Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health

Association of childhood adversity with HPA axis activity in children and adolescents: A systematic review and meta-analysis

Childhood adversity (CA) is associated with alteration of the hypothalamus-pituitary-adrenal (HPA) axis. We conducted a meta-analysis to synthesize existing evidence on the association between CA and HPA axis activity among children and adolescents and investigate four research questions: (1) Is CA associated with different aspects of the HPA axis (i.e., diurnal cortisol, acute stress response, chronic cortisol levels)?, (2) Does this association vary by the child's age?, (3) Are threat and deprivation dimensions of CA differentially associated with HPA axis activity?, and (4) Does this association depend on both the dimension and timing of CA? Meta-analyses were conducted with 129 studies reporting 506 effect sizes. Results showed significant associations between CA with higher afternoon cortisol levels (r = 0.053), a flatter diurnal slope (r = 0.048), more blunted reactivity (r = -0.043), and higher hair cortisol concentration (r = 0.098), but not other cortisol indicators (morning cortisol, cortisol awakening response, daily output, and cortisol recovery). Older children and adolescents had more pronounced blunted reactivity and steeper recovery with CA than younger children. Threat and deprivation did not differ in overall impact for any cortisol indicator; however, there are timing-dependent associations specific to threat or deprivation for some cortisol indicators. For instance, threat was associated with heightened reactivity when occurred before middle childhood, and with blunted reactivity when occurred after age 15 years; in contrast, deprivation was associated with blunted reactivity regardless of its timing. Findings could inform targeted interventions to reduce negative impacts of CA on development.

Psychological resilience and childhood maltreatment: The role of self-efficacy, personality functioning and social support in young adult residential care leavers

BACKGROUND

Although the psychopathological consequences of childhood maltreatment (CM) are widely acknowledged, less is known about the underlying pathways of resilience following CM. Recent work to harmonize operationalization and definition of resilience quantifies resilience as the residual variance in psychosocial functioning after accounting for adversity exposure.

OBJECTIVE

This study investigates the association of self-efficacy, personality functioning, and social support with residual resilience after CM in young adults with previous youth residential care placements in Switzerland.

METHODS

The psychological resilience of 189 young adults (M age = 26.18 years; SD = 3.01; 35 % women) was evaluated as the residual of the regression of childhood maltreatment on mental health problems. Multiple regression models were conducted to assess the association between residual resilience and self-efficacy, personality function, and social support. A multiple regression model with an individual composite score of self-efficacy and personality functioning was used to investigate the importance of individual and social factors in resilience.

RESULTS

The severity of CM was significantly associated with self-reported mental health problems, β = 0.37; p < .001. Residual resilience was significantly associated with self-efficacy, β = 0.33; p < .001, and impaired personality functioning (self-direction, β = -0.63, p < .001, empathy, β = -0.39, p < .001, intimacy, β = -0.37, p < .001, identity, β = -0.51, p < .001). However, it was not significantly associated with social support, β = 0.10; p = .14 in regression models testing individual predictors. In combined models, the individual composite score was more strongly associated with residual resilience than the social support.

CONCLUSION

Personality functioning and self-efficacy are crucial for psychological resilience following childhood maltreatment. They represent important targets for preventive interventions in youth residential care and therapy programs for those who experienced maltreatment in childhood.

Research Review: Assessment of early-life adversity and trauma - cumulative risk and dimensional approaches

In this research review, we present approaches and recommendations for assessing early-life adversity and childhood trauma aligned with two leading conceptual models of adversity: cumulative risk and dimensional models. We summarize the measurement implications of each conceptual model and common approaches for assessing early-life adversity in studies utilizing each of these models. We consider other critical components in the assessment of early-life adversity and trauma, including retrospective and prospective reporting, objective and subjective measurement, and caregiver and child reporting. Finally, we briefly summarize the existing interview and questionnaire measures that are widely used to assess early-life adversity and trauma using both cumulative risk and dimensional approaches. This work suggests that there is greater heterogeneity in measures used to assess the dimensional model relative to those used to assess the cumulative risk model, which allows for more flexibility in the assessment of early-life adversity. In addition, we observed that more detailed measures were available to assess experiences of threat compared to experiences of deprivation. Measures that assess adversity experiences in terms of frequency and severity across multiple dimensions of experience within a single measure are needed to facilitate consistent and reliable assessment of early-life adversity and trauma, particularly when applying dimensional models.

Maternal caregiving moderates relations between maternal childhood maltreatment and infant cortisol regulation

BACKGROUND

Children of maltreated mothers are at increased risk for adverse physical and psychological health. Both prenatal and postnatal alterations in offspring biological stress systems have been proposed as mechanisms contributing to such transmission. The aim of the current study was to assess whether maternal postnatal care of the infant moderated any effect of maternal childhood maltreatment on infant cortisol output during a mild stressor at 4 months of age.

METHODS

Participants included 181 mother-infant dyads, screened at recruitment to result in 57.4% reporting one or more forms of childhood maltreatment. Mothers were assessed for quality of caregiving, and infants were assessed for infant salivary cortisol output during the Still-Face Paradigm at infant age 4 months. Maternal childhood maltreatment was assessed using the Maltreatment and Abuse Chronology of Exposure (MACE) self-report scales.

RESULTS

Greater severity of maternal childhood neglect interacted with higher levels of maternal disoriented caregiving to predict higher infant cortisol output over the course of the Still-Face Paradigm. In contrast, maternal childhood abuse interacted with higher levels of maternal negative-intrusion to predict lower infant cortisol output. Greater maternal role confusion was linked to greater infant cortisol output regardless of maternal maltreatment history.

CONCLUSIONS

Maternal caregiving may moderate the effects of risk factors existing prior to the infant's birth. Disoriented caregiving in the context of maternal childhood neglect and negative-intrusive behavior in the context of maternal childhood abuse were associated with opposite directions of effect on infant stress hormone output. The results suggest that interventions addressing risks from both prenatal and postnatal periods may be most effective in mitigating intergenerational effects of maltreatment.

Adverse childhood experiences and loneliness: A systematic review and meta-analysis

Adverse childhood experiences are considered a powerful determinant of emotional health. One indicator of emotional health is loneliness, which refers to a distressing experience that one's social relationships are less in quality and quantity than those desired. This preregistered review aimed to examine the association between adverse childhood experiences (e.g., physical abuse/neglect, emotional abuse/neglect, sexual abuse, parental separation/divorce, family conflict, domestic violence) and loneliness in adulthood. A database search (Embase, Ovid, Cochrane Library, APA PsychINFO, Medline, Pubmed, Scopus) was conducted. After removal of duplicates, 3689 papers were reviewed and 20 met inclusion criteria. When feasible, results were pooled using a random-effects meta-analysis and inverse variance modelling and reported narratively. Meta-analyses revealed a statistically significant association between cumulative adverse childhood experiences and loneliness (r = 0.30, 95% CI [0.22-0.37]; prediction interval = 0.04-0.52) and between specific adversity types and loneliness, namely sexual abuse, physical abuse, physical neglect, emotional abuse, and emotional neglect. Some heterogeneity was observed across studies. Subgroup and sensitivity analyses revealed no differences in age, gender, age group, continent, or measures of adversity/loneliness. This research indicates that adversities in childhood may have some long-term influences on loneliness, both cumulatively and within adversity subtypes.

Childhood adversity and racial discrimination forecast suicidal and death ideation among emerging adult Black men: A longitudinal analysis

OBJECTIVES

Disproportionate exposure to childhood adversity and the effects of racial discrimination take a toll on Black American men's mental health. Despite increasing rates of suicidal behaviors and thoughts among young adult, Black American men, few longitudinal studies examine their risk for suicidal and death ideation (SDI). We tested a developmental model linking childhood adversity (experiences of deprivation and threatening experiences) and emerging adult exposure to racial discrimination to increases in SDI and examined a potential mechanism for these effects, negative relational schemas.

METHOD

A sample of 504 Black men (Mage = 20.7) from rural Georgia were recruited with respondent-driven sampling and completed a baseline survey. Men participated in two additional follow-up surveys (Mage = 21.9 and Mage = 23.5). Hypotheses were tested using structural equation modeling.

RESULTS

Analyses largely supported the proposed model. Childhood adversities were associated directly with reports of SDI. Childhood deprivation indirectly predicted SDI via negative schemas (β = 0.03, 95% CI [.014, .046]). Racial discrimination also indirectly predicted SDI via negative relational schemas (β = 0.01, 95% CI [.001, .018]).

CONCLUSION

Study results suggest that clinical and preventive interventions for suicidality should target the influence of racism and adverse experiences and the negative relational schemas they induce. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Stressful and potentially traumatic events and healthcare utilization: the 7th Tromsø survey

BACKGROUND

Stressful and potentially traumatic life events (SLEs/PTEs) can have a profound negative impact on the individual's mental and physical wellbeing and health. Consequently, an association of SLEs/PTEs with increased healthcare utilization has been found. However, most studies have been conducted in selected samples (e.g., veterans), and there is a paucity of studies in the general population. The present study examined the associations between SLEs/PTEs and the utilization of healthcare services in the general population using data from the seventh survey of the Tromsø study (Tromsø7).

