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Campbell JA, Egede LE. Contextualizing risk, pathways, and solutions for the relationship between adverse childhood experiences (ACEs) and type 2 diabetes among inner-city African Americans: A qualitative analysis and development of a theoretical framework. J Affect Disord 2024; 361:522-527. [PMID: 38917888 PMCID: PMC11328455 DOI: 10.1016/j.jad.2024.06.051] [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: 01/03/2024] [Revised: 05/29/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE Adverse childhood experiences (ACEs) confer significant risk for diabetes in adulthood. The purpose of this study was to explore perceptions about risk, potential pathways leading to diabetes, and solutions based on the lived experience. METHODS Three focus groups were conducted. A semi-structured interview guide was used to explore prevalence and causes of ACEs, pathways to diabetes, and possible solutions. Grounded theory was used for analysis. Constant comparisons resulted in emergent themes that were indexed and compared with the rest of the data to establish analytical categories. Analytical categories were further refined as additional data was collected until groups of key themes or categories were identified and used to construct a theoretical framework. RESULTS Participants totaled 23 across 3 groups. All participants were African American. Average age was 49, average number of years living with diabetes was 13 years. Participants included both men and women. Participants experienced one or more occasions of sexual abuse, physical and verbal abuse, and neglect. The major themes can be classified as A. Cause, B. Pathway, and C. Treatment/solution. LIMITATIONS Findings may not generalize to the overall population with ACEs and diabetes. CONCLUSIONS Three major themes were identified: family instability and financial hardship as risks for ACEs, maladaptive coping leading to diabetes, and social structure as a potential solution. Future research is needed to examine quantitatively, pathways to inform prevention at the primary, secondary, and tertiary levels of care for both the prevention of ACEs, mitigating risk for diabetes, and improving overall health.
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Affiliation(s)
- Jennifer A Campbell
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States of America; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, United States of America.
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States of America; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, United States of America
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McGovern R, Balogun-Katung A, Artis B, Bareham B, Spencer L, Alderson H, Brown E, Brown J, Lingam R, McArdle P, Newham JJ, Wojciechowska A, Rankin J, Redgate S, Thomason P, Kaner E. The Effectiveness of Preventative Interventions to Reduce Mental Health Problems in at-risk Children and Young People: A Systematic Review of Reviews. JOURNAL OF PREVENTION (2022) 2024; 45:651-684. [PMID: 38884876 PMCID: PMC11271346 DOI: 10.1007/s10935-024-00785-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
Mental health problems are the leading cause of childhood disability worldwide, resulting in poor outcomes for children and young people that persist into adulthood. It is essential that those young people most at risk of developing mental health problems receive effective preventative interventions. Whilst there have been a number of systematic reviews which have examined the effectiveness of secondary prevention interventions for specific groups of children and young people, or to address identified mental health concerns, no review has engaged with the breadth of this literature. We conducted a systematic review of systematic reviews to map this complex field of secondary preventative interventions and identify effective interventions to prevent mental health problems in children and adolescents aged 3-17 years. The review protocol was registered on PROSPERO. We searched five electronic databases from inception to February 2023. The certainty of the evidence was appraised using the AMSTAR 2. We included 49 unique systematic reviews each including between 2 and 249 (mean 34) unique studies; the majority of which were reviews which included only or mostly randomised controlled trials (70%). The reviews examined selective interventions (defined as interventions which are delivered to sub-group populations of young people at increased risk of mental health problems) (n = 22), indicated interventions (defined as interventions which target young people who are found to have pre-clinical symptoms) (n = 15) or a synthesis of both (n = 12). The certainty of the evidence in the reviews was rated as high, (n = 12) moderate (n = 5), low (n = 9) and critically low (n = 23). We found evidence to support both selective and indicated interventions in a range of populations and settings, with most of this evidence available for children and young people in their mid-years (6-10 years) and early adolescence (11-13 years). There was a large body of evidence suggesting that resilience enhancing, cognitive behaviour therapy-based and psychoeducational interventions for children who experience adversity, or those with subclinical externalising problems may offer promise. Early selective interventions for a subpopulation of children and young people who have experienced adversity which combines risk reduction and resilience enhancing approaches directed at children and their families may be effective at reducing mental health problems.
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Affiliation(s)
- R McGovern
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Artis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Bareham
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - E Brown
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - J Brown
- Children's Social Care, Newcastle City Council, Newcastle upon Tyne, UK
| | - R Lingam
- Population Child Health Research Group, School of Women and Children's Health, University New South Wales, Sydney, Australia
| | - P McArdle
- Child and Adolescent Mental Health Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - A Wojciechowska
- Disabilities Integrated Team at the Tees, Esk and Wear Valleys, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - S Redgate
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - P Thomason
- Children's Social Care, Gateshead Council, Tyne and Wear, UK
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
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Al Azri Z, Al-abri K, Al Sawafi A, Jaju S, Al Qadire M. Adverse childhood experiences and risky behaviors in Oman: A cross-sectional study. Prev Med Rep 2024; 44:102809. [PMID: 39071240 PMCID: PMC11277357 DOI: 10.1016/j.pmedr.2024.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Objective Adverse childhood experiences (ACEs), which refer to potentially traumatic events occurring during childhood, have been consistently linked to detrimental effects on high-risk behaviors through various studies. Nonetheless, such an association has rarely been examined in the context of Arab culture. This study aimed to investigate the association between ACE levels and high-risk behaviors (e.g., smoking, alcohol consumption, drug use, high-risk sexual behavior, and physical inactivity) among Omani adults. Methods This was a cross-sectional study with convenience sampling. The participants were recruited from a university-affiliated medical facility in Oman. Data were collected in 2022. They were asked to complete the Adverse Childhood Experience International Questionnaire (ACE-IQ). Results The study included 1648 Omani adults. Analyses revealed that the adjusted odds ratios (ORs) for engaging in some of the identified high-risk behaviors increased as the level of ACEs increased. Specifically, individuals with an ACE level of 4 exhibited higher odds of smoking (OR: 2.6), alcohol consumption (OR: 2.9), and risky sexual behavior (OR: 32) than those without ACEs. Conclusion The findings of this study underscore a notable association between ACEs and high-risk behaviors among Omani adults. Consequently, there is a pressing need for intensified efforts to prevent ACEs when possible and to alleviate their adverse effects, emphasizing the importance of public health initiatives and interventions in Oman.
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Affiliation(s)
- Zeinab Al Azri
- College of Nursing, Sultan Qaboos University, P.O. Box 66, PC 123, Muscat, Oman
| | - Khalood Al-abri
- College of Nursing, Sultan Qaboos University, P.O. Box 66, PC 123, Muscat, Oman
| | - Aziza Al Sawafi
- College of Nursing, Sultan Qaboos University, P.O. Box 66, PC 123, Muscat, Oman
| | - Sanjay Jaju
- Department of Family Medicine and Public Health, Sultan Qaboos University, PO Box 35, 123, Muscat, Oman
| | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, P.O. Box 66, PC 123, Muscat, Oman
- Faculty of Nursing Institution, Al Al-Bayt University, Mafraq 25113, Jordan
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Siewert-Markus U, Ittermann T, Klinger-König J, Grabe HJ, Stracke S, Völzke H, Targher G, Dörr M, Markus MRP, Töpfer P. Childhood maltreatment and risk of metabolic dysfunction-associated steatotic liver disease - Evidence of sex-specific associations in the general population. J Psychosom Res 2024; 183:111829. [PMID: 38896985 DOI: 10.1016/j.jpsychores.2024.111829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/30/2024] [Accepted: 06/08/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND AIMS Childhood maltreatment (CM) is linked to self-reported liver disease in adulthood. However, specific diagnostic entities, e.g., metabolic dysfunction-associated steatotic liver disease (MASLD) as the most frequent chronic liver disease, and sex-differences have previously not been considered. METHODS Cross-sectional analyses were conducted in 4188 adults from a population-based cohort in Northeastern Germany after excluding individuals with excessive alcohol consumption, cirrhosis, or chronic viral hepatitis. CM-exposure was assessed using the Childhood Trauma Questionnaire (CTQ). Liver-related outcomes included serologic liver enzymes, fibrosis-4 score (FIB-4) and, in 1863 subjects who underwent magnetic resonance imaging examination, liver fat content. Sex-stratified linear regression and logistic regression models predicting liver-related outcomes and risk for MASLD, respectively, from overall CTQ scores were adjusted for age, school education, alcohol consumption, and waist circumference. Exploratory analyses investigated effects of CTQ-subscales on liver-related outcomes and risk for MASLD. RESULTS In both sexes, overall CM-exposure was associated with higher levels of serum aspartate aminotransferase and FIB-4 score. In men, effects were mainly driven by physical abuse, and in women by emotional neglect. Only in men, overall CM-exposure (β = 0.70, 95%-CI 0.26-1.13, p = 0.002) and four CTQ-subscales were associated with greater liver fat content, and physical abuse (aOR = 1.22, 95%-CI 1.02-1.46, p = 0.034) and physical neglect (aOR = 1.25, 95%-CI 1.04-1.49, p = 0.015) were associated with higher risk for MASLD. CONCLUSIONS These results suggest sex differences in the association between CM and objective serum and imaging markers of MASLD in adulthood. For men especially, a history of CM-exposure may increase risk of developing MASLD in adulthood.
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Affiliation(s)
- Ulrike Siewert-Markus
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Johanna Klinger-König
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Sylvia Stracke
- Clinic and Polyclinic for Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Clinic and Polyclinic for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Clinic and Polyclinic for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD) Partner Site Greifswald, Greifswald, Germany
| | - Philipp Töpfer
- Clinic and Polyclinic for Internal Medicine A, University Medicine Greifswald, Greifswald, Germany.
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Rost F, Booker T, Gonsard A, de Felice G, Asseburg L, Malda-Castillo J, Koutoufa I, Ridsdale H, Johnson R, Taylor D, Fonagy P. The complexity of treatment-resistant depression: A data-driven approach. J Affect Disord 2024; 358:292-301. [PMID: 38697222 DOI: 10.1016/j.jad.2024.04.093] [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: 11/20/2023] [Revised: 03/27/2024] [Accepted: 04/21/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Recent systematic reviews highlight great variability in defining and assessing treatment-resistant depression (TRD). A key problem is that definitions are consensus rather than data-led. This study seeks to offer a comprehensive socio-demographic and clinical description of a relevant sample. METHODS As part of a pragmatic randomized controlled trial, patients (N = 129) were managed in primary care for persistent depression and diagnosed with TRD. Data included previous treatment attempts, characteristics of the depressive illness, functioning, quality of life, co-occurring problems including suicidality, psychiatric and personality disorders, physical health conditions, and adverse events. RESULTS Findings show a severe and chronic course of depression with a duration of illness of 25+ years. Overall, 82.9 % had at least one other psychiatric diagnosis and 82.2 % at least one personality disorder; 69.8 % had significant musculoskeletal, gastrointestinal, genitourinary, or cardiovascular and respiratory physical health problems. All but 14 had severe difficulties in social and occupational functioning and reported severely impaired quality of life. Suicidal ideation was high: 44.9 % had made at least one serious suicide attempt and several reported multiple attempts with 17.8 % reporting a suicide attempt during childhood or adolescence. Of the patients, 79.8 % reported at least one adverse childhood experience. LIMITATIONS Potential for recall bias, not examining possible interactions, and absence of a control group. CONCLUSIONS Our findings reveal a complex and multifaceted condition and call for an urgent reconceptualization of TRD, which encompasses many interdependent variables and experiences. Individuals with TRD may be at a serious disadvantage in terms of receiving adequate treatment.
