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Frearson A, Duncan M. An Interpretive Phenomenological Analysis of Teachers' Lived Experiences of Working with Traumatised Children in the Classroom. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:555-570. [PMID: 38938955 PMCID: PMC11199442 DOI: 10.1007/s40653-024-00614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 06/29/2024]
Abstract
This study illuminates teachers' lived experiences of working with traumatised children in school environments. Children who experience trauma display a range of behaviours in the classroom which impact on attainment and outcomes. Dealing with childhood trauma in the classroom is challenging and brings risks to teachers' mental health including secondary traumatic stress and burnout. Interpretative phenomenological analysis (IPA) was employed to understand the lived experiences of teachers working with traumatised children in the classroom. Findings from in-depth semi-structured interviews with six teachers indicate that teachers increasingly support traumatised children in the classroom but there is a need for targeted trauma-informed training and effective support from senior management to support teachers' mental health and wellbeing.
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Affiliation(s)
- Antoinette Frearson
- School of Education, St John’s Campus, University of Worcester, Henwick Grove, WR2 6AJ Worcester, UK
| | - Mandy Duncan
- School of Education, St John’s Campus, University of Worcester, Henwick Grove, WR2 6AJ Worcester, UK
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Lor Y, George KM, Gilsanz P, Meunier CC, Peterson RL, Hayes-Larson E, Barnes LL, Mungas D, Whitmer RA. What is the association between adverse childhood experiences and late-life cognitive decline? Study of Healthy Aging in African Americans (STAR) cohort study. BMJ Open 2023; 13:e072961. [PMID: 37918928 PMCID: PMC10626853 DOI: 10.1136/bmjopen-2023-072961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are associated with higher risk of chronic disease, but little is known about the association with late life cognitive decline. We examined the longitudinal association between ACEs and late-life cognitive decline in the Study of Healthy Aging in African Americans (STAR). DESIGN Linear mixed models with random intercepts and slope examined the association of individual and composite ACEs with cognitive change adjusting for years from baseline (timescale), baseline age, sex, parental education, childhood socioeconomic status and childhood social support. Participants reported whether they had experienced nine types of ACEs. Executive function and verbal episodic memory were measured up to three times over a 3-year period using the Spanish and English Neuropsychological Assessment Scales. SETTINGS Kaiser Permanente Northern California members living in the Bay Area. PARTICIPANTS STAR is a cohort study of cognitive ageing launched in 2018 that has enrolled 764 black Americans ages ≥50 years (mean age=67.5; SD=8.5). RESULTS Twenty-one per cent of participants reported no ACEs, 24% one ACE, 20% two ACEs, 17% three ACEs and 17% four or more ACEs. Compared with no ACEs, two ACEs (β=0.117; 95% CI 0.052 to 0.182), three ACEs (β=0.075; 95% CI 0.007 to 0.143) and four or more ACEs (β=0.089; 95% CI 0.002 to 0.158) were associated with less decline in executive function. There were no significant associations between number of ACEs and baseline or longitudinal verbal episodic memory or between individual ACEs and executive function or verbal episodic memory. CONCLUSION In this cohort of older black Americans, there was no association between ACEs and baseline cognition or cognitive change in verbal episodic memory; however, experiencing ≥ 2 ACEs was associated with less decline in executive function. These results may indicate that participants who survived to age 50+ and experienced ACEs may have cognitive resilience that warrants further investigation.
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Affiliation(s)
- Yi Lor
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
| | - Kristen M George
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Claire C Meunier
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
| | - Rachel L Peterson
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University, Chicago, Illinois, USA
| | - Dan Mungas
- Department of Neurology, University of California Davis, Sacramento, California, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
- Department of Neurology, University of California Davis, Sacramento, California, USA
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Lee C, Cao J, Eagen-Torkko M, Mohammed SA. Network analysis of adverse childhood experiences and cardiovascular diseases. SSM Popul Health 2023; 22:101358. [PMID: 36846630 PMCID: PMC9947418 DOI: 10.1016/j.ssmph.2023.101358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/28/2022] [Accepted: 02/05/2023] [Indexed: 02/10/2023] Open
Abstract
Significance The findings to date indicate that adverse childhood experiences (ACEs) increase the risk of cardiovascular disease (CVD) in later life. We demonstrate how network analysis, a statistical method that estimates complex patterns of associations between variables, can be used to model ACEs and CVD. The main goal is to explore the differential impacts of ACE components on CVD outcomes, conditioned on other ACEs and important covariates using network analysis. We also sought to determine which ACEs are most synergistically correlated and subsequently cluster together to affect CVD risk. Methods Our analysis was based on cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System, which included 31,242 adults aged 55 or older (54.6% women, 79.8% whites, mean age of 68.7 ± 7.85 years). CVD outcomes included angina/coronary heart disease (CHD) and stroke prevalence. Mixed graphical models were estimated using the R-package mgm, including all variables simultaneously to elucidate their one-to-one inter-relationships. Next, we conducted Walktrap cluster detection on the estimated networks using the R-package igraph. All analyses were stratified by gender to examine group differences. Results In the network for men, the variable "household incarceration" was most strongly associated with stroke. For women, the strongest connection was between "physical abuse" and stroke, followed by "sexual abuse" and angina/CHD. For men, angina/CHD and stroke were clustered with several CVD risk factors, including depressive disorder, diabetes, obesity, physical activity, and smoking, and further clustered with components of household dysfunction (household substance abuse, household incarceration, and parental separation/divorce). No clusters emerged for women. Conclusions Specific ACEs associated with CVDs across gender may be focal points for targeted interventions. Additionally, findings from the clustering method (especially for men) may provide researchers with valuable information on potential mechanisms linking ACEs with cardiovascular health, in which household dysfunction plays a critical role.
