda A. Violence as a Health Problem. An Pediatr (Barc) 2024; 100:202-211. [PMID: 38431447 DOI: 10.1016/j.anpede.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual's life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social. A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care. Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities. In summary, this work aims to promote the training and awareness of all professionals specialized in children's health, so that they pursue the goal of achieving their patients' greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice.
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Affiliation(s)
- Blanca Bravo-Queipo-de-Llano
- Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain; Instituto de Investigación Biomédica Hospital La Paz (IdiPAZ)
| | - Talía Sainz
- Instituto de Investigación Biomédica Hospital La Paz (IdiPAZ); Unidad de Pediatría Social, Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC); Universidad Autónoma de Madrid (UAM)
| | - Carmen Díez Sáez
- Servicio de Pediatría, Hospital Universitario de Basurto, Bilbao, Spain
| | - Ester Barrios Miras
- Pediatría de Atención Primaria, Centro de Salud Mejorada del Campo, Mejorada del Campo, Madrid, Spain
| | - Marta Bueno Barriocanal
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Juan Alonso Cózar Olmo
- Unidad de Gestión Clínica (UGC) Pediatría Área Jaén Norte, Hospital Universitario de San Agustín, Jaén, Spain
| | - Anna Fabregas Martori
- Coordinadora Equipo EMMA (Equipo de Atención a las Violencias hacia la Infancia y la Adolescencia), Departamento de Pediatría, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Antonio Gancedo Baranda
- Consulta de Pediatría Social, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
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11
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Petrican R, Fornito A, Boyland E. Lifestyle Factors Counteract the Neurodevelopmental Impact of Genetic Risk for Accelerated Brain Aging in Adolescence. Biol Psychiatry 2024; 95:453-464. [PMID: 37393046 DOI: 10.1016/j.biopsych.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/30/2023] [Accepted: 06/19/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND The transition from childhood to adolescence is characterized by enhanced neural plasticity and a consequent susceptibility to both beneficial and adverse aspects of one's milieu. METHODS To understand the implications of the interplay between protective and risk-enhancing factors, we analyzed longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study (n = 834; 394 female). We probed the maturational correlates of positive lifestyle variables (friendships, parental warmth, school engagement, physical exercise, healthy nutrition) and genetic vulnerability to neuropsychiatric disorders (major depressive disorder, Alzheimer's disease, anxiety disorders, bipolar disorder, schizophrenia) and sought to further elucidate their implications for psychological well-being. RESULTS Genetic risk factors and lifestyle buffers showed divergent relationships with later attentional and interpersonal problems. These effects were mediated by distinguishable functional neurodevelopmental deviations spanning the limbic, default mode, visual, and control systems. More specifically, greater genetic vulnerability was associated with alterations in the normative maturation of areas rich in dopamine (D2), glutamate, and serotonin receptors and of areas with stronger expression of astrocytic and microglial genes, a molecular signature implicated in the brain disorders discussed here. Greater availability of lifestyle buffers predicted deviations in the normative functional development of higher density GABAergic (gamma-aminobutyric acidergic) receptor regions. The two profiles of neurodevelopmental alterations showed complementary roles in protection against psychopathology, which varied with environmental stress levels. CONCLUSIONS Our results underscore the importance of educational involvement and healthy nutrition in attenuating the neurodevelopmental sequelae of genetic risk factors. They also underscore the importance of characterizing early-life biomarkers associated with adult-onset pathologies.
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Affiliation(s)
- Raluca Petrican
- Institute of Population Health, Department of Psychology, University of Liverpool, Liverpool, United Kingdom.
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Emma Boyland
- Institute of Population Health, Department of Psychology, University of Liverpool, Liverpool, United Kingdom
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12
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Daughtrey HR, Ruiz MO, Felix N, Saynina O, Sanders LM, Anand KJS. Incidence of mental health conditions following pediatric hospital admissions: analysis of a national database. Front Pediatr 2024; 12:1344870. [PMID: 38450296 PMCID: PMC10915034 DOI: 10.3389/fped.2024.1344870] [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: 11/26/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Despite increasing survival of children following hospitalization, hospitalization may increase iatrogenic risk for mental health (MH) disorders, including acute stress, post-traumatic stress, anxiety, or depression. Using a population-based retrospective cohort study, we assessed the rates of new MH diagnoses during the 12 months after hospitalization, including the moderating effects of ICU exposure. Study design/methods This was a retrospective case control study using the Truven Health Analytics insurance database. Inclusion criteria included children aged 3-21 years, insurance enrollment for >12 months before and after hospital admission. We excluded children with hospitalization 2 years prior to index hospitalization and those with prior MH diagnoses. We extracted admission type, ICD-10 codes, demographic, clinical, and service coordination variables from the database. We established age- and sex-matched cohorts of non-hospitalized children. The primary outcome was a new MH diagnosis. Multivariable regression methods examined the risk of incident MH disorder(s) between hospitalized and non-hospitalized children. Among hospitalized children, we further assessed effect modification from ICU (vs. non-ICU) stay, admission year, length of stay, medical complexity, and geographic region. Results New MH diagnoses occurred among 19,418 (7%) hospitalized children, 3,336 (8%) ICU-hospitalized children and 28,209 (5%) matched healthy controls. The most common MH diagnoses were anxiety (2.5%), depression (1.9%), and stress/trauma (2.2%) disorders. Hospitalization increased the odds of new MH diagnoses by 12.3% (OR: 1.123, 95% CI: 1.079-1.17) and ICU-hospitalization increased these odds by 63% (OR: 1.63, 95% CI: 1.483-1.79) as compared to matched, non-hospitalized children. Children with non-complex chronic diseases (OR: 2.91, 95% CI: 2.84-2.977) and complex chronic diseases (OR: 5.16, 95% CI: 5.032-5.289) had a substantially higher risk for new MH diagnoses after hospitalization compared to patients with acute illnesses. Conclusion Pediatric hospitalization is associated with higher, long-term risk of new mental health diagnoses, and ICU hospitalization further increases that risk within 12 months of the acute episode. Acute care hospitalization confers iatrogenic risks that warrant long-term mental and behavioral health follow-up.
