Extending the ACEs Framework: Examining the Relations Between Childhood Abuse and Later Victimization and Perpetration With College Men

Impact of Adverse Childhood Experiences in Young Adults and Adults: A Systematic Literature Review

BACKGROUND

Investigations have shown the different impacts that ACEs have on an individual's adult life, on both physical and mental health, but they have not yet shown the issue of the influence of ACEs on adults and young adults. Objective/Participants and Setting: This systematic review, performed according to the PRISMA norms and guidelines, intended to understand the most frequent outcomes of adverse childhood experiences in the life of young adults and adults.

METHODS

Studies were identified through multiple literature search databases at EBSCOhost, Web of Science, and PubMed April 2023, and a total of 279 studies, published between 1999 and 2002, were excluded, 256 because of multiple factors: being duplicates, showing statistical analysis with correlations only, being systematic reviews or case studies, comprising individuals under the age of 18, and not meeting the intended theme; ultimately, we selected for the review a total of 23 studies.

RESULTS AND CONCLUSIONS

The impacts of the various articles are subdivided into three main themes: antisocial and criminal behaviour; sexual Behaviour and intimate partner violence; and attachment, quality of life, and therapeutic alliance.

Hostile Masculinity, Male Peer Support for Violence, and Problematic Anger: Linking Childhood Abuse to Men's Partner Violence Perpetration

Child abuse and masculinity have been linked to intimate partner violence (IPV) perpetration. However, there is a lack of work examining multiple aspects of masculinity as links between early abuse experiences and men's IPV perpetration. Grounded in notions of gendered power and patriarchy, this study aimed to examine hostile masculinity, male peer support for violence against women, and problematic anger as aspects of masculinity connecting childhood victimization and men's violence against women. Structural equation modeling results demonstrated that childhood adversity was indirectly related to IPV perpetration via the proposed factors. However, various patterns emerged based on the type of childhood abuse experienced. Practice-based implications are offered.

Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa

Background

Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA).

Objective

To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA.

Participants and setting

Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years.

Methods

Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated.

Result

ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes.

Conclusion

ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.

"'I am a Man. How Could I Possibly Have Been Raped?' Men Making Sense of Their Experiences With Sexual Violence"

Sexual violence among college students is an enduring issue that can shape adverse outcomes for victim survivors. The gender dynamics of college sexual assault and rape include rates of women overrepresented as victims and men as perpetrators. Dominant cultural frames reinforcing the (hetero)normative gendered sexual scripts of masculinity often preclude men from being considered as legitimate victims of sexual violence, despite evidence documenting their victimization. The present study contributes to knowledge of men's experiences of sexual violence by sharing the narratives of 29 college men survivors and how they make sense of their experiences. Through open and focused thematic qualitative coding, findings revealed how men struggled to understand their victimization experiences within cultural frameworks that exclude men as victims. Participants engaged in complex linguistic processes (i.e., "epiphanies") to process their unwanted sexual encounter, in addition to altering their sexual behavior after experiencing sexual violence. Findings can inform programing and interventions to be more inclusive of supporting men as victims.

The Role of Sexual Scripts in the Relationship Between Pornography Use and Sexual Coercion

Decades of research have examined the association between pornography use and sexual coercion, with the most significant relationships found between more deviant genres of pornography use and sexual violence. However, researchers have yet to provide a comparable body of research examining the theoretical mechanism of this association. One theory that has shown promise in explaining the association between certain variables of pornography use and sexual coercion is the sexual script theory. In this theory, scripts can best be understood as a mechanism through which society defines and disseminates what is acceptable, desirable, and pleasurable sexual conduct. Studies examining the application of the sexual script theory to the association between pornography use and sexual coercion have found that pornography use has a significant indirect effect on sexual coercion and correlates of sexual coercion through sexual scripts. The current study sought to extend this line of inquiry by examining the relationship between pornography use, sexual scripts, and sexual coercion. A structural equation model examining direct and indirect effects of sexual scripts and pornography use on sexually coercive behaviors was run using a sample of 390 college-aged males. Results of the study indicated there were significant direct and indirect effects in the model. Specifically, pornography use, while not directly related to sexually coercive behaviors, had a significant indirect effect on sexual coercion through sexual scripts. These results further support the use of the sexual scripts theory to help explain the relationship between pornography use and sexual coercion.

