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Panagou C, Macbeth A. Trajectories of risk and resilience: The role of empathy and perceived social support in the context of early adversity. CHILD ABUSE & NEGLECT 2024; 153:106811. [PMID: 38703490 DOI: 10.1016/j.chiabu.2024.106811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Evidence overwhelmingly suggests that adverse childhood experiences (ACEs) is a risk factor for poor mental health outcomes. However, the specific mechanisms via which ACEs confer an increased risk of psychopathology are less well understood. OBJECTIVE The study modelled the effect of empathy and perceived social support (PSS) on mental health outcomes in a mixed clinical and non-clinical population, within the context of exposure to ACEs. PARTICIPANTS AND SETTING A total of 575 participants (comprising a treatment-receiving and community-based sample), aged 18 to 65 completed self-report measures assessing early adversity, PSS, empathy, and mental health outcomes. METHODS Multiple mediation analyses were used to investigate whether empathy and PSS mediated the relationship between self-reported ACEs and mental health outcomes, and whether affective and cognitive empathy affected differentially the link between emotional neglect and psychological distress. RESULTS Results revealed a statistically significant indirect effect of ACEs on adult mental health through affective empathy and PSS. Emotional neglect was the only type of adversity significantly correlated with both dimensions of empathy. The indirect effect of emotional neglect on mental health outcomes via cognitive and affective empathy was also statistically significant. CONCLUSIONS Study results highlight the role of affective empathy and PSS as transdiagnostic mechanisms influencing the pathway between early adversity and adult mental health, and the importance of taking these into account when designing interventions aiming to promote well-being among those who have experienced childhood adversity.
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Affiliation(s)
- Corinna Panagou
- Clinical Psychologist & Clinical Fellow in Psychological Therapies, The University of Edinburgh, United Kingdom of Great Britain and Northern Ireland.
| | - Angus Macbeth
- Clinical Psychologist & Senior Lecturer in Clinical Psychology, The University of Edinburgh, United Kingdom of Great Britain and Northern Ireland
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Meshelemiah JCA, Dellor E, Karandikar S, Munshi A, Barboza-Salerno G, Steinke HR. Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work. SOCIAL WORK 2024; 69:265-275. [PMID: 38745387 DOI: 10.1093/sw/swae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/09/2024] [Accepted: 03/17/2024] [Indexed: 05/16/2024]
Abstract
The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.
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Affiliation(s)
- Jacquelyn C A Meshelemiah
- Jacquelyn C. A. Meshelemiah, PhD, is associate professor, College of Social Work, The Ohio State University, 325D Stillman Hall, 1947 North College Road, Columbus, OH 43210, USA
| | - Elinam Dellor
- Elinam Dellor, PhD, is an assistant professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Sharvari Karandikar
- Sharvari Karandikar, PhD, is a professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Additti Munshi
- Additti Munshi, MSW, is a doctoral student, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Gia Barboza-Salerno
- Gia Barboza-Salerno, JD, PhD, is an assistant professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Hannah Ruth Steinke
- Hannah Ruth Steinke, BA, is a graduate research associate, College of Social Work, The Ohio State University, Columbus, OH, USA
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Ren Y, Yang S, Peng Y, Liu A, Zhu Z. Retrospective ACEs predict complex PTSD symptoms in a large sample of Chinese young adults longitudinally: the moderating role of self-compassion. BMC Psychiatry 2024; 24:425. [PMID: 38844888 PMCID: PMC11155039 DOI: 10.1186/s12888-024-05830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/09/2024] [Indexed: 06/10/2024] Open
Abstract
This longitudinal study in Mainland China (2021-2022) explored the impact of adverse childhood experiences (ACEs) on complex posttraumatic stress disorder (CPTSD) symptoms, with a focus on the role of self-compassion. Among 18,933 surveyed university students, 21.2% reported experiencing at least one ACE. Results revealed a clear relationship between ACEs and CPTSD symptoms. Furthermore, self-compassion, particularly the dimensions of self-judgment and isolation, moderated the association between retrospective ACEs and posttraumatic stress disorder (PTSD) and disturbance in self-organization (DSO) symptoms. These findings highlight the enduring impact of ACEs on CPTSD symptoms and emphasize the importance of early identification and targeted interventions, especially addressing self-judgment and isolation, to mitigate CPTSD risk among young Chinese adults.
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Affiliation(s)
- Yizhen Ren
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Shuhan Yang
- Faculty of Education, Yunnan Normal University, Kunming, 650500, China
| | - Yu Peng
- Students Mental Health Education & Counseling Center, Kunming University of Science and Technology, Kunming, 650500, China.
- Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, 56000, Malaysia.
| | - Aiyi Liu
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Zibin Zhu
- School of Philosophy, Psychology and Language Science, University of Edinburgh, Edinburgh, UK
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Lian J, Kiely KM, Callaghan BL, Anstey KJ. Childhood adversity is associated with anxiety and depression in older adults: A cumulative risk and latent class analysis. J Affect Disord 2024; 354:181-190. [PMID: 38484890 DOI: 10.1016/j.jad.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/09/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The long-lasting influence of childhood adversity on mental health is well documented; however empirical research examining how this association extends into older adults is limited. This study operationalises adversity using cumulative risk and latent class analysis (LCA) models to assess how adversity exposure and typologies may predict anxiety and depression in older adults. METHODS Data came from the Personality and Total Health (PATH) Through Life Project (N = 2551, age 60-66). Participants retrospectively reported their childhood experiences of domestic adversity on a 17-item scale. Mental health was measured using four validated questionnaires of depression and anxiety. RESULTS Linear and generalised additive models (GAM) indicated a dose-response relationship, where a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. LCA identified a four-class solution; with high adversity and high parental dysfunction being associated with poorer mental health outcomes while moderate parental dysfunction and low adversity groups scored at healthy levels. Women reported higher overall anxiety than men, but no notable interactions between ACEs and gender were observed. Patterns revealed by LCA were similar to patterns shown by the cumulative risk model. LIMITATIONS There is a large time gap from childhood to assessment, making our study susceptible to recall bias. Also, our findings were based on cross-sectional data, limiting causal inferences. CONCLUSION Childhood adversity had independent and additive contributions to depression and anxiety in older adulthood, and both cumulative risk and person-centred approaches captured this relationship.
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Affiliation(s)
- James Lian
- School of Psychology, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Kim M Kiely
- School of Psychology, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | - Bridget L Callaghan
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
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Ferrajão PC, Tourais B, Faria I, Dias J, Elklit A. A Latent Class Analysis of Adverse Life Events for Kenyan Adolescents. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:261-273. [PMID: 38938956 PMCID: PMC11199438 DOI: 10.1007/s40653-023-00603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 06/29/2024]
Abstract
Extant evidence indicates that exposure to adverse childhood experiences (ACE) tend to cluster among children and adolescents. Considering that adolescents from African countries present higher risk of being exposed to multiple ACE compared to other countries, the identification of victimization profiles in this population is clearly warranted. The aim of this study was to determine meaningful clusters of individuals with similar experiences of ACE in a sample of Kenyan adolescents. Latent class analysis (LCA) was conducted to identify latent classes of exposure to ACE. In addition, the relationships between the latent classes and gender, parental education, living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A three-class solution was found to be the best description of ACE, and the classes were labelled ''Low Risk'', ''Intermediate Risk'', and ''High Risk''. Compared with the Low-Risk class, the High-Risk class was found to be significantly more likely to have a diagnosis of PTSD and being a female may be an antecedent risk factor for high exposure to ACE. The Intermediate Risk class was significantly less likely to have parents with high school or college education. This paper indicates that Kenyan adolescents present higher risk of being exposed to multiple ACE and that trauma research may turn its focus on the individual as the unit of analysis rather than traumatic events.