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Affiliation(s)
- Felicitas Rost
- Tavistock and Portman NHS Foundation Trust, London, UK; The Open University, School of Psychology and Psychotherapy, Faculty of Arts and Social Sciences, Milton Keynes, UK.
| | - Thomas Booker
- Tavistock and Portman NHS Foundation Trust, London, UK; Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | | | | | | | | | | | | | | | - David Taylor
- Tavistock and Portman NHS Foundation Trust, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
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Wimmelmann CL, Sejling C, Clarke RB, Elsenburg LK, Sørensen TIA, Rod NH. Childhood adversity trajectories and weight status in young adult men: a register-based study including 359,783 Danish men. Int J Obes (Lond) 2024; 48:1157-1163. [PMID: 38816565 PMCID: PMC11281903 DOI: 10.1038/s41366-024-01540-4] [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: 11/24/2023] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Childhood adversity has previously been associated with overweight and obesity in adult life, but there is a need for larger population-based studies using prospectively obtained adversity trajectories across childhood to confirm these associations. Moreover, childhood adversity may also be associated with underweight, which is less often studied. The aim of the current study is to investigate the association between childhood adversity trajectories from 0-15 years with weight categories in young adult men. METHODS The Danish Life Course Cohort (DANLIFE) was linked with the Danish Conscription Registry resulting in a study sample of 359,783 men, who have been assigned to one of five previously identified adversity trajectories from 0-15 years: "low adversity", "early material deprivation", "persistent material deprivation", "loss or threat of loss", and "high adversity". Height and weight in young adulthood was assessed at a draft board examination at age 18-26 years. Associations of adversity trajectories and weight categories were investigated in multinomial regression models. RESULTS Compared with the "low adversity" group, the four other adversity groups had higher risks of underweight, overweight, and obesity. The "high adversity" group showed the strongest associations with both underweight (1.44 (1.32, 1.58)) and obesity (1.50 (1.39, 1.61)) when adjusted for parental origin, birth year, age at draft board examination, and maternal age. CONCLUSION Childhood adversity, experienced between 0 and 15 years of life, was associated with a higher risk of underweight, overweight, and obesity in young adulthood among men.
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Affiliation(s)
- Cathrine L Wimmelmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark.
- Centre for Childhood Health, Islands Brygge 41, 2300 Copenhagen S, Copenhagen, Denmark.
| | - Christoffer Sejling
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Rebecca B Clarke
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Centre for Childhood Health, Islands Brygge 41, 2300 Copenhagen S, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
- Section on Genomic Physiology and Translation, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Copenhagen, Denmark
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
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Okumura K, Takeda T, Komori T, Toritsuka M, Yamamuro K, Takada R, Ikehara M, Kamikawa K, Noriyama Y, Nishi Y, Ishida R, Kayashima Y, Yamauchi T, Iwata N, Makinodan M. Adverse childhood experiences exacerbate peripheral symptoms of autism spectrum disorder in adults. Psychiatry Clin Neurosci 2024. [PMID: 39037014 DOI: 10.1111/pcn.13712] [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: 02/01/2024] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/23/2024]
Abstract
AIM Adverse childhood experiences are potentially traumatic events with long-lasting effects on the health and well-being of patients with autism spectrum disorder (ASD). It is important to clarify which types of long-lasting autism-related symptoms are influenced by childhood experiences to design future intervention studies. However, few studies have examined the association between childhood experiences and autistic symptoms in large samples of adults with ASD and individuals with typical development (TD). In this study, we evaluate the effects of adverse childhood experiences on multiple ASD phenotypes among both individuals with ASD and those with TD. METHOD We combined questionnaire evaluations; Childhood Abuse and Trauma Scale, the Japanese version of the Autism-Spectrum Quotient, Conners' Adult ADHD Rating Scale, the Japanese version of the Impact of Event Scale-Revised, and the Japanese version of the Adolescent/Adult Sensory Profile. RESULTS Individuals with ASD and those with TD (n = 205 and 104, respectively) were included. There were significant correlations between the extent of adverse childhood experiences and severity of attention-deficit/hyperactivity disorder symptoms, posttraumatic stress disorder symptoms, and hypersensitivity in both participants with ASD and those with TD. By contrast, ASD core symptoms showed no significant correlation with adverse childhood experiences in either group. These results remained consistent after adjusting for age, sex, and the estimated intelligence quotient. CONCLUSION These findings suggest the need for a detailed disentanglement of ASD-related core and peripheral symptoms of adverse childhood experiences, which may help to appropriately set outcomes for future early interventions for the childhood experiences of individuals with ASD.
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Affiliation(s)
- Kazuki Okumura
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Tsutomu Takeda
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takashi Komori
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Michihiro Toritsuka
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Ryohei Takada
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Minobu Ikehara
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kohei Kamikawa
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yuki Noriyama
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yuki Nishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Rio Ishida
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshinori Kayashima
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Takahira Yamauchi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
- Osaka Psychiatric Research Center, Osaka, Japan
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8
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Park J, Song M, Cho A, Yang H, Lee H. Adverse childhood experiences of Korean mothers with young children: a latent class analysis. Eur J Psychotraumatol 2024; 15:2372994. [PMID: 38984740 PMCID: PMC11238651 DOI: 10.1080/20008066.2024.2372994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/17/2024] [Indexed: 07/11/2024] Open
Abstract
Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs.Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified.Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups.Results: The participants were classified into two subgroups: the 'high-ACEs group' and the 'low-ACEs group'. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group.Conclusion: The findings highlight the significant role of ACEs on the formation of an individual's psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.
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Affiliation(s)
- Jeongok Park
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - MinKyoung Song
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Ahyoung Cho
- Education of Counseling, Konkuk University, Gwangjin-gu, Seoul, South Korea
| | - HaYeJin Yang
- Yonsei University College of Nursing, Seodaemun-gu, Seoul, South Korea
| | - Hyojin Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seodaemun-gu, Seoul, South Korea
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Hartley G, Sirois F, Purrington J, Rabey Y. Adverse Childhood Experiences and Autism: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2297-2315. [PMID: 38041427 DOI: 10.1177/15248380231213314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Evidence suggests that autistic children have a higher probability of experiencing adverse childhood experiences (ACEs) compared to their non-autistic peers. This meta-analysis (PROSPERO: CRD42022262635) aimed to quantify the association of autism and ACEs. Eight databases and Google Scholar were searched for studies that reported dichotomous outcomes regarding the associations between ACEs and autistic individuals, compared to non-autistic individuals. A random-effects model was used to calculate the average Odds Ratio (OR) of the relationship between a diagnosis of autism and ACEs. A total of 40 studies with 5,619,584 participants were included, generating an overall average OR 2.11 (CI 1.61, 2.77). Significant differences in the magnitude of association were found across studies with regards to the type of ACEs studied, comparison groups, and population type. Overall, moderate certainty evidence (downgraded for bias) indicates that autistic individuals are at greater risk of experiencing ACEs, compared to non-autistic individuals. Appropriate support for autistic individuals and their families are required to prevent ACEs and treat the impact of ACEs.
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Appleton J, Stockton DA, Dickinson M, Debono D. Improving Outcomes for Regional Families in the Early Years: Increasing Access to Child and Family Health Services for Regional Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:728. [PMID: 38928974 PMCID: PMC11203508 DOI: 10.3390/ijerph21060728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
Providing child and family health (CFH) services that meet the needs of young children and their families is important for a child's early experiences, development and lifelong health and well-being. In Australia, families living in regional and rural areas have historically had limited access to specialist CFH services. In 2019, five new specialist CFH services were established in regional areas of New South Wales, Australia. The purpose of this study is to understand the regional families' perceptions and experiences of these new CFH services. A convergent mixed-methods design involving a survey and semi-structured interviews with parents who had used the service was used for this study. Data collected include demographics, reasons for engaging with the service, perception, and experience of the service, including if the service provided was family centred. Triangulation of the quantitative and qualitative analysis uncovered three main findings: (i) The regional location of the service reduced the burden on families to access support for their needs; (ii) providing a service that is family-centred is important to achieve positive outcomes; and (iii) providing a service that is family-centred advances the local reputation of the service, enabling a greater reach into the community. Providing local specialist CFH services reduces the burden on families and has positive outcomes; however, providing services that are family-centred is key.
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Affiliation(s)
- Jessica Appleton
- Tresillian Family Care Centres, Mackenzie St., Belmore, NSW 2192, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Deborah A. Stockton
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Marie Dickinson
- Tresillian Family Care Centres, Mackenzie St., Belmore, NSW 2192, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
| | - Deborah Debono
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia (D.D.)
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Daníelsdóttir HB, Aspelund T, Shen Q, Halldorsdottir T, Jakobsdóttir J, Song H, Lu D, Kuja-Halkola R, Larsson H, Fall K, Magnusson PKE, Fang F, Bergstedt J, Valdimarsdóttir UA. Adverse Childhood Experiences and Adult Mental Health Outcomes. JAMA Psychiatry 2024; 81:586-594. [PMID: 38446452 PMCID: PMC10918580 DOI: 10.1001/jamapsychiatry.2024.0039] [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: 09/15/2023] [Accepted: 12/31/2023] [Indexed: 03/07/2024]
Abstract
Importance Exposure to adverse childhood experiences (ACEs) has consistently been associated with multiple negative mental health outcomes extending into adulthood. However, given that ACEs and psychiatric disorders cluster within families, it remains to be comprehensively assessed to what extent familial confounding contributes to associations between ACEs and clinically confirmed adult psychiatric disorders. Objective To investigate whether associations between ACEs and adult mental health outcomes remain after adjusting for familial (genetic and environmental) confounding. Design, Setting, and Participants This Swedish twin cohort study used a discordant twin pair design based on monozygotic (MZ) and dizygotic (DZ) twins. A total of 25 252 adult twins (aged 18-47 years) from the Swedish Twin Registry born between 1959 and 1998 were followed up from age 19 years until 2016, with a maximum follow-up time of 39 years. Data were analyzed from April 2022 to November 2023. Exposures A total of 7 ACEs, including family violence, emotional abuse or neglect, physical neglect, physical abuse, sexual abuse, rape, and hate crime, were assessed with items from the Life Stressor Checklist-Revised in a web-based survey. Main Outcomes and Measures Adult (ages >18 years) clinical diagnosis of psychiatric disorders (ie, depressive, anxiety, alcohol or drug misuse, or stress-related disorders) were obtained from the Swedish National Patient Register. Results Of 25 252 twins included in the study (15 038 female [59.6%]; mean [SD] age at ACE assessment, 29.9 [8.7] years), 9751 individuals (38.6%) reported exposure to at least 1 ACE. A greater number of ACEs was associated with increased odds of any psychiatric disorder in the full cohort (odds ratio [OR] per additional ACE, 1.52; 95% CI, 1.48-1.57). The association remained but ORs per additional ACE were attenuated in DZ (1.29; 95% CI, 1.14-1.47) and MZ (1.20; 95% CI, 1.02-1.40) twin pairs. Individuals who were exposed to sexual abuse compared with those who were not exposed had increased odds of any clinically confirmed psychiatric disorder in all comparisons: full cohort (OR, 3.09; 95% CI, 2.68-3.56), DZ twin pairs (OR, 2.10; 95% CI, 1.33-3.32), and MZ twin pairs (1.80; 95% CI, 1.04-3.11). Conclusions and relevance This study found that associations between ACEs and adult mental health outcomes remained after controlling for shared genetic and environmental factors, which was particularly evident after multiple ACEs or sexual abuse. These findings suggest that targeted interventions may be associated with reduced risks of future psychopathology.