METHODS

The sample comprised 20,069 participants aged 40 years and above (52.5% female, mean age 57.3 years, SD = 11.4 years) who completed measures of SLE/PTE exposure in childhood/adolescence and adulthood (including a question about mental preoccupation with SLEs/PTEs), utilization of a variety of healthcare services (general practitioner, medical specialist, hospital, emergency room, mental health services, physiotherapist, and complementary and alternative medicine provider) in the previous year, and self-reported feeling of being anxious or depressed.

RESULTS

The results showed that SLE/PTE exposure is associated with an increased use of all healthcare services, especially mental health professionals. Exposure to physical and emotional neglect in childhood/adolescence, violence, and sexual abuse showed the strongest associations with the utilization of mental health services. The strength of the associations with health service utilization increased with the number of SLEs/PTEs. Finally, mental preoccupation with the event(s) moderated the associations between SLE/PTE exposure and the utilization of healthcare services but not self-reported feeling of being anxious or depressed.

CONCLUSION

It is concluded that the prevention of SLEs/PTEs and screening for SLE/PTE exposure in healthcare services to provide trauma-informed care should be a prioritized public health focus.

Heritability and polygenic load for comorbid anxiety and depression

Anxiety and depression commonly occur together resulting in worse health outcomes than when they occur in isolation. We aimed to determine whether the genetic liability for comorbid anxiety and depression was greater than when anxiety or depression occurred alone. Data from 12,792 genotyped twins (ages 38-85) were analysed, including 1,986 complete monozygotic and 1,594 complete dizygotic pairs. Outcomes were prescription of antidepressant and anxiolytic drugs, as defined by the World Health Organization Anatomical Therapeutic Chemical Classification System (ATC) convention, for comorbid anxiety and depression (n = 1028), anxiety only (n = 718), and depression only (n = 484). Heritability of each outcome was estimated using twin modelling, and the influence of common genetic variation was assessed from polygenic scores (PGS) for depressive symptoms, anxiety, and 40 other traits. Heritability of comorbid anxiety and depression was 79% compared with 41% for anxiety and 50% for depression alone. The PGS for depressive symptoms likewise predicted more variation in comorbid anxiety and depression (adjusted odds ratio per SD PGS = 1.53, 95% CI = 1.43-1.63; ΔR2 = 0.031, ΔAUC = 0.044) than the other outcomes, with nearly identical results when comorbid anxiety and depression was defined by International Classification of Diseases (ICD) diagnoses (adjusted odds ratio per SD PGS = 1.70, 95% CI = 1.53-1.90; ΔR2 = 0.036, ΔAUC = 0.051). Individuals in the highest decile of PGS for depressive symptoms had over 5 times higher odds of being prescribed medication for comorbid anxiety and depression compared to those in the lowest decile. While results on a predominant role of depressive symptoms may have been biased by the size and heterogeneity of available data bases, they are consistent with the conclusion that genetic factors explain substantially more variation in comorbid anxiety and depression than anxiety or depression alone.

Validation of the Childhood Trauma Questionnaire (CTQ) in the Context of Trauma-Focused Treatment

Background: The Childhood Trauma Questionnaire (CTQ) is widely used, but retrospective self-report measures may be susceptible to bias especially in the context of pathology. Therefore, we aimed to validate the CTQ in the context of reduced psychopathology following trauma-focused treatment. Methods: We analyzed 149 outpatients with posttraumatic stress disorder (PTSD) related to childhood abuse. Participants received one of three variants of prolonged exposure. The CTQ was administered at baseline and six months later. The internal consistency of the CTQ was assessed using Cronbach's alpha, inter-item and item-total correlations. Convergent validity was assessed with the clinician administered PTSD Scale for DSM-5 (CAPS-5). The consistency of CTQ scores over time was analyzed using linear mixed models and intra-class correlation coefficients. Results: Most CTQ subscales demonstrated high internal consistency and satisfactory inter-item and item-total correlations except for physical neglect and minimization/denial subscales. CTQ subscales physical and sexual abuse exhibited adequate convergent validity with the CAPS-5. None of the CTQ subscales mean score changed significantly from baseline to follow-up. Agreement between the baseline and follow-up assessment within-persons was moderate at item-level but good at subscale-level except for subscale minimization/denial. Minimization/denial at baseline and change in symptomatology during treatment were not significantly related to change in CTQ subscale scores. Conclusions: These findings support the use of the CTQ subscales to retrospectively assess childhood maltreatment.

Adverse Childhood Experiences (ACEs) in Specific Vulnerable Developmental Periods Can Increase the Likelihood of Chronic Pain in Adulthood-Results from a Cross-Sectional Study

Background: Adverse childhood experiences (ACEs) have been identified as a major risk factor for physical and mental ill health in adulthood. So far, no studies have investigated whether ACEs during sensitive periods in infant development are associated with a higher likelihood of chronic pain (CP) in adulthood. Methods: Patients of the University Hospital of Innsbruck (Austria) completed questionnaires retrospectively assessing their ACEs as well as their current levels of CP, psychological distress, and trauma-related symptoms in this cross-sectional study. Dose-dependent associations of ACEs with CP were investigated through binary logistic regressions. To detect vulnerable developmental periods, a machine learning grid search was applied. Results: A total of n = 2577 patients were included in the analyses, with 31.5% reporting CP. Polytraumatization (i.e., four or more types of ACEs) was associated with a threefold increase for CP (OR: 3.01; 95% CI: 2.16-4.19; p < 0.001). The machine learning approach revealed maltreatment between 10 and 12 years to be the most predictive of CP (Ada Boost Classifier). Discussion: CP is a highly prevalent symptom among hospital patients and is clearly associated with ACEs. This is the first study to present evidence for a timing-dependent association of ACEs with CP. Early identification and appropriate psychosocial support for patients with ACEs is a crucial task for healthcare professionals.

Predictors of preterm births in North Dakota: a retrospective study of the North Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)

Background

Preterm births represent approximately 10% of all births in the United States (US) annually. Although North Dakota (ND) has large rural and American Indian populations that experience disparities in health outcomes relative to the general population, few studies have investigated risk factors of preterm births in this state. Therefore, the objective of this study was to investigate predictors of preterm births in ND among women who had a live singleton birth and no prior history of preterm births.

Methods

Data on live births from 2017 to 2021 were obtained from the ND Pregnancy Risk Assessment Monitoring System. Potential predictors of preterm birth were identified using a conceptual model. Multivariable logistic regression was then used to investigate and identify significant predictors of preterm births.

Results

The overall prevalence of preterm birth in North Dakota from 2017 to 2021 was 8.1%. However, among the population of interest in this study, which excluded births with multiple infants as well as women with a prior history of preterm birth, the preterm birth rate was 6.4%. Race, age, pregestational diabetes, and gestational hypertension were significantly associated with preterm birth in the final multivariable logistic model. The odds of preterm birth were higher among women who were American Indian (adjusted odds ratio (AOR) = 1.7, 95% confidence interval (CI) [1.3-2.4]), were aged 35 years or older (AOR = 1.6, 95% CI [1.01-2.5]), had pregestational diabetes (AOR = 4.3, 95% CI [2.0-9.3]), and had gestational hypertension (AOR = 4.5, 95% CI [3.1-6.7]) compared to women who were White, aged 20-34 years, and did not have pregestational diabetes or gestational hypertension.

Conclusions

Preventing and controlling chronic diabetes and hypertensive disorders of pregnancy is critical for reducing the risk of preterm birth, especially among women of advanced maternal age. Further research is needed to understand the underlying causes of racial disparities of preterm birth in ND.

Adverse childhood experiences and diurnal cortisol pattern and heart rate variability in adults

Dysregulation of hypothalamic-pituitary-adrenal axis (HPA axis) and of the autonomic nervous system may link stress throughout the life course with poorer health. This study aims to investigate whether multiple adverse childhood experiences have a long-term impact on markers of these systems - cortisol secretion and heart rate variability - in adulthood. Data were from the Whitehall II cohort study. Fourteen adversities, collected retrospectively in midlife, were considered. Outcomes were total amount of cortisol secretion during the day (area under the curve [AUC]), cortisol awakening response (CAR), and diurnal slope, estimated from six saliva samples taken on a weekday; and resting heart rate (rHR) and heart rate variability (HRV) measured for five minutes at three time points over 10 years with the last measures taken at the same time as the salivary measurement. Regression models were used to examine the association of adversities with AUC, CAR, rHR and HRV and multilevel modelling was applied to analyses of cortisol diurnal slope and the 10-year follow-up of rHR and HRV. At least one early life adversity was reported by 68 % of participants. There was little evidence that increasing number of adversities was associated with any measures of cortisol, rHR or HRV or 10-year change in rHR or HRV. Of the individual adversities, only parental death was associated with increased AUC and CAR. In conclusion, although the HPA axis and autonomic nervous system have been hypothesized as mechanisms relating to adverse childhood experiences with health, our study finds no evidence to support this.