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Affiliation(s)
- Paulo Correia Ferrajão
- Faculdade de Ciências Sociais e Tecnologia, Universidade Europeia, Lisbon, Portugal
- National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Bárbara Tourais
- Faculdade de Ciências Sociais e Tecnologia, Universidade Europeia, Lisbon, Portugal
| | - Inês Faria
- Faculdade de Ciências Sociais e Tecnologia, Universidade Europeia, Lisbon, Portugal
| | - Joana Dias
- Faculdade de Ciências Sociais e Tecnologia, Universidade Europeia, Lisbon, Portugal
| | - Ask Elklit
- Faculdade de Ciências Sociais e Tecnologia, Universidade Europeia, Lisbon, Portugal
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Hsueh YZ, Huang CY, Kuo PH, Cheng YC, Huang MC, Chiu CC, Kuo CJ, Chen PY, Chen WY. Cluster analysis exploring the impact of childhood neglect on cognitive function in patients with bipolar disorder. Int J Bipolar Disord 2024; 12:13. [PMID: 38676782 PMCID: PMC11055839 DOI: 10.1186/s40345-024-00335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental disorder related to neurocognitive deficits. Exposure to childhood trauma is associated with worse cognitive performance. Different compositions of childhood trauma in BD and their impacts on cognition are rarely reported. METHODS We used the Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognitive performance and the Chinese version of the Short Form of the Childhood Trauma Questionnaire (C-CTQ-SF) to assess childhood trauma experience among 55 euthymic BD patients. Cluster analysis was applied to dissect their childhood trauma experiences, which revealed three distinct clusters: a low trauma group, neglect-focus group, and multiple-trauma-experience group. We compared the cognitive function between the three clusters and used a generalized linear model to evaluate the impact of childhood neglect on cognitive domains. RESULTS The neglect-focus cluster showed prominent exposures to physical and emotional neglect (41.8%). BD patients in this cluster performed worse in BAC-A compared with patients in the multiple trauma cluster, especially in working memory and processing speed. The neglect-focus group revealed a significant negative effect on the composite score (ß = -0.904, p = 0.025) and working memory (ß = -1.150, p = 0.002) after adjusting sex, age, education year, BMI and total psychotropic defined daily dose. CONCLUSIONS Distinct patterns of childhood trauma experience are seen in BD patients and are related with different cognitive profiles. Early exposure of neglect-focus trauma was associated with the worst cognitive performance in current study. Further studies investigating the intensity of the neglect, as well as individual resilience and coping mechanisms in BD, are warranted.
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Affiliation(s)
- Yuan-Zhi Hsueh
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
| | - Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chian-Jue Kuo
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan.
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Romm KF, Berg CJ. Patterns of Adverse Childhood Experiences and Problematic Health Outcomes Among US Young Adults: A Latent Class Analysis. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:191-200. [PMID: 38258814 DOI: 10.1177/29767342231218081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) predict problematic health outcomes (eg, substance use, mental health) among young adults; whether specific ACEs are differentially associated with specific substance use and mental health symptoms is understudied. METHODS Latent class analysis (LCA) identified classes of ACEs among 2209 US young adults (Mage = 24.69, range: 18-34; 57.4% female; 30.9% sexual minority; 35.8% racial/ethnic minority) in a 2-year study (2018-2020). Multivariable logistic regressions examined ACEs (reported in 2019) in relation to 2020 reports of current (past 30-day) substance use (ie, tobacco use; cannabis use and hazardous use; alcohol use and binge drinking) and mental health (ie, ≥moderate depression and anxiety symptoms), controlling for sociodemographics (ie, age, gender, race, ethnicity, sexual orientation, education). RESULTS Overall, 65.4% reported ≥1 ACE (M = 2.09, SD = 2.30); 34.8%, 39.1%, and 71.1% current tobacco, cannabis, and alcohol use; 39.1% and 15.3% hazardous cannabis use and binge drinking; and 24.2% and 34.5% ≥moderate depression and anxiety symptoms, respectively. LCA yielded 4 classes: Low ACEs (referent; 55.6%), Poor family health and divorce (16.3%), Parental abuse (16.0%), and High ACEs (12.1%). High ACEs (vs Low ACEs) was associated with each adverse substance use and mental health outcome except alcohol use. Poor family health and divorce was associated with tobacco use, cannabis use, and both mental health outcomes. Parental abuse was associated with tobacco use, cannabis use, hazardous cannabis use, and both mental health outcomes. CONCLUSIONS Health promotion interventions for young adults must assess ACEs, given that certain types of ACEs may be associated with distinct substance use and mental health outcomes.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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Barger SD, Oláis JA. Partitioning the Composition of Adverse Childhood Experiences From Accumulated Adversity: Cross-Sectional Evidence From 2 U.S. Samples. AJPM FOCUS 2024; 3:100192. [PMID: 38419615 PMCID: PMC10899063 DOI: 10.1016/j.focus.2024.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Introduction Adverse childhood experiences are linked to adult morbidity and mortality. However, it is unknown whether the patterning of adverse childhood experiences, individually and in combination, confer health risk distinct from that of a cumulative adversity score. This study evaluates whether individual and comorbid adverse childhood experience exposures within a cumulative risk score are equally associated with current smoking and lifetime history of depression. Methods Cross-sectional analysis of adverse childhood experience assessments in the Behavioral Risk Factor Surveillance System from 21 states in 2019 (n=115,183) and 23 states in 2020 (n=120,416) was performed. We modeled cumulative adverse childhood experience scores and the 5 most common distinct adverse childhood experience components that compose a given adverse childhood experience score, up to a cumulative score of 4. We compared adverse childhood experience components, adjusting for covariates. Results Across both samples, 23% and 57%-58% of persons reported 1 adverse childhood experience and 2 or more adverse childhood experiences, respectively. In 2019 smoking prevalence was 10.4% for persons reporting zero adverse childhood experiences and 14.2% for persons reporting 1 adverse childhood experience. When the single adverse childhood experience was experiencing parental divorce, smoking was higher (16.6%) than when the single adverse childhood experience was verbal abuse (11.8%) or living with a mentally ill household member (9.5%). Lifetime depression prevalence was 9.6% and 14.1% across zero and 1 adverse childhood experience, respectively, whereas it was 26.6% if the single adverse childhood experience was living with a mentally ill household member and 11.0% when the adverse childhood experience was experiencing parental divorce. This heterogeneity was replicated in 2020 data. Additional heterogeneity was observed for higher cumulative adverse childhood experience scores. Conclusions Cumulative adverse childhood experience scores mask substantial health risk heterogeneity, which can be delineated by examining distinct components of cumulative adverse childhood experience scores.