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Affiliation(s)
- Hannah R. Daughtrey
- Pediatric Cardiac Critical Care Medicine, Children’s National Heart Institute, Washington, DC, United States
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, United States
| | - Monica O. Ruiz
- Department of Pediatric Critical Care Medicine, The Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Nicole Felix
- Department of Pediatric Critical Care Medicine, The Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Olga Saynina
- Department of Pediatrics, Stanford Child Wellness Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Lee M. Sanders
- Department of Pediatrics, Stanford Child Wellness Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine, Palo Alto, CA, United States
- Academic General Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Kanwaljeet J. S. Anand
- Department of Pediatrics, Stanford Child Wellness Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine, Palo Alto, CA, United States
- Pediatric Critical Care Medicine, Stanford Children’s Health, Palo Alto, CA, United States
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13
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von Werdt L, Binz TM, O’Gorman RT, Schmid A, Naef N, Rousson V, Kretschmar O, Liamlahi R, Latal B, Ehrler M. Stress Markers, Executive Functioning, and Resilience Among Early Adolescents With Complex Congenital Heart Disease. JAMA Netw Open 2024; 7:e2355373. [PMID: 38334997 PMCID: PMC10858402 DOI: 10.1001/jamanetworkopen.2023.55373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/18/2023] [Indexed: 02/10/2024] Open
Abstract
Importance Infants with complex congenital heart disease (cCHD) may experience prolonged and severe stress when undergoing open heart surgery. However, little is known about long-term stress and its role in neurodevelopmental impairments in this population. Objective To investigate potential differences between early adolescents aged 10 to 15 years with cCHD and healthy controls in physiological stress markers by hair analysis, executive function (EF) performance, and resilience. Design, Setting, and Participants This single-center, population-based case-control study was conducted at the University Children's Hospital Zurich, Switzerland. Patients with different types of cCHD who underwent cardiopulmonary bypass surgery during the first year of life and who did not have a genetic disorder were included in a prospective cohort study between 2004 and 2012. A total of 178 patients were eligible for assessment at ages 10 to 15 years. A control group of healthy term-born individuals was cross-sectionally recruited. Data assessment was between 2019 and 2021. Statistical analysis was performed from January to April 2023. Exposure Patients with cCHD who underwent infant open heart surgery. Main Outcomes and Measures Physiological stress markers were quantified by summing cortisol and cortisone concentrations measured with liquid chromatography with tandem mass spectrometry in a 3-centimeter hair strand. EFs were assessed with a neuropsychological test battery to produce an age-adjusted EF summary score. Resilience was assessed with a standardized self-report questionnaire. Results The study included 100 patients with cCHD and 104 controls between 10 and 15 years of age (mean [SD] age, 13.3 [1.3] years); 110 (53.9%) were male and 94 (46.1%) were female. When adjusting for age, sex, and parental education, patients had significantly higher sums of hair cortisol and cortisone concentrations (β, 0.28 [95% CI, 0.12 to 0.43]; P < .001) and lower EF scores (β, -0.36 [95% CI, -0.49 to -0.23]; P < .001) than controls. There was no group difference in self-reported resilience (β, -0.04 [95% CI, -0.23 to 0.12]; P = .63). A significant interaction effect between stress markers and EFs was found, indicating a stronger negative association in patients than controls (β, -0.65 [95% CI, -1.15 to -0.15]; P = .01). The contrast effects were not significant in patients (β, -0.21 [95% CI, -0.43 to -0.00]; P = .06) and controls (β, 0.09 [95% CI, -0.11 to 0.30]; P = .38). Conclusions and Relevance This case-control study provides evidence for altered physiological stress levels in adolescents with cCHD and an association with poorer EF. These results suggest that future studies are needed to better understand the neurobiological mechanisms and timing of alterations in the stress system and its role in neurodevelopment.
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Affiliation(s)
- Lilian von Werdt
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Tina M. Binz
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Ruth Tuura O’Gorman
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- Center for MR Research, University Children’s Hospital Zurich, Switzerland
| | - Alenka Schmid
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Nadja Naef
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Valentin Rousson
- Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Oliver Kretschmar
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- Pediatric Cardiology, Pediatric Heart Center, Department of Surgery, University Children’s Hospital Zurich, Switzerland
| | - Rabia Liamlahi
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Bea Latal
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Switzerland
| | - Melanie Ehrler
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Switzerland
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14
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Apsley AT, Lee SA, Bhat AC, Rush J, Almeida DM, Cole SW, Shalev I. Affective reactivity to daily stressors and immune cell gene expression in the MIDUS study. Brain Behav Immun 2024; 115:80-88. [PMID: 37797778 PMCID: PMC10841912 DOI: 10.1016/j.bbi.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023] Open
Abstract
Affective reactivity to stress is a person-level measurement of how well an individual copes with daily stressors. A common method of measuring affective reactivity entails the estimation of within-person differences of either positive or negative affect on days with and without stressors present. Individuals more reactive to common stressors, as evidenced by affective reactivity measurements, have been shown to have increased levels of circulating pro-inflammatory markers. While affective reactivity has previously been associated with inflammatory markers, the upstream mechanistic links underlying these associations are unknown. Using data from the Midlife in the United States (MIDUS) Refresher study (N = 195; 52% female; 84% white), we quantified daily stress processes over 10 days and determined individuals' positive and negative affective reactivities to stressors. We then examined affective reactivity association with peripheral blood mononuclear cell (PBMC) gene expression of the immune-related conserved transcriptional response to adversity. Results indicated that individuals with a greater decrease in positive affect to daily stressors exhibited heightened PBMC JUNB expression after Bonferroni corrections (p-adjusted < 0.05). JUNB encodes a protein that acts as a transcription factor which regulates many aspects of the immune response, including inflammation and cell proliferation. Due to its critical role in the activation of macrophages and maintenance of CD4+ T-cells during inflammation, JUNB may serve as a potential upstream mechanistic target for future studies of the connection between affective reactivity and inflammatory processes. Overall, our findings provide evidence that affective reactivity to stress is associated with levels of immune cell gene expression.
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Affiliation(s)
- Abner T Apsley
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA; Department of Molecular, Cellular, and Integrative Biosciences, The Pennsylvania State University, University Park, PA, USA
| | - Sun Ah Lee
- Department of Human Development and Family Studies, The Pennsylvania State University, USA
| | - Aarti C Bhat
- Department of Human Development and Family Studies, The Pennsylvania State University, USA
| | - Jonathan Rush
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, USA
| | - Steven W Cole
- Departments of Psychiatry and Biobehavioral Sciences and Medicine, Division of Hematology-Oncology, University of California Los Angeles, Los Angeles, CA 90095, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, and the Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Idan Shalev
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.
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15
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Verma H, Verma A, Bettag J, Kolli S, Kurashima K, Manithody C, Jain A. Role of Effective Policy and Screening in Managing Pediatric Nutritional Insecurity as the Most Important Social Determinant of Health Influencing Health Outcomes. Nutrients 2023; 16:5. [PMID: 38201835 PMCID: PMC10780641 DOI: 10.3390/nu16010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Social Determinants of Health (SDOH) impact nearly half of health outcomes, surpassing the influence of human behavior, clinical care, and the physical environment. SDOH has five domains: Economic Stability, Education Access and Quality, Health Care Access and Quality, Neighborhood and Built Environment, and Social and Community Context. Any adversity arising out of these interlinked domains predominantly affects children due to their greater susceptibility, and the adverse outcomes may span generations. Unfavorable SDOH may cause food insecurity, malnutrition, unbalanced gut microbiome, acute and chronic illnesses, inadequate education, unemployment, and lower life expectancy. Systematic screening by health care workers and physicians utilizing currently available tools and questionnaires can identify children susceptible to adverse childhood experiences, but there is a deficiency with respect to streamlined approach and institutional support. Additionally, current ameliorating supplemental food programs fall short of pediatric nutritional requirements. We propose a nutrition-based Surveillance, Screening, Referral, and Reevaluation (SSRR) plan encompassing a holistic approach to SDOH with a core emphasis on food insecurity, coupled with standardizing outcome-based interventions. We also propose more inclusive use of Food Prescription Programs, tailored to individual children's needs, with emphasis on education and access to healthy food.
