Adverse childhood experiences among doctor of pharmacy students

OBJECTIVE

Adverse Childhood Experiences (ACEs) have demonstrated negative impact on physical, emotional, and cognitive health outcomes. This study aimed to assess prevalence of ACEs among Doctor of Pharmacy (PharmD) students, and their associations with mental health, substance use, academic performance, and sleep patterns.

METHODS

A cross-sectional survey was conducted on PharmD students at a private University. ACE scores, mental health history, substance use, academic performance, and sleep habits were self-reported. Descriptive statistics and chi-square tests were used for analysis.

RESULTS

From 54 participants across all cohorts of students in the curriculum (response rate: 19%), 48% reported ≥4 ACEs. A majority of students reported having been diagnosed with or sought treatment for depression (56%) or anxiety (67%), while 42.9% reported a history of contemplating suicide. Participants with ACE scores of ≥4 were more likely to have sought treatment for depression, any mental health condition, contemplated suicide, or used alcohol for mental health purposes. No differences in academic performance based on ACE scores were found.

CONCLUSION

High numbers of ACEs were common and linked to mental illness, suicidality, and use of alcohol for mental health purposes. While no direct academic impact was found in this small sample size, adopting a trauma-informed approach is crucial to supporting student well-being. Further research in this area is needed to optimize interventions to support academic and professional success among students with ≥4 ACEs.

Adverse Childhood Experiences and Quality of Life: A Mediating Role of Physical Activity

PURPOSE

Examine whether barriers to physical activity (PA) and PA level serve as serial mediators to the relationship between adverse childhood experiences (ACEs) and perceived quality of physical health. Design: Cross-sectional. Setting: A public university in Southeast United States.

SUBJECTS

Seventy-five participants (18- 49 years). Measures: Self-report measures related to ACEs, barriers to PA, amount of PA, and perceived quality of physical health.

ANALYSIS

Serial mediation analysis. Barriers to PA was a first-order mediator, and PA level was a second-order mediator between ACEs and perceived quality of physical health.

RESULTS

Barriers to PA and PA levels serially mediated the relationship between ACEs and perceived quality of physical health (c = -1.01, SE = .251, P = .0002, 95% CI [-1.50, -.499]). The direct effect of ACEs on perceived quality of physical health was nonsignificant when mediators were controlled (c' = -.383, SE = .252, P = .133, 95% CI [-.886, .120]). Higher ACE scores were associated with more barriers to PA, lower PA levels, and in turn, lower perceived quality of physical health.

CONCLUSION

The current study highlights specific pathways that contribute to the relationship between ACEs and perceived quality of physical health. Albeit limited by the sample size, preliminary data support prioritization of interventions that reduce barriers to PA when trying to increase PA in populations that are prone to early adversity.

Early-life adversities and later-life reproductive patterns in women with fully traced reproductive history

One of the most crucial determinants of early-life development is the experience of childhood adversities. However, limited evidence is available for how these experiences shape later-life reproductive outcomes in women. Here we test the association between early-life adversities and reproductive parameters in women. Post-reproductive women (N = 105; mean age = 59.7; SD = 10.09) were recruited at the Mogielica Human Ecology Study Site in Poland within a traditional population with a low prevalence of birth control usage and fully traced reproductive histories. Reproductive parameters, as well as exposure to early-life abuse and neglect, were assessed using questionnaires. Childhood adversity was associated negatively with age at menarche (p = 0.009). Analyses on specific subtypes revealed that compared to women who did not experience any kind of early-life adversities in childhood, those who were exposed to emotional (p = 0.007) and physical (p = 0.023) neglect had an earlier age at menarche, those who experienced emotional abuse reported an earlier age at first birth (p = 0.035), and those who were exposed to physical abuse gave birth to fewer number of sons (p = 0.010). Our results suggest that women exposed to childhood adversities experience earlier physiological reproductive readiness and timing of the first birth, but their overall biological condition might be impaired as they bear fewer sons.

A pilot study of the adverse childhood experiences-dimensions questionnaire (ACE-DQ): Associations with depression

BACKGROUND

Recent ACE research proposed items to assess ACE dimensions, such as the frequency or timing of adverse events, that can be added to the original ACE-Study Questionnaire.