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Affiliation(s)
- Steven D Barger
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
- the Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - Jose A Oláis
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
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Wang X, Jiang L, Barry L, Zhang X, Vasilenko SA, Heath RD. A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges. TRAUMA, VIOLENCE & ABUSE 2024; 25:1695-1708. [PMID: 37594222 DOI: 10.1177/15248380231192922] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.
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Silke C, Heary C, Bunting B, Devaney C, Groarke A, Major E, Durcan M, O'Brien C, Brady B. Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022. J Affect Disord 2024; 349:234-243. [PMID: 38163570 DOI: 10.1016/j.jad.2023.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022). METHODS Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277). RESULTS Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide. LIMITATIONS These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings. DISCUSSION Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Ireland.
| | | | | | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Ireland
| | | | - Emmet Major
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Ireland
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Liu Q, Wang X, Razza RA, Vasilenko SA. Early adverse childhood experiences and preschoolers' attentional regulation: A latent class analysis. CHILD ABUSE & NEGLECT 2024; 149:106703. [PMID: 38395020 DOI: 10.1016/j.chiabu.2024.106703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly disrupt preschoolers' attentional regulation development. Different patterns of ACEs may be associated with different attentional regulation outcomes. OBJECTIVE Drawing from developmental systems theory and attachment theory, this study aimed to identify distinct patterns of early ACEs at age three and examined the associations of these patterns with preschoolers' attentional regulation at age five. PARTICIPANTS AND SETTING This study used the two waves of longitudinal data from the Future of Families and Child Wellbeing Study (N = 4457). METHODS First, this study applied latent class analysis (LCA) across nine indicators of ACEs at age three. Second, class membership was examined for associations with preschoolers' attentional regulation at age five. RESULTS LCA identified four latent classes of ACEs: separation (41.2 %), parental incarceration (33 %), family dysfunction (20.8 %), and child abuse (5 %). Children in the child abuse class exhibited lower levels of attentional regulation than those in the family dysfunction class (0.33 standard deviation difference, p < .01) or separation class (0.48 standard deviation difference, p < .001). Children in the parental incarceration class demonstrated lower levels of attentional regulation than those in the separation class (0.63 standard deviation difference, p < .001). CONCLUSIONS Findings provide implications for the need to prevent early child abuse and incorporate trauma-informed intervention programs to support preschoolers' attentional regulation during school-entry age.
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Affiliation(s)
- Qingyang Liu
- Department of Human Development and Family Science, Syracuse University, United States of America.
| | - Xiafei Wang
- School of Social Work, Syracuse University, United States of America
| | - Rachel A Razza
- Department of Human Development and Family Science, Syracuse University, United States of America
| | - Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University, United States of America
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Barboza-Salerno GE, Meshelemiah JCA. Associations between early child adversity and lifetime suicide attempts among gender diverse individuals: A moderated mediation. CHILD ABUSE & NEGLECT 2024; 149:106705. [PMID: 38422580 DOI: 10.1016/j.chiabu.2024.106705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND This study examines the effect of adverse childhood experiences (ACEs) on lifetime suicide attempts (LSA) across five gender subgroups (i.e., transgender men, transgender women, transgender non-binary, cisgender men and cisgender women). OBJECTIVE To examine (1) the prevalence of LSA across gender identity subgroups; (2) whether the association between ACEs and LSA is moderated by gender identity subgroup; (3) depressive symptoms, alcohol use disorder, social support, and social well-being as mechanisms linking ACEs with LSA; and (4) the moderating role of gender identity on the four putative mediators. PARTICIPANTS AND SETTINGS We used nationally representative data from a population-based survey of N = 1368 transgender and cisgender individuals collected between 2016 and 2019. METHODS Structural equation modeling was used to explore the indirect effect of depressive symptoms on the relation between ACEs and LSA, and the moderating impact of gender identity. RESULTS LSA was significantly more prevalent among transgender respondents (cisgender man = 5 %; cisgender woman = 9 %; transgender man = 42 %; transgender woman = 33 %; transgender non-binary = 37 %; p < 0.001). Individuals with more ACEs had a greater risk of engaging in LSA regardless of gender identity; however, moderation results showed that the impact of each additional ACE on LSA was stronger for individuals with transgender identities: the likelihood of engaging in LSA was statistically similar for transgender men with no ACEs and cisgender men with all 8 ACEs. Indirect effects of ACEs on LSA via depressive symptoms were also observed, and the mediating effect was moderated by gender identity. CONCLUSIONS By examining the mechanisms linking childhood adversity to LSA, this study demonstrates that not all ACEs impact gender minority subgroups equally.
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Affiliation(s)
- Gia E Barboza-Salerno
- The Ohio State University, College of Public Health & College of Social Work, 352 Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
| | - Jacquelyn C A Meshelemiah
- The Ohio State University, College of Social Work, 325D Stillman Hall, 1947 North College Road, Columbus, OH 43210, United States of America.
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Kamis C, Lynch S, Copeland WE. Associations Between Configurations of Childhood Adversity and Adult Mental Health Disorder Outcomes. SOCIETY AND MENTAL HEALTH 2024; 14:23-38. [PMID: 38500789 PMCID: PMC10947149 DOI: 10.1177/21568693231197746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
The life course perspective and cumulative inequality theory suggest that childhood adversity, occurring during a sensitive period of the life course, can have long-term consequences for adult mental health and well-being. Yet, the long-term influence of adversity on adult outcomes may depend on both the features of adverse childhood experiences (e.g., the number, type, and co-occurrence of adversities) as well as the outcome assessed. Using latent class analysis applied to several waves of prospective data from the Great Smoky Mountain Study (GSMS; N=1,420) we identify subpopulations that are similar in their adversity experiences before age 18. We then predict adult internalizing and substance use disorder diagnoses by adversity experience. Results reveal five distinct classes of adversity, with unique risks for specific diagnoses in adulthood.