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Affiliation(s)
- Hilda Björk Daníelsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Qing Shen
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Institute for Advanced Study, Tongji University, Shanghai, China
| | | | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Huan Song
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jacob Bergstedt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
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Ugarteche Pérez A, Berger E, Kelly-Irving M, Delpierre C, Capuron L, Castagné R. Early life stress in relation with risk of overweight, depression, and their comorbidity across adulthood: findings from a British birth cohort. Psychol Med 2024; 54:1853-1866. [PMID: 38197250 DOI: 10.1017/s0033291723003823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Multimorbidity, known as the co-occurrence of at least two chronic conditions, has become of increasing concern in the current context of ageing populations, though it affects all ages. Early life risk factors of multimorbidity include adverse childhood experiences (ACEs), particularly associated with psychological conditions and weight problems. Few studies have considered related mechanisms and focus on old age participants. We are interested in estimating, from young adulthood, the risk of overweight-depression comorbidity related to ACEs while adjusting for early life confounders and intermediate variables. METHODS We used data from the 1958 National Child Development Study, a prospective birth cohort study (N = 18 558). A four-category outcome (no condition, overweight only, depression only and, overweight-depression comorbidity) was constructed at 23, 33, and 42 years. Multinomial logistic regression models adjusting for intermediate variables co-occurring with this outcome were created. ACEs and sex interaction on comorbidity risk was tested. RESULTS In our study sample (N = 7762), we found that ACEs were associated with overweight-depression comorbidity risk throughout adulthood (RRR [95% CI] at 23y = 3.80 [2.10-6.88]) though less overtime. Comorbidity risk was larger than risk of separate conditions. Intermediate variables explained part of the association. After full-adjustment, an association remained (RRR [95% CI] at 23y = 2.00 [1.08-3.72]). Comorbidity risk related to ACEs differed by sex at 42. CONCLUSION Our study provides evidence on the link and potential mechanisms between ACEs and the co-occurrence of mental and physical diseases throughout the life-course. We suggest addressing ACEs in intervention strategies and public policies to go beyond single disease prevention.
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Affiliation(s)
| | - Eloïse Berger
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| | | | | | - Lucile Capuron
- University of Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France
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Sasaki N, Watanabe K, Kanamori Y, Tabuchi T, Fujiwara T, Nishi D. Effects of expanded adverse childhood experiences including school bullying, childhood poverty, and natural disasters on mental health in adulthood. Sci Rep 2024; 14:12015. [PMID: 38797740 PMCID: PMC11128446 DOI: 10.1038/s41598-024-62634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14-9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50-64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21-27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiaki Kanamori
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan.
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Andresen JB, Graugaard C, Andersson M, Bahnsen MK, Frisch M. Adverse childhood experiences, sexual risk-taking and non-consensual sexual experiences in a nationally representative study of 15-29-year-old Danes. CHILD ABUSE & NEGLECT 2024; 151:106720. [PMID: 38471426 DOI: 10.1016/j.chiabu.2024.106720] [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: 10/25/2023] [Revised: 01/30/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been linked with risky health-related behaviors and poor health. OBJECTIVE This study aimed to investigate associations of ACEs with a broad panel of sexual risk-taking behaviors and non-consensual sexual experiences among young people in Denmark. PARTICIPANTS AND SETTING Baseline questionnaire data from 15 to 29-year-old participants in the nationally representative cohort study Project SEXUS were used in combination with data from Danish national registers to include a total of 13,132 individuals. METHODS In logistic regression analyses, confounder-adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were obtained for associations of five ACE categories (Household challenges, Loss or threat of loss, Material deprivation, Abuse, and Neglect) and a cumulative ACE score with measures of sexual risk-taking and non-consensual sexual experiences. RESULTS Statistically significant associations were observed between ACEs and multiple sexual risk-taking behaviors and non-consensual sexual experiences with particularly increased odds among individuals with a history of Abuse, Neglect, or an ACE score of 3 or more. Specifically, Abuse was associated with having received payment for sex (women: aOR 5.38; 95 % CI 2.73-10.61; men: aOR 2.11; 95 % CI 1.22-3.64), with having paid for sex (men: aOR 1.88; 95 % CI 1.41-2.51), and with having been the victim of a sexual assault after age 18 years (women: aOR 3.33; 95 % CI 2.36-4.68). CONCLUSIONS In this Danish study, multiple measures of sexual risk-taking and non-consensual sexual experiences were markedly more common among young people with ACEs than in those without ACEs. This knowledge should be considered in future initiatives to promote sexual health among young people.
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Affiliation(s)
- Josefine Bernhard Andresen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mikael Andersson
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mikkel Kjær Bahnsen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Frisch
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Hughes K, Bellis MA, Cresswell K, Hill R, Ford K, Hopkins JC. Examining relationships between adverse childhood experiences and coping during the cost-of-living crisis using a national cross-sectional survey in Wales, UK. BMJ Open 2024; 14:e081924. [PMID: 38692715 PMCID: PMC11086514 DOI: 10.1136/bmjopen-2023-081924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect individuals' resilience to stressors and their vulnerability to mental, physical and social harms. This study explored associations between ACEs, financial coping during the cost-of-living crisis and perceived impacts on health and well-being. DESIGN National cross-sectional face-to-face survey. Recruitment used a random quota sample of households stratified by health region and deprivation quintile. SETTING Households in Wales, UK. PARTICIPANTS 1880 Welsh residents aged ≥18 years. MEASURES Outcome variables were perceived inability to cope financially during the cost-of-living crisis; rising costs of living causing substantial distress and anxiety; and self-reported negative impact of rising costs of living on mental health, physical health, family relationships, local levels of antisocial behaviour and violence, and community support. Nine ACEs were measured retrospectively. Socioeconomic and demographic variables included low household income, economic inactivity, residential deprivation and activity limitation. RESULTS The prevalence of all outcomes increased strongly with ACE count. Perceived inability to cope financially during the cost-of-living crisis increased from 14.0% with 0 ACEs to 51.5% with 4+ ACEs. Relationships with ACEs remained after controlling for socioeconomic and demographic factors. Those with 4+ ACEs (vs 0 ACEs) were over three times more likely to perceive they would be unable to cope financially and, correspondingly, almost three times more likely to report substantial distress and anxiety and over three times more likely to report negative impacts on mental health, physical health and family relationships. CONCLUSIONS Socioeconomically deprived populations are recognised to be disproportionately impacted by rising costs of living. Our study identifies a history of ACEs as an additional vulnerability that can affect all socioeconomic groups. Definitions of vulnerability during crises and communications with services on who is most likely to be impacted should consider childhood adversity and history of trauma.
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Affiliation(s)
- Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Katie Cresswell
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Rebecca Hill
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - Kat Ford
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Joanne C Hopkins
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
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MacConnachie L, Zhang YS, Farina M, Gutierrez C, Hoover A, He Y, Aiello AE, Noppert GA. The association between incarceration and housing insecurity and advanced immune age during late life. Soc Sci Med 2024; 347:116698. [PMID: 38461610 PMCID: PMC11164318 DOI: 10.1016/j.socscimed.2024.116698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024]
Abstract
Emerging evidence suggests that psychosocial stress ages the immune system. Accordingly, immune aging may be an important potential mechanism linking psychosocial stress to aging-related decline and disease. Incarceration and housing insecurity represent severe and complex experiences of a multitude of psychosocial stressors, including discrimination, violence, and poverty. In this study, we investigated the association between incarceration and/or housing insecurity and advanced immune age in adults aged 55 and older. Our sample was derived from the Health and Retirement Survey (HRS), with n = 7003 individuals with valid housing insecurity data and n = 7523 with valid incarceration data. From 2016 Venous Blood Study data, we assessed immune aging using a comprehensive set of immune markers including inflammatory markers (IL-6, CRP, s-TNFR1), markers of viral control (CMV IgG antibodies), and ratios of T cell phenotypes (CD8+:CD4+, CD+ Memory: Naïve, CD4+ Memory: Naïve, CD8+ Memory: Naïve ratios). We found that both incarceration and housing insecurity were strongly associated with more advanced immune aging as indicated by increased inflammation, reduced viral control, and reduction in naïve T cells relative to memory T cells. Given that those who experienced incarceration, housing insecurity, and/or are racialized minorities were less likely to be included in this study, our results likely underestimated these associations. Despite these limitations, our study provided strong evidence that experiencing incarceration and/or housing insecurity may accelerate the aging of the immune system.
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Affiliation(s)
- Lauren MacConnachie
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Yuan S Zhang
- Department of Sociomedical Sciences and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Mateo Farina
- Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, TX, USA.
| | - Carmen Gutierrez
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Andrew Hoover
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Yuelin He
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
| | - Allison E Aiello
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Grace A Noppert
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48103, USA.
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Sarkar S, Jackson B, Manzo LL, Jeon S, Poghosyan H. Association between adverse childhood experiences and self-reported health-risk behaviors among cancer survivors: A population-based study. PLoS One 2024; 19:e0299918. [PMID: 38512934 PMCID: PMC10956880 DOI: 10.1371/journal.pone.0299918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
AIMS Existing evidence shows that people who report Adverse Childhood Experiences (ACEs) are more likely to exhibit health-risk behaviors. However, limited research on this topic pertains to oncology population. We aim to address this knowledge gap by estimating the prevalence of ACEs and investigating their association with self-reported health-risk behaviors among adult cancer survivors living in the U.S. METHODS We conducted a secondary analysis using cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System ACE module. We included 4,126 adults, aged ≥18 years, with a history of cancer. The outcome variable was self-reported health-risk behaviors, which included cigarette smoking, e-cigarette use, and binge alcohol drinking. Self-reported ACEs history was the primary independent variable, comprised of 11 questions regarding child abuse and dysfunctional households. We conducted descriptive statistics and multivariable logistic regression to describe the relationship between the ACE history and health-risk behaviors. RESULTS Overall, 84.2% of cancer survivors self-reported as White, 58.4% were women, and 76.6% were aged 65+ years. Nearly two-thirds of the sample (63.2%) self-reported at least one ACE (prior to age 18) and 21.7% engaged in ≥1 health-risk-behaviors, such as cigarette smoking, binge alcohol drinking, or e-cigarette use. Experiencing ≥3 ACEs was associated with 145% increased odds of reporting at least one health-risk behavior (OR = 2.45, 95% CI [1.78-3.38]) when compared to those without a history of ACEs. Besides, survivors who were younger, divorced, less educated, and had low income had higher odds of reporting at least one health-risk behavior. CONCLUSIONS Overall, a history of ACEs is associated with health-risk behaviors. These all can negatively impact cancer survivors' overall well-being. Early screening for ACE during oncologic visits can be a protective measure for preventing health-risk behaviors among cancer survivors.
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Affiliation(s)
- Sayantani Sarkar
- Yale University School of Nursing, Orange, CT, United States of America
| | - Brianna Jackson
- Yale University School of Nursing, Orange, CT, United States of America
| | - Laura L. Manzo
- Yale University School of Nursing, Orange, CT, United States of America
- US Army, AMEDD Student Detachment, Joint Base San Antonio, Fort Sam Houston, TX, United States of America
| | - Sangchoon Jeon
- Yale University School of Nursing, Orange, CT, United States of America
| | - Hermine Poghosyan
- Yale University School of Nursing, Orange, CT, United States of America
- COPPER Center, Yale School of Medicine, New Haven, CT, United States of America
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18
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Ortiz R, Kershaw KN, Zhao S, Kline D, Brock G, Jaffee S, Golden SH, Ogedegbe G, Carroll J, Seeman TE, Joseph JJ. Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Circ Cardiovasc Qual Outcomes 2024; 17:e009794. [PMID: 38258561 DOI: 10.1161/circoutcomes.122.009794] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND This study aimed to quantify the association between childhood family environment and longitudinal cardiovascular health (CVH) in adult CARDIA (Coronary Artery Risk Development in Young Adults) Study participants. We further investigated whether the association differs by adult income. METHODS We applied the CVH framework from the American Heart Association including metrics for smoking, cholesterol, blood pressure, glucose, body mass index, physical activity, and diet. CVH scores (range, 0-14) were calculated at years 0, 7, and 20 of the study. Risky Family environment (range, 7-28) was assessed at year 15 retrospectively, for childhood experiences of abuse, caregiver warmth, and family or household challenges. Complete case ordinal logistic regression and mixed models associated risky family (exposure) with CVH (outcome), adjusting for age, sex, race, and alcohol use. RESULTS The sample (n=2074) had a mean age of 25.3 (±3.5) years and 56% females at baseline. The median risky family was 10 with ideal CVH (≥12) met by 288 individuals at baseline (28.4%) and 165 (16.3%) at year 20. Longitudinally, for every 1-unit greater risky family, the odds of attaining high CVH (≥10) decreased by 3.6% (OR, 0.9645 [95% CI, 0.94-0.98]). Each unit greater child abuse and caregiver warmth score corresponded to 12.8% lower and 11.7% higher odds of ideal CVH (≥10), respectively (OR, 0.872 [95% CI, 0.77-0.99]; OR, 1.1165 [95% CI, 1.01-1.24]), across all 20 years of follow-up. Stratified analyses by income in adulthood demonstrated associations between risky family environment and CVH remained significant for those of the highest adult income (>$74k), but not the lowest (<$35k). CONCLUSIONS Although risky family environmental factors in childhood increase the odds of poor longitudinal adult CVH, caregiver warmth may increase the odds of CVH, and socioeconomic attainment in adulthood may contextualize the level of risk. Toward a paradigm of primordial prevention of cardiovascular disease, childhood exposures and economic opportunity may play a crucial role in CVH across the life course.