The Relationship of Risky Online Behaviors and Adverse Childhood Experiences to Online Sexual Victimization Among Korean Female Adolescents

Prior research has demonstrated that online sexual victimization (OSV) is a significant social problem and is associated with adolescents' negative developmental outcomes. However, it remains unclear whether adolescents' risky online behaviors and offline victimization are related to the risk of OSV. The present study examined whether female adolescents' risky online behaviors (mood regulation through the Internet, ingratiating behavior, disclosure of personal information, harassing behavior, talking with someone met online, and sexual behavior) and offline victimization (adverse childhood experiences [ACEs]) would be associated with OSV. This study recruited female adolescents and their mothers within six metropolitan cities and provinces of residential areas of South Korea. A total of 509 female adolescents participated in the survey (aged 13-18 years). The present study employed multivariate regression to examine the relationship of risky online behaviors and offline victimization to the experience of OSV. Female adolescents' risky online behaviors (harassing behavior, talking with someone met online, and sexual behavior) were significantly associated with OSV, and those with high exposure to maltreatment and family dysfunction during childhood were more at risk of OSV than adolescents with low exposure to ACEs. The results suggest that it is important to address the effects of risky online behaviors and exposure to offline victimization on female adolescents' sexual victimization online. Identifying risky online behaviors and offline victimization related to OSV can help researchers and practitioners further understand female adolescents' online victimizations in the context of offline and online dynamics.

Adverse Childhood Experiences: Mental Health Consequences and Risk Behaviors in Women and Men in Chile

Studies conducted worldwide indicate that adverse childhood experiences (ACEs) are among the most intense and frequent sources of stress, considerably influencing mental and physical health while also resulting in risk behaviors in adulthood.

METHODOLOGY

We used data from the Pilot National Survey of Adversity and Sexual Abuse in Childhood (2020), conducted by CUIDA UC, which comprises the Adverse Childhood Experiences International Questionnaire [ACE-IQ] (Adapted). The cross-sectional methodology used made it possible to directly calculate the prevalence of adverse childhood experiences in the population sampled, at a single point in time. We performed a bivariate and univariate descriptive analysis, a correlation analysis, and a multivariate analysis, all of which will be detailed in the section entitled "General Data Analysis Procedure".

RESULTS

We found equally high rates of adverse childhood experiences in men and women, with community violence exhibiting the highest prevalence. We found significant low- to moderate-sized associations between the multiple types of ACEs considered and mental health problems, substance use problems, criminal behaviors, and intrafamily violence (IFV), which differed between men and women. Significant correlations were detected between the ACE score and mental health, substance use, criminal behaviors, and IFV in both men and women. Importantly, ACEs were found to be predictors of all of these variables, with differences observed between men and women.

CONCLUSIONS

Nearly all participants reported having had at least one ACE and more than half reported had four or more ACEs. Those who had had four or more ACEs were more likely to report problems throughout their life. Having an ACE of any type was found to be a better predictor of mental health problems and IFV in men than in women and might be a stronger risk factor for substance use and criminal behaviors in women than in men.

Associations between Adverse Childhood Experiences within the Family Context and In-Person and Online Dating Violence in Adulthood: A Scoping Review

Background: Adverse childhood experiences (ACEs) are a common pathway to risky behaviour, violence or re-victimisation, disability, illness, and premature mortality and, as such, may be associated with victimisation and perpetration of dating violence not only in adolescence but also in adulthood. Method: A scoping review was performed in accordance with PRISMA guidelines. Four databases (Web of Science, Scopus, PubMed, and PsycINFO) were used to search for studies published between 2000 and 2021 that analysed the relationship between adverse childhood experiences within the family context and the perpetration or victimisation of dating violence in adulthood. Results: The search yielded 599 articles, 32 of which met the inclusion criteria and were ultimately included in the review. Most of the study samples were from the United States. Most of the studies sampled university populations. The studies had a clear objective, were of an appropriate design, contained a detailed description of the sample, and used valid and reliable measurement instruments. Conclusion: This scoping review shows that the relationship between ACEs and perpetration and/or subsequent victimisation is complex and that, while adverse childhood experiences are a factor associated with adult dating violence, they are likely to coexist with other personal, family, and environmental problems. Therefore, adverse childhood experiences may not be a necessary or sufficient condition for experiencing dating violence.