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Affiliation(s)
- Chiyoung Lee
- School of Nursing & Health Studies, University of Washington Bothell, 18115 Campus Way NE, Bothell, WA, 98011, USA,Corresponding author.
| | - Jiepin Cao
- Section for Health Equity, Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Meghan Eagen-Torkko
- School of Nursing & Health Studies, University of Washington Bothell, 18115 Campus Way NE, Bothell, WA, 98011, USA
| | - Selina A. Mohammed
- School of Nursing & Health Studies, University of Washington Bothell, 18115 Campus Way NE, Bothell, WA, 98011, USA
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Liu Y, Wang C, Liu Y. Association between adverse childhood experiences and later-life cardiovascular diseases among middle-aged and older Chinese adults: The mediation effect of depressive symptoms. J Affect Disord 2022; 319:277-285. [PMID: 36162657 DOI: 10.1016/j.jad.2022.09.080] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/27/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND To date, few studies have focused on examining either the direct or indirect effect of adverse childhood experiences (ACEs) on cardiovascular diseases (CVD). This study aimed to investigate the mediation effect of depressive symptoms as a mediator between ACEs and CVD. METHODS This study included a total of 12,981 participants from the 2011 to 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were examined using the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CESD-10). The mediation effect analysis adjusted for potential confounding factors was conducted. RESULTS 6635 (51.11 %) of the participants reported 4 and more ACEs count. Participants with certain ACEs were significantly associated with later-life incident depressive symptoms and CVD. Depressive symptoms partially mediated [20.72 %, 95 % CI: (13.02 %-38.12 %)] of the association between self-reported health status and CVD, [0.72 %, 95 % CI: (13.02 %-38.12 %)] of the association between health limitation and CVD, and [22.24 %, 95 % CI: (14.35 %-59.29 %)] of the association between hunger and CVD. In addition, as ACEs count increased by 1 unit, participants had the increased risk of incident depressive symptoms [5.01 %, 95 % CI: (4.53 %-5.50 %)] and CVD [0.61 %, 95 % CI: (0.23 %-0.99 %)]. LIMITATIONS Not all potential confounding factors were measured and adjusted in the analysis, and ACEs were collected retrospectively. CONCLUSIONS ACEs are significantly associated with both onset and increased depressive symptoms and CVD, and depressive symptoms mediated the association between ACEs and incident CVD. Our results suggested that target mental health intervention programs should be delivered to ACEs populations.
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Affiliation(s)
- Yunguang Liu
- Department of Public Health, Medical College of Qinghai University, Xining 810001, Qinghai, China
| | - Chaocai Wang
- Department of Infection Disease, Qinghai Center for Disease Prevention and Control, Xining 810001, Qinghai, China
| | - Yan Liu
- Department of Public Health, Medical College of Qinghai University, Xining 810001, Qinghai, China.