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Affiliation(s)
- Hema Verma
- SLU College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Arun Verma
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Jeffery Bettag
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Sree Kolli
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Kento Kurashima
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Chandrashekhara Manithody
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Ajay Jain
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
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Dong WL, Li YY, Zhang YM, Peng QW, Lu GL, Chen CR. Influence of childhood trauma on adolescent internet addiction: The mediating roles of loneliness and negative coping styles. World J Psychiatry 2023; 13:1133-1144. [PMID: 38186732 PMCID: PMC10768484 DOI: 10.5498/wjp.v13.i12.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/18/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND In the information age, the use of the internet and multimedia tools has large effects on the life of middle school students. Improper use of the internet may result in internet addiction (IA). Thus, actively exploring the factors influencing adolescent and the mechanism of addiction as well as promoting adolescent physical and mental health and academic development are priorities that families, schools, and society urgently need to address. AIM To explore the effect of childhood trauma on adolescent IA and to consider the roles of loneliness and negative coping styles. METHODS A total of 11310 students from six junior high schools in Henan, China, completed the child trauma questionnaire, IA test, loneliness scale, and simple coping style questionnaire. In addition, data were collected from 1044 adolescents with childhood trauma for analysis with IBM SPSS 26.0 and AMOS 28.0; we examined the relationships among childhood trauma, IA, loneliness, and negative coping styles. RESULTS We found that childhood trauma not only directly affected adolescents' IA but also affected IA through loneliness and negative coping styles. CONCLUSION Therefore, this study has theoretical implications regarding adolescent mental health and may inform interventions for IA.
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Affiliation(s)
- Wang-Lin Dong
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng 475000, Henan Province, China
| | - Yuan-Yuan Li
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng 475000, Henan Province, China
| | - Yi-Ming Zhang
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng 475000, Henan Province, China
| | - Qian-Wen Peng
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng 475000, Henan Province, China
| | - Guang-Li Lu
- School of Business, Institute of Business Administration, Henan University, Kaifeng 475000, Henan Province, China
| | - Chao-Ran Chen
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng 475000, Henan Province, China
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Wang Z, Zou J, Zhang L, Ning J, Zhang X, Jiang B, Liang Y, Zhang Y. The impact of early adversity on the cerebral cortex - a Mendelian randomization study. Front Neurosci 2023; 17:1283159. [PMID: 37965215 PMCID: PMC10641447 DOI: 10.3389/fnins.2023.1283159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
Background The early adversity is associated with a series of negative outcomes in adulthood, and the impact on the cerebral cortex may be one of the fundamental causes of these adverse consequences in adulthood. In this study, we aim to investigate the causal relationship between early adversity and changes in cerebral cortex structure using Mendelian randomization (MR) analysis. Methods The GWAS summary statistics of 6 early adversity traits were obtained from individuals of European ancestry in the UK Biobank. The GWAS summary statistics of 34 known functional cortical regions were obtained from the ENIGMA Consortium. Causal relationships between the adversity factors and brain cortical structure were assessed using the inverse-variance weighted (IVW), MR-Egger, and weighted median methods, with IVW being the primary evaluation method. Cochran's Q-test, MR-PRESSO, leave-one-out analysis, and funnel plot examination were employed to detect potential heterogeneity and pleiotropy, as well as to identify and exclude outliers. Results At a global level, no causal relationship was found between early adversity and cortical thickness (TH) or surface area (SA) of the brain. However, at the regional level, early adversity was found to potentially influence the TH of the caudal anterior cingulate, superior temporal, entorhinal, paracentral, lateral occipital, banks of the superior temporal sulcus, and supramarginal regions, as well as the SA of the pars triangularis, lateral occipital, parahippocampal, medial orbitofrontal, and isthmus cingulate regions. All findings were nominally significant and passed sensitivity analyses, with no significant heterogeneity or pleiotropy detected. Discussion Our study provides evidence for the association between early adversity and alterations in brain cortical structure, which may serve as a foundation for certain mental disorders. Furthermore, magnetic resonance imaging (MRI) might be considered as a promising tool to aid healthcare professionals in identifying individuals with a history of adverse experiences, allowing for early interventions.
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Affiliation(s)
- Zhen Wang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Jing Zou
- The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Le Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Jinghua Ning
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Xin Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
| | - Bei Jiang
- Yunnan Key Laboratory of Screening and Research on Anti-pathogenic Plant Resources from West Yunnan (Cultivation), Dali, Yunnan, China
| | - Yi Liang
- Princess Margaret Cancer Centre, University Health Network, TMDT-MaRS Centre, Toronto, ON, Canada
| | - Yuzhe Zhang
- College of Basic Medical Sciences, Dali University, Dali, Yunnan, China
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18
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Adynski H, Propper C, Beeber L, Gilmore JH, Zou B, Santos HP. The role of social adversity on emotional dysregulation during infancy and early childhood. J Pediatr Nurs 2023; 72:26-35. [PMID: 37037102 PMCID: PMC10560316 DOI: 10.1016/j.pedn.2023.03.010] [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: 12/01/2022] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE The purpose of this study was to investigate if social adversity is associated with mother reported emotional dysregulation behaviors and trajectories during infancy and early childhood. DESIGN & METHODS A secondary data analysis from the Durham Child Health and Development study study included 206 child-mother dyads. Three models were used to explore the relationship between social adversity and mother reported emotional dysregulation during infancy (Infant Behavior Questionnaire-Revised) and early childhood (Child Behavior Checklist - Dysregulation Profile). Linear mixed effects models were adopted to investigate if social adversity was associated with mother reported emotional dysregulation longitudinally. Regression analysis was conducted to explore if social adversity was associated with maternal reported emotional dysregulation trajectory slope scores and maternal reported emotional dysregulation trajectory class. Maternal psychological distress and the child's sex assigned at birth were included as covariates in each analysis. RESULTS Infants with greater social adversity scores had significantly higher maternal reported fear responses across the first year of life. Social adversity was associated with maternal reported distress to limitations trajectory, dysregulated recovery class, and dysregulated distress to limitations class. During early childhood social adversity was significantly associated with maternal reported emotional dysregulation but not trajectories which showed little variability. CONCLUSION & PRACTICAL IMPLICATIONS Our results indicate that social adversity is associated with maternal reported emotional dysregulation during infancy and early childhood. Nursing and other professionals can participate in early screening to determine risk and provide intervention.