Lifetime Prevalence of Victimization and Perpetration as Related to Men's Health: Clinical Insights

Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience (i.e., both expose and perpetration), age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence (perpetration, victimization, or both). The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system.

Charting a Course towards Resilience Following Adverse Childhood Experiences: Addressing Intergenerational Trauma via Strengths-Based Intervention

Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, the study of childhood adversity has blossomed, with expanded conceptualizations and assessments of ACEs. This review brings together various biological, psychological, and sociological principles that inform our understanding of ACEs and our approach to treatment. Specifically, we document the evolution of ACEs research, focusing on the intergenerational impact of ACEs, the importance of incorporating a resilience framework when examining ACEs, and implementing interventions that address adversity across generations and at multiple levels of the social ecology. Evidence is provided to support the evolving perspective that ACEs have long-lasting effects beyond the ACE(s)-exposed individual, with significant attention to the impact of parental ACEs on child development. An intergenerational and multilevel approach to understanding and addressing ACEs offers specific areas to target in interventions and in public policy.

Psychological intervention with adult victims of sexual abuse: A comprehensive review

Child sexual abuse (CSA) is a phenomenon that is ubiquitous to all cultures and social classes. It has short- and long-term consequences, with specific treatment models that have been developed and adapted from psychological intervention models. A wide variety of studies have sought to evaluate the results of treatments with adult CSA survivors. This study presents an overview of research on the treatment of adult victims of CSA, by reviewing the existing literature on the types of treatment and the most studied psychotherapeutic avenues, and reports the findings related to the efficacy of these treatments. It is possible to conclude that psychological intervention exhibits benefits in the reduction of symptoms resulting from the experience of CSA and demonstrates the need to conduct further research on the effectiveness of intervention.

Adverse Childhood Experiences and Early Maladaptive Schemas as Predictors of Cyber Dating Abuse: An Actor-Partner Interdependence Mediation Model Approach

The increasing role that new technologies play in intimate relationships has led to the emergence of a new form of couple violence, cyber dating abuse, especially among adolescents and young adults. Although this phenomenon has received increased attention, no research has investigated predictors of cyber dating abuse taking into account the interdependence of the two partners. The study examines adverse childhood experiences (abuse, neglect, and witnessed intimate partner violence) and early maladaptive schemas (emotional deprivation and abandonment) as possible predictors of young adults' perpetrated and suffered cyber dating abuse. Adopting a dyadic approach, mediational models in which adverse childhood experiences were assumed to be related to individual and partner's cyber dating abuse through individual early maladaptive schemas were tested. 134 couples completed online self-reports of the variables of interest, including a bidimensional measure of cyber dating abuse assessing pressure-aggression and control-monitoring. Actor-partner interdependence mediation model analyses were conducted. Results indicated that the emotional deprivation schema mediated the association between adverse childhood experiences and cyber dating abuse, whereas the abandonment schema did not. Specifically, more frequent experiences of emotional abuse and physical neglect during childhood were indirectly related to increased likelihood of perpetrating cyber dating pressure-aggression as well as of perpetrating and suffering cyber dating control-monitoring in both males and females. These associations were mediated by a stronger internalization of the emotional deprivation schema and were supported by both self-reported and partner-reported data. Also, a strong and direct association was found between childhood exposure to intimate partner violence by the opposite-sex parent and cyber dating pressure-aggression by females or control-monitoring by both males and females. These findings help to clarify the potential negative effects of specific adverse childhood experiences and early maladaptive schemas on the tendency to perpetrate and suffer cyber abuse in romantic relationships. The implications for prevention and treatment programs are noted and avenues for future research are described.

Adolescent Adverse Childhood Experiences and Risk of Adult Intimate Partner Violence

INTRODUCTION

Exposure to adverse experiences during adolescence may have significant implications for intimate partner violence during adulthood because it is during this developmental stage that many youth begin to have romantic relationships. Yet, few prospective longitudinal analyses on this topic exist. This study aims to fill a gap in the literature by examining the adverse childhood experiences during adolescence and intimate partner violence 15 years later during adulthood.