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Affiliation(s)
- Robin Ortiz
- Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine (R.O.)
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (K.N.K.)
| | - Songzhu Zhao
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (D.K.)
| | - Guy Brock
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - Sara Jaffee
- Department of Psychology, The University of Pennsylvania, Philadelphia (S.J.)
| | - Sherita H Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.H.G.)
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
- Department of Medicine, New York University, Grossman School of Medicine (G.O.)
| | - Judith 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 and Biobehavioral Sciences (J.C.)
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (T.E.S.)
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus (J.J.J.)
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Liu J, Guo T, Han B, Cheng X, Qu S, Wang R, Dong X, Fang J, Wang J, Tang M, Yao Y, Jin L. Adverse childhood experiences and human immunodeficiency virus testing among adults with human immunodeficiency virus risk behaviours. Stress Health 2024; 40:e3262. [PMID: 37226429 DOI: 10.1002/smi.3262] [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: 09/08/2022] [Revised: 02/28/2023] [Accepted: 04/25/2023] [Indexed: 05/26/2023]
Abstract
Adverse childhood experiences (ACEs) have been associated with poor HIV testing in adulthood yet, they have not been extensively described in those at increased risk for HIV. Cross-sectional analysis data (n = 204,231) on ACEs and HIV testing were obtained from the 2019-2020 Behavioural Risk Factor Surveillance Survey. Weighted logistic regression models were used to access the association of ACEs exposure, ACEs score, and ACEs type with HIV testing among adults with HIV risk behaviours, and stratified analysis was also performed to examine gender differences. The results indicated the overall rate of HIV testing was 38.8% and was higher among those with HIV risk behaviours (64.6%) than those without (37.2%). In populations with HIV risk behaviours, the negative association of HIV testing with ACEs exposure, ACEs score, and ACEs type was identified. Relative to those without ACEs, adults who were exposed to ACEs might decrease the rate of HIV testing, participants with ≥4 ACEs scores were less likely to have HIV testing, and childhood exposure to sexual abuse had the greatest impact on HIV testing. For both males and females, childhood exposure to ACEs was associated with lower odds of HIV testing and ACEs score ≥4 had the most robust associations with HIV testing. For males, those who experienced witnessed domestic violence had the lowest odds of HIV testing but the odds of engaging in HIV testing for females were the lowest among those who experienced childhood sexual abuse.
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Affiliation(s)
- Jun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Tingting Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Baihui Han
- Chaoyang Center for Disease Control and Prevention, Beijing, China
| | - Xiaowei Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Shifang Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ruying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Mengyao Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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20
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Suh BC, Gallaway MS, Celaya MF. Supportive Relationships Mitigate the Effect of Cumulative Exposure to Adverse Childhood Experiences on Depression, Anxiety, Stress, and Suicide Considerations-The Arizona Youth Risk Behavior Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:161. [PMID: 38397273 PMCID: PMC10887230 DOI: 10.3390/children11020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Declining adolescent mental health is a significant public health concern during the COVID-19 pandemic. Social distancing and stay-at-home orders have led to missed social connections with peers and adults outside households, and this has increased the risk of mental health problems in children and adolescents, particularly those with adverse childhood experiences (ACEs). Studies have shown that strong interpersonal support improves adolescent mental health. We examined the association between ACEs and poor mental health (including stress, anxiety, and depression) and how the presence of interpersonal support from caring adults and friends and school connectedness can mitigate this relationship among adolescents in Arizona. This study analyzed data from the 2021 Arizona Youth Risk Behavior Survey (YRBS; n = 1181), a population-based survey conducted biennially across the United States. The Arizona sample included high school students in grades 9-12 who were enrolled in public and charter schools. This study revealed that nearly three of four adolescents experienced an ACE, and one of five experienced ≥4 ACEs. Compared with adolescents who experienced zero ACEs, those with ≥4 ACEs experienced less interpersonal support from caring adults, friends, and school and more frequently reported poor mental health and suicidal thoughts. However, adolescents with interpersonal support consistently reported lower rates of mental health issues, even with exposure to multiple ACEs. Post-pandemic programs to improve social relationships with adults, peers, and schools are critical, especially for adolescents with multiple adversities.
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Affiliation(s)
- Bin C. Suh
- Arizona Department of Health Services, Phoenix, AZ 85007, USA;
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21
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Li Y, Chen H. Does childhood parental death impact late life health directly and indirectly? Evidence from a National Survey in China. DEATH STUDIES 2024:1-10. [PMID: 38270435 DOI: 10.1080/07481187.2024.2306471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Despite growing interest in understanding the impact of childhood parental death, less is known about its long-term effects on older adults. We investigated the mediating role of poor health perception in the relationship between childhood parental loss and late life health. A cross-sectional study using data from the 2016 China Longitudinal Aging Social Survey was conducted. Our final sample featured 8,547 older adults. The prevalence of childhood parental death was 9.8%. Results indicated a significant direct impact of childhood parental death on depression and cognitive function. Mediating effects were observed, with older adults who experienced childhood parental loss perceiving their health status as significantly worse. This, in turn, predicted higher levels of objective physical impairment, greater depression, and lower levels of cognitive function. Our study offers the first empirical evidence of the enduring negative effects of childhood parental death as well as the pivotal mediating role of poor health perception.
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Affiliation(s)
- Yunjun Li
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Honglin Chen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
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22
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Hjern A, Vinnerljung B, Brännström L. Cardiovascular Disease and Risk Factors in Individuals With a History of Out-of-home Care. Pediatrics 2024; 153:e2023063174. [PMID: 38263888 DOI: 10.1542/peds.2023-063174] [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] [Accepted: 10/03/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Exposure to childhood out-of-home care (foster family and residential care) is associated with an increased risk of ill-health and disability in adulthood, but the risk for cardiovascular disease has not previously been studied longitudinally. METHODS This was a national cohort study generated from linkage of a range of population-based registers, resulting in a national cohort of 881 731 of whom 26 310 (3.0%) had a history of out-of-home care. The study population, born 1972 to 1981, was followed from age 18 to age 39 to 48 years for hospitalizations and death. RESULTS After adjusting for year of birth and maternal education, individuals with a history of childhood out-of-home-care experienced a doubling of the risk for coronary disease (hazard ratio; 95% confidence interval: 2.05; 1.74-2.41) and stroke (hazard ratio 1.85; 1.59-2.15), compared with the general population, with similar estimates for men and women. Women with a history of out-of-home care had a more than doubled risk for cigarette smoking in early pregnancy, with a relative risk of 2.26; (2.18-2.34) and a moderately increased risk for gestational diabetes relative risk 1.49 (1.19-1.86). There was marked attenuation (40% to 90%) in effect estimates for disease and risk factors after further control for cohort members educational achievement at age 15-16 years. CONCLUSIONS A history of childhood out-of-home care was associated with a doubled risk of early cardiovascular disease events. Cigarette smoking and educational underachievement were the main identified risk factors.
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Affiliation(s)
- Anders Hjern
- Clinical Epidemiology and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bo Vinnerljung
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Lars Brännström
- Department of Social Work, Stockholm University, Stockholm, Sweden
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Nation A, Pacella R, Monks C, Mathews B, Meinck F. Prevalence of violence against children in the United Kingdom: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023; 146:106518. [PMID: 37944361 DOI: 10.1016/j.chiabu.2023.106518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Violence against children can have extensive, long-term, and far-reaching adverse impacts on survivors and society. There is currently little consensus in the United Kingdom around the prevalence of violence against children: maltreatment, intimate partner violence, sexual violence, bullying, and community violence, and most existing studies focus on only a single or a few forms of violence. This study aims to produce data to highlight the current magnitude of the problem in the UK, to inform policy, drive action and allow for monitoring of progress over time. OBJECTIVE To produce weighted prevalence estimates by violence type, as well as gender and age sub-categories, to give as full a picture as possible of the current prevalence of violence against children in the UK. PARTICIPANTS AND SETTING The prevalence of violence against children from 23 self-report studies conducted in the United Kingdom was gathered through a systematic review. METHODS Databases were searched from inception to 24th June 2022. Studies were reviewed systematically for appropriate data and meta-analyses were conducted to give pooled prevalence data based on a quality effects model. RESULTS The most prevalent self-reported experience of childhood violence was community violence at 27.33 % (95 % CI [9.84, 48.97]). Prevalence of bullying was also high at 22.75 % (95 % CI [13.25, 33.86]). The most prevalent forms of child maltreatment were domestic violence exposure at 11.9 % (95 % CI [6.34, 18.84]) and emotional maltreatment at 11.84 % (95 % CI [5.58, 19.89]). CONCLUSION National child maltreatment surveys are needed in the UK, using a comprehensive and conceptually robust approach, and valid and reliable instruments, to provide data for researchers and policymakers on the prevalence of all types of violence against children including exposure to multiple types. This allows monitoring of trends over time, can inform strategies for prevention, and can enable monitoring of future progress in reducing violence against children and its associated health and economic burden.
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Affiliation(s)
- Alexandra Nation
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom.
| | - Rosana Pacella
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom
| | - Claire Monks
- Institute for Lifecourse Development, University of Greenwich, Park Row, Greenwich, London SE10 9LS, United Kingdom
| | - Ben Mathews
- Australian Centre for Health Law Research, Queensland University of Technology, 130 Victoria Park Road, Brisbane, Queensland 4059, Australia; Johns Hopkins University, Bloomberg School of Public Health, 3400 N Charles Street, Baltimore, MD 21218, United States of America
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, EH8 9LD, United Kingdom; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Optentia, North-West University, Vanderbijlpark, South Africa
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24
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Kerr-Davis A, Hillman S, Anderson K, Cross R. Introducing Routine Assessment of Adverse Childhood Experiences For Looked-After Children: The Use and Properties of the Trauma and Adverse Life Events (TALE) Screening Tool. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:981-994. [PMID: 38045847 PMCID: PMC10689631 DOI: 10.1007/s40653-023-00559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 12/05/2023]
Abstract
The present study aims to illustrate the process of developing, implementing, and clinically validating a new assessment measure, the Trauma and Adverse Life Events (TALE) screening tool, to assess Adverse Childhood Experiences (ACEs) among looked-after children. The TALE was developed by adapting existing ACEs measures to reflect the experiences of looked-after children. The TALE was completed by the local authority social worker for 218 children placed with Five Rivers Child Care (a UK fostering agency, residential, and educational care provider). Reliability was examined and exploratory factor analysis was conducted. Correlations between TALE scores, background variables, and psychosocial wellbeing using the carer-report Strengths and Difficulties Questionnaire (SDQ) and Child Dissociative Checklist (CDC) were also explored. The TALE was found to have acceptable reliability (α = .71). A three-factor solution was found which explained 46.24% of the variance, with factors labelled 'Direct Experience of Abuse', 'Witnessing Harm', and 'Household Dysfunction'. Exposure score was significantly associated with total difficulties score on the SDQ (rs = .24, p < .001) and Impact score was associated with the SDQ's impact score (rs = .33, p < .001). Exposure and Impact scores were both positively correlated with CDC scores (rs = .16, p = .021 and rs = .22, p = .002). This paper presents evidence of the importance of screening looked-after children for ACEs and demonstrates that the TALE is a valid and reliable tool for this purpose. Adverse and traumatic experiences were highly prevalent in this population and appeared to be closely related with children's psychosocial wellbeing. Results emphasise the importance of routine assessment of past experiences within trauma-informed psychological care and intervention planning for looked-after children.