OBJECTIVE

The goal of our study was to pilot-test the refined ACE-Dimensions Questionnaire (ACE-DQ) to determine its predictive validity and compare scoring approaches.

PARTICIPANTS AND SETTING

Cross-sectional online survey via MTurk with U.S. adults to collect data on the ACE-Study Questionnaire and the newly developed ACE dimension items, and mental health outcomes.

METHODS

We compared ACE exposure by assessment approach and their associations with depression outcomes. We used logistic regression to compare the predictive validity of different ACE scoring approaches for depression outcomes.

RESULTS

Participants (n = 450) were on average 36 years old, half were female, and the majority was White. Almost half reported depressive symptoms; approximately two-thirds had experienced ACEs. Participants reporting depression had significantly higher ACE scores. Using the ACE index, participants with ACEs were 45 % more likely to report depression symptoms than participants without ACEs (OR 1.45, 95%CI 1.33-1.58). When using perception-weighted scores, participants had smaller, yet significant odds of reporting depression outcomes.

CONCLUSIONS

Our results suggest that the ACE index may overestimate the impact of ACEs and the effects of ACEs on depression. Adding the comprehensive set of conceptual dimensions to more fully weigh participants' experience of adverse events can increase the accuracy of ACE measurement but will also increase participant burden considerably. We recommend including items to assess a person's perception of each adverse event for improved screening efforts and in research focused on cumulative adversity.

Childhood trauma and college student health: a review of the literature

The experience of childhood trauma is known to predict health-relevant outcomes across the lifespan. Previous reviews summarize existing knowledge of the implications of childhood trauma for health in young adults and adults more generally. The current theoretical review aims to integrate the existing literature on the relationship between childhood trauma and health-relevant outcomes specifically in college students, consolidating findings across specific health domains. Further, the following theoretical review highlights the need for more research in this area and discusses how college campuses may use the knowledge in this area of work to develop targeted interventions aimed at improving the health of college students who experienced trauma in childhood.

Does screening or routine enquiry for adverse childhood experiences (ACEs) meet criteria for a screening programme? A rapid evidence summary

BACKGROUND

Adverse childhood experiences (ACEs) are traumatic events in childhood that can have impacts throughout life. It has been suggested that ACEs should be 'screened' for, or routinely enquired about, in childhood or adulthood. The aim of this work is to review evidence for this against the United Kingdom National Screening Committee (UKNSC) programme criteria.

METHODS

A rapid review of evidence on ACEs screening was conducted using the approach of the UKNSC.

RESULTS

Good quality evidence was identified from meta-analyses for associations between ACEs and a wide range of adverse outcomes. There was no consistent evidence on the most suitable screening tool, setting of administration, and time or frequency of use. Routine enquiry among adults was feasible and acceptable to service users and professionals in various settings. A wide range of potentially effective interventions was identified. Limited evidence was available on the potential for screening or routine enquiry to reduce morbidity and mortality or possible harms of screening.

CONCLUSIONS

Based on the application of available evidence to UKNSC screening criteria, there is currently insufficient evidence to recommend the implementation of a screening programme for ACEs. Further research is needed to determine whether routine enquiry can improve morbidity, mortality, health and wellbeing.

The Adverse Childhood Experiences - International Questionnaire (ACE-IQ) in community samples around the world: A systematic review (part I)

BACKGROUND

The Adverse Childhood Experiences International Questionnaire (ACE-IQ) collects additional data (e.g., witness community violence/terrorism) than the previous version. Despite ACE-IQ is widely used and validated in several languages, no reviews focus on this measure.

OBJECTIVE

The main goals are to: 1) synthesize the ACE-IQ prevalence rates and average means among community samples, both for total ACE and single dimensions (e.g., intrafamily abuse, bullying); 2) discuss these data in light of the characteristics of studies and samples; 3) identify main research lines of the field.

PARTICIPANTS AND SETTING

The search for studies using the ACE-IQ with community participants was conducted on seven academic databases, including retrieval of grey literature. The screening process led to include 63 documents.

METHODS

A systematic review following the PRISMA guidelines was performed.

RESULTS

1) On average, 75% of community respondents experienced ACEs, with a mean of three, primarily emotional abuse and bullying. 2) Males experienced more ACEs, but they were underrepresented, as well as children and adolescents. Most studies were conducted in Asia or Africa, and different geographical areas showed different pathways of prevalence in subdimensions. 3) Most research focused on prevalence and relationships between ACE-IQ scores and respondents' mental and physical health, suicide and parenting, focusing on intrafamily ACEs more than on those outside the household.