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Affiliation(s)
- Harry Adynski
- School of Nursing, University of North Carolina at Chapel Hill, NC, United States.
| | - Cathi Propper
- School of Nursing, University of North Carolina at Chapel Hill, NC, United States
| | - Linda Beeber
- School of Nursing, University of North Carolina at Chapel Hill, NC, United States
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, United States
| | - Baiming Zou
- Department of Biostatistics, University of North Carolina at Chapel Hill, NC, United States
| | - Hudson P Santos
- The University of Miami School of Nursing and Health Studies, Florida, United States
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19
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Bhutta ZA, Bhavnani S, Betancourt TS, Tomlinson M, Patel V. Adverse childhood experiences and lifelong health. Nat Med 2023; 29:1639-1648. [PMID: 37464047 DOI: 10.1038/s41591-023-02426-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023]
Abstract
With the advent of the sustainable development goals, the field of global child health has shifted its focus from reducing mortality to improving health, nutrition and development outcomes - often measured as human capital. A growing knowledge of the biology of development and neuroscience has highlighted the importance of adverse environmental exposures, collectively termed adverse childhood experiences (ACEs) on health outcomes. ACEs are associated with short-term, medium-term and long-term negative consequences for health and development and their effects may be multiplicative, especially during critical periods of sensitivity and developmental plasticity. Some of these effects are compounded by emerging global threats such as climate change, conflict and population displacement. In this Review, we discuss the key mechanisms linking ACEs to health outcomes and consider promising strategies to prevent and mitigate their effects, highlighting evidence from programs in low-income and middle-income countries. Finally, we emphasize the need for early recognition of ACEs and delivery of packages of interventions spanning key sectors such as health, education, women's empowerment and social protection.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
- Institute for Global Health & Development, The Aga Khan University, South Central Asia, East Africa, United Kingdom, and Karachi, Pakistan.
| | | | | | - Mark Tomlinson
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Vikram Patel
- Department of Global Health and Population, Harvard Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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20
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Yirmiya K, Motsan S, Zagoory-Sharon O, Schonblum A, Koren L, Feldman R. Continuity of psychopathology v. resilience across the transition to adolescence: role of hair cortisol and sensitive caregiving. Psychol Med 2023; 53:4487-4498. [PMID: 35634966 PMCID: PMC10388331 DOI: 10.1017/s0033291722001350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The transition to adolescence implicates heightened vulnerability alongside increased opportunities for resilience. Contexts of early life stress (ELS) exacerbate risk; still, little research addressed biobehavioral mediators of risk and resilience across the adolescent transition following ELS. Utilizing a unique cohort, we tested biosocial moderators of chronicity in adolescents' internalizing disorders v. resilience. METHOD Families exposed to chronic war-related trauma, v. controls, were followed. We utilized data from three time-points framing the adolescent transition: late childhood (N = 177, Mage = 9.3 years ± 1.41), early adolescence (N = 111, Mage = 11 0.66 years ± 1.23), and late adolescence (N = 138, Mage = 15.65 years ± 1.31). In late childhood and late adolescence children's internalizing disorders were diagnosed. At early adolescence maternal and child's hair cortisol concentrations (HCC), maternal sensitivity, and mothers' post-traumatic symptoms evaluated. RESULTS War-exposed children exhibited more internalizing disorders of chronic trajectory and mothers were less sensitive and more symptomatic. Three pathways elucidated the continuity of psychopathology: (a) maternal sensitivity moderated the risk of chronic psychopathology, (b) maternal post-traumatic symptoms mediated continuity of risk, (c) trauma exposure moderated the association between child internalizing disorders at late childhood and maternal HCC, which linked with child HCC. Child HCC linked with maternal post-traumatic symptoms, which were associated with child disorders in late adolescence. CONCLUSION Results demonstrate the complex interplay of maternal and child's biosocial factors as mediators and moderators of risk chronicity across the adolescent transition following trauma. Findings are first to utilize maternal and child's HCC as biomarkers of chronic stress v. resilience during adolescence, a period of neural reorganization and personal growth that shapes the individual's lifetime adaptation.
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Affiliation(s)
- Karen Yirmiya
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Shai Motsan
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | | | - Anat Schonblum
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Lee Koren
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Ruth Feldman
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
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21
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Oppegaard KR, Mayo SJ, Armstrong TS, Kober KM, Anguera J, Wright F, Levine JD, Conley YP, Paul S, Cooper B, Miaskowski C. An Evaluation of the Multifactorial Model of Cancer-Related Cognitive Impairment. Nurs Res 2023; 72:272-280. [PMID: 37104681 PMCID: PMC10330009 DOI: 10.1097/nnr.0000000000000660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Up to 45% of patients report cancer-related cognitive impairment (CRCI). A variety of characteristics are associated with the occurrence and/or severity of CRCI. However, an important gap in knowledge of risk factors for CRCI is the relative contribution of each factor. The multifactorial model of cancer-related cognitive impairment (MMCRCI) is a conceptual model of CRCI that can be used to evaluate the strength of relationships between various factors and CRCI. OBJECTIVES The purpose of this study was to use structural regression methods to evaluate the MMCRCI using data from a large sample of outpatients receiving chemotherapy ( n = 1,343). Specifically, the relationships between self-reported CRCI and four MMCRCI concepts (i.e., social determinants of health, patient-specific factors, treatment factors, and co-occurring symptoms) were examined. The goals were to determine how well the four concepts predicted CRCI and determine the relative contribution of each concept to deficits in perceived cognitive function. METHODS This study is part of a larger, longitudinal study that evaluated the symptom experience of oncology outpatients receiving chemotherapy. Adult patients were diagnosed with breast, gastrointestinal, gynecological, or lung cancer; had received chemotherapy within the preceding 4 weeks; were scheduled to receive at least two additional cycles of chemotherapy; were able to read, write, and understand English; and gave written informed consent. Self-reported CRCI was assessed using the attentional function index. Available study data were used to define the latent variables. RESULTS On average, patients were 57 years of age, college educated, and with a mean Karnofsky Performance Status score of 80. Of the four concepts evaluated, whereas co-occurring symptoms explained the largest amount of variance in CRCI, treatment factors explained the smallest amount of variance. A simultaneous structural regression model that estimated the joint effect of the four exogenous latent variables on the CRCI latent variable was not significant. DISCUSSION These findings suggest that testing individual components of the MMCRCI may provide useful information on the relationships among various risk factors, as well as refinements of the model. In terms of risk factors for CRCI, co-occurring symptoms may be more significant than treatment factors, patient-specific factors, and/or social determinants of health in patients receiving chemotherapy.