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Affiliation(s)
- Asa Kerr-Davis
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Child Attachment and Psychological Therapies Research (ChAPTRe), Anna Freud Centre, London, UK
| | - Saul Hillman
- Child Attachment and Psychological Therapies Research (ChAPTRe), Anna Freud Centre, London, UK
| | - Katharine Anderson
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
| | - Richard Cross
- Assessment and Therapy, Five Rivers Child Care Limited, Salisbury, Wiltshire UK
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O'Connor DB, Branley-Bell D, Green JA, Ferguson E, O'Carroll RE, O'Connor RC. Effects of childhood trauma on sleep quality and stress-related variables in adulthood: evidence from two multilevel studies. Psychol Health 2023:1-22. [PMID: 37975565 DOI: 10.1080/08870446.2023.2281712] [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: 01/23/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Childhood trauma has been found to have serious negative consequences for mental and physical health. However, the precise mechanisms through which trauma influences health outcomes are unclear. Childhood trauma-related disruptions to sleep in adulthood represent an important potential mechanism. Two 7-day multilevel studies investigated the effects of childhood trauma on daily sleep outcomes and stress-related variables and whether the effects of trauma on sleep outcomes were mediated through these stress-related variables (or vice versa). Participants completed the Childhood Trauma Questionnaire before a 7-day online daily diary study. Measures of daily stress, perseverative cognition, and sleep were completed daily. Multi-level modelling found that higher levels of childhood neglect were associated with poorer daily sleep quality, shorter sleep duration, longer sleep onset latency, and higher daily stress and rumination levels. Higher childhood abuse was associated with shorter sleep duration, greater morning tiredness, and higher levels of daily stress, rumination, and worry. Childhood trauma was found also to have bidirectional, indirect effects on sleep quality and morning tiredness through daily stress-related variables. The current findings suggest that interventions aimed at mitigating the negative effects of childhood trauma should also incorporate components that target modifiable risk factors, such as sleep, stress, worry, and rumination.
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Affiliation(s)
| | - Dawn Branley-Bell
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | | | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | | | - Rory C O'Connor
- Suicidal Behavior Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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26
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D'Arcy-Bewick S, Turiano N, Sutin AR, Terracciano A, O'Súilleabháin PS. Adverse childhood experiences and all-cause mortality risk in adulthood. CHILD ABUSE & NEGLECT 2023; 144:106386. [PMID: 37542995 DOI: 10.1016/j.chiabu.2023.106386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have been associated with mortality risk in adulthood. It is unclear, however, whether ACEs perpetrated beyond parents may be associated with mortality risk, if the risk is accumulative or plateaus at a certain frequency, whether associations differ dependent on ACE types, whether types interact with one another, or if observed effects differ by sex. OBJECTIVE To examine associations between ACEs and mortality risk. PARTICIPANTS AND SETTING 6319 participants (age range 25-74 years, mean [SD] 46.91 [12.95] years; 51.6 % female) followed from 1995/96 to 2018 as part of the survey of Midlife Development in the United States. METHODS ACE variables were self-reported exposure to 20 ACE types from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Cox proportional hazards models were used to estimate mortality risk. RESULTS ACEs were accumulatively associated with increased mortality risk in adjusted models (HR = 1.033; p ≤ .001, 95 % CI, 1.014-1.053). The association was linear. Only physical abuse (HR = 1.05; p = .024, 95 % CI, 1.01-1.10) remained significantly predictive of increased mortality risk adjusting for other types. No interaction by sex or amongst ACE types was observed. CONCLUSIONS ACEs may be cumulatively associated with increased mortality risk, such that each individual ACE increases risk. Physical abuse may be an important ACE type within a mortality risk context. Individual ACE types warrant further study as each type may have their own differential impact on mortality risk.
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Affiliation(s)
- Sinéad D'Arcy-Bewick
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | | | - Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
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27
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Matsukura H, Yamaoka Y, Matsuyama Y, Kondo K, Fujiwara T. Association between adverse childhood experiences and marital status among Japanese older adults. CHILD ABUSE & NEGLECT 2023; 144:106340. [PMID: 37467673 DOI: 10.1016/j.chiabu.2023.106340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 05/19/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Marital status is a well-known social determinant of health. Adverse childhood experiences (ACEs) affect attachment, critical to establishing and maintaining intimate relationships, such as marital status. OBJECTIVE This study examined the association between ACEs and marital status among older Japanese adults. PARTICIPANTS AND SETTING This research used data from a nationwide population-based study among functionally independent people aged 65 and above in Japan. METHODS ACEs were assessed by self-reported questionnaires on the following experiences before 18 years old: parental death, parental divorce, parental mental disease, exposure to intimate partner violence, physical abuse, psychological neglect, psychological abuse, and poverty. Marital status was asked as currently having a spouse (including common-law marriage), widowed, divorced, or unmarried. Associations between the total number of ACEs and marital status were analyzed by multinomial logistic regression. RESULTS Three or more ACEs showed higher risks of being widowed, divorced, or unmarried. Psychological neglect led to higher divorce risks among males (RRR, 95%CI = 1.41, 1.13-1.76) and females (RRR, 95%CI = 1.56, 1.28-1.89). Childhood poverty showed higher risks of unmarried among males (RRR, 95%CI = 1.25, 1.02-1.53) and females (RRR, 95%CI = 1.41, 1.18-1.69). Association between ACEs and divorce risks showed gender differences (RRR, 95%CI of having three or more ACEs in males: 2.19, 1.66-2.90; in females: 3.45, 2.71-4.38; p for interaction = 0.034). CONCLUSIONS ACEs showed higher risks of being widowed, divorced, and unmarried among older Japanese people. Policy to tackle ACEs and research investigating how ACEs, attachment, and relationship quality influence marital status are required to promote well-being in later life.
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Affiliation(s)
- Hanayo Matsukura
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, M&D Tower 16F 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan
| | - Yui Yamaoka
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, M&D Tower 16F 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, M&D Tower 16F 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inage Ward, Chiba 263-8522, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, M&D Tower 16F 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan.
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Amos RLM, Cresswell K, Hughes K, Bellis MA. ACEtimation-The Combined Effect of Adverse Childhood Experiences on Violence, Health-Harming Behaviors, and Mental Ill-Health: Findings across England and Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6633. [PMID: 37681773 PMCID: PMC10487644 DOI: 10.3390/ijerph20176633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health. Data were from eight cross-sectional surveys conducted in England and Wales between 2012 and 2022. The sample included 21,716 adults aged 18-69 years; 56.6% were female. Exposure to child maltreatment and household dysfunction in isolation were strong predictors of variant outcomes, whereas witnessing violence was not. However, additive models showed that witnessing violence amplified the measured risk beyond expected levels for being a victim or perpetrator of violence. The multiplicative effect of all three ACE categories demonstrated the highest level of risk (RRs from 1.7 to 7.4). Given the increased risk associated with co-occurring ACEs, it is crucial to target individuals exposed to any ACE category to prevent their exposure to additional harm. Implementing universal interventions that safeguard children from physical, emotional, and sexual violence is likely to mitigate a range of subsequent issues, including future involvement in violence.
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Affiliation(s)
| | - Katie Cresswell
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
| | - Karen Hughes
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
| | - Mark A. Bellis
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
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29
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Wang G, Zhou Y, Duan J, Kan Q, Cheng Z, Tang S. Effects of adverse childhood health experiences on cognitive function in Chinese middle-aged and older adults: mediating role of depression. BMC Public Health 2023; 23:1293. [PMID: 37407916 DOI: 10.1186/s12889-023-16169-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Adverse childhood experiences are critical factors in depression and cognitive decrease, but the effect of adverse childhood health experiences (ACHEs) on cognitive function and the role of depression have not been fully studied. METHODS Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2018. This study used indicators of situational memory ability and mental status to measure cognitive capacity. Besides analyzing the different types of ACHEs, scores for ACHEs were calculated to represent the severity of ACHEs. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. The analysis of this study employed two different analytical strategies in order to examine the mediated effects of depression. We used Sobel's test and Baron and Kenny's causal step approach, which utilized a generalized least squares regression model. Furthermore, a logistic regression model was used to evaluate the robustness of the Karlson-Holm-Breen (KHB) approach. RESULTS In this study, 6301 individuals who met the requirements of the study were included. We found that being confined to bed (ACHE3) (β=-0.3846, p = 0.022) in childhood had a negative impact on cognitive function. Similarly, ACHEs had a negative effect on cognitive function (β=-0.0819, p = 0.090). And after the depression had been introduced into the model, the regression coefficient of ACHEs on cognitive function was no longer significant (β=-0.0170, p = 0.727). The Sobel test showed that for ACHE3, the mediated proportion of the total effect of depression was 36.92%. While for ACHEs, the proportion of the mediated effect of depression was 70.11%. Finally, a robustness test of the mediating effect using the KHB method revealed that the mediating effect still existed. Further, based on different gender, age, and educational levels, the heterogeneity test indicated that the relationship between ACHEs and cognitive function and mediating effects of the depression were different as well as passing the robustness test of the interaction. CONCLUSION The decline in cognition had been shown to be correlated with ACHEs and depression mediated this relationship. Positive interventions might help to improve cognitive performance in individuals suffering from ACHEs and depression.
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Affiliation(s)
- Gaoling Wang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Yuqin Zhou
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Jing Duan
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Qianqian Kan
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Zhaopeng Cheng
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Shaoliang Tang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China.
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Walper S, Ulrich SM, Kindler H. [Family stressors on young children's emotional development]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03730-3. [PMID: 37402949 DOI: 10.1007/s00103-023-03730-3] [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: 01/13/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACE) have been pointed out as risk factors for physical and mental health, with consequences extending from childhood into adulthood. Based on research regarding the effects of selected ACE as well as the accumulation of ACE, this article investigates how different types of family stressors are linked to children's negative emotionality in infancy and early childhood. METHODS Data are from the KiD 0-3 study (N = 5583) and the follow-up of a subsample after 2 years (n = 681). Based on 14 stress factors, we distinguish families with no/little stressors, socioeconomic stressors, parenting stressors, and multiple stressors. RESULTS Children in multiply stressed families have the highest risk of high negative emotionality (compared to unstressed families: Odds Ratios [OR] ranging from 13.00 to 6.81), controlling for demographic characteristics, child-related stress factors (e.g., excessive crying), and caregiver childhood stress. Children in families primarily characterized by parenting stress also showed a significantly increased risk of high negative emotionality (OR ranging from 8.31 to 6.95), whereas this did not hold for children from socioeconomically stressed families (without parenting stress) compared to those from unstressed families. Longitudinal analyses of the follow-up subsample showed that changes in the number of stressors were also associated with parallel changes in children's negative emotionality. DISCUSSION These results confirm findings from international research on ACE in Germany and for early childhood. They underline the importance of a well-developed early intervention system.