A framework for understanding adverse adolescent experiences

Adolescence (ages 10-24) is characterized by cognitive, behavioural and social development. Childhood environments are typically centred on home and care settings, whereas adolescents increasingly engage with peer and community environments. These changing environments confer risks of experiencing specific adversities at different ages. Despite the unique characteristics of adversities in adolescence and potential associations with lifespan outcomes, few frameworks exist to systematize adversities in adolescents. Here we review current research and propose an approach specific to this developmental period: the adverse adolescent experiences (AAEs) framework. Building on existing models (for example, the adverse childhood experiences framework), the AAEs focus on potentially traumatizing experiences during adolescence. The framework builds on Bronfenbrenner's ecological systems theory to conceptualize adversities at intrapersonal, interpersonal, community and societal levels. We argue that this approach can enhance our understanding of adolescent adversity, facilitate the study of its potential effects, and guide prevention and intervention efforts.

Adverse Childhood Experiences and Bullying: Findings from the Growing Up in Scotland Cohort

Adverse childhood experiences (ACEs) are defined as stressful or traumatic events occurring within a child's family environment during their first 18 years of life. Research examining the associations between exposure to ACEs in childhood and bullying experiences in adolescence is sparse. To address this gap, data from the first 10 sweeps of the Growing Up in Scotland prospective cohort study was used to evaluate the relationship between 6 different ACEs and the risk of being bullied or engaging in bullying others at age 14 among a sample of 2,669 adolescents. Multiple univariable logistic regression models were fitted to explore independent associations between each of the six ACEs measured, 1+ ACE and 3+ ACEs and bullying perpetration and victimization, respectively. Results showed that a high proportion of young people in Scotland experience bullying victimization (31%) and a very high percentage reported exposure to at least one type of adversity (73.6%). Young people whose parents reported drug or alcohol misuse and females whose parents had divorced or separated had higher odds of engaging in bullying others. Having a parent who had mental health problems was the only ACE that predicted higher odds of experiencing bullying. Substance misuse in the family predicted a higher risk of bullying victimization for females. Logistic regression analyses further showed that females with greater exposure to ACEs were more likely to engage in bullying in mid-adolescence. Our findings underscore the importance of understanding bullying perpetration as a maladaptive way to manage life stressors.

Adults' Recollections of Support and Closeness During Adolescence Amid Interparental Conflict

This study examined adults' memories of childhood exposure to interparental conflict, including support for and closeness to each parent. Closeness and support were explored based on three dimensions: dyadic concordance types of intimate partner violence (father to mother, mother to father, or both), form of violence (verbal or physical), and sex. This study featured 548 Israeli adults who completed a retrospective questionnaire on their parents' interparental violence, their level of support for each parent during conflict, and their closeness to each parent. The results revealed a notable pattern: adolescents exhibited greater support and closeness toward nonviolent parents compared to violent parents, irrespective of the form of violence. Sex differences emerged across types and severity of violence. Theoretical and practical implications of the findings are discussed.

Impact of adverse childhood experiences on analgesia-related outcomes: a systematic review

BACKGROUND

There is well-established evidence linking adverse childhood experiences (ACEs) and chronic pain in adulthood. It is less clear how ACE exposure might influence the response to chronic pain treatment. In this systematic review, we synthesise the literature assessing the impact of ACE exposure on outcomes relating to the use, benefits, and harms of analgesic medications (analgesia-related outcomes).

METHODS

We searched seven databases from inception to September 26, 2023, for studies investigating adverse events in childhood (<18 yr) and any analgesia-related outcome during adulthood (≥18 yr). Title/abstract screening, full-text review, data extraction, and risk of bias assessment were performed independently by two authors. Given the high degree of study heterogeneity, a narrative synthesis was performed.

RESULTS

From 7531 records, 66 studies met inclusion criteria, involving 137 395 participants. Analgesia-related outcomes were classed into six categories: use of analgesics (n=12), analgesic side-effects (n=4), substance misuse (n=45), lifetime drug overdose (n=2), endogenous pain signalling (n=4), and other outcomes (n=2). No studies assessed the effect of ACE exposure on the potential benefits of analgesics. ACE exposure was associated with greater use of analgesic medication, higher incidence of analgesic medication side-effects, greater risk and severity of substance misuse, greater risk of drug overdose, and greater risk of attempted suicide in opioid dependency.

CONCLUSIONS

Adverse childhood experience exposure is associated with poor analgesia-related outcomes, so individual assessment adverse childhood experiences is important when considering the treatment of chronic pain. However, significant gaps in the literature remain, especially relating to the use and harms of non opioid analgesics.

SYSTEMATIC REVIEW PROTOCOL

CRD42023389870 (PROSPERO).

Beyond the Score: Exploring the Associations Between Adverse Childhood Experiences and Electrophysiological Responses to Errors

Adverse childhood experiences (ACEs) have diverse effects on physical development and mental health. This study aimed to clarify the relationship between the quantity of ACE exposure, type of ACE exposure, and subjective level of stress felt, correlated with event-related potential activity across the scalp, while controlling for relevant confounding variables. Fifty-three participants aged 18-32 years completed questionnaires assessing their current mental health, self-regulation, childhood socioeconomic status, and history of traumatic events. Electroencephalographic activity was recorded while participants completed the Combined Attention Systems Task, a modified flanker task. Using cluster-corrected robust statistical approaches, significant relationships existed between the total number of ACEs, ACE type, the subjective impact of trauma, and amplitudes during the error-related negativity (ERN) and error positivity (Pe) at various scalp locations. In the ERN time window, greater error-correct differences were associated with greater total ACEs, abuse, and other ACEs at C5, P9, and TP10/C1 clusters, respectively. In addition, reduced error-correct differences at cluster-maximal C2 during the timing of the Pe were related to experiencing greater numbers of total ACEs while increased error-correct differences at cluster-maximal FPz during the timing of the Pe were associated with greater numbers of other ACEs. The subjective impact of total number of ACEs was not associated with error-correct differences, however, the subjective impact of household dysfunction, abuse, and 'other' ACE types were linked to error-correct differences at various scalp locations and timings. Notably, increased, rather than decreased, subjective impact of household dysfunction was related to greater error-correct differentiation during the timing of the ERN, maximal at Cz. These results suggest that both ACE type and subjective rating are relevant to future outcomes. The effects extended beyond the ERN-affecting error-related positivity and later event-related potentials-indicating associations with the number, type, and subjective impact of ACEs across a larger time window and scalp topography.

Conceptualizing self-reported adverse childhood experiences: From epidemiologic exposure to psychometric latent variable

In this paper, we apply a measurement science perspective to explore both the epidemiologic and psychometric frameworks for the conceptualization, operationalization and assessment of self-reported adverse childhood experiences (srACEs). The epidemiologic paradigm suggests that srACEs are 'exposures', while the psychometric paradigm views responses on srACEs instrumentation as 'indicators'. It is the central premise of this paper that srACEs cannot be both exposures and indicators of scales. We review issues of reliability and validity from both perspectives, examine the degree of agreement between objective and subjective reports of childhood maltreatment and the implications of poor agreement, and conclude that the for the assessment of ACEs via self-report, the epidemiologic paradigm is not a good fit. We then review a number of reflexive and formative latent variable models that might be usefully fit to srACEs data for purposes of modeling structural properties of assessments, and/or to model ACE-health relationships. We highlight the mismatch and limitations of the reflexive measurement model for srACEs and conclude by endorsing either a formative latent variable model or application of latent class analyses. We emphasize the importance of considering and potentially formally testing competing measurement models and conducting both rationale analysis, conceptualization and hypothesis-testing to assess the fit of these models.

The Moderating Role of Genetic and Environmental Risk Factors for Schizophrenia on the Relationship between Autistic Traits and Psychosis Expression in the General Population

Background

Psychosis-related environmental risks in autism, along with genetic overlaps between autism and psychosis, have been well-established. However, their moderating roles in the relationship between autistic traits (ATs) and psychotic experiences (PEs) remain underexplored.

Methods

First-wave data from 792 twins and siblings (mean age: 17.47 ± 3.6, 60.23% female) in the TwinssCan Project were analyzed. PEs and ATs were assessed using the Community Assessment of Psychic Experiences and the Autism-Spectrum Quotient, respectively. Polygenic risk scores for schizophrenia and psychosis-associated environmental factors (ie, childhood trauma (CT), bullying, negative life events, obstetric complications, cannabis use, winter birth, and hearing impairment) were tested for their independent effects on PEs and their interaction effects with ATs in moderating the relationship between ATs and PEs using separate multilevel linear regression models with Bonferroni's correction.

Results

ATs, all CT subtypes, bullying, and negative life events were positively associated with PEs (all P < .004). Moderation analyses revealed that the association between ATs and PEs was amplified by emotional abuse (B:0.08, 95% CI, 0.05-0.11, P < .001), physical abuse (B:0.11, P = .001), sexual abuse (B:0.09, 95% CI, 0.03-0.15, P = .002), and physical neglect (B:0.06, 95% CI, 0.03-0.10, P = .001), emotional neglect (B:0.04, 95% CI, 0.01-0.07, P = .007), and negative life events (B:0.007, 95% CI, 0.0005-0.014, P = .04), although the latter 2 risks did not survive Bonferroni's correction. No significant main or interacting effects of genetic and other risk factors were found.