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Affiliation(s)
- Christina Kamis
- Center for Demography of Health and Aging, University of Wisconsin-Madison
| | | | - William E Copeland
- Department of Psychiatry, University of Vermont Larner College of Medicine
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14
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Lafrenaye-Dugas AJ, Bélanger RE, Poliakova N, Riva M, Fletcher C, Godbout N, Fraser S, Courtemanche Y, Moisan C, Muckle G. Profiles of childhood adversities in Inuit from Nunavik: description and associations with indicators of socioeconomic characteristics, support, and community involvement. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:97-113. [PMID: 37079263 PMCID: PMC10830971 DOI: 10.17269/s41997-023-00750-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/30/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Distress and associated health problems reported by Nunavik Inuit emanate from heterogeneous roots, including adverse childhood experiences. This study aims to (1) identify distinct childhood adversity profiles and (2) examine associations between these profiles and sex, socioeconomic characteristics, social support, and community involvement among Nunavimmiut. METHODS In a sample of 1109 adult Nunavimmiut, sex, socioeconomic characteristics, support, community involvement, residential school attendance, and 10 forms of adverse childhood experiences (ACEs) were documented using questionnaires. Latent class analyses and weighted comparisons were performed for three subgroups: 18-49 years; 50 years and above with experience of residential school; and 50 years and above without experience of residential school. The analysis design, the manuscript drafts, and the key findings were discussed and co-interpreted with the collaboration of community representatives, taking into consideration Inuit culture and needs. RESULTS A total of 77.6% of Nunavimmiut reported having experienced at least one form of childhood adversity. Three ACE profiles were identified among the 18-49-year-olds: low ACEs (43.0%), household stressors (30.7%), and multiple ACEs (26.3%). Two profiles characterized ACEs experienced among the 50-year-olds and over with and without history of residential schooling: low ACEs (80.1% and 77.2%, respectively) and multiple ACEs (19.9% and 22.8%, respectively). Among the group of 18-49-year-olds, as compared to the low ACE profile, the profile with household stressors included proportionally more women (odds ratio [OR] = 1.5) and was associated with lower involvement in volunteering and community activities (mean score reduced by 0.29 standard deviation [SD]) and lower family cohesion (SD = - 0.11), while the multiple ACE profile was related to a lower rate of employment (OR = 0.62), lower family cohesion (SD = - 0.28), and lower satisfaction with ability to practice traditional activities (SD = - 0.26). CONCLUSION Childhood adversities among Nunavimmiut do not occur in isolation and experiencing multiple forms of childhood adversities predicts lower socioeconomic status, support, and community involvement in adulthood. Implications for the planning of health and community services in Nunavik are discussed.
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Affiliation(s)
- Anne-Julie Lafrenaye-Dugas
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada.
- Département de pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada.
| | - Richard E Bélanger
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- Département de pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Natalia Poliakova
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | | | - Christopher Fletcher
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | | | | | - Yohann Courtemanche
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | - Caroline Moisan
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- École de psychologie, Faculté des sciences sociales, Université Laval, Québec, QC, Canada
| | - Gina Muckle
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- École de psychologie, Faculté des sciences sociales, Université Laval, Québec, QC, Canada
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15
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Elrefaay SMM, Elyzal AS. Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation. J Psychosoc Nurs Ment Health Serv 2024; 62:45-54. [PMID: 37527517 DOI: 10.3928/02793695-20230726-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].
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La Charite J, Khan M, Dudovitz R, Nuckols T, Sastry N, Huang C, Lei Y, Schickedanz A. Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study. SSM Popul Health 2023; 24:101558. [PMID: 38034480 PMCID: PMC10685007 DOI: 10.1016/j.ssmph.2023.101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Background Positive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure. Methods We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures. Results The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure. Conclusion Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.
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Affiliation(s)
- Jaime La Charite
- Department of General Internal Medicine, University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mariam Khan
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
- Fielding School of Public Health at University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA
| | - Rebecca Dudovitz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
| | - Teryl Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, 8700 Beverly Blvd Ste 113 Los Angeles, California, 90048, USA
| | - Narayan Sastry
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Cher Huang
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Yvonne Lei
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
| | - Adam Schickedanz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
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Meshelemiah JCA, Thanises AC, Yeboah PO. Sex Trafficked Women, Drug Dealers, and Men Who Buy Sex: A Look at "Race". Violence Against Women 2023:10778012231216711. [PMID: 37997358 DOI: 10.1177/10778012231216711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Black, Native American, Latinx, Asian, and Pacific Islander women all have histories of sexual violence in the United States. Their historical victimizations have set a precedence for contemporary commercial sex victimization. The purpose of this study was to examine the role of "race" in sex trafficking. Data from 50 women with sex trafficking histories resulted in three candidate themes and five subthemes that include (a) sex trafficked women (White women, Black women vs. White women, and all women with unique subthemes related to drug use and locations); (b) Black male traffickers; and (c) Black and White male customers.
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18
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Anthony R, Scourfield J, Moore G, Paranjothy S, Evans A, Brophy S, Daniel R, Long S. Adversity profiles of children receiving care and support from social services: A latent-class analysis of school-aged children in Wales. Child Care Health Dev 2023; 49:889-897. [PMID: 36682888 PMCID: PMC10946723 DOI: 10.1111/cch.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 12/13/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Children receive care and support from social services due to the risk of harm or impeded development or because of disability. This study aimed to identify typologies of adversity experienced by children receiving care and support from social services and to explore how typologies differ by sociodemographic characteristics. METHODS This is a cross-sectional study of 'Children Receiving Care and Support' (N = 12 792) during 2017/2018 in Wales, UK. We sought to (1) examine the prevalence of household adversities experienced by children in receipt of care and support from social services; (2) identify typologies of household adversities; and (3) explore how typologies of household adversities differ by family characteristics (demographics, measures of social disadvantage, perinatal and care factors). RESULTS We found evidence for multiple risk factor constellations. The four-class solution suggested four distinct classes of adversities: child disability (50.0%), low adversities (20.3%), family poor health (6.7%) and multiple risks (23.0%). Children in the 'multiple risk' class were significantly more likely to be younger, more deprived and 'looked after' by the local authority compared with those in the 'low adversities' class. CONCLUSIONS Given the presence of different constellations of household adversities, policies and interventions that address multiple risk factors simultaneously may be more effective and have longer-lasting benefits.
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Affiliation(s)
- Rebecca Anthony
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
- Wolfson Centre for Young People's Mental HealthCardiff UniversityCardiffUK
| | - Jonathan Scourfield
- Children's Social Care Research and Development Centre (CASCADE), School of Social SciencesCardiff UniversityCardiffUK
| | - Graham Moore
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
- Wolfson Centre for Young People's Mental HealthCardiff UniversityCardiffUK
| | - Shantini Paranjothy
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
- Centre for Health Data ScienceUniversity of AberdeenAberdeenUK
| | - Annette Evans
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Sinead Brophy
- Health Data Research UKSwansea University Medical School, Swansea UniversitySwanseaUK
| | - Rhian Daniel
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Sara Long
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
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Barboza-Salerno GE, Kosloski A, Weir H, Thompson D, Bukreyev A. A Network Analysis of the Relationship Between Mental and Physical Health in Unsheltered Homeless Persons in Los Angeles County. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5902-5936. [PMID: 36300615 DOI: 10.1177/08862605221127222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Homelessness is a public health crisis both nationally, in the United States, and internationally. Nevertheless, due to the hidden vulnerabilities of persons who are without shelter, little is known about their experiences during periods of homelessness. The present research adopts a network approach that conceptualizes how the major risk factors of homelessness interact, namely substance abuse problems, poor mental health, disability, and exposure to physical or sexual violence by an intimate partner. Our analysis draws on a large demographic survey of over 5,000 unsheltered homeless persons conducted in 2017 by the Los Angeles Homeless Services Authority. We estimated a network structure for 12 survey items tapping individual risk using the graphical least absolute shrinkage and selection operator algorithm. We then examined network centrality metrics and implemented a community detection algorithm to detect communities in the network. Our results indicated that mental illness and intimate partner violence (IPV) are central measures that connect all other mental and physical health variables together and that post-traumatic stress disorder and IPV are both highly affected by changes in any part of the network and, in turn, affect changes in other parts of the network. A community detection analysis derived four communities characterized by disability, sexual victimization and health, substance use, and mental health issues. Finally, a directed acyclic graph revealed that drug abuse and physical disability were key drivers of the overall system. We conclude with a discussion of the major implications of our findings and suggest how our results might inform programs aimed at homelessness prevention and intervention.