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Affiliation(s)
- Sabine Walper
- Deutsches Jugendinstitut, Nockherstr. 2, 81541, München, Deutschland.
| | - Susanne M Ulrich
- Deutsches Jugendinstitut, Nockherstr. 2, 81541, München, Deutschland
| | - Heinz Kindler
- Deutsches Jugendinstitut, Nockherstr. 2, 81541, München, Deutschland
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Bourassa KJ, Moffitt TE, Harrington H, Houts R, Poulton R, Ramrakha S, Rasmussen LJH, Wertz J, Caspi A. Childhood Adversity and Midlife Health: Shining a Light on the Black Box of Psychosocial Mechanisms. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:817-828. [PMID: 36083434 PMCID: PMC9995600 DOI: 10.1007/s11121-022-01431-y] [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] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the "black box" of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
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Affiliation(s)
- Kyle J Bourassa
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
| | - Terrie E Moffitt
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - HonaLee Harrington
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Renate Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Line J H Rasmussen
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Jasmin Wertz
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- School of Philosophy, Psychology, and Language Science, University of Edinburgh, Edinburgh, Scotland
| | - Avshalom Caspi
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
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Noppert GA, Duchowny KA, Stebbins R, Aiello AE, Dowd JB, Clarke P. Biological expressions of early life trauma in the immune system of older adults. PLoS One 2023; 18:e0286141. [PMID: 37343002 PMCID: PMC10284407 DOI: 10.1371/journal.pone.0286141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Poor immune function is associated with increased risk for a number of age-related diseases, however, little is known about the impact of early life trauma on immune function in late-life. METHODS Using nationally representative data from the Health and Retirement Study (n = 5,823), we examined the association between experiencing parental/caregiver death or separation before age 16 and four indicators of immune function in late-life: C-reactive Protein (CRP), Interleukin-6 (IL-6), soluble Tumor Necrosis Factor (sTNFR), and Immunoglobulin G (IgG) response to cytomegalovirus (CMV). We also examined racial/ethnic differences. FINDINGS Individuals that identified as racial/ethnic minorities were more likely to experience parental/caregiver loss and parental separation in early life compared to Non-Hispanic Whites, and had poorer immune function in late-life. We found consistent associations between experiencing parental/caregiver loss and separation and poor immune function measured by CMV IgG levels and IL-6 across all racial/ethnic subgroups. For example, among Non-Hispanic Blacks, those that experienced parental/caregiver death before age 16 had a 26% increase in CMV IgG antibodies in late-life (β = 1.26; 95% CI: 1.17, 1.34) compared to a 3% increase in CMV antibodies among Non-Hispanic Whites (β = 1.03; 95% CI: 0.99, 1.07) controlling for age, gender, and parental education. INTERPRETATION Our results suggest a durable association between experiencing early life trauma and immune health in late-life, and that structural forces may shape the ways in which these relationships unfold over the life course.
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Affiliation(s)
- Grace A. Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Kate A. Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Rebecca Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jennifer B. Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, United Kingdom
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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Dynes ME, Rasiah SS, Knox M. When Attitudes Become Obstacles: An Exploratory Study of Future Physicians' Concerns about Reporting Child Maltreatment. CHILDREN (BASEL, SWITZERLAND) 2023; 10:979. [PMID: 37371211 DOI: 10.3390/children10060979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Child maltreatment (CM) makes up a significant portion of events under the larger umbrella term of adverse childhood experiences (ACEs). Therefore, we need to develop a competent healthcare workforce that is prepared to assess and report CM in order to create a comprehensive framework for assessing and addressing ACEs. The objective of the present study was to examine the obstacles to reporting CM among a sample of future physicians. METHODS Two samples of medical students and residents (N = 196) completed the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale and rated how likely they would be to report suspected CM. RESULTS Medical students were found to have more negative feelings about and perceive more obstacles to reporting CM compared to residents in our sample. Scores on the Reporting Responsibilities subscale were not significantly associated with increased likelihood of reporting CM. However, lower scores on the Concerns about Reporting subscale were related to an increased likelihood of reporting CM. CONCLUSIONS Future physicians who perceived fewer obstacles to reporting CM reported being more likely to report suspected CM. Misinformed fears about outcomes such as retaliation, removal of the child from the home, and being sued may interfere with future physicians' adherence to mandated reporting responsibilities. Efforts should be made early in physician education to identify and address common myths and misconceptions around mandated reporting and its outcomes.
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Affiliation(s)
- Morgan E Dynes
- Department of Psychiatry, University of Toledo, Toledo, OH 43614, USA
| | - Stephne S Rasiah
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA
| | - Michele Knox
- Department of Psychiatry, University of Toledo, Toledo, OH 43614, USA
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Wang YX, Sun Y, Missmer SA, Rexrode KM, Roberts AL, Chavarro JE, Rich-Edwards JW. Association of early life physical and sexual abuse with premature mortality among female nurses: prospective cohort study. BMJ 2023; 381:e073613. [PMID: 37137504 PMCID: PMC10155244 DOI: 10.1136/bmj-2022-073613] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To explore associations between early life physical and sexual abuse and subsequent risk of premature mortality (death before age 70 years). DESIGN Prospective cohort study. SETTING The Nurses' Health Study II (2001-19). PARTICIPANTS 67 726 female nurses aged 37-54 years when completing a violence victimization questionnaire in 2001. MAIN OUTCOME MEASURES Hazard ratios and 95% confidence intervals for total and cause specific premature mortality by childhood or adolescent physical and sexual abuse, estimated by multivariable Cox proportional hazard models. RESULTS 2410 premature deaths were identified over 18 years of follow-up. Nurses who experienced severe physical abuse or forced sexual activity in childhood and adolescence had a higher crude premature mortality rate than nurses without such abuse in childhood or adolescence (3.15 v 1.83 and 4.00 v 1.90 per 1000 person years, respectively). The corresponding age adjusted hazard ratios for premature deaths were 1.65 (95% confidence interval 1.45 to 1.87) and 2.04 (1.71 to 2.44), respectively, which were materially unchanged after further adjusting for personal characteristics and early life socioeconomic status (1.53, 1.35 to 1.74, and 1.80, 1.50 to 2.15, respectively). Cause specific analyses indicated that severe physical abuse was associated with a greater risk of mortality due to external causes of injury and poisoning (multivariable adjusted hazard ratio 2.81, 95% confidence interval 1.62 to 4.89), suicide (3.05, 1.41 to 6.60), and diseases of the digestive system (2.40, 1.01 to 5.68). Forced sexual activity as a child and adolescent was associated with greater risk of mortality due to cardiovascular disease (2.48, 1.37 to 4.46), external injury or poisoning (3.25, 1.53 to 6.91), suicide (4.30, 1.74 to 10.61), respiratory disease (3.74, 1.40 to 9.99), and diseases of the digestive system (4.83, 1.77 to 13.21). The association of sexual abuse with premature mortality was stronger among women who smoked or had higher levels of anxiety during adulthood. Smoking, low physical activity, anxiety, and depression each explained 3.9-22.4% of the association between early life abuse and premature mortality. CONCLUSION Early life physical and sexual abuse could be associated with a greater risk of adult premature mortality.
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Affiliation(s)
- Yi-Xin Wang
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yang Sun
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Picha KJ, Welch Bacon CE, Bay RC, Lewis JH, Snyder Valier AR. Athletic Trainers' Perceptions of and Experience with Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085602. [PMID: 37107884 PMCID: PMC10138865 DOI: 10.3390/ijerph20085602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
The role that social determinants of health (SDHs) play in athletic healthcare is gaining attention, yet little is known about athletic trainers' (ATs) perceptions of and encounters with the impact of SDHs. The purpose of this study was to evaluate ATs' perceptions of various SDHs and their experience treating patients whose health and well-being were influenced by SDHs. This was a cross-sectional, web-based survey completed by 1694 ATs (completion rate = 92.6%; 61.1% female; age = 36.6 ± 10.8 years). The survey consisted of several multipart questions focusing on specific SDHs. Descriptive statistics were used to report frequencies and percentages. Results indicated widespread agreement that SDHs matter to patient health and are of concern in athletic healthcare. The SDHs that ATs most commonly reported encountering included lifestyle choices (n = 1306/1406; 93.0%), social support (n = 1185/1427; 83.0%), income (n = 1167/1502; 77.7%), and access to quality and timely healthcare (n = 1093/1420, 77.0%). The SDHs that ATs least commonly reported having experience with was governmental policy (n = 684/1411; 48%). The perceived importance of SDHs among ATs and their commonly reported experiences managing patient cases in which SDHs negatively influence patients' health and healthcare suggest that efforts to assess these factors are needed so that strategies to address their influence on athletic healthcare can be identified.
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Affiliation(s)
- Kelsey J. Picha
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
- Correspondence:
| | - Cailee E. Welch Bacon
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
- Department of Basic Science Education, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA
| | - R. Curt Bay
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
| | - Joy H. Lewis
- Department of Public Health, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA
| | - Alison R. Snyder Valier
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
- Department of Basic Science Education, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA
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Tabone JK, Rishel CW, Hartnett HP, Szafran KF, Royse R. Examining the Effects of Adverse Childhood Experiences and Gender on Trauma-Informed Intervention Outcomes. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:9-19. [PMID: 36776631 PMCID: PMC9908787 DOI: 10.1007/s40653-022-00456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 06/18/2023]
Abstract
Purpose The prevalence of Adverse Childhood Experiences (ACEs) and their link to negative behavioral and health outcomes is well documented, but very few studies have empirically examined the effect of ACEs on intervention outcomes. There is also emerging evidence of gender differences in vulnerability to developing traumatic symptoms, which relates to intervention outcomes. The current study examined the effects of ACEs and gender on trauma-informed intervention outcomes in a community-based clinical setting. Methods The study includes data from children who were treated with trauma-informed intervention services grounded in the Attachment, Self-Regulation, and Competency (ARC) framework from 2017 to 2019. ACE scores are measured as a total across 10 items and different types, maltreatment versus family dysfunction, at intake. Children's trauma-related symptoms are assessed at intake and every 90 days under the ARC framework. In order to examine the changes of traumatic symptoms over time, a total of 362 children with three time points are included for the current analyses using Multilevel modeling with SAS PROC MIXED. Results The study found that a trauma-informed intervention based on the ARC framework was effective in reducing children's trauma related symptoms until they experienced 6 or more ACEs. The intervention effect, however, did not hold when children's ACEs were cumulated to 7 or more. The study also revealed gender differences in intervention outcomes. Conclusions The finding has significant implications for early detection and preventative intervention efforts with children's ACEs before their ACEs further cumulate to a higher number. Gender difference should be considered in intervention planning and monitored during the intervention process.