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Wilson-Genderson M, Heid AR, Cartwright F, Pruchno R. Adverse childhood experiences, adult trauma, and depressive symptom trajectories. Aging Ment Health 2022; 26:2170-2178. [PMID: 34541986 DOI: 10.1080/13607863.2021.1978926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Associations among adverse childhood experiences prior to age 18 (ACEs), subjective reports of trauma during Hurricane Sandy, and trajectories of depressive symptoms reported by community-dwelling older people were examined. METHODS We analyzed 6 waves of data from 5,688 people aged 50-74 recruited in 2006 and followed for 12-years using multilevel mixed effects models. RESULTS We found that: (1) people who experienced ACEs had trajectories of depressive symptoms in late life that were higher than people not having these experiences, (2) people experiencing two or more ACEs were more likely to report fear and distress when Hurricane Sandy hit than people experiencing either one or no adverse childhood experiences, and (3) while both ACE exposure and peri-traumatic stress were associated with trajectories having higher levels of depressive symptoms, the risk associated with ACEs (especially multiple ACEs) was greater. CONCLUSION Findings support life course stress theories including the cumulative inequality theory and stress proliferation theory, suggesting that inequalities are manifested over the life course and that people experiencing adversity during childhood are at increased risk of experiencing adversity in late life. By studying the relationship between adverse childhood experiences and response to Hurricane Sandy our findings demonstrate that adverse childhood experiences can alter the way traumatic events in adulthood are experienced. This finding in turn, has important implications for clinical practice, as it identifies a group of people likely to be at risk for adult trauma.
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Affiliation(s)
| | | | - Francine Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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Sacchi L, Merzhvynska M, Augsburger M. Effects of cumulative trauma load on long-term trajectories of life satisfaction and health in a population-based study. BMC Public Health 2020; 20:1612. [PMID: 33109171 PMCID: PMC7590721 DOI: 10.1186/s12889-020-09663-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifetime traumatic events are known to have a detrimental long-term impact on both mental and physical health. Yet, heterogeneity in the stress response regarding well-being in adults is not well understood. This study investigates effects of cumulative trauma on latent trajectories of two indices of well-being, subjective health and life satisfaction in a large representative sample by means of latent variable modelling techniques. METHODS Data from the pairfam study wave 2-9, a longitudinal representative survey was used (N = 10,825). Individuals reported on lifetime trauma type exposure on wave 7 and indicated levels of life satisfaction and health at each wave. Different types of latent Variable Mixture Models were applied in an iterative fashion. Conditional models investigated effects of cumulative trauma load. RESULTS The best fitting model indicated three latent trajectories for life, and four for health, respectively. Trauma load significantly predicted class membership: Higher exposure was associated with non-stable trajectories for both indices but followed complex patterns of both improving and decreasing life satisfaction and health. Trauma load also explained variability within classes. CONCLUSIONS The current study expands on evidence to the long-term development of health and life satisfaction in response to traumatic events from a latent variable modelling perspective. Besides detrimental effect, it also points to functional adaptation after initial decline and increased well-being associated with trauma exposure. Thus, response to traumatic stress is marked by great heterogeneity. Future research should focus on variables beyond exposure to trauma that can further identify individuals prone to trajectories of declining well-being.
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Affiliation(s)
- Livia Sacchi
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Binzmuehlestrasse 14/17, 8050, Zurich, Switzerland
| | - Mariia Merzhvynska
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Binzmuehlestrasse 14/17, 8050, Zurich, Switzerland
| | - Mareike Augsburger
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Binzmuehlestrasse 14/17, 8050, Zurich, Switzerland.
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Hajek A, König HH. Which factors contribute to loneliness among older Europeans? Findings from the Survey of Health, Ageing and Retirement in Europe: Determinants of loneliness. Arch Gerontol Geriatr 2020; 89:104080. [PMID: 32371343 DOI: 10.1016/j.archger.2020.104080] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/06/2020] [Accepted: 04/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND While previous studies have examined the determinants of loneliness (i) using a longitudinal approach and (ii) using data from nationally representative samples, only few studies have done both at once. Hence, the purpose of our study was to clarify which factors are associated with loneliness longitudinally based on nationally representative data. METHODS Data were taken from wave 5 to 7 of the "Survey of Health Ageing, and Retirement in Europe "(SHARE; covering 27 European countries and Israel in total) (in our analytical sample, n = 101,909 observations). Loneliness was assessed using the three-item loneliness scale. As explanatory variables, we included age, marital status, income, self-rated health, depressive symptoms, functional decline, cognitive functioning and chronic diseases. Exploiting the features of panel data and mitigating the problem of unobserved heterogeneity, linear FE regressions were used. RESULTS FE regressions showed that loneliness increased with increasing age (β = .02, p < .001), changes from married and living together with spouse/registered partnership to another marital status (β=-.71, p < .001), decreases in log income (β=-.01, p < .05), worsening self-rated health (β = .04, p < .001), functional decline (β = .09, p < .001), increases in depressive symptoms (β = .13, p < .001) and decreases in cognitive functioning (β=-.01, p < .001), whereas it was not associated with changes in chronic diseases. CONCLUSION Our longitudinal study based on nationally representative SHARE data contributed to identify the determinants of loneliness among older Europeans using panel data methods. Tackling the identified risk factors may assist in avoiding loneliness in older adults living in Europe.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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