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Affiliation(s)
| | - Samantha J. Mayo
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, Canada
| | | | - Kord M. Kober
- School of Nursing, University of California San Francisco
| | | | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, NY
| | - Jon D. Levine
- School of Medicine, University of California San Francisco
| | | | - Steven Paul
- School of Nursing, University of California San Francisco
| | - Bruce Cooper
- School of Nursing, University of California San Francisco
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco
- School of Medicine, University of California San Francisco
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22
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Zhang Y, Li Y, Jiang T, Zhang Q. Role of body mass index in the relationship between adverse childhood experiences, resilience, and mental health: a multivariate analysis. BMC Psychiatry 2023; 23:460. [PMID: 37353758 PMCID: PMC10290297 DOI: 10.1186/s12888-023-04869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/13/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVES Depression among adolescents is a global concern. Adverse childhood experiences (ACEs) have been correlated with negative physical and mental health such as obesity and depression; however, increasing evidence has suggested that their correlation might be moderated by BMI and resilience. In this study, we aim to explore (1) whether resilience moderate the risk of mental health by ACEs; (2) whether BMI is a moderator of this relationship. STUDY DESIGN Adolescents were obtained from 4 grade college students by a multi-stage convenience sampling method in the period of May to Jun, 2022. METHODS We use the Connor-Davidson Resilience scale, Depression, Anxiety and Stress Scale-21 Item (DASS-21) questionnaires to measure the ACEs, BMI, resilience and mental health. The primary exposure was ACEs and the primary outcome was mental health; while resilience and BMI were moderators. Multivariable linear regression model was used to establish the relationship of ACEs, resilience and BMI against mental health status. Moderate analysis was employed by PROCESS method to explore the relationship between these variables. RESULTS A total of 3600 individuals were initially enrolled, after excluding 22 with invalid questionnaires, 3578 adolescents were finally included. The mean age was (20.53 ± 1.65) years old. After adjusted for covariates, multivariable linear regression suggest that the high level ACEs (, β =0.58, , 95%CI:0.54,0.62, P < 0.01), resilience (, β=-0.27, 95%CI: , 95%CI: -0.28,-0.26, P < 0.01) were associated with higher depression symptoms, and BMI (, β =0.073, 95%CI: 0.002-0.15, P < 0.05) was associated with higher depression symptoms. There is also the interaction between resilience, ACEs and mental health (depression, anxiety and stress symptoms). In the relationship between ACEs and mental health, resilience and BMI played a moderator role. CONCLUSIONS The moderate analysis also provided further evidence of a link between resilience, ACEs, BMI and mental health. The findings shed new light on potential mechanisms between ACEs and mental health, including the effects of the co-interaction of resilience and BMI, adding to previous literature. ACEs may be a profound variable to measure adolescents' psychosocial environment to influence mental health, and resilience moderate this effect and is also moderated by BMI.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yonghan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
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23
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Huang Z, Jordan JD, Zhang Q. Early life adversity as a risk factor for cognitive impairment and Alzheimer's disease. Transl Neurodegener 2023; 12:25. [PMID: 37173751 PMCID: PMC10182702 DOI: 10.1186/s40035-023-00355-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/13/2023] [Indexed: 05/15/2023] Open
Abstract
Neurological conditions, including cognitive impairment and Alzheimer's disease (AD), impose a huge burden on society, affecting millions of people globally. In addition to genetic factors, recent studies indicate that environmental and experiential factors may contribute to the pathogenesis of these diseases. Early life adversity (ELA) has a profound impact on brain function and health later in life. In rodent models, exposure to ELA results in specific cognitive deficits and aggravated AD pathology. Extensive concerns have been raised regarding the higher risk of developing cognitive impairments in people with a history of ELA. In this review, we scrutinize findings from human and animal studies focusing on the connection of ELA with cognitive impairment and AD. These discoveries suggest that ELA, especially at early postnatal stages, increases susceptibility to cognitive impairment and AD later in life. In terms of mechanisms, ELA could lead to dysregulation of the hypothalamus-pituitary-adrenal axis, altered gut microbiome, persistent inflammation, oligodendrocyte dysfunction, hypomyelination, and aberrant adult hippocampal neurogenesis. Crosstalks among these events may synergistically contribute to cognitive impairment later in life. Additionally, we discuss several interventions that may alleviate adverse consequences of ELA. Further investigation into this crucial area will help improve ELA management and reduce the burden of related neurological conditions.
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Affiliation(s)
- Zhihai Huang
- Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - J Dedrick Jordan
- Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Quanguang Zhang
- Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71103, USA.
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24
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Silke C, Brady B, Devaney C, O'Brien C, Durcan M, Bunting B, Heary C. Youth Suicide and Self-Harm: Latent Class Profiles of Adversity and the Moderating Roles of Perceived Support and Sense of Safety. J Youth Adolesc 2023; 52:1255-1271. [PMID: 36964434 PMCID: PMC10121538 DOI: 10.1007/s10964-023-01762-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023]
Abstract
Research suggests that exposure to adversity can lead to an increased risk of experiencing suicidal and self-injurious thoughts or behaviours, but few studies have examined whether different patterns of adversity are differentially associated with youth suicide/self-harm. The current study aims to explore the relationship between exposure to adversity across various social domains and youth self-harm and suicidality, using a person centred approach, and examines whether access to social support and a sense of safety across home, peer or school settings buffer the relationship between adversity and self-harm/suicidality. Secondary data analyses were carried out on cross-sectional self-report data collected from 4848 (Mage=15.78, SD = 0.59; 50% female) adolescents who participated in the Irish Planet Youth survey. Latent Class Analyses identified four distinct profiles of adversity; low-adversity (n = 2043, 42%); peer-adversity (n = 972, 20%); parental-adversity (n = 1189, 25%); and multiple-adversity (n = 644, 13%). Findings from logistic moderated regressions indicated that there were significant differences in self-harm and suicidality across the adversity classes. Although parental support and perceived safety at school were negatively associated with suicidality and self-harm outcomes, no significant moderation effects were observed. These findings suggest that youth who experience adversity across multiple social domains are more likely to report suicidal and self-harm thoughts and behaviours, and should be key targets for intervention/prevention efforts. While parental support and school safety may act as significant compensatory factors, further work is needed to identify the social resources that can offset the risk imposed by youth's adverse experiences.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland.
| | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | | | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Caroline Heary
- School of Psychology, University of Galway, Galway, Ireland
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25
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Rodgers EL, Kuhlman KR. Early life adversity is associated with attenuated testosterone reactivity to acute stress among adolescents. Psychoneuroendocrinology 2023; 153:106087. [PMID: 37019055 DOI: 10.1016/j.psyneuen.2023.106087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/11/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
Understanding how testosterone responds to stress or challenge may be integral to uncovering biological pathways to potentially harmful behaviors like aggression. Yet, studies investigating patterns of testosterone reactivity under stress within adolescent populations are limited. Among those conducted, even fewer have investigated environmental factors which may shape such patterns. Exposure to early life adversity (ELA) has been shown to influence other biological markers of stress reactivity, though how it may be associated with alterations in testosterone reactivity remains underexplored. The current study addresses these gaps by examining salivary testosterone concentrations across the administration of a Trier Social Stress Test for Children in a sample of 87 adolescents (46.4% female, Mage = 13.91 years, SDage = 1.57). The current study tested two central hypotheses: (1) that testosterone would rise in response to a standardized laboratory stressor, and (2) that greater ELA would be associated with higher baseline (or, pre-stress) testosterone scores and a dampened testosterone response to stress. Adolescents in the current sample showed a robust increase in testosterone following administration of the TSST-C, supporting the limited previous findings which indicate testosterone does mount an acute stress response in adolescents. Contrary to hypotheses, ELA was not associated with significant elevations in baseline testosterone scores. However, ELA was associated with dampened testosterone reactivity, even after controlling for important demographic and biological factors. Methodological implications, including considerations for researchers aiming to capture an acute testosterone response, as well as how our understanding of ELA's role in adolescent biological functioning is extended by our findings regarding testosterone, are discussed.