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Affiliation(s)
- Jiyoung K. Tabone
- School of Social Work, West Virginia University, PO Box 6830, 26506 Morgantown, WV United States
| | - Carrie W. Rishel
- School of Social Work, West Virginia University, PO Box 6830, 26506 Morgantown, WV United States
| | - Helen P. Hartnett
- School of Social Work, West Virginia University, PO Box 6830, 26506 Morgantown, WV United States
| | - Kathy F. Szafran
- Crittenton Services of West Virginia, Inc, 2606 National Road, 26003 Wheeling, WV United States
| | - Richard Royse
- Crittenton Services of West Virginia, Inc, 2606 National Road, 26003 Wheeling, WV United States
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Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Thomas EBK, Taylor A, Teague TK, Jenkins NDM. Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences. J Appl Physiol (1985) 2023; 134:742-752. [PMID: 36727632 PMCID: PMC10027078 DOI: 10.1152/japplphysiol.00524.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Adverse childhood experiences (ACEs) are early-life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-wk combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21 ± 3 yr) with ≥4 (ACE+; n = 28) or 0 ACEs (ACE-; n = 14) participated in this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n = 14) or nonexercise control (ACE+CON; n = 14) group, whereas all ACE- participants were assigned to a nonexercise control (n = 14) group. Hope agency and DBP did not change in any group (P ≥ 0.43), but hope pathways improved only in ACE+EXT (means ± SE change; +1.6 ± 0.74 au, P = 0.032, Hedges' g = 0.53). ET-1 decreased in ACE+EXT only (-0.31 ± 0.15 pg/mL, P = 0.043, g = 0.46). Although the interactions for resilience and SBP did not reach significance (P = 0.05-0.06), forced post hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, P = 0.012, g = 0.64) and SBP tended to improve (-4.0 ± 2.0 mmHg, P = 0.053, g = 0.51) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ = -0.43, P = 0.023) and ET-1 (ρ = -0.53, P = 0.005), and between changes in SBP and ET-1 (ρ = 0.49; P = 0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.NEW & NOTEWORTHY This randomized controlled pilot trial shows, for the first time, that 8 wk of structured, progressive exercise training lowers serum endothelin-1 (ET-1) and improves positive psychological coping in young women with significant early-life psychosocial stress. Furthermore, the observed associations among changes in psychological attributes, ET-1, and systolic blood pressure signify a potential interplay between positive psychology and cardiovascular disease risk among women with adverse childhood experiences.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio, United States
| | | | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, Oklahoma, United States
| | - Emily B K Thomas
- Department of Psychology and Brain Sciences, University of Iowa, Iowa City, Iowa, United States
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Science, Tulsa, Oklahoma, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
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Daniels TE, Mathis KJ, Gobin AP, Lewis-de Los Angeles WW, Smith EM, Chanthrakumar P, de la Monte S, Tyrka AR. Associations of early life stress with leptin and ghrelin in healthy young adults. Psychoneuroendocrinology 2023; 149:106007. [PMID: 36577337 PMCID: PMC9931677 DOI: 10.1016/j.psyneuen.2022.106007] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Childhood adversity is a major risk factor for cardiometabolic health problems. Stress-related changes in diet suggest a role for endocrine factors that influence dietary intake, such as leptin and ghrelin. These hormones influence metabolism and may contribute to the relationship of early adversity, mental, and cardiometabolic health. This study examined levels of leptin and ghrelin in a sample of young adults with and without early life stress (ELS). METHODS Young adults ages 18-40 (N = 200; 68.5% female) were recruited from the community. Participants with ELS (N = 118) had childhood maltreatment, and a subset, n = 92 (78.0%) also had parental loss, and n = 65 (55.1%) also had a current psychiatric disorder. Control participants (N = 82) had no maltreatment, parental loss, or psychiatric disorders. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Exclusion criteria included medical conditions and current medications other than hormonal contraceptives. Body Mass Index (BMI) and other anthropometrics were measured, and fasting plasma was assayed for total ghrelin and leptin with the Bio-Plex Pro Human Diabetes Panel. RESULTS While ELS was significantly associated with greater leptin (r = .16, p = .025), a finding which held when adjusted for age and sex (F(3196)= 28.32, p = .011), this relationship was abolished when accounting for BMI (p = .44). Participants with ELS also had significantly lower total ghrelin (r = .21, p = .004), which held adjusting for age and sex (p = .002) and was attenuated (p = .045) when the model included BMI (F=46.82, p < .001). Current psychiatric disorder was also a significant predictor of greater leptin (r = .28, p < .001) and lower ghrelin (r = .29, p = .003). In the model with ELS and covariates, psychiatric disorder remained significant (F=7.26, p = .008) and ELS was no longer significant (p = .87). Associations with severity and recent perceived stress were also examined. CONCLUSION The relationship of ELS and leptin was no longer significant when accounting for BMI, suggesting potential avenues for intervention. Ghrelin findings persisted after correction for BMI, which may be secondary to physiological differences in the regulation of these hormones (leptin is produced by adipocytes, whereas ghrelin is produced primarily in the GI tract). Lastly, these findings suggest that psychiatric functioning may be a key component contributing to the relationship of lower total ghrelin and childhood adversity.
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Affiliation(s)
- Teresa E Daniels
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA.
| | | | - Asi Polly Gobin
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - William W Lewis-de Los Angeles
- Department of Pediatrics, Hasbro Children's Hospital and Bradley Hospital, RI, USA; Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Eric M Smith
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Suzanne de la Monte
- Warren Alpert Medical School, Brown University, Providence, RI, USA; Departments of Medicine, Neurology, and Pathology and Laboratory Medicine, Rhode Island Hospital, Women and Infants Hospital of Rhode Island, and Providence VA Medical Center, Providence, RI, USA
| | - Audrey R Tyrka
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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Dimitriadis MM, Jeuring HW, Marijnissen RM, Wieringa TH, Hoogendijk EO, Oude Voshaar RC. Adverse Childhood Experiences and frailty in later life: a prospective population-based cohort study. Age Ageing 2023; 52:7036282. [PMID: 36794713 PMCID: PMC9933059 DOI: 10.1093/ageing/afad010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The deficit accumulation method considers the ageing process underlying frailty as a random accumulation of health deficits. OBJECTIVE Although Adverse Childhood Experiences (ACE) have consistently been associated with the onset of mental disorders and somatic diseases during adolescence and midlife, it remains unknown whether ACE still exert detrimental health effects in late life. Therefore, we examined cross-sectionally and prospectively the association between ACE and frailty among community-dwelling older people. DESIGN Based on the health-deficit accumulation method, a Frailty Index was calculated with values ≥0.25 considered as frail. ACE were measured by a validated questionnaire. The cross-sectional association was examined by logistic regression among 2,176 community dwelling participants aged 58-89 years. The prospective association was examined by Cox-regression among 1,427 non-frail participants during a 17-year follow-up. Interactions with age and sex were tested and analyses were adjusted for potential confounders. SETTING The present study was embedded in the Longitudinal Aging Study Amsterdam. RESULTS ACE and frailty were positively associated at baseline (OR = 1.88; 95% CI = 1.46-2.42; P = 0.05). Among non-frail participants at baseline (n = 1,427), ACE interacted with age on the prediction of frailty. Stratified analyses showed that a history of ACE only resulted in a higher hazard rate for the incidence of frailty among those aged ≥70 years (HR = 1.28; P = 0.044). CONCLUSION Even in the oldest-old, ACE still lead to an accelerated rate of the accumulation of health deficits and therefore contribute to the onset of frailty.
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Affiliation(s)
- Menelaos M Dimitriadis
- Address correspondence to: Menelaos Marios Dimitriadis, University of Groningen, University Medical Center Groningen, 9713 EZ Groningen, the Netherlands. Tel: +31 050 361 29 83.
| | - Hans W Jeuring
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Radboud M Marijnissen
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Thomas H Wieringa
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands,Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC—VU University Medical Center, Amsterdam, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Bengtsson J, Elsenburg LK, Andersen GS, Larsen ML, Rieckmann A, Rod NH. Childhood adversity and cardiovascular disease in early adulthood: a Danish cohort study. Eur Heart J 2023; 44:586-593. [PMID: 36375818 DOI: 10.1093/eurheartj/ehac607] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/23/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS To examine the effect of childhood adversity on the development of cardiovascular disease (CVD) between ages 16 and 38, specifically focusing on ischaemic heart disease and cerebrovascular disease. METHODS AND RESULTS Register data on all children born in Denmark between 1 January 1980 and 31 December 2001, who were alive and resident in Denmark without a diagnosis of CVD or congenital heart disease until age 16 were used, totalling 1 263 013 individuals. Cox proportional hazards and Aalen additive hazards models were used to estimate adjusted hazard ratios (HRs) and adjusted hazard differences of CVD from ages 16 to 38 in five trajectory groups of adversity experienced between ages 0 and 15. In total, 4118 individuals developed CVD between their 16th birthday and 31 December 2018. Compared with those who experienced low levels of adversity, those who experienced severe somatic illness and death in the family (men: adjusted HR: 1.6, 95% confidence interval: 1.4-1.8, women: 1.4, 1.2-1.6) and those who experienced very high rates of adversity across childhood and adolescence (men: 1.6, 1.3-2.0, women: 1.6, 1.3-2.0) had a higher risk of developing CVD, corresponding to 10-18 extra cases of CVD per 100 000 person-years in these groups. CONCLUSIONS Individuals who have been exposed to childhood adversity are at higher risk of developing CVD in young adulthood compared to individuals with low adversity exposure. These findings suggest that interventions targeting the social origins of adversity and providing support for affected families may have long-term cardio-protective effects.
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Affiliation(s)
- Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Post Box 2099, 1014 Copenhagen, Denmark
| | - Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Post Box 2099, 1014 Copenhagen, Denmark
| | - Gregers Stig Andersen
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Mogens Lytken Larsen
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Post Box 2099, 1014 Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Post Box 2099, 1014 Copenhagen, Denmark
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The association between adverse childhood experiences and peripartal pain experience. Pain 2023:00006396-990000000-00255. [PMID: 36787580 DOI: 10.1097/j.pain.0000000000002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/03/2023] [Indexed: 02/16/2023]
Abstract
ABSTRACT Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM (r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.
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Liévano-Karim L, Thaxton T, Bobbitt C, Yee N, Khan M, Franke T. A Balancing Act: How Professionals in the Foster Care System Balance the Harm of Intimate Partner Violence as Compared to the Harm of Child Removal. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2023:1-24. [PMID: 36785696 PMCID: PMC9909141 DOI: 10.1007/s42448-023-00153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
The striking prevalence of child exposure to intimate partner violence (IPV) and its associated adverse health outcomes necessitates a robust response from professionals who must grapple with the ethical dilemma of how to serve and support children in these circumstances. In 2020, 42 participants from four different professional backgrounds (attorneys, nonprofit leadership, licensed therapists, and social workers) were interviewed or participated in a focus group discussion. All groups acknowledged the shortfalls of current intervention practices, which often result in child removal. Group 1, which included social workers that work for children's legal services, minor's counsel, and Los Angeles Department of Child and Family Services social workers, were more conflicted in their recommendations for change. Some Group 1 participants recommended more training, while others thought more training would make little difference and recommended more substantial changes to prevent child removal when possible. Group 2, which included parents' counsel, and Group 3, which included social workers, attorneys, and nonprofit leadership at IPV nonprofits, were more closely aligned in their recommendations, primarily focusing on systemic changes to the child welfare system. Participants whose employment required them to advocate for parents tend to view child removal from a non-offending parent as harmful for both the child and IPV survivor. These findings illuminate how the perspectives of these diverse participants are influenced by their professional and personal experiences.
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Affiliation(s)
| | - Taylor Thaxton
- School of Public Health, UC Berkeley, Berkeley, CA USA
- Charles R Drew/David Geffen School of Medicine, UCLA, Los Angeles, CA USA
| | | | - Nicole Yee
- UCLA Pritzker Center for Strengthening Children and Families, UCLA, Los Angeles, CA USA
| | - Mariam Khan
- Fielding School of Public Health, UCLA, Los Angeles, CA USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA USA
| | - Todd Franke
- Luskin School of Public Affairs, UCLA, Los Angeles, CA USA
- UCLA Pritzker Center for Strengthening Children and Families, UCLA, Los Angeles, CA USA
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43
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Pernebo K, Almqvist K. Reduced Posttraumatic Stress in Mothers Taking Part in Group Interventions for Children Exposed to Intimate Partner Violence. VIOLENCE AND VICTIMS 2023; 38:130-147. [PMID: 36717191 DOI: 10.1891/vv-2021-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This study investigated whether interventions for children exposed to intimate partner violence combining parallel groups for children and mothers contribute to positive outcomes for partaking mothers. The study included 39 mothers in a long-term within-subject design without a control group in a Swedish naturalistic setting. Maternal psychological health was assessed pre- and posttreatment and at 6-month and 12-month follow-up. Mothers reported medium- to large-sized decrease in psychological symptoms, including symptoms of posttraumatic stress, postintervention (p = < .001 d = 0.45-0.96). During the follow-up period, sustained and further decrease of symptoms was reported (p = < .001 d = 0.58-1.60). Mothers also reported decreased exposure to violence. Results indicate that these child-focused programs have major and sustainable positive effects on mothers' psychological health.