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Affiliation(s)
| | - Anna Kosloski
- School of Public Affairs, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Henriikka Weir
- School of Public Affairs, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | | | - Alexey Bukreyev
- College of Arts, Letters and Sciences, University of Colorado Colorado Springs, Colorado Springs, CO, USA
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20
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Desch J, Mansuri F, Tran D, Schwartz SW, Bakour C. The association between adverse childhood experiences and depression trajectories in the Add Health study. CHILD ABUSE & NEGLECT 2023; 137:106034. [PMID: 36706612 DOI: 10.1016/j.chiabu.2023.106034] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are potentially traumatic experiences that occur before age 18. ACEs are linked to depression in adulthood, but little is known about the association between ACEs and depression trajectories across the lifespan. OBJECTIVE To examine the association between specific types of ACEs, cumulative ACE scores, and depression trajectories from adolescence to adulthood. PARTICIPANTS AND SETTING Waves 1-4 of the National Longitudinal Study of Adolescent to Adult Health (N = 12,888), spanning ages 12 years to 43 years. METHODS We constructed trajectories of depression scores using a modified 9-item Center for Epidemiologic Studies Depression Scale (CES-D-9). We used weighted logistic regression to calculate odds ratios and confidence intervals for each ACE and ACE score and depression trajectories after adjusting for confounders. RESULTS We found 75.3 % experienced at least one ACE and 14.7 % experienced 4+ ACEs. We identified three CES-D-9 trajectories: consistently low (Group 1), decreasing (Group 2), and increasing (Group 3) depression scores. All types of abuse, neglect, and community violence were significantly associated with trajectory Groups 2 and 3 vs 1 (p < .05). Foster home placement, poverty, and parental incarceration were associated with Group 2 vs 1. ACE scores showed a dose-response association with Group 3 vs 1 [aORs for 1ACE = 1.43 (0.93-2.20); 2-3ACEs = 1.97 (1.30-3.00); 4+ACEs = 3.08 (1.86-5.09)], and Group 2 vs 1 [aORs for 1ACE = 1.26 (0.87-1.83); 2-3ACEs = 1.93 (1.36-2.74); 4+ACES = 2.70 (1.90-3.84)]. CONCLUSIONS ACEs can have a lasting impact on depression through adulthood, highlighting the need to mitigate their impact to prevent depression-associated morbidity and mortality.
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Affiliation(s)
- Jill Desch
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Fahad Mansuri
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Dieu Tran
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Skai W Schwartz
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Chighaf Bakour
- College of Public Health, University of South Florida, Tampa, FL, USA.
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Wooldridge JS, Tynan M, Rossi FS, Gasperi M, McLean CL, Bosch J, Trivedi RB, Herbert MS, Afari N. Patterns of adverse childhood experiences and cardiovascular risk factors in U.S. adults. Stress Health 2023; 39:48-58. [PMID: 35618265 PMCID: PMC9699903 DOI: 10.1002/smi.3167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023]
Abstract
Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (cardiovascular (CVD)) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioural CVD prevention programs should target these CVD risk factors simultaneously.
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Affiliation(s)
- Jennalee S. Wooldridge
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Mara Tynan
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology
| | - Fernanda S. Rossi
- VA Palo Alto Health Care System, Center for Innovation to Implementation
- Stanford University Department of Psychiatry and Behavioral Sciences
| | - Marianna Gasperi
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Caitlin L. McLean
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
| | - Jeane Bosch
- National Center for PTSD, Dissemination & Training Division
| | - Ranak B. Trivedi
- VA Palo Alto Health Care System, Center for Innovation to Implementation
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Public Mental Health and Population Sciences
| | - Matthew S. Herbert
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Niloofar Afari
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
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Choi J, Seo M, Kim JW, Kim K. The Relationship of Risky Online Behaviors and Adverse Childhood Experiences to Online Sexual Victimization Among Korean Female Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3637-3660. [PMID: 35968731 DOI: 10.1177/08862605221109888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
| | - Mihye Seo
- Sungkyunkwan University, Seoul, South Korea
| | - Jae-Won Kim
- Seoul National University College of Medicine, Seoul, South Korea
| | - Kihyun Kim
- Sungkyunkwan University, Seoul, South Korea
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23
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Kim Y, Park A, Murphy J. Patterns of Adverse Childhood Experiences and Mental Health: Evidence From College Students in Korea. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3011-3029. [PMID: 35584536 DOI: 10.1177/08862605221102487] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adverse childhood experiences (ACEs) are concerning exposures that may have detrimental effects on mental health. Much of the prior evidence on ACEs comes from the U.S and western developed countries. In light of the limited knowledge of ACEs in other social contexts and the interconnection among adversities, this study aims to identify distinct patterns of co-occurring ACEs and examines the associations between those adversities and mental health in South Korea. We used data from a national sample of Korean college students recruited via non-probability quota sampling in 2019 (N = 1037). The dependent variables included three measures of mental health assessed by the Brief Symptom Inventory depression symptoms, anxiety symptoms, and somatization symptoms. The independent variable was the patterns of ACEs identified using 14 indicators of childhood adversity. We conducted a Latent Class Analysis with a distal outcome, using the Bolck, Croons, and Hagenaars method. The analysis found four patterns of ACEs: extreme adversity (8%), family violence (20.3%), economic adversity (10.4%), and low adversity (61.3%). The extreme adversity group exhibited multiple exposures, including interpersonal violence in home environments, economic hardship, and bullying victimization by peers. The results suggest that the extreme adversity and family violence groups showed significantly worse mental health symptoms than the economic adversity and low adversity groups. Also, the extreme adversity group reported significantly higher levels of depression symptoms and somatization symptoms than the family violence group. This study expands the current understanding of ACEs and their harmful effects on mental health in young adulthood specific to Korea while comparing them with other social contexts. Researchers and practitioners should recognize the co-occurrence of child adversities, rather than overestimating sole adversity, to develop effective strategies for promoting mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Aely Park
- Department of Social Welfare, 65380Sunchon National University, Suncheon, South Korea
| | - Jennifer Murphy
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
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Feng JY, Hwa HL, Shen ACT, Hsieh YP, Wei HS, Huang CY. Patterns and trajectories of children's maltreatment experiences in Taiwan: Latent transition analysis of a nationally representative longitudinal study. CHILD ABUSE & NEGLECT 2023; 135:105951. [PMID: 36395698 DOI: 10.1016/j.chiabu.2022.105951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about the patterns of child maltreatment change over time and vary according to gender and child protective services (CPS) experience in Taiwan. OBJECTIVE To examine the latent status and the trajectories of child maltreatment and to identify effects that gender and CPS have on these statuses and trajectories in Taiwan. PARTICIPANTS AND SETTING A national proportionately stratified sample of 6233 4th-grade students were recruited from 314 elementary schools in Taiwan, and followed up at 6th and 8th graders. A total of 1908 students completed valid data at all three time points was analyzed. METHODS Latent class analysis and latent transition analysis were used to identify the number of latent variables and the patterns of child maltreatment. Multiple-group model was used to test with gender difference. RESULTS Four latent maltreatment statuses were identified: high all maltreatment, high psychological maltreatment, high neglect, and no/low maltreatment. A reduction in maltreatment severity occurred over time was found. The percentage of students in the "high all maltreatment" and "high neglect" groups decreased whereas those in the "high psychological maltreatment" and "no/low maltreatment" groups increased. Differences in the transition probabilities of latent maltreatment status by gender was revealed. The percentage of CPS recipients in the "high all maltreatment" decreased over time. CONCLUSIONS This study highlighted the dynamic nature of child maltreatment and described the timing, continuity, and change that characterizes children's exposure to maltreatment in Taiwan. Policies and interventions geared toward early detection, mitigation, and prevention of child maltreatment are needed.