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Affiliation(s)
- Emma Louise Rodgers
- Department of Psychological Science, University of California, Irvine, United States.
| | - Kate Ryan Kuhlman
- Department of Psychological Science, University of California, Irvine, United States; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, United States; Institute for Interdisciplinary Salivary Bioscience Research, School of Social Ecology, University of California, Irvine, United States
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26
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Petrican R, Fornito A. Adolescent neurodevelopment and psychopathology: The interplay between adversity exposure and genetic risk for accelerated brain ageing. Dev Cogn Neurosci 2023; 60:101229. [PMID: 36947895 PMCID: PMC10041470 DOI: 10.1016/j.dcn.2023.101229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/08/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023] Open
Abstract
In adulthood, stress exposure and genetic risk heighten psychological vulnerability by accelerating neurobiological senescence. To investigate whether molecular and brain network maturation processes play a similar role in adolescence, we analysed genetic, as well as longitudinal task neuroimaging (inhibitory control, incentive processing) and early life adversity (i.e., material deprivation, violence) data from the Adolescent Brain and Cognitive Development study (N = 980, age range: 9-13 years). Genetic risk was estimated separately for Major Depressive Disorder (MDD) and Alzheimer's Disease (AD), two pathologies linked to stress exposure and allegedly sharing a causal connection (MDD-to-AD). Adversity and genetic risk for MDD/AD jointly predicted functional network segregation patterns suggestive of accelerated (GABA-linked) visual/attentional, but delayed (dopamine [D2]/glutamate [GLU5R]-linked) somatomotor/association system development. A positive relationship between brain maturation and psychopathology emerged only among the less vulnerable adolescents, thereby implying that normatively maladaptive neurodevelopmental alterations could foster adjustment among the more exposed and genetically more stress susceptible youths. Transcriptomic analyses suggested that sensitivity to stress may underpin the joint neurodevelopmental effect of adversity and genetic risk for MDD/AD, in line with the proposed role of negative emotionality as a precursor to AD, likely to account for the alleged causal impact of MDD on dementia onset.
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Affiliation(s)
- Raluca Petrican
- Institute of Population Health, Department of Psychology, University of Liverpool, Bedford Street South, Liverpool L69 7ZA, United Kingdom.
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
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27
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Ortiz R, Zhao S, Kline DM, Brock G, Carroll JE, Seeman TE, Jaffee SR, Berger JS, Golden SH, Carnethon MR, Joseph JJ. Childhood environment early life stress, caregiver warmth, and associations with the cortisol diurnal curve in adulthood: The coronary artery risk development in young adults (CARDIA) study. Psychoneuroendocrinology 2023; 149:106008. [PMID: 36599226 PMCID: PMC10029914 DOI: 10.1016/j.psyneuen.2022.106008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early life stress (ELS) is associated with increased morbidity and mortality across the lifecourse. Studies observing a relationship between ELS and stress physiology (cortisol), may help explain the connection to poor health outcomes, but have been limited by cortisol measures used. PURPOSE We examined the association between ELS measured by a Risky Family (RF) environment questionnaire, and adult diurnal cortisol profile inclusive of multiple cortisol measures. METHODS RF and cortisol were collected from Coronary Artery Risk Development in Young Adults Study participants at follow-up (Year 15). Complete case (n = 672) data were included in multi-variable regression analyses with log transformed cortisol measures (outcomes) including wake-up cortisol, cortisol awakening response [CAR], AUC and five other cortisol diurnal curve measures. RESULTS Participants were age 39.9 + /- 3.7 years and 51.6% Black. For every 1 unit increase in RF, there was a 1.4% greater wake-up cortisol and flatter CAR after adjustment for age, sex, income, and smoking (B=0.014, p = 0.023; B=-0.014, p = 0.028, respectively). Each unit increase in caregiver warmth/affection was associated with a 6.9% higher (steeper) CAR (B=0.069, p = 0.03). Results remained significant after adjusting for other covariates except social support in adulthood. An interaction between child abuse and caregiver warmth was nearly significant (p = 0.068), such that for those with exposure to the greatest caregiver warmth and lowest child abuse, CAR was steepest CONCLUSIONS: We demonstrate that ELS is associated with altered cortisol regulation in adulthood. However, further research is needed to assess how healthy relationships throughout the life course may modulate cortisol regulation in adulthood.
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Affiliation(s)
- Robin Ortiz
- Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, USA; Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine, New York, NY, USA.
| | - Songzhu Zhao
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - David M Kline
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Guy Brock
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Judith E Carroll
- The University of California, Los Angeles, David Geffen School of Medicine, Jane and Terri Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA, USA
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Sara R Jaffee
- Department of Psychology, The University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey S Berger
- Departments of Medicine and Surgery, New York University, Grossman School of Medicine, New York, NY, USA; Center for the Prevention of Cardiovascular Disease, Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Sherita H Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
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28
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Williams B. Understanding the effects of adverse childhood experiences on older people. Nurs Older People 2023; 35:37-42. [PMID: 36475401 DOI: 10.7748/nop.2022.e1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 12/12/2022]
Abstract
There is increasing recognition that adverse childhood experiences are linked to suboptimal mental and physical health in later life. Despite this, there has been little research into the effects of adverse childhood experiences on older people. This article gives an overview of the long-term mental and physical effects of adverse childhood experiences and discusses how childhood trauma may manifest in older people. The author also discusses how nurses and unpaid family carers may themselves have been exposed to adverse childhood experiences and how this may affect their caring role. It is crucial that nurses adopt a trauma-informed approach to the care of older people to take account of possible adverse childhood experiences and prevent re-traumatisation.
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Affiliation(s)
- Bronwen Williams
- Bronwen Williams Training, Education and Development, Malvern, Worcestershire, England
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29
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Yu Z, Wang L, Chen W, Zhang J, Bettencourt AF. Positive Childhood Experiences Associate with Adult Flourishing Amidst Adversity: A Cross Sectional Survey Study with a National Sample of Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14956. [PMID: 36429674 PMCID: PMC9690672 DOI: 10.3390/ijerph192214956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to examine the prevalence of PCEs among young adults in Mainland China and the extent to which the cumulative number of PCEs moderates the associations between ACEs and flourishing in adulthood. Between August and November 2020, we used convenience and snowball sampling to recruit 9468 young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China to participate in a survey, which included measures on flourishing, exposure to ACEs and PCEs, and demographic characteristics. Approximately 92% of participants reported experiencing seven to nine PCEs, with harmonious family relationships (96.9%), feeling supported by friends (96.8%) and being treated fairly at school (96.3%) being the most common PCEs reported. Results of the multiple regression indicated that the cumulative number of PCEs statistically significantly moderated the relation between the cumulative number of ACEs and flourishing (interaction term b = -0.060 [-0.071, -0.049], p < 0.001, adjusted R2 = 0.183); as the number of ACEs increased up through eight ACEs, decreases in flourishing were smaller among those with higher numbers of PCEs. PCEs are common among young adults from Mainland China and serve a potential buffering effect against exposure to ACEs.