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Affiliation(s)
- Karin Pernebo
- Department of Psychology, Linnaeus University, Växjö, Sweden
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Kjerstin Almqvist
- Department of Social and Psychological Sciences, Karlstad University, Karlstad, Sweden
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Zara S, Brähler E, Sachser C, Fegert JM, Häuser W, Krakau L, Kampling H, Kruse J. Associations of different types of child maltreatment and diabetes in adulthood - the mediating effect of personality functioning: Findings from a population-based representative German sample. Ann Epidemiol 2023; 78:47-53. [PMID: 36586456 DOI: 10.1016/j.annepidem.2022.12.004] [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: 09/18/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE This study aimed to examine the role of personality functioning in the association between various types of child maltreatment (CM) (sexual, physical, and emotional abuse as well as physical and emotional neglect) and diabetes in adulthood. METHODS Analyses are based on representative data of the German population (N = 5,041) from 2016 to 2019. Self-report questionnaires assessed diagnosis of diabetes, child maltreatment (CTQ), personality functioning (OPD-SQS), and symptoms of depression/anxiety (PHQ-4). Odd ratios were calculated to examine the association between CM and diabetes, and mediation analyses including PHQ-4 as covariate were conducted to examine the role of personality functioning. RESULTS All CM types significantly elevated the odds of having diabetes in adulthood. Personality functioning mediated the association between abuse and diabetes (sexual: b = 0.012, 95% CI [.002, 0.022], PM = 25.0%, physical: b = 0.009, 95% CI [.001, 0.017], PM = 12.0%, and emotional: b = 0.013, 95% CI [.002, 0.024], PM = 59.8%), but not between neglect and diabetes. CONCLUSIONS CM is associated with an increased risk of diabetes, with personality functioning being a relevant mediator for CM abuse types. Hence, by focusing on CM prevention and considering impaired personality functioning in diabetes treatment, diabetes self-management and health behavior could be improved.
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Affiliation(s)
- Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany.
| | - Elmar Brähler
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Winfried Häuser
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany; Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany
| | - Lina Krakau
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Marburg, Germany
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Joshi D, Gonzalez A, Lin D, Raina P. The association between adverse childhood experiences and epigenetic age acceleration in the Canadian longitudinal study on aging (CLSA). Aging Cell 2023; 22:e13779. [PMID: 36650913 PMCID: PMC9924940 DOI: 10.1111/acel.13779] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/07/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Research examining the association between exposure to a wide range of adverse childhood experiences (ACEs) and accelerated biological aging in older adults is limited. The purpose of this study was to examine the association of ACEs, both as a cumulative score and individual forms of adversity, with epigenetic age acceleration assessed using the DNA methylation (DNAm) GrimAge and DNAm PhenoAge epigenetic clocks in middle and older-aged adults. This cross-sectional study analyzed baseline and first follow-up data on 1445 participants aged 45-85 years from the Canadian Longitudinal Study on Aging (CLSA) who provided blood samples for DNAm analysis. ACEs were assessed using a validated self-reported questionnaire. Epigenetic age acceleration was estimated by regressing each epigenetic clock estimate on chronological age. Cumulative ACEs score was associated with higher DNAm GrimAge acceleration (β: 0.07; 95% CI: 0.02, 0.11) after adjusting for covariates. Childhood exposure to parental separation or divorce (β: 0.06; 95% CI: 0.00, 0.11) and emotional abuse (β: 0.06; 95% CI: 0.00, 0.12) were associated with higher DNAm GrimAge acceleration after adjusting for other adversities and covariates. There was no statistical association between ACEs and DNAm PhenoAge acceleration. Early life adversity may become biologically embedded and lead to premature biological aging, in relation to DNAm GrimAge, which estimates risk of mortality. Strategies that increase awareness of ACEs and promote healthy child development are needed to prevent ACEs.
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Affiliation(s)
- Divya Joshi
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada,Labarge Centre for Mobility in AgingMcMaster UniversityHamiltonOntarioCanada,McMaster Institute for Research on AgingMcMaster UniversityHamiltonOntarioCanada
| | - Andrea Gonzalez
- Labarge Centre for Mobility in AgingMcMaster UniversityHamiltonOntarioCanada,McMaster Institute for Research on AgingMcMaster UniversityHamiltonOntarioCanada,Department of Psychiatry and Behavioral NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Offord Centre for Child StudiesHamiltonOntarioCanada
| | - David Lin
- Centre for Molecular Medicine and TherapeuticsBC Children's Hospital Research InstituteVancouverBritish ColumbiaCanada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada,Labarge Centre for Mobility in AgingMcMaster UniversityHamiltonOntarioCanada,McMaster Institute for Research on AgingMcMaster UniversityHamiltonOntarioCanada,Department of Psychiatry and Behavioral NeurosciencesMcMaster UniversityHamiltonOntarioCanada
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Alhowaymel FM, Kalmakis KA, Chiodo LM, Kent NM, Almuneef M. Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1651. [PMID: 36674405 PMCID: PMC9863315 DOI: 10.3390/ijerph20021651] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/30/2022] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health.
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Affiliation(s)
- Fahad M. Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra 11911, Saudi Arabia
| | - Karen A. Kalmakis
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Lisa M. Chiodo
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Nicole M. Kent
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Maha Almuneef
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
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Kageyama M, Sakamoto T, Kobayashi A, Hirama A, Tamura H, Yokoyama K. Childhood Adversities and Psychological Health of Adult Children of Parents with Mental Illness in Japan. Healthcare (Basel) 2023; 11:healthcare11020214. [PMID: 36673582 PMCID: PMC9859196 DOI: 10.3390/healthcare11020214] [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: 12/15/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
In this study, we seek to clarify whether the present-day experience of psychological distress among adults whose parents suffered from mental illness is related to their childhood experiences of abuse and neglect and their provision of emotional care for their parents during their school-age years. To this end, a web-based cross-sectional study was conducted. A total of 120 participants over the age of 20 who attended a self-help group responded (50% response rate); of these, 94 had a parent diagnosed with a mental illness, and these participants were included for data analysis purposes. Of the 94 respondents, 65 (69.2%) were highly distressed, as measured by a Kessler (K) 6 measure of ≥5. A logistic regression analysis revealed that the experience of providing emotional care for parents during school-age childhood was significantly related to high levels of distress in adulthood (OR = 3.48; 95% CI 1.21-9.96). For children of parents with mental illnesses, the effects of providing emotional care for parents during childhood may include long-term psychological distress. For this reason, mentally ill parents raising children need visiting community nurses or other professionals to provide emotional care on behalf of their children.
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Affiliation(s)
- Masako Kageyama
- Institute of Advanced Co-Creation Studies, Osaka University, 1-7 Yamadaoka, Suita 565-0871, Osaka, Japan
- Correspondence: ; Tel./Fax: +81-6-6879-2553
| | - Taku Sakamoto
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Ayuna Kobayashi
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Akiko Hirama
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Hiroyuki Tamura
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Nursing, Yokohama Soei University, 1 Miho-cho, Yokohama 226-0015, Kanagawa, Japan
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Sharratt K, Mason SJ, Kirkman G, Willmott D, McDermott D, Timmins S, Wager NM. Childhood Abuse and Neglect, Exposure to Domestic Violence and Sibling Violence: Profiles and Associations With Sociodemographic Variables and Mental Health Indicators. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1141-NP1162. [PMID: 35445607 PMCID: PMC9709533 DOI: 10.1177/08862605221090562] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research indicates substantial overlap between child abuse and neglect (CAN), exposure to domestic violence and sibling abuse, with multiple victimisation experiences conferring greater risk for adverse mental health outcomes than does exposure to a single subtype. The application of latent class analysis (LCA) to child maltreatment has gained momentum, but it remains the case that few studies have incorporated a comprehensive range of subtypes, meaning that real-life patterns in victimisation experiences cannot be accurately modelled. Based on self-report data from an ethnically diverse sample (N = 2813) of 10-17 year olds in the United Kingdom, the current study used LCA to model constellations among nine types of maltreatment in the home (physical, emotional and sexual abuse; physical and emotional neglect; exposure to physical and verbal domestic violence, or a drug-related threat; and sibling violence). A four-class solution comprising of a low victimisation class (59.3% of participants), an emotional abuse and neglect class (19.0%), a high verbal domestic violence class (10.5%) and a maltreatment and domestic violence class (11.2%) provided the best fit for the data. Associations with sociodemographic variables were examined, revealing differences in the composition of the classes. Compared to the low victimisation class, participants in the verbal domestic violence class, emotional abuse and neglect class and especially the maltreatment and domestic violence class, reported higher symptoms of anxiety and depression and an increased likelihood of non-suicidal self-injury, suicide ideation and suicide attempt. The findings carry important implications for understanding patterns of child maltreatment, and the implications for preventative strategies and support services are discussed.
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Shin SH, Kim YK. Early Life Stress, Neuroinflammation, and Psychiatric Illness of Adulthood. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:105-134. [PMID: 36949308 DOI: 10.1007/978-981-19-7376-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Stress exposure during early stages of life elevates the risk of developing psychopathologies and psychiatric illness in later life. The brain and immune system are not completely developed by birth and therefore continue develop after birth; this post birth development is influenced by several psychosocial factors; hence, early life stress (ELS) exposure can alter brain structural development and function. A growing number of experimental animal and observational human studies have investigated the link between ELS exposure and increased risk of psychopathology through alternations in the immune system, by evaluating inflammation biomarkers. Recent studies, including brain imaging, have also shed light on the mechanisms by which both the innate and adaptive immune systems interact with neural circuits and neurotransmitters, which affect psychopathology. Herein, we discuss the link between the experience of stress in early life and lifelong alterations in the immune system, which subsequently lead to the development of various psychiatric illnesses.
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Affiliation(s)
- Sang Ho Shin
- Department of Psychiatry, College of Medicine, Korea University Ansan Hospital, Korea University, Ansan, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University Ansan Hospital, Korea University, Ansan, Republic of Korea.
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Kivimäki M, Bartolomucci A, Kawachi I. The multiple roles of life stress in metabolic disorders. Nat Rev Endocrinol 2023; 19:10-27. [PMID: 36224493 PMCID: PMC10817208 DOI: 10.1038/s41574-022-00746-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 02/01/2023]
Abstract
The activation of stress-related neuroendocrine systems helps to maintain homeostasis, but excessive stress can damage body functions. We review current evidence from basic sciences and epidemiology linking stress to the development and progression of metabolic disorders throughout life. Findings from rodents demonstrate that stress can affect features of metabolic dysfunction, such as insulin resistance, glucose and lipid homeostasis, as well as ageing processes such as cellular senescence and telomere length shortening. In human studies, stressors in the home, workplace and neighbourhood are associated with accelerated ageing and metabolic and immune alterations, both directly and indirectly via behavioural risks. The likelihood of developing clinical conditions, such as diabetes mellitus and hepatic steatosis is increased in individuals with adverse childhood experiences or long-term (years) or severe stress at work or in private life. The increased risk of metabolic disorders is often associated with other stress-related conditions, such as mental health disorders, cardiovascular disease and increased susceptibility to infections. Equally, stress can worsen prognosis in metabolic diseases. As favourable modifications in stressors are associated with reductions in incidence of metabolic disorders, further investigation of the therapeutic value of targeting stress in personalized medicine is warranted.
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Affiliation(s)
- Mika Kivimäki
- Department of Mental Health of Older People, Faculty of Brain Sciences, University College London, London, UK.
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Alessandro Bartolomucci
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA.
- Department of Medicine, University of Parma, Parma, Italy.
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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