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Affiliation(s)
- Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 70101, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Rd., Tainan 70403, Taiwan.
| | - Hsiao-Lin Hwa
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, 1, Sec. 1, Jen Ai Rd., Taipei 10051, Taiwan; The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - April Chiung-Tao Shen
- The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan; Department of Social Work, National Taiwan University, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, 225 Centennial Drive, Stop 7135, Grand Forks, ND 58202, USA.
| | - Hsi-Sheng Wei
- Department of Social Work, College of Social Sciences, National Taipei University, 151, University Rd., San Shia District, New Taipei City 23741, Taiwan.
| | - Ching-Yu Huang
- School of Psychology, Keele University, Staffordshire ST5 5BG, UK.
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25
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Miedema SS, Le VD, Chiang L, Ngann T, Shortt JW. Adverse Childhood Experiences and Intimate Partner Violence Among Youth in Cambodia: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1446-NP1472. [PMID: 35471130 PMCID: PMC10263171 DOI: 10.1177/08862605221090573] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adverse childhood experiences (ACEs) are a global public health problem, including in low- and middle-income country settings, and are associated with increased risk of intimate partner violence (IPV) during young adulthood. However, current measurement of ACEs may underestimate sequelae of different combinations, or classes, of ACEs and mask class-specific associations with adult exposure to IPV. We used data among ever-partnered young women and men aged 18-24 years from the Cambodia Violence Against Children Survey (Nw = 369; Nm = 298). Participants retrospectively reported on seven ACEs and lifetime physical and/or sexual IPV victimization and perpetration. Latent classes comprised of ACEs were used as predictors of physical and/or sexual IPV perpetration and victimization, controlling for household wealth. Identified latent classes for women were "Low ACEs" (60%), "Community Violence and Physical Abuse" (23%), and "Physical, Sexual and Emotional Abuse" (17%). Latent classes for men were "Low ACEs" (48%) and "Household and Community Violence" (52%). Among women, those in the Physical, Sexual and Emotional Abuse class were more likely to experience and perpetrate physical and/or sexual IPV in their romantic relationships compared to the reference group (Low ACEs). Women in the Community Violence and Physical Abuse class were more likely to perpetrate physical and/or sexual IPV, but not experience IPV, compared to women in the Low ACEs class. Among men, those in the Household and Community Violence class were more likely to perpetrate physical and/or sexual IPV against a partner, compared to men in the Low ACEs class. Overall, patterns of ACEs were differently associated with IPV outcomes among young women and men in Cambodia. National violence prevention efforts might consider how different combinations of childhood experiences shape risk of young adulthood IPV and tailor interventions accordingly to work with youth disproportionately affected by varied combinations of ACEs.
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Affiliation(s)
- Stephanie S. Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi Donna Le
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chiang
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thanak Ngann
- Gender and Development for Cambodia (GAD/C), Phnom Penh, Cambodia
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Mumford EA, Copp J, MacLean K. Childhood Adversity, Emotional Well-Being, Loneliness, and Optimism: a National Study. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:137-149. [PMID: 36466586 PMCID: PMC9684794 DOI: 10.1007/s42844-022-00084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 05/05/2023]
Abstract
Optimism and loneliness, which reflect the expected inverse associations with excess morbidity and mortality, are theoretically and empirically associated with early adversities and offer potential avenues for clinical support. The current study first estimates latent classes of adverse childhood experiences and, second, assesses the role of these experiences on later reports of optimism and loneliness in late adolescence and emerging adulthood, and the role of emotional regulation and common mental disorders. Surveys were conducted in a longitudinal household sample of adolescents recruited in 2013 (average age of 20 at wave 6 follow-ups). The analytic sample included 1177 female and male respondents representative of their age group in the USA at baseline. Latent classes were estimated based on 10 indicators of childhood adversity. Respondents were assigned to classes using posterior probabilities of latent class membership, and class membership was used to predict psychological outcomes in multivariable models. Three latent classes of childhood adversity were identified in the current sample, representing low childhood adversity (81.5%), higher probability of family dysfunction with lower levels of interpersonal abuse (13.4%), and high adversity including higher probabilities of parental discord and violence as well as child abuse (5.1%). Both classes of respondents who faced greater childhood adversity were more likely to report greater loneliness and lower optimism in emerging adulthood. Results were attenuated by measures of emotional well-being. Addressing adolescent loneliness and supporting optimistic outlooks in emerging adulthood are two pathways with potential benefits to reduce mental and physical morbidities.