Conclusions

People with high ATs were more likely to have PEs when exposed to CT. Trauma screening and early interventions might be warranted in this at-risk population.

Associations between childhood maltreatment, peripheral immune biomarkers, and psychiatric symptoms in adults: A cohort study of over 138,000 participants

BACKGROUND

Few studies have integrated the impact of individual and cumulative childhood maltreatment on multiple psychiatric symptoms, with the mechanisms underlying these associations largely unknown. This study aims to comprehensively assess the associations between childhood maltreatment, multiple peripheral immune biomarkers, and various psychiatric symptoms in adulthood and to explore whether peripheral immune inflammation plays a mediator role in the associations between childhood maltreatment and psychiatric symptoms in adulthood.

METHODS

Using data from the UK Biobank, we constructed a retrospective cohort study of 138,915 participants who provided self-reported childhood maltreatment and had peripheral immune biomarkers assessed. We examined seven types of psychiatric symptoms in adulthood, including depressive symptoms, anxiety symptoms, mania, post-traumatic stress disorder (PTSD), psychotic experiences, self-harm, and alcohol use disorder. Logistic regression models were performed to explore the associations between childhood maltreatment, immune biomarkers, and psychiatric symptoms, calculating the average marginal effects for each indicator of childhood maltreatment. Mediation analyses were conducted to determine the extent to which the immune biomarkers could explain the association between childhood maltreatment and psychiatric symptoms in adulthood. Subgroup and sensitivity analyses were also performed.

RESULTS

Among the participants, 77,937 (56.10 %) were female, with a mean age of 55.91 (SD: 7.73) years at baseline. There were dose-response relationships existed between the accumulation of childhood maltreatment indicators and all seven assessed psychiatric symptoms and multimorbidity in adulthood (e.g., for depressive symptoms, OR = 1.67 [95 %CI, 1.57 to 1.78] for one childhood maltreatment indicator; OR = 2.77 [95 % CI, 2.58 to 2.97] for two; OR = 4.91 [95 % CI, 4.61 to 5.24] for three or more). Emotional abuse and physical neglect showed the strongest average marginal effects on psychiatric symptoms. Levels of C-reactive protein (CRP) and counts of leukocytes and neutrophils were positively associated with depressive symptoms (e.g., OR = 1.13 [95 % CI, 1.08 to 1.17] for CRP level), anxiety symptoms, PTSD, and psychotic experiences. Moreover, levels of CRP partially mediated the association between childhood maltreatment scores and psychiatric symptoms, albeit with a relatively low mediation proportion (0.65 %-1.77 %).

CONCLUSIONS

Our findings underscore the importance of interventions that address multiple forms of childhood maltreatment to mitigate long-term mental health challenges substantially. While peripheral immunity responses may serve as predictors of mental health problems, they might not to be the primary mechanism through which childhood maltreatment influences psychiatric symptoms in adulthood.

Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis

Importance

Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability.

Objective

To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates.

Design, Setting, and Participants

Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024.

Main Outcomes and Measures

ACEs.

Results

The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90).

Conclusions

In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.

The association between childhood adversity and hippocampal volumes is moderated by romantic relationship experiences

Reduced hippocampal volumes are a feature of many mental disorders. Childhood maltreatment is a known risk factor for the development of psychopathology and has consistently been linked to hippocampal volume reductions in adults, but not in children and adolescents. We propose that maltreatment-related difficulties in coping with developmental tasks in adolescence and young adulthood might underlie the delayed emergence of hippocampal volume reductions in maltreated individuals. In a study with 196 healthy young adults (mean age [years]: 24.0 ± 3.2, 50% female, 20.6% living with a partner (missings: n = 2)), we investigated the interaction between childhood maltreatment (Childhood Trauma Screener) and the breakup of a steady romantic relationship (List of Threatening Experiences Questionnaire) on hippocampal magnetic resonance imaging grey matter volumes. The experience of a romantic relationship breakup moderated the association between childhood maltreatment and bilateral hippocampal volumes, revealing more negative associations with hippocampal volumes in participants with at least one breakup compared to those with no breakup experience (right hippocampus: β = - 0.05 ± 0.02, p = 0.031, p (FDR) = 0.031; left hippocampus: β = -0.06 ± 0.02, p = 0.005, p (FDR) = 0.009). Moreover, our findings provide some evidence that childhood maltreatment is related to smaller bilateral hippocampal volumes only in those adults who suffered from a relationship breakup (right hippocampus: β = -0.23 ± 0.10, p = 0.018, p (FDR) = 0.018; left hippocampus: β = -0.24 ± 0.10, p = 0.016, p (FDR) = 0.018;). Our study highlights the interaction of adult social bonds with early adversity on vulnerability to psychopathology.

Infants show negative changes in affect and physiology when re-experiencing a stressor, its context, and a positive event 24-h later

Exposure to early life stress shapes further development, affects later stress reactivity, and mental health outcomes. Despite the central role of early experiences, there is little understanding of how these rapidly forgotten events gain their influence. An infant's ability to cope with everyday stressors is founded on successful co-regulation through mother-infant interaction. A significant disruption of this interaction through the Face-to-Face Still-Face paradigm elicits a well-documented behavioral and physiological stress response in infants. What has yet to be explored is whether infants show regulatory adaptions when encountering the situation over again. To fill this gap, 80 mother-infant dyads were observed in the lab on two consecutive days. Infants in the experimental condition (n = 40) were exposed to a double Still-Face paradigm on day one. Infants in the control group (n = 40) completed time-matched episodes of typical play during their first visit. Mother-infant dyads from both groups returned to the lab 24 h later and participated in the double Still-Face paradigm. Changes in behavior (positive and negative affect), physiology (heart rate), and salivary cortisol, compared to day one and between groups, were evaluated and used to infer adaption to the previous experienced laboratory visit. Infants in the experimental condition showed a significant decrease in positive affect (p = 0.016) and an increase in heart rate (p < 0.001) on day two, compared to controls, even during baseline measures and a neutral first play episode. Infants in the control condition showed a significant decrease in affect (p = 0.05) and non-significant increase in heart rate on day two when first encountering the Still-Face paradigm. Infants in the experimental condition showed significant higher heart rate on day two compared to the control group (p = 0.046). Infants in the experimental condition also exhibited a marginally significant increase in salivary cortisol on day two, compared to day one (p = 0.054). The change in infant heart rate was independent of maternal heart rate which did not differ between day one and day two, or between groups. Findings suggest that a previous stressful experience may elicit a behavioral and physiological adaption in infants 24 h later. Our results suggest that even a short, acute stressful event can elicit a lasting stress response in infants 24 h later. The effect we observed was specific to the context of the stressful event, not just the stressor. More precisely, the effect "spilled over" from the stressful experience on day one into the baseline measure of day two, usually a neutral experience. The results could have implications for further research on how stressful experiences may shape the stress response.

Association between adverse childhood experiences and mortality: A systematic review and meta-analysis

Adverse childhood experiences represent a critical public health concern that warrants urgent attention and cannot be overlooked. The evidence regarding the relationship between adverse childhood experiences and mortality has been insufficient and inconsistent. To address this gap, we conducted a systematic review and meta-analysis to explore the association between adverse childhood experiences, including their subtypes, and various mortality outcomes. We systematically searched PubMed, Web of Science, EMBASE, CINAHL, and the Cochrane Library from inception to 9 March 2024. Ultimately, 49 studies were included. Among them, 46 studies involving 24,276,424 participants investigated the association between adverse childhood experiences and mortality. The results showed adverse childhood experiences were significantly associated with overall mortality (OR, 1.64; 95 % CI, 1.51 to 1.78; P < 0.001), external cause mortality (OR, 1.91; 95 % CI, 1.7 to 2.15; P < 0.001), and internal cause mortality (OR, 1.3; 95 % CI, 1.17 to 1.44; P < 0.001). Among women and men, the effect sizes were 1.39 (95 %CI, 1.25 to 1.54; P < 0.001) and 1.4 (95 %CI, 1.22 to 1.6; P < 0.001), respectively. Increased mortality risk was also observed for those exposed to maltreatment (OR, 1.95; 95 %CI, 1.65 to 2.3; P < 0.001), household dysfunction (OR, 1.36; 95 %CI, 1.22 to 1.51; P < 0.001), low socioeconomic status (OR, 1.25; 95 %CI, 1.09 to 1.43; P = 0.002), or out-of-home care (OR, 2.87; 95 %CI, 2.12 to 3.9; P < 0.001). Gender differences were not statistically significant, except for minor variations within the low socioeconomic status. This study underscores the profound impact of adverse childhood experiences on mortality risk, highlighting the need for targeted public health interventions and policies.