METHODS

Multilevel negative-binomial regression was used to examine the relationship between adolescent adverse childhood experiences (age 13-19 years) and adult intimate partner violence (age 28-34 years) in 499 participants over 5 waves of data from a 24-year longitudinal study (Wave 1: 1994) based in Flint, Michigan. Adolescent adverse childhood experiences included being a victim of violence, observed family conflict, parental intoxication, parental divorce, and observed community violence. Data analysis was conducted between 2019 and 2020.

RESULTS

First, investigators modeled the adverse childhood experience variables as a summary score to predict intimate partner violence during adulthood while controlling for known risk factors and individual random effects. Secondly, this study examined individual adverse childhood experiences iteratively to understand which adverse experiences predicted intimate partner violence in adulthood and found that observed community violence remained significant when accounting for all other adverse childhood experiences (β=0.276, p<0.05).

CONCLUSIONS

These findings support the negative effects of community violence in adolescence on later risk of intimate partner violence. Prevention interventions that focus on community health and violence prevention with a focus on healthy adolescent development may be pertinent in lowering intimate partner violence victimization in adulthood.

Intimate partner violence and lower relationship quality are associated with faster biological aging

The characteristics of people's relationships have relevance to health-high quality romantic relationships are associated with improved health whereas intimate partner violence is associated with poorer health. Recently, increased attention has been focused on the biological processes underpinning these associations. A geroscience approach-examining whether close relationship characteristics are associated with biological aging-would complement previous research focused on individual disease pathways. This study used participants from the Dunedin Study (N = 974) to investigate relationship characteristics and biological aging across almost 20 years, from age 26 to 45. Being involved in romantic relationships was associated with slower biological aging, β = -0.12, p < .001. This difference represented 2.9 years of aging over the two decades. Greater relationship quality was also associated with slower biological aging, β = -0.19, p < .001, whereas higher levels of partner violence were associated with faster biological aging, β = 0.25, p < .001. A 1 SD difference in these characteristics was associated with a difference of 1.0 and 1.3 years of aging over the two decades, respectively. Secondary analyses suggested that experiencing violence from a partner was more strongly associated with biological aging than perpetrating violence, and that the experience of physical violence was more strongly associated with aging than psychological violence. These findings suggest that the characteristics of romantic relationships have relevance for biological aging in midlife. Interventions designed to increase relationship quality and decrease partner violence could reduce future morbidity and early mortality by slowing people's biological aging. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Cumulative lifetime violence severity scale: development and initial testing among men

BACKGROUND

Knowledge of the relationship between men's health and violence is flawed by narrow and faulty conceptualization and measurement of violence that often results in attribution of health problems to one form or type of violence without consideration of other exposures. Our purpose is to describe the development and initial testing of the Cumulative Lifetime Violence Severity scale designed for use in health research to measure men's perceptions of the severity of their cumulative lifetime violence.

METHODS

We framed the dimensions of violence severity as: type (physical, psychological, sexual), timing (childhood, adulthood), focus (perpetrator, target), context, frequency, and degree of distress. Items reflecting these dimensions were vetted by local experts including individuals who identified as men, with particular attention to meaningful language for men. The measure was pretested, revised to 64 items, and tested for test-retest reliability prior to use in a study of 685 English-speaking Eastern Canadian men, ages 19 to 65 years. We used Principal Components Analysis to illuminate the underlying dimensionality of the items.

RESULTS

Principal Components Analysis yielded a 44-item 11 component solution that accounted for 64.06% of variance with good model fit and a Cronbach's alpha of .92. All dimensions of our conceptualization of violence severity were reflected in the components, except Adult Target Sexual Violence. Convergent validity between the Cumulative Lifetime Violence Severity-44 Scale and a global lifetime violence rating scale was r = .750 (p < .001) and concurrent validity was moderate and significant between the Cumulative Lifetime Violence Severity-44 scale and measures of mental health problems commonly experienced by people with violence histories.

CONCLUSIONS

The Cumulative Lifetime Violence Severity-44 scale shows promise as the first comprehensive measure of cumulative lifetime violence for health research that considers gender, individual distress and experiences as both perpetrator and target. Next steps include further exploratory analysis with a more diverse sample of men and confirmatory factor analysis.