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Affiliation(s)
- Elizabeth A. Mumford
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814 USA
| | - Jennifer Copp
- Florida State University, 314B Criminology & Criminal Justice Building, 112 S. Copeland Street, Tallahassee, FL 32306-1273 USA
| | - Kai MacLean
- NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814 USA
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Wang X, Heath RD, Majewski D, Blake C. Adverse childhood experiences and child behavioral health trajectory from early childhood to adolescence: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 134:105879. [PMID: 36115324 DOI: 10.1016/j.chiabu.2022.105879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly influence child development. Different patterns of ACEs among boys and girls may be associated with different developmental trajectories. OBJECTIVE This study aimed to identify patterns of ACEs at age three and tested the associations of these patterns with child behavioral health problems from age three to age fifteen. PARTICIPANTS AND SETTING This study used data (N = 4898) from the Fragile Families Child Wellbeing Study. METHODS First, this study conducted latent class analysis (LCA) across ten indicators of ACEs at age 3. LCA was conducted separately for boys and girls. Second, class membership was tested for associations with child internalizing symptoms and externalizing behaviors (ages three, five, nine, and fifteen years). RESULTS LCA identified five classes of ACEs for girls: low ACEs, parental separation, financial difficulty, chaotic home, and child maltreatment. LCA for boys, however, identified a six-class solution, in which there was a physical abuse-only class, while also a sixth high ACEs class that included both physical and emotional abuse. Classes with the most ACEs often had the highest symptomology (internalizing symptoms ranging from 0.24 to 0.56; externalizing ranging from 0.36 to 1.00; ps < .05). However, differences in behavioral health were detected depending on the patterns of ACES. At ages nine and fifteen, the financial difficulty group also had high symptomatology (internalizing symptoms ranging from 0.23 to 0.43; externalizing from 0.23 to 0.46; ps < .05). CONCLUSIONS Findings provide implications including the need to examine ACEs heterogeneity and address financial difficulty as a substantial ACE.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| | - Ryan D Heath
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Daniel Majewski
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Corinne Blake
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
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Grummitt LR, Keyes KM, Rajan S, Kelly EV, Barrett EL, Newton NC. Clusters of Adversity Types Among U.S. Youth: Associations With Mental Health. Am J Prev Med 2022; 63:331-340. [PMID: 35523697 DOI: 10.1016/j.amepre.2022.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Childhood adversities are risk factors for subsequent mental health problems. Research commonly focuses on adverse childhood experiences, despite evidence that other exposures, such as neighborhood violence or peer victimization, co-occur with adverse childhood experiences and are associated with similar mental health outcomes. This study explored the clustering of these exposures and examined the associations with mental health. METHODS Data were a nationally representative sample of U.S. children aged 10-17 years (N=1,959), collected in 2013-2014. Latent class analysis was conducted on 22 types of childhood adversity. Regression models examined associations with mental health and substance use. These secondary analyses were conducted in 2021. RESULTS A total of 5 classes were identified: Low all (59% of the sample), Abuse (29%), High multiple adversities (5%), Peer adversity (4%), and Neighborhood violence (4%). All classes had poorer mental health and a higher prevalence of substance use than Low all, with particularly harmful levels in High multiple adversities. Neighborhood violence was not significantly different from High multiple adversities on mental health symptoms and showed a greater proportion of past-year substance use than all other classes except High multiple adversities. Peer adversity and Abuse classes did not differ significantly in any outcomes. CONCLUSIONS Findings highlight the particularly deleterious impact of neighborhood violence and highly co-occurring adversity types on mental health and substance use. It is important to extend our conceptualization of adverse childhood experiences to include peer adversity and neighborhood violence and shift from a siloed approach to examining all these exposures.
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Affiliation(s)
- Lucinda R Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sonali Rajan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Teachers College, A Graduate School of Education & Psychology, Columbia University, New York, New York
| | - Erin V Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Yu J, Patel RA, Haynie DL, Vidal-Ribas P, Govender T, Sundaram R, Gilman SE. Adverse childhood experiences and premature mortality through mid-adulthood: A five-decade prospective study. LANCET REGIONAL HEALTH. AMERICAS 2022; 15:100349. [PMID: 36467261 PMCID: PMC9718480 DOI: 10.1016/j.lana.2022.100349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Adverse childhood experiences (ACEs) can have lasting effects on adult health and survival. In this study, we aimed to examine how the cumulative number and clustering patterns of ACEs were related to premature mortality. Methods Participants (N=46 129; 45% White, 48% Black; 49·5% females) were offspring (born in 1959-1966) of participants enrolled in the Collaborative Perinatal Project (CPP). We conducted latent class analysis to examine the clustering patterns of ACEs assessed between children's birth and age seven. We also calculated the cumulative ACE scores of 13 individual ACEs. Cox regression models were used to examine the associations of ACE clusters and scores with risk of premature mortality from adolescence to mid-adulthood. Findings At the start of the follow-up for mortality in 1979, participants were 12-20 years old (Mean=15·99 years), and within the 38-year follow-up through 2016, 3 344 deaths were observed among the 46 129 CPP offspring. Five latent classes of ACEs were identified. Compared to children with Low Adversity (48% of the sample), children in Family Instability (9%, HR=1·28, 95%CI 1·07-1·53), Poverty & Crowded Housing (21%, HR=1·41, 95%CI 1·24-1·62), and Poverty & Parental Separation (19%, HR=1·50, 95%CI 1·33-1·68) classes had higher hazards of premature mortality. In addition, children with 2 (HR=1·27, 95%CI 1·14-1·41), 3 (HR=1·29, 95%CI 1·15-1·45), and 4+ (HR=1·45, 95%CI 1·30-1·61) ACEs had higher hazards of mortality than those with no ACE. The clusters of Poverty & Crowded Housing (HR=1·28, 95%CI 1·10-1·49) and Poverty & Parental Separation (HR=1·23, 95%CI 1·02-1·48) remained associated with higher risk of premature mortality, beyond the cumulative risk of higher number of ACEs (HR=1·05, 95%CI 1·01-1·08). Interpretation About half of the CPP cohort experienced early life adversities that clustered into four distinct patterns, which were associated with different risk of premature mortality. It is important to deepen our understanding of how specific clusters of childhood adversities affect health and premature mortality to better inform approaches to prevention and interventions.
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Affiliation(s)
- Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States,Corresponding author at: 6710B Rockledge Drive, Room 3155A, Bethesda, MD 20817, United States.
| | - Reeya A. Patel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Denise L. Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Rajeshwari Sundaram
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States
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Hemady CL, Speyer LG, Murray AL, Brown RH, Meinck F, Fry D, Do H, Sikander S, Madrid B, Fernando A, Walker S, Dunne M, Foley S, Hughes C, Osafo J, Baban A, Taut D, Ward CL, Van Thang V, Fearon P, Tomlinson M, Valdebenito S, Eisner M. Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: a latent class analysis. BMC Pregnancy Childbirth 2022; 22:505. [PMID: 35733125 PMCID: PMC9215006 DOI: 10.1186/s12884-022-04839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). METHODS A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. RESULTS Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes. CONCLUSION Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.
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Affiliation(s)
- Chad Lance Hemady
- Social Work Department, University of Edinburgh, Edinburgh, UK. .,School of Social and Political Science, 15a George Square, Edinburgh, EH8 9LD, UK.
| | | | | | | | - Franziska Meinck
- Social Work Department, University of Edinburgh, Edinburgh, UK.,Faculty of Humanities, North-West University, Potchefstroom, South Africa
| | - Deborah Fry
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Huyen Do
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Siham Sikander
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.,Global Institute of Human Development, Shifa Tameer-E-Millat University, Islamabad, Pakistan
| | - Bernadette Madrid
- Child Protection Unit, University of the Philippines, Manila, Philippines
| | - Asvini Fernando
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Susan Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Michael Dunne
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Sarah Foley
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Vo Van Thang
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Pasco Fearon
- Division of Psychology & Language Sciences, University College London, London, UK
| | - Mark Tomlinson
- Department of Global Health, Institute of Life Course Health Research, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, UK.,Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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MacLochlainn J, Mallett J, Kirby K, McFadden P. Stressful Events and Adolescent Psychopathology: A Person-Centred Approach to Expanding Adverse Childhood Experience Categories. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:327-340. [PMID: 35600522 PMCID: PMC9120305 DOI: 10.1007/s40653-021-00392-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 06/15/2023]
Abstract
Stress from cumulative adverse childhood experiences (ACEs) can pose a serious risk of experiencing anxiety, depression, and other mood disorders in adolescence. However, there is a paucity of research identifying specific profiles or combinations of exposure to other forms of stressful life events and their impact on adolescent psychopathology. This study attempted a conceptual expansion of the ACE checklist by examining these stressful events. The study used cross-sectional data from a modified version of the CASE Study survey where 864 adolescents (56% female, n = 480), aged from 11 - 18 years were recruited from four post-primary schools in the North-West region of NI. Latent class analysis of the 20-item stressful events checklist revealed 3 distinct risk classes: a low-risk class (53.5%), at-risk class (42.7%), and an immediate-risk class (3.8%). Results showed those at most risk of adolescent psychopathology had the highest probability of encountering interpersonal relationship issues, experiencing family dysfunction, and having close friends experiencing psychological difficulties. Findings indicate that the original ten ACE categories may be too narrow in focus and do not capture the wide range of childhood adversity. Expanding the ACE checklist to include other stressful events is discussed as these may also be antecedents to psychopathologic responses.