Genetic and environment influences on childhood victimization: a systematic review and meta-analysis

Childhood victimization is a key risk factor for poor mental and physical health. In order to prevent childhood victimization, it is important to better understand its underlying etiological factors. Childhood victimization is not randomly distributed in the population but occurs more often in the context of certain characteristics of the child, the family, and the broader environment. These characteristics may be both genetically and environmentally influenced, making genetically informative designs valuable to disentangle the etiological factors. Here we performed meta-analyses of the genetic and environmental influences on childhood victimization based on twin studies. We also tested whether genetic and environmental influences on childhood victimization vary depending on key features of victimization experiences including the reporter of victimization experiences, the type of victimization, and the age at exposure. Following PRISMA guidelines, a search for relevant literature was conducted using MEDLINE, APA PsycInfo, and Embase databases until September 2023. A meta-analysis based on 21 studies with 62,794 participants showed that genetic influences accounted for 40% of the variance in childhood victimization, shared environmental influences for 20%, and non-shared environmental influences for 40%. In addition, we found that genetic and environmental influences on victimization varied based on the reporter and the type of victimization, and the age at victimization. The quantitative summary of genetic and environmental influences provided by this study advances our understanding of the mechanisms underlying risk for childhood victimization and points to prevention targets for victimization and its health effects.

Sexual identity-related inequalities in associations between adverse childhood experiences and health in late adolescence-A national cohort study

This study examined associations between adverse childhood experiences (ACEs) and mental health and health-risk behaviours, including differences by sexual minority (SM) identity. We included 8,686 adolescents (males = 50.7%, SM = 10.3%) from the UK-wide Millennium Cohort Study with data on eight ACEs (e.g., domestic violence, parental psychological distress, bullying) recorded between ages 3-14 and a wide-range of health indicators and health-risk behaviours at age 17. Associations between 1) Sexual identity and ACEs were analysed using multinomial logistic regression and 2) Cumulative ACE scores and all outcomes were analysed using linear/logistic regression (with appropriate interactions assessing differences in ACE-outcome associations by sexual identity and adjusted for sex, ethnicity, and parental income). Results showed SM individuals had a higher prevalence of bullying (33.9% vs. 20.3%) and experiencing ≥3ACEs [Bisexual: RRR 1.87 (95% CI 1.35, 2.57), Gay/Lesbian RRR 2.08 (1.24, 3.48)]. The number of individuals experiencing adverse mental health outcomes increased in relation to greater ACE exposure with evidence for effect-moderation by sexual identity in certain outcomes. For example, among individuals with 0 ACEs, 8% of heterosexual adolescents reported psychological distress vs. 22% in bisexual and 17% in gay/lesbian peers, increasing to 16% in heterosexual vs. 41% in bisexual and 45% in gay/lesbian adolescents with ≥3 ACEs. Similar patterns were observed for other health indicators (e.g., self-harm, suicidality, sleep quality) and health-risk behaviours (e.g., risky sex). Our findings indicate that ACEs are associated (with a gradient) with worse mental health and well-being, and higher risk of some health-risk behaviours. However, the detrimental effect of ACEs on health is worse in SM adolescents compared to heterosexual peers.

Adverse childhood experiences and emotion dynamics in daily life: a two sample study

Research suggests that adverse childhood experiences (ACEs) can have life-long consequences on emotional functioning. However, it is unclear how ACEs shape the dynamic features of everyday emotions. In the current preregistered study with two adult ecological momentary assessment samples (Ns = 122 and 121), we examined the linear and curvilinear associations of ACEs with daily emotion dynamic features. We expected ACEs to show linear associations with a higher baseline level, variability, and inertia of negative emotions, as well as a lower baseline level of positive emotions. Moreover, we expected ACEs to show U-shaped curvilinear associations with the variability of negative and positive emotions. The results did not support our hypotheses. Instead, ACEs showed an inverted U-shaped association with the baseline level and variability of negative emotions. Furthermore, ACEs also showed a U-shaped association with the baseline level of positive emotions and a linear association with higher variability of positive emotions. However, all associations were present in only one of the two samples. Our study underscores the critical need to incorporate a broad spectrum of ACEs in research samples to adequately capture their developmental consequences and the role of ACEs in contributing to the baseline level and variability of daily emotions.

Adverse childhood experiences and left hippocampal volumetric reductions: A structural magnetic resonance imaging study

BACKGROUND

Adverse childhood experiences (ACEs) have been associated with volume alterations of stress-related brain structures among aging and clinical populations, however, existing studies have predominantly assessed only one type of ACE, with small sample sizes, and it is less clear if these associations exist among a general population of young adults.

OBJECTIVE

The aims were to describe structural hippocampal volumetric differences by ACEs exposure and investigate the association between ACEs exposure and left and right hippocampal volume in a student sample of young adults.

METHODS

959 young adult students (18-24 years old) completed an online questionnaire on ACEs, mental health conditions, and sociodemographic characteristics. Magnetic resonance imaging (MRI) was used to measure left and right hippocampal volume (mm3). We used linear regression to explore the differences of hippocampal volumes in university students with and without ACEs.

RESULTS

Two thirds of students (65.9%) reported ACEs exposure. As ACEs exposure increased there were significant volumetric reductions in left (p < 0.0001) and right hippocampal volume (p = 0.001) and left (p = 0.0023) and right (p = 0.0013) amygdala volume. After adjusting for intracranial brain volume, sex, age, and depression diagnosis there was a negative association between ACEs exposure and left (β = -22.6, CI = -44.5, -0.7, p = 0.0412) but not right hippocampal volume (β = -18.3, CI = -39.2, 2.6, p = 0.0792). After adjusting for intracranial volume there were no associations between ACEs exposure and left (β = -9.2, CI = -26.2, 7.9 p = 0.2926) or right (β = -5.6, CI = -19.9,8.8 p = 0.4466) amygdala volume.

CONCLUSIONS

Hippocampal volume varied by ACEs exposure in young adult students. ACEs appear to contribute to neuroanatomic differences in young adults from the general population.

Considering context: Current relationship satisfaction in a second-generation model of men's physical intimate partner violence

Despite a half-century of scholarship devoted to explicating and disrupting the intergenerational transmission of family violence, it remains a prominent and destructive social force in the United States. Theoretical models have posited a variety of historical and concurrent risk and protective factors implicated in the trajectory from childhood violence exposure to adult perpetration. Using a second-generation model of intimate partner violence (IPV), we integrated social learning and attachment conceptualizations to examine pathways from family-of-origin violence to IPV perpetration among adult men. A sample of mixed-sex couples (N = 233) completed self-report measures related to social learning and attachment-based factors (e.g., violence in past relationships, child exposure, IPV attitudes, adult attachment) and participated in a 10-min conversation about a desired area for change in their relationship. Following, each partner participated in a video-mediated-recall procedure assessing their anger volatility and eliciting attributions of their partners' behavior. We tested mediation pathways (consistent with social learning and attachment theories) between violence in men's families of origin and their adult IPV perpetration as a function of relationship satisfaction. The proposed model fit the data well (CFI = 0.95) but had notable modifications from the hypothesized model. Generally, social-learning pathways were more consistent with the data. Relationship satisfaction interacted with some parameters. Results support theoretical advances in understanding IPV. Although exposure to violence in men's family of origin confers risk for later IPV, and a social learning developmental pathway is consistent with results, some of these effects are altered by relationship context.

The future of intergenerational transmission research: A prospective, three-generation approach

Dr. Dante Cicchetti's pioneering theory and research on developmental psychopathology have been fundamental to the proliferation of research on intergenerational transmission over the last 40 years. In part due to this foundation, much has been learned about continuities and discontinuities in child maltreatment, attachment, parenting, and psychopathology across generations. Looking towards the future, we propose that this field stands to benefit from a prospective, three-generation approach. Specifically, following established prospective, longitudinal cohorts of children over their transition to parenting the next generation will afford the opportunity to investigate the developmental origins of intergenerational transmission. This approach also can address key outstanding questions and methodological limitations in the extant literature related to the confounding of retrospective and prospective measures; examination of mediators and moderators; and investigation of the roles of biology, environment, and their interplay. After considering these advantages, we offer several considerations and recommendations for future research, many of which are broadly applicable to the study of two or more generations. We hope that this discussion will inspire the leveraging of existing prospective cohorts to carry forward Dr. Cicchetti's remarkable contributions, with the ultimate aim to inform the development of preventions and interventions that disrupt deleterious intergenerational cycles.

Association between self-reported child maltreatment and risk of hospital-treated infectious diseases in middle-aged and older adults: A UK Biobank cohort study

OBJECTIVE

This study aimed to explore the association between child maltreatment and hospital-treated infectious diseases in middle-aged and older adults.

METHODS

145,151 participants aged 38-72 years from the UK Biobank between 2006 and 2010 were enrolled and interviewed. Child maltreatment included five types: physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse. Patterns of maltreatment were identified using latent class analysis (LCA). Cox regression was employed to estimate the associations between child maltreatment (number of types, individual types, and patterns) and infectious diseases. Further, we evaluated potential mediators using mediation analysis.