CONCLUSIONS

Several issues emerged in terms of lack of reporting prevalence or means, lack of studies in Europe, America and Oceania, and no attention to collective/community/peer violence, plus a lack of consensus toward the dimensions of the ACE-IQ.

The dimensionality of adverse childhood experiences: A scoping review of ACE dimensions measurement

OBJECTIVE

Despite extensive research, the concept of adverse childhood experiences (ACEs) is not fully developed and there is low agreement on how the concept should be defined and measured. The purpose of this study was to 1) identify different conceptual dimensions associated with ACEs, such as timing or frequency; and 2) determine how these dimensions have been operationalized and analyzed to this point, in order to advance the conceptual understanding of ACEs.

METHODS

We conducted a scoping review of empirical journal articles on ACEs published after the original ACE-Study in 1998 to summarize the use of dimensions for the 10 conventional ACE domains. We used a PRISMA methodology to identify articles that assessed at least two of the 10 conventional ACE domains and at least two ACE dimensions. A standardized data extraction spreadsheet was used to record basic article information and specifics on ACE domains and dimensions.

RESULTS

Of 15,417 initial search results, 61 articles met all selection criteria. We identified four primary dimensions used for most ACE domains: frequency, timing, perception, and the role of the perpetrator. Additionally, we found several secondary and domain-specific dimensions, which relate to the intensity of the adverse event.

DISCUSSION

We identified the most commonly used ACE dimensions, but these lack standardized phrasing of items and response options. The inclusion of ACE dimensions may increase the accuracy of the association between ACEs and health outcomes and provide for more tailored treatment plans for people who have experienced ACEs. Future research should include a more comprehensive list of ACE domains and aim to develop a clearly articulated, standardized approach to assessing and analyzing ACE dimensions.

The "Best of 2020 List" of Health Promotion Researchers

Each year, the editorial team of the American Journal of Health Promotion selects our "Best of the Year List" of health promotion studies from the prior year. This editorial features the Editor's picks, the Editor in Chief's favorites and other award categories for the research and writing published in 2020 in this journal. Our criteria for selection includes: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed; whether the paper is often cited and downloaded; if the study findings offer a unique contribution to the literature; and if the paper is well-written and enjoyable to read. Awardees in 2020 offered new insights into confronting systemic racism, the impact of state health policies on eating behaviors, the role of leaders in influencing employee health practices and the role of physicians in influencing patient health practices. You will see how researchers are studying psychological and emotional resiliency in ever more specific populations.

Examining the Role of Childhood Adversity on Excess Alcohol Intake and Tobacco Exposure among US College Students

BACKGROUND

Adverse childhood experiences (ACEs) are often associated with substance use behaviors such as drinking excess alcohol and tobacco use. Resilience may protect individuals from engaging in these maladaptive behaviors following ACEs. Objectives: We examined the associations between ACEs and excessive alcohol consumption, and ACEs and tobacco intake and exposure among diverse college students, and whether resilience buffered this relationship. Methods: We conducted a cross-sectional online survey in October 2018 with students at a large Southern university to assess ACEs, levels of resilience, and students' health behaviors. We used the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) and the Brief Resilience Scale. Logistic regression modeled the relationship between ACEs and students' substance use behaviors. We adjusted for demographics, other health behaviors, and emotional health and we tested resilience as a possible buffer. Results: Participants (n = 568) were in their early twenties, almost three-fourths were female. We had a racially/ethnically diverse sample. Over two-thirds had experienced 1-4 ACEs. ACE exposure was not associated with excess alcohol consumption but exhibited a consistent dose-response relationship in unadjusted and adjusted models. Moderate ACEs increased the odds of tobacco exposure by 227% (OR: 3.27, 95% CI: 1.17-9.11) in adjusted models. Resilience was unrelated to either behavior. Black respondents had significantly reduced odds for both substance use outcomes. Tobacco exposure and excess alcohol intake were comorbid behaviors. Conclusion: Childhood adversity was a significant predictor for tobacco exposure among diverse US college students. Resilience did not buffer this relationship. Age, gender, and race/ethnicity were differentially associated with substance use.