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Affiliation(s)
- Zhiyuan Yu
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Wenyi Chen
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Juan Zhang
- International Peace Maternity and Children Hospital of China Welfare Institution, Departments of Nursing, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Amie F. Bettencourt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
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Lean RE, Smyser CD, Brady RG, Triplett RL, Kaplan S, Kenley JK, Shimony JS, Smyser TA, Miller JP, Barch DM, Luby JL, Warner BB, Rogers CE. Prenatal exposure to maternal social disadvantage and psychosocial stress and neonatal white matter connectivity at birth. Proc Natl Acad Sci U S A 2022; 119:e2204135119. [PMID: 36219693 PMCID: PMC9586270 DOI: 10.1073/pnas.2204135119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022] Open
Abstract
Early life adversity (social disadvantage and psychosocial stressors) is associated with altered microstructure in fronto-limbic pathways important for socioemotional development. Understanding when these associations begin to emerge may inform the timing and design of preventative interventions. In this longitudinal study, 399 mothers were oversampled for low income and completed social background measures during pregnancy. Measures were analyzed with structural equation analysis resulting in two latent factors: social disadvantage (education, insurance status, income-to-needs ratio [INR], neighborhood deprivation, and nutrition) and psychosocial stress (depression, stress, life events, and racial discrimination). At birth, 289 healthy term-born neonates underwent a diffusion MRI (dMRI) scan. Mean diffusivity (MD) and fractional anisotropy (FA) were measured for the dorsal and inferior cingulum bundle (CB), uncinate, and fornix using probabilistic tractography in FSL. Social disadvantage and psychosocial stress were fitted to dMRI parameters using regression models adjusted for infant postmenstrual age at scan and sex. Social disadvantage, but not psychosocial stress, was independently associated with lower MD in the bilateral inferior CB and left uncinate, right fornix, and lower MD and higher FA in the right dorsal CB. Results persisted after accounting for maternal medical morbidities and prenatal drug exposure. In moderation analysis, psychosocial stress was associated with lower MD in the left inferior CB among the lower-to-higher socioeconomic status (SES) (INR ≥ 200%) group, but not the extremely low SES (INR < 200%) group. Increasing access to social welfare programs that reduce the burden of social disadvantage and related psychosocial stressors may be an important target to protect fetal brain development in fronto-limbic pathways.
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Affiliation(s)
- Rachel E. Lean
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Christopher D. Smyser
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Rebecca G. Brady
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Regina L. Triplett
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Sydney Kaplan
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Jeanette K. Kenley
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Joshua S. Shimony
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Tara A. Smyser
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - J. Phillip Miller
- Department of Biostatistics, Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Deanna M. Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Psychological and Brain Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO 63130
| | - Joan L. Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Barbara B. Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Newborn Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110
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Li H, Cheong JPG. The Impact of the COVID-19 Pandemic on the Physical Fitness of Primary School Students in China Based on the Bronfenbrenner Ecological Theory. Front Psychol 2022; 13:896046. [PMID: 35846611 PMCID: PMC9278268 DOI: 10.3389/fpsyg.2022.896046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
After the outbreak of the COVID-19 pandemic, nation lockdown became an effective way to isolate the spread of the virus. Schools were postponed, students had to stay at home and opportunities for physical activity amongst school children were severely affected. This research sought to determine the impact of the pandemic on the physical fitness of primary school students. In total, 1,235 students from grades one to five in a primary school in Beijing took part in this research. Using the Chinese National Student Physical Fitness Standard as a guide, the students were subjected to BMI, vital capacity, 50 m sprint, sit and reach, timed rope-skipping, timed sit-ups, and 50m × 8 shuttle run measurements. These tests were administered once before and once after the lockdown period. The results showed that the overall physical fitness of the participants was better after the lockdown [p = 0.000, r = -0.14, 95% CI (-0.219, -0.061)]. Specifically, vital capacity, sit and reach, timed rope-skipping and timed sit-ups had improved after the lockdown. Meanwhile, 50m × 8 shuttle run dropped slightly but not significantly whereas 50 m sprint dropped sharply after the lockdown. The proportion of overweight and obese students increased, but the difference before and after the lockdown was small. It appeared that during the pandemic, through the intervention of many comprehensive factors, home-based fitness was normalized and promoted the healthy development of students.
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Affiliation(s)
- Hailing Li
- Centre for Sport and Exercise Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jadeera Phaik Geok Cheong
- Centre for Sport and Exercise Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
- UM STEM Centre, Universiti Malaya, Kuala Lumpur, Malaysia
- Pusat Kajian Kecemerlangan Melayu, Universiti Malaya, Kuala Lumpur, Malaysia
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Stevenson DK, Gotlib IH, Buthmann JL, Marié I, Aghaeepour N, Gaudilliere B, Angst MS, Darmstadt GL, Druzin ML, Wong RJ, Shaw GM, Katz M. Stress and Its Consequences-Biological Strain. Am J Perinatol 2022. [PMID: 35292943 DOI: 10.1055/a-1798-1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Understanding the role of stress in pregnancy and its consequences is important, particularly given documented associations between maternal stress and preterm birth and other pathological outcomes. Physical and psychological stressors can elicit the same biological responses, known as biological strain. Chronic stressors, like poverty and racism (race-based discriminatory treatment), may create a legacy or trajectory of biological strain that no amount of coping can relieve in the absence of larger-scale socio-behavioral or societal changes. An integrative approach that takes into consideration simultaneously social and biological determinants of stress may provide the best insights into the risk of preterm birth. The most successful computational approaches and the most predictive machine-learning models are likely to be those that combine information about the stressors and the biological strain (for example, as measured by different omics) experienced during pregnancy.
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Affiliation(s)
- David K Stevenson
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Ian H Gotlib
- Department of Psychology, Stanford University School of Humanities and Science, Stanford, California
| | - Jessica L Buthmann
- Department of Psychology, Stanford University School of Humanities and Science, Stanford, California
| | - Ivana Marié
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Martin S Angst
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Gary L Darmstadt
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Maurice L Druzin
- Department of Obstetrics and Gynecology-Maternal-Fetal Medicine, Stanford University School of Medicine, Stanford, California
| | - Ronald J Wong
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Gary M Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Michael Katz
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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Slopen N, Cook BL, Morgan JW, Flores MW, Mateo C, Garcia Coll C, Acevedo Garcia D, Priest N, Wethington E, Lee E, Moyer M, Tran NM, Krumholz S, Williams DR. Family Stressors and Resources as Social Determinants of Health among Caregivers and Young Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:452. [PMID: 35455496 PMCID: PMC9027644 DOI: 10.3390/children9040452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
Abstract
Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young children (birth to 5 years) from a community health clinic and administered survey questions to assess stressors and resources. We constructed inventories of stressors and resources and examined the relationships between these inventories and caregivers' depressive symptoms, anxiety symptoms, and sleep problems, and young children's medical diagnoses derived from electronic health records. Cumulative stressors and resources displayed bivariate and adjusted associations with caregivers' depressive symptoms, anxiety symptoms, and sleep problems. For depressive and anxiety symptoms, these associations were evident in models that included stressors and resources together. Caregivers with high stressors and low resources displayed the highest levels of depressive and anxiety symptoms and sleep problems. In terms of children's health outcomes, only modest trends were evident for developmental/mental health outcomes, but not other diagnostic categories. Future studies are needed to examine stressors and resources together in larger samples and in relation to prospectively assessed measures of child well-being.
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Affiliation(s)
- Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; (J.W.M.); (S.K.); (D.R.W.)
- Center on the Developing Child, Harvard University, Cambridge, MA 02138, USA
| | - Benjamin Le Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA 02139, USA; (B.L.C.); (M.W.F.); (M.M.)