RESULTS

Over a median follow-up of 13.4 years, 22,688 participants (12.26 per 1000 person-years) were hospitalized for an infectious disease. Participants reporting any maltreatment had elevated infectious diseases risk (HR 1.18, 95 % CI: 1.15-1.21) than those without maltreatment. A dose-response relationship was observed between the number of maltreatment types and infectious disease (one, HR 1.09 [95 % CI 1.06-1.13]; two, HR 1.17 [95 % CI 1.12-1.23]; three to five, HR 1.48 [95 %CI 1.41-1.55]; Ptrend < 0.001). Each type of maltreatment was associated with increased infectious diseases risk. LCA identified four patterns (low maltreatment, child neglect, child abuse, and poly-maltreatment), with those who experienced poly-maltreatment exhibiting the highest infectious diseases risk (HR 1.51, 95 % CI: 1.43-1.59). The association between child maltreatment and infectious diseases was mediated by C-reactive protein, phenotypic age acceleration, loneliness, psychiatric disorders, and unhealthy lifestyles.

CONCLUSIONS

Child maltreatment may increase susceptibility to a broad spectrum of infectious diseases in adulthood, highlighting the need for early-life maltreatment prevention policies.

The future of childhood maltreatment research: Diversity and equity-informed perspectives for inclusive methodology and social justice

A long-standing practice in clinical and developmental psychology research on childhood maltreatment has been to consider prospective, official court records to be the gold standard measure of childhood maltreatment and to give less weight to adults' retrospective self-reports of childhood maltreatment, sometimes even treating this data source as invalid. We argue that both formats of assessment - prospective and retrospective - provide important information on childhood maltreatment. Prospective data drawn from court records should not necessarily be considered the superior format, especially considering evidence of structural racism in child welfare. Part I overviews current maltreatment definitions in the context of the developmental psychopathology (DP) framework that has guided maltreatment research for over 40 years. Part II describes the ongoing debate about the disproportionalities of minoritized children at multiple decision-making stages of the child welfare system and the role that racism plays in many minoritized families' experience of this system. Part III offers alternative interpretations for the lack of concordance between prospective, official records of childhood maltreatment and retrospective self-reports, and for the differential associations between each format of data with health outcomes. Moving forward, we recommend that future DP research on childhood maltreatment apply more inclusive, diversity and equity-informed approaches when assessing and interpreting the effects of childhood maltreatment on lifespan and intergenerational outcomes. We encourage future generations of DP scholars to use assessment methods that affirm the lived experiences of individuals and families who have directly experienced maltreatment and the child welfare system.

Research Review: Why do prospective and retrospective measures of maltreatment differ? A narrative review

BACKGROUND

Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped.

METHODS

In this review, we draw on multi-disciplinary research and present an integrated framework to explain maltreatment measurement disagreement.

RESULTS

We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment.

CONCLUSIONS

A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment-related psychopathology and targets for novel interventions.

The prevalence and profiles of adverse childhood experiences and their associations with adult mental health outcomes in China: a cross-sectional study

Background

Adverse childhood experiences (ACEs) are common and associated with mental disorders. However, the prevalence and co-occurrence of ACEs and their association with mental health outcomes among Chinese adults have not been well demonstrated.

Methods

China Mental Health Survey, a cross-sectional nationally representative survey consisting of 28,140 adults, was conducted from July 2013 to March 2015. Twelve ACEs and mental health outcomes, including mood disorder, anxiety disorder, substance-use disorder, and suicide were measured using the Composite International Diagnostic Interview (CIDI) 3.0 in a weighted representative subsample of 9378 respondents. Latent class analysis was used to identify the co-occurrence profiles of ACEs, and logistic regression was applied to examine the association between ACEs and mental health outcomes. Population-attributable fractions (PAFs) were calculated to quantify the attribution of ACEs to these outcomes.

Findings

Among the 9378 respondents, the weighted count (proportion) of females was 4642 (49.5%), with a weighted mean (SD) age of 43.0 (15.8) years. In this study, 27.1% of respondents showed at least one ACE, with multiple ACEs common (37.6%) among those affected. Neglect was the most prevalent ACE (11.3%), followed by physical abuse (9.1%). Latent class analysis identified four co-occurrence profiles: low risk of ACEs, maltreatment, caregiver's maladjustment and parental loss. The strongest association with mental health outcomes was found in the caregiver's maladjustment group (OR, 4.9; 95% CI, 3.2-7.6). Estimates of PAFs indicated that all ACEs together explained 39.4% (95% CI, 31.3%-47.4%) of observed mental health outcomes. Gender differences were noted in prevalence and associations with outcomes.

Interpretation

ACEs are highly prevalent and interrelated in China, attributing to over one-third of the mental disorder burden. In resource-limited settings, prioritizing the reduction of the most prevalent and impactful ACEs through education and policy can more effectively alleviate the disease burden.

Funding

The National Twelfth Five-Year Plan for Science and Technology Support from the Chinese Ministry of Science and Technology (grant numbers 2012BAI01B01 & 2015BAI13B00), and the National Key R&D Program of China (grant numbers 2017YFC0907800 and 2017YFC0907801).

Childhood adversity and health: The mediating roles of emotional expression and general trust

Introduction

This study examined whether adverse childhood experiences, positive emotional expressivity in personal (i.e., expressing positive emotions when good things happened to oneself) and social settings (i.e., expressing positive emotions when good things happened to others such as friends or family), and general trust predict levels of happiness and loneliness among American and Japanese participants. We also explored whether these two types of emotional expression and general trust mediate the relationship between adverse childhood experiences and happiness/loneliness.

Methods

American and Japanese participants who agreed to participate in the current study first completed the Subjective Happiness Scale. Next, they answered the Emotion Expression Questionnaire, the 5-item General Trust Scale, and the revised UCLA Loneliness Scale. They then responded to the Risky Family Questionnaire. Finally, they answered demographic questions (e.g., age, gender). We hypothesized that regardless of culture, adverse childhood experiences would be negatively (positively) associated with happiness (loneliness), while positive emotional expression in personal and social settings and general trust would be positively (negatively) related to happiness (loneliness). We also predicted that positive emotional expression in both personal and social settings, as well as general trust, would mediate the relationships between adverse childhood experiences and happiness/loneliness.

Results

As expected, adverse childhood experiences were negatively (positively) associated with happiness (loneliness), while positive emotional expression in personal and social settings and general trust were positively (negatively) related to happiness (loneliness). Besides, positive emotional expression in a personal situation mediated the relationships between adverse childhood experiences and happiness/loneliness, such that greater early life adversity was negatively linked to positive emotional expressivity in a personal setting, which, in turn, predicted lower happiness and higher loneliness.

Discussion

The present study advances the understanding of psychological mechanisms linking adverse childhood experiences to happiness and loneliness by highlighting the significant role of positive emotional expression in a personal situation. This result underscores the importance of developing therapeutic practices and public health strategies that foster authentic emotional expression in response to personal achievement or fortune, regardless of cultural background.

The Impact of Maternal Childhood Trauma on Children's Problem Behaviors: The Mediating Role of Maternal Depression and the Moderating Role of Mindful Parenting

Objective

This study investigates the impact of maternal childhood trauma on children's problem behaviors, focusing on the mediating role of maternal depression and the moderating role of mindful parenting.

Methods

The study used a convenience sampling method to survey 385 mother-child pairs from kindergartens in Jinan, China. Data were collected in two waves, and various validated questionnaires were used to assess maternal childhood trauma, depression, mindful parenting, and children's problem behaviors.

Results

Maternal childhood trauma positively predicted children's problem behaviors. Maternal depression was found to mediate this relationship. Mindful parenting moderated the effects of maternal childhood trauma and depression on children's problem behaviors, with high levels of mindful parenting mitigating these adverse effects.

Conclusion

Maternal childhood trauma impacts children's problem behaviors both directly and indirectly through maternal depression. Mindful parenting serves as a protective factor, reducing the negative impact of maternal childhood trauma and depression on children's problem behaviors. These findings highlight the importance of interventions aimed at enhancing mindful parenting practices to improve child outcomes.

Childhood Maltreatment and Electrodermal Reactivity to Stress Among Pregnant Women

There are competing theoretical hypotheses regarding the consequences of early adversity, such as childhood maltreatment, for individuals' autonomic nervous system activity. Research examining potential implications of child maltreatment for sympathetic nervous system activity, specifically, is scarce. In this preregistered study, we examined whether childhood maltreatment history is associated with pregnant adults' sympathetic responses to different stressors. This population is particularly relevant, given potential intergenerational consequences of pregnant individuals' physiological responses to stress. Pregnant women's (N = 162) electrodermal levels were recorded while completing the Trier Social Stress Test (TSST), which elicits social-evaluative threat, and while watching a video of an unfamiliar infant crying, which was intended to activate the attachment system. Pregnant women's retrospective reports of childhood maltreatment were negatively associated with their electrodermal reactivity to the TSST and to the video of the infant crying. Follow-up analyses indicated that these associations were specific to reported experiences of childhood abuse and not childhood neglect. Altogether, these findings indicate that self-reported childhood maltreatment experiences, and childhood abuse in particular, may result in blunted activity of the sympathetic nervous system in response to multiple types of stressors.

Evaluating the Psychometric Properties of the Sexual and Gender Minority Adverse Childhood Experiences Scale Among Sexual Minority Men and Women

BACKGROUND

Adverse childhood experiences (ACEs) are known determinants of negative health outcomes. Sexual and gender minority (SGM) individuals have higher ACE scores than non-SGM individuals. The SGM-ACE scale was developed to better assess this population but is not yet validated in SGM subgroups.

AIMS

This study aims to validate the sexual and gender minority adverse childhood experiences (SGM-ACE) scale among sexual minority men (SMM) and sexual minority women (SMW), while testing measurement invariance across both groups.

METHODS

A cross-sectional survey included 530 sexual minority adults (265 men, 265 women) in the United States. Cronbach's alpha established internal consistency reliability. Validity was assessed via confirmatory factor analysis (CFA) for the SGM-ACE's theoretical structure and Pearson's correlations for concurrent validity with substance use outcomes (alcohol, cannabis, and drugs). Multigroup structural equation modeling (SEM) determined measurement invariance between SMM and SMW.

RESULTS

The CFA of the original model exhibited good fit. Fit was improved after removing the institutionalization item, chi-square (χ2) = 14.26, degrees of freedom (df) = 9, p = 0.113, minimum discrepancy (CMIN/df) = 1.59, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.03, 90% confidence interval (CI): (0.00-0.06), and standardized root mean square residual (SRMR) = 0.02. Internal consistency reliability was established (α = 0.78). SGM-ACE exhibited weak, yet significant relationships with each substance use outcome. Multigroup SEM indicated measurement invariance between SMM and SMW.

CONCLUSION

This study provides psychometric validation of the SGM-ACE, establishing measurement invariance between SMM and SMW. Future research should explore its utility in diverse SGM minority subgroups.

The Chain Mediation Effect of Victimization and Neuroticism on the Association Between Sexual Orientation and Depressive Symptoms: A Prospective Birth Cohort Study

This study tested whether sexual orientation differences in depressive symptoms were partially explained by the chain mediation effect of neuroticism and victimization. Using the Avon Longitudinal Study of Parents and Children from the UK (N = 4647, 36.52% men, 88% White), self-reported neuroticism, sexual orientation, and depressive symptoms were measured at age 13.5, 21, and 22 years, respectively. Childhood abuse between birth and age 11 years and the individuals' experiences of being bullied at age 17.5 years were measured as the components of victimization. Structural equation modeling was used to analyze the data. Non-heterosexual individuals reported higher depressive symptoms than heterosexual individuals, with a total effect (standardized path coefficient) of 0.590 and 0.768 for men and women, respectively. This association was partially explained by childhood abuse (indirect effect = 0.043 and 0.046 for men and women, respectively) and neuroticism directly (indirect effect = 0.036 and 0.056 for men and women, respectively). Sexual orientation differences in depressive symptoms were also partially explained by a path through increased risk of experiencing childhood abuse leading to higher levels of neuroticism (indirect effect = 0.004 and 0.009 for men and women, respectively) and by a path through higher levels of neuroticism leading to increased risk of being bullied (indirect effect = 0.004 and 0.002 for men and women, respectively). The findings suggest that while some of the association between sexual orientation and depression might be explained by neuroticism and experiences of victimization measured prospectively, these factors do not account for most of this relationship.

Why do prospective and retrospective measures of childhood maltreatment differ? Qualitative analyses in a cohort study

BACKGROUND

Research indicates that prospective and retrospective measures of maltreatment often identify different groups of individuals, yet the reasons for these discrepancies remain understudied.

OBJECTIVE

This study explores potential sources of disagreement between prospective and retrospective measures of maltreatment, utilising qualitative data from interviewers' notes.

PARTICIPANTS AND SETTING

The Environmental Risk Longitudinal Twin Study includes 2232 children followed from ages 5-18. Prospective measures relied on caregiver interviews and researcher observations from ages 5-12, while retrospective measures involved self-reports via the Childhood Trauma Questionnaire at age 18.

METHODS

We purposively sampled written interviewer notes from 36 participants who reported more types of maltreatment retrospectively than prospectively ('new reports' group) and 31 participants who reported fewer types retrospectively than prospectively ('omitted reports' group). We conducted a framework analysis of the notes, comparing between the two groups to explore explanations for measurement disagreement.

RESULTS

Three categories of themes emerged related to measurement discrepancies: challenges with prospective measures, highlighting reasons given by the 'new reports' group for why maltreatment went undetected or was not adequately responded to prospectively; challenges with retrospective measures that highlight difficulties with openness and accuracy of self-reports; and differences in appraisals of violence or distressing childhood experiences between the two groups that might lead to new or omitted retrospective reports.

CONCLUSIONS

Our findings underscore potential mechanisms underlying the disagreement between prospective and retrospective measures, contributing to better understanding of these different constructs and more balanced interpretation of related findings.

Child maltreatment in a high adversity context: Associations of age, type and timing of exposure with psychopathology in middle childhood

BACKGROUND

While cumulative childhood maltreatment (CM) has been linked to psychopathological outcomes, recent studies point to the relevance of the type and timing of exposure. The aim of the current study was to better understand their importance beyond the cumulative burden of CM for psychopathological symptoms in middle childhood.

METHODS

A total of N = 341 children (M = 9.92, SD = 1.51) were interviewed to assess trauma load (UCLA - University of California at Los Angeles Event List), exposure to CM (pediMACE - Maltreatment and Abuse Chronology of Exposure - Pediatric Interview) and different outcomes of psychopathology (UCLA Posttraumatic Stress Disorder Reaction Index, Children's Depression Inventory (CDI), Strengths and Difficulties Questionnaire (SDQ). We employed conditioned random forest regression, incorporating type, timing, and cumulative indicators of CM, to assess the importance of each predictor simultaneously.

RESULTS

Exposure to CM (abuse, neglect and cumulative indicators) exhibited a robust association with psychopathological outcomes. Recent abuse and recent neglect showed most robust associations with outcomes, neglect was stronger related to internalizing problems and timing of exposure showed clear associations with diverse pathological outcomes.

CONCLUSION

Beyond the cumulative burden, type and timing of CM show direct and diverse associations to pathological outcomes in middle childhood. Our results highlight the critical importance of early and detailed identification of CM, particularly recent exposure. This finding is valuable for researchers and clinicians, as it can refine diagnostic assessments and pave the way for effective early intervention strategies for affected children.

The Continuity of Adversity: Negative Emotionality Links Early Life Adversity With Adult Stressful Life Events

Adversity that exhibits continuity across the life course has long-term detrimental effects on physical and mental health. Using 920 participants from the Dunedin Study, we tested the following hypotheses: (1) children (ages 3-15) who experienced adversity would also tend to experience adversity in adulthood (ages 32-45), and (2) interim personality traits in young adulthood (ages 18-26) would help account for this longitudinal association. Children who experienced more adversity tended to also experience more stressful life events as adults, β=.11, 95% CI [.04, .18], p=.002. Negative emotionality-particularly its sub-facet alienation, characterized by mistrust of others-helped explain this childhood-to-midlife association (indirect effect: β=.06, 95% CI [.04, .09], p<.001). Results were robust to adjustment for sex, socioeconomic origins, childhood IQ, preschool temperament, and other young-adult personality traits. Prevention of early-life adversity and treatment of young-adult negative emotionality may reduce vulnerability to later life stress and thereby promote the health of aging adults.

Prediction of depressive symptoms in young adults by polygenic score and childhood maltreatment: Results from a population-based birth cohort

Childhood maltreatment is linked with later depressive symptoms, but not every maltreated child will experience symptoms later in life. Therefore, we investigate whether genetic predisposition for depression (i.e., polygenic score for depression, PGSDEP) modifies the association between maltreatment and depressive symptoms, while accounting for different types of maltreatment and whether it was evaluated through prospective and retrospective reports. The sample included 541-617 participants from the Quebec Longitudinal Study of Child Development with information on maltreatment, including threat, deprivation, assessed prospectively (5 months-17 years) and retrospectively (reported at 23 years), PGSDEP and self-reported depressive symptoms (20-23 years). Using hierarchical linear regressions, we found that retrospective, but not prospective indicators of maltreatment (threat/deprivation/cumulative) were associated with later depressive symptoms, above and beyond the PGSDEP. Our findings also show the presence of gene-environment interactions, whereby the association between maltreatment (retrospective cumulative maltreatment/threat, prospective deprivation) and depression was strengthened among youth with higher PGSDEP scores. Consistent with the Diathesis-Stress hypothesis, our findings suggest that a genetic predisposition for depression may exacerbate the putative impact of maltreatment on later depressive symptoms, especially when maltreatment is retrospective. Understanding the gene-environment interplay emerging in the context of maltreatment has the potential to guide prevention efforts.

Child maltreatment and executive function development throughout adolescence and into young adulthood

Child maltreatment impacts approximately one in seven children in the United States, leading to adverse outcomes throughout life. Adolescence is a time period critical for the development of executive function, but there is little research examining how abuse and neglect may differently affect the developmental trajectories of executive function throughout adolescence and into young adulthood. In the current study, 167 adolescents participated at six time points from ages 14 to 20. At each time point, adolescents completed behavioral tasks measuring the three dimensions of executive function (working memory, inhibitory control, and cognitive flexibility). Neglect and abuse in early life (ages 1-13) were reported at ages 18-19. Unconditional growth curve models revealed age-related improvement in all three executive function dimensions. Conditional growth curve models tested the prospective effects of recalled neglect and abuse on the developmental trajectories of executive function. The results revealed that neglect was associated with developmental changes in working memory abilities, such that greater levels of neglect during ages 1-13 were associated with slower increases in working memory abilities across ages 14-20. These findings highlight the adverse consequences of early neglect experiences shown by delayed working memory development during adolescence into young adulthood.