- Harvard Medical School, Boston, MA 02115, USA;
| | - Justin Winston Morgan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; (J.W.M.); (S.K.); (D.R.W.)
| | - Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA 02139, USA; (B.L.C.); (M.W.F.); (M.M.)
| | | | - Cynthia Garcia Coll
- Department of Pediatrics, University of Puerto Rico, San Juan 00935, Puerto Rico;
| | - Dolores Acevedo Garcia
- Institute for Child, Youth and Family Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02454, USA;
| | - Naomi Priest
- Center for Social Research and Methods, Australia National University, Canberra 0200, Australia;
- Population Health, Murdoch Children’s Research Centre, Royal Children’s Hospital, Melbourne 3025, Australia
| | - Elaine Wethington
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MA 48106, USA;
| | - Esther Lee
- University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
| | - Margo Moyer
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA 02139, USA; (B.L.C.); (M.W.F.); (M.M.)
| | - Nathaniel M. Tran
- Department of Health Policy, Vanderbilt University, Nashville, TN 37203, USA;
| | - Sandra Krumholz
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; (J.W.M.); (S.K.); (D.R.W.)
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; (J.W.M.); (S.K.); (D.R.W.)
- Departments of African and African American Studies and of Sociology, Harvard University, Cambridge, MA 02138, USA
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Rudmer de Vries T, Arends I, Hulvej Rod N, Oldehinkel AJ, Bültmann U. Proposing network analysis for early life adversity: An application on life event data. Soc Sci Med 2022; 296:114784. [DOI: 10.1016/j.socscimed.2022.114784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/16/2022] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
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Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
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Non-human contributions to personality neuroscience – from fish through primates. An introduction to the special issue. PERSONALITY NEUROSCIENCE 2022; 5:e11. [PMID: 36258777 PMCID: PMC9549393 DOI: 10.1017/pen.2022.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022]
Abstract
The most fundamental emotional systems that show trait control are evolutionarily old and extensively conserved. Psychology in general has benefited from non-human neuroscience and from the analytical simplicity of behaviour in those with simpler nervous systems. It has been argued that integration between personality, psychopathology, and neuroscience is particularly promising if we are to understand the neurobiology of human experience. Here, we provide some general arguments for a non-human approach being at least as productive in relation to personality, psychopathology, and their interface. Some early personality theories were directly linked to psychopathology (e.g., Eysenck, Panksepp, and Cloninger). They shared a common interest in brain systems that naturally led to the use of non-human data; behavioural, neural, and pharmacological. In Eysenck’s case, this also led to the selective breeding, at the Maudsley Institute, of emotionally reactive and non-reactive strains of rat as models of trait neuroticism or trait emotionality. Dimensional personality research and categorical approaches to clinical disorder then drifted apart from each other, from neuropsychology, and from non-human data. Recently, the conceptualizations of both healthy personality and psychopathology have moved towards a common hierarchical trait perspective. Indeed, the proposed two sets of trait dimensions appear similar and may even be eventually the same. We provide, here, an introduction to this special issue of Personality Neuroscience, where the authors provide overviews of detailed areas where non-human data inform human personality and its psychopathology or provide explicit models for translation to human neuroscience. Once all the papers in the issue have appeared, we will also provide a concluding summary of them.
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Petrican R, Miles S, Rudd L, Wasiewska W, Graham KS, Lawrence AD. Pubertal timing and functional neurodevelopmental alterations independently mediate the effect of family conflict on adolescent psychopathology. Dev Cogn Neurosci 2021; 52:101032. [PMID: 34781251 PMCID: PMC10436252 DOI: 10.1016/j.dcn.2021.101032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022] Open
Abstract
This study tested the hypothesis that early life adversity (ELA) heightens psychopathology risk by concurrently altering pubertal and neurodevelopmental timing, and associated gene transcription signatures. Analyses focused on threat- (family conflict/neighbourhood crime) and deprivation-related ELAs (parental inattentiveness/unmet material needs), using longitudinal data from 1514 biologically unrelated youths in the Adolescent Brain and Cognitive Development (ABCD) study. Typical developmental changes in white matter microstructure corresponded to widespread BOLD signal variability (BOLDsv) increases (linked to cell communication and biosynthesis genes) and region-specific task-related BOLDsv increases/decreases (linked to signal transduction, immune and external environmental response genes). Increasing resting-state (RS), but decreasing task-related BOLDsv predicted normative functional network segregation. Family conflict was the strongest concurrent and prospective contributor to psychopathology, while material deprivation constituted an additive risk factor. ELA-linked psychopathology was predicted by higher Time 1 threat-evoked BOLDSV (associated with axonal development, myelination, cell differentiation and signal transduction genes), reduced Time 2 RS BOLDsv (associated with cell metabolism and attention genes) and greater Time 1 to Time 2 control/attention network segregation. Earlier pubertal timing and neurodevelopmental alterations independently mediated ELA effects on psychopathology. Our results underscore the differential roles of the immediate and wider external environment(s) in concurrent and longer-term ELA consequences.
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Affiliation(s)
- Raluca Petrican
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom.
| | - Sian Miles
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - Lily Rudd
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - Wiktoria Wasiewska
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - Kim S Graham
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - Andrew D Lawrence
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, United Kingdom
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Wakefield SM, McPherson P. How the Evolving State of Neuroscience Informs the Definition of Adulthood: a Psychiatrist’s Perspective. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2021. [DOI: 10.1007/s40817-021-00116-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hirschfeld S, Goodman E, Barkin S, Faustman E, Halfon N, Riley AW. Health Measurement Model-Bringing a Life Course Perspective to Health Measurement: The PRISM Model. Front Pediatr 2021; 9:605932. [PMID: 34178878 PMCID: PMC8222802 DOI: 10.3389/fped.2021.605932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
Health is a multidimensional concept that is challenging to measure, and in the rapidly evolving developmental changes that occur during the first 21 years of human life, requires a dynamic approach to accurately capture the transitions, and overall arc of a complex process of internal and external interactions. We propose an approach that integrates a lifecourse framework with a layered series of assessments, each layer using a many to many mapping, to converge on four fundamental dimensions of health measurement-Potential, Adaptability, Performance, and Experience. The four dimensions can conceptually be mapped onto a plane with each edge of the resulting quadrilateral corresponding to one dimension and each dimensions assessment calibrated against a theoretical ideal. As the plane evolves over time, the sequential measurements will form a volume. We term such a model the Prism Model, and describe conceptually how single domain assessments can be built up to generate the holistic description through the vehicle of a layer of Exemplar Cases. The model is theoretical but future work can use the framework and principles to generate scalable and adaptable applications that can unify and improve the precision of serial measurements that integrate environmental and physiologic influences to improve the science of child health measurement.
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Affiliation(s)
- Steven Hirschfeld
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Elizabeth Goodman
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, United States
| | - Shari Barkin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Elaine Faustman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Neal Halfon
- Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anne W. Riley
- Department of Population, Family, and Reproductive Health, Johns Hopkins University, Baltimore, MD, United States
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Learning from atypical development: A systematic review of executive functioning in children and adolescents with the 22q11.2 deletion syndrome. DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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