The effect of polygenic risk score and childhood adversity on transdiagnostic symptom dimensions at first-episode psychosis: evidence for an affective pathway to psychosis

Childhood adversity is associated with various clinical dimensions in psychosis; however, how genetic vulnerability shapes the adversity-associated psychopathological signature is yet to be studied. We studied data of 583 First Episode Psychosis (FEP) cases from the EU-GEI FEP case-control study, including Polygenic risk scores for major depressive disorder (MDD-PRS), bipolar disorder (BD-PRS) and schizophrenia (SZ-PRS); childhood adversity measured with the total score of the Childhood Trauma Questionnaire (CTQ); and positive, negative, depressive and manic psychopathological domains from a factor model of transdiagnostic dimensions. Genes and environment interactions were explored as a departure from a multiplicative effect of PRSs and total CTQ on each dimension. Analyses were adjusted for age, sex, 10 PCA, site of recruitment and for medication. A childhood adversity and PRS multiplicative interaction was observed between A) the CTQ and MDD-PRS on the predominance of positive (β = 0.42, 95% CI = [0.155, 0.682], p = 0.004); and depressive (β = 0.33, 95% CI = [0.071, 0.591], p = 0.013) dimensions; B) between the CTQ and BD-PRS on the positive dimension (β = 0.45, 95% CI = [0.106, 0.798], p = 0.010), and C) with the CTQ and SZ-PRS on the positive dimension (β = -0.34, 95% CI = [-0.660, -0.015], p = 0.040). Bonferroni corrected p-value of significance was set at 0.0125. In conclusion, despite being underpowered, this study suggests that genetic liability for MDD and BD may have a moderating effect on the sensibility of childhood adversity on depressive and positive psychotic dimensions. This supports the hypothesis of an affective pathway to psychosis in those exposed to childhood adversity.

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BACKGROUND

The COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents' wellbeing during these periods.

METHODS

Using a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.

RESULTS

Through thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents' systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools' strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.

CONCLUSIONS

The findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents' capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents' systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

Association between adverse childhood experiences and pregnancy morbidities: A nationwide online-based cross-sectional study

OBJECTIVE

To examine the association between adverse childhood experiences (ACEs) and pregnancy morbidities, including preterm birth (PTB), gestational diabetes (GDM), preeclampsia, and small-for-gestational-age (SGA) among the general population in Japan.

METHODS

The data were from the JACSIS study, an online-based nationwide survey conducted from July to August 2021 in Japan (N = 5444). ACEs included physical, sexual, and psychological abuse, neglect, childhood poverty, bully victimization, domestic violence, parental death, and parental divorce. Pregnancy morbidities, including PTB, GDM, preeclampsia, and SGA were identified through questionnaires. A multivariable logistic regression model was applied.

RESULTS

Of 5444 women, 2778 (51.0%) had no ACEs, and 374 (6.9%) had four or more ACEs. A dose-response association was found between total ACE score and PTB and preeclampsia (p-value: 0.016 and 0.001). Women with four or more ACE scores showed higher risks of preeclampsia (adjusted odds ratio [aOR] [95% confidence interval, CI]: 3.06 [1.57-5.94], p-value: 0.001). Besides, those with two or three ACEs had higher risks of PTB (aOR [95%CI]: 1.42 [1.01-2.02], p-value: 0.046, and aOR [95%CI]: 1.61 [1.04-2.50], p-value: 0.041), and women with one ACE showed a higher risk of GDM (aOR [95%CI]: 1.34 [1.02-1.77], p-value: 0.035). SGA was not associated with ACEs.

CONCLUSION

ACEs were associated with an increased risk of PTB, preeclampsia, and GDM, but not SGA among the general population in Japan.

The questions on violence (FOV) tool for interpersonal violence inquiry in Swedish healthcare settings - evaluation of content validity, face validity and test-retest reliability

BACKGROUND

Previous research indicates that routine inquiry or screening conducted by healthcare providers may significantly increase the identification of interpersonal violence. There is a lack of comprehensive instruments to routinely assess patients about interpersonal violence and violence against children in the household. The purpose of this study was to assess the content validity, face validity and reliability of the Questions on Violence (FOV) tool, an instrument specifically designed for routine inquiries about interpersonal violence in healthcare settings within the Swedish context.

METHODS

The content validity, face validity and reliability of the FOV instrument was assessed through (1) a content validity index with six experts in the field of intimate partner violence, (2) cognitive interviews with nine patients recruited from a primary healthcare facility, and (3) an evaluation of the test-retest reliability based on responses from 37(50.0%) university students. The intraclass correlation coefficient, model 2.1, was calculated to assess the degree of correlation and agreement between the two measurements.

RESULTS

Calculations based on the content validity index indicated that five out of seven items had excellent content validity (≥ 0.78). The average content validity index of included items was 0.88, which is slightly below the recommended threshold for excellent content validity. The results based on the cognitive interviews revealed that participants found the seven items to be relevant and easy to understand. Overall, the participants agreed that the concept of 'close relationships' primarily encompassed intimate partners, family members, and close friends. The value of the intraclass correlation coefficient was 0.85 (0.77-0.91; CI 95%), indicating good reliability with an interval of good to excellent test-retest reliability.

CONCLUSIONS

The results demonstrate that the seven-item FOV instrument has good content and face validity as well as good to excellent test-retest reliability. The current study provides healthcare professionals with a short yet comprehensive instrument for identifying patients who have experienced or perpetrated different forms of interpersonal violence.

The Impact of Adverse Childhood Experiences on Cognitive Control Across the Lifespan: A Systematic Review and Meta-analysis of Prospective Studies

Adverse childhood experiences (ACEs) are strongly associated with impaired cognitive control, yet research on ACEs' effects across cognitive control domains-working memory, cognitive flexibility, and inhibitory control-remains sparse. This systematic review and meta-analysis evaluated the overall impact of ACEs on each of these cognitive control domains and explored moderating factors such as age, gender, cognitive control paradigms, and ACEs subtypes based on the dimensional model of adversity and psychopathology. A database search was conducted in SCOPUS, MedLine, PsycINFO, and Web of Science. Only prospective studies were included to ensure temporal order inferences, with at least two data collection points, assessing ACEs at baseline (T1) and cognitive control during follow-up (T2). Thirty-two studies (N = 26,863) producing 124 effect sizes were analyzed. Three-level meta-analyses revealed small-to-medium negative associations between ACEs and overall cognitive control (g = -0.32), and in each domain: working memory (g = -0.28), cognitive flexibility (g = -0.28), and inhibitory control (g = -0.32). The negative associations between ACEs and cognitive control were consistent across age, gender, and cognitive control paradigms. ACEs subtypes moderated the association with cognitive flexibility (p = .04) but not working memory or inhibitory control. Specifically, the deprivation subtype exhibited a stronger negative association with cognitive flexibility compared to threat and threat-and-deprivation subtypes. These findings highlight the pervasive negative impact of ACEs on cognitive control across ages and emphasize the need for targeted interventions. Implications, current gaps, limitations in research, and future study recommendations are discussed.

The association between patterns of exposure to adverse life events and the risk of chronic kidney disease: a prospective cohort study of 140,997 individuals

Exposure to adverse life events is linked to somatic disorders. The study aims to evaluate the association between adverse events at varying life stages and the risk of chronic kidney disease (CKD), a condition affecting about 10% population worldwide. This prospective cohort study included 140,997 participants from the UK Biobank. Using survey items related to childhood maltreatment, adulthood adversity and catastrophic trauma, we performed latent class analysis to summarize five distinct patterns of exposure to adverse life events, namely "low-level exposure", "childhood exposure", "adulthood exposure", "sexual abuse" and "child-to-adulthood exposure". We used Cox proportional hazard regression to evaluate the association of patterns of exposure to adverse life events with CKD, regression-based mediation analysis to decompose the total effect, and gene-environment-wide interaction study (GEWIS) to identify interactions between genetic loci and adverse life events. During a median follow-up of 5.98 years, 2734 cases of incident CKD were identified. Compared with the "low-level exposure" pattern, "child-to-adulthood exposure" was associated with increased risk of CKD (hazard ratio 1.37, 95% CI 1.14 to 1.65). BMI, smoking and hypertension mediated 11.45%, 9.79%, and 4.50% of this total effect, respectively. Other patterns did not show significant results. GEWIS and subsequent analyses indicated that the magnitude of the association between adverse life events and CKD differed according to genetic polymorphisms, and identified potential underlying pathways (e.g., interleukin 1 receptor activity). These findings underscore the importance of incorporating an individual's psychological encounters and genetic profiles into the precision prevention of CKD.