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Affiliation(s)
- Justin MacLochlainn
- School of Psychology, Ulster University, Room H259, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - John Mallett
- School of Psychology, Ulster University, Room H259, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - Karen Kirby
- School of Psychology, Ulster University, Room H245, Cromore Road, Coleraine campus, Co. Derry, BT52 1SA Coleraine, Northern Ireland
| | - Paula McFadden
- School of Applied Social and Policy Sc, Institute for Research in Social Sciences, Magee campus, Room MF211, Derry, BT48 7JL Northern Ireland
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Sosnowski DW, Feder KA, Astemborski J, Genberg BL, Letourneau EJ, Musci RJ, Mojtabai R, McCall L, Hollander E, Loving L, Maher BS, Kirk GD, Mehta SH, Sun J. Adverse childhood experiences and comorbidity in a cohort of people who have injected drugs. BMC Public Health 2022; 22:986. [PMID: 35578217 PMCID: PMC9109307 DOI: 10.1186/s12889-022-13369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood adversity is associated with the onset of harmful adult substance use and related health problems, but most research on adversity has been conducted in general population samples. This study describes the prevalence of adverse childhood experiences in a cohort of people who have injected drugs and examines the association of these adverse experiences with medical comorbidities in adulthood. METHODS Six hundred fifty three adults were recruited from a 30-year cohort study on the health of people who have injected drugs living in and around Baltimore, Maryland (Median age = 47.5, Interquartile Range = 42.3-52.3 years; 67.3% male, 81.1% Black). Adverse childhood experiences were assessed retrospectively in 2018 via self-report interview. Lifetime medical comorbidities were ascertained via self-report of a provider diagnosis. Multinomial logistic regression with generalized estimating equations was used to examine the association between adversity and comorbid conditions, controlling for potential confounders. RESULTS Two hundred twelve participants (32.9%) reported 0-1 adverse childhood experiences, 215 (33.3%) reported 2-4, 145 (22.5%) reported 5-9, and 72 (11.1%) reported ≥10. Neighborhood violence was the most commonly reported adversity (48.5%). Individuals with ≥10 adverse childhood experiences had higher odds for reporting ≥3 comorbidities (Adjusted Odds Ratio = 2.9, 95% CI = 1.2 - 6.8, p = .01). CONCLUSIONS Among people who have injected drugs, adverse childhood experiences were common and associated with increased occurrence of self-reported medical comorbidities. Findings highlight the persistent importance of adversity for physical health even in a population where all members have used drugs and there is a high burden of comorbidity.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kenneth A Feder
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jacquie Astemborski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Elizabeth J Letourneau
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rashelle J Musci
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa McCall
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eileen Hollander
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Lynnet Loving
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jing Sun
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
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Helton JJ, Davis JP, Lee DS, Pakdaman S. Expanding adverse child experiences to inequality and racial discrimination. Prev Med 2022; 157:107016. [PMID: 35301044 DOI: 10.1016/j.ypmed.2022.107016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
Abstract
There is a well-established correlation between health and adverse childhood experiences (ACEs). Arguments have been made to expand ACE scales to include indicators of racism and structural inequalities. In this paper, we use nationally representative data to examine the relationships between latent groups of an expanded adversity scale and a broad range of child health outcomes. Data were obtained from a merger of the 2017 and 2018 National Survey of Children's Health (NSCH) and analyzed in 2021 (n = 52,129). Adversities were defined as violent victimization, violence exposure, a range of parental problems, racial discrimination, food insecurity, and unkempt housing. Latent class analysis (LCA) was used to uncover emergent groups of adversities, and logistic regression was used to assess group relationship to global and diagnosed measures of health. Four groups emerged: high all (3.6%), material and food hardship (11.9%), parental problems (10.3%), and low all (74.2%). Results showed the high all groups at greater odds of almost all outcomes. Compared to low all group, high all had particularly higher odds of any special (OR = 2.29) or complex (OR = 2.53) healthcare need, frequent severe headaches (OR = 2.07), and depression (OR = 3.4) or anxiety (OR = 2.11). Our analysis noted separation of experiences based on additional items related to structural inequalities: food insecurity, poverty, and unkempt housing. However, augmenting existing ACE scales with these indicators may be unnecessary as children most at-risk for poor health were a very small group (1 in 28) that experienced multiple forms of violence and parental problems.
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Affiliation(s)
- Jesse J Helton
- College of Public Health and Social Justice, School of Social Work, St. Louis University, St. Louis, MO, United States of America.
| | - Jordan P Davis
- USC Center for Artificial Intelligence in Society, United States of America; USC Center for Mindfulness Science, United States of America; USC Institute for Addiction Science, United States of America; Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Daniel S Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Sheila Pakdaman
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
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Personality as a Possible Intervention Target to Prevent Traumatic Events in Adolescence. Behav Sci (Basel) 2022; 12:bs12040090. [PMID: 35447662 PMCID: PMC9031006 DOI: 10.3390/bs12040090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Traumatic events (severe injury, violence, threatened death) are commonly experienced by children. Such events are associated with a dose-response increasing risk of subsequent substance use, mental illness, chronic disease, and premature mortality. Preventing the accumulation of traumatic events is thus an urgent public health priority. Substance use risk personality profiles (impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) may be an important target for preventing trauma exposure, given associations between these personality traits and risky behaviour, substance misuse, and injuries across adolescence. The current study aimed to investigate associations between personality at age 13 and the number of traumatic events experienced by age 18. It also examined associations between traumas before age 13 and personality at age 13. Participants were the control group of a cluster-randomised controlled trial examining prevention of adolescent alcohol misuse. Baseline data were collected at ages 12–13 (2012). Participants were followed-up at ages 18–19 (2017–2018). Personality profiles of hopelessness, anxiety sensitivity, impulsivity, and sensation seeking were measured at baseline using the Substance Use Risk Profile Scale. Traumatic events and age of exposure were measured at age 18–19 using the Life Events Checklist for DSM-5. Mixed-effect regression was conducted on 287 participants in Stata 17, controlling for sex. High scores on hopelessness, impulsivity, and sensation seeking at age 13 were associated with a greater number of traumatic events by age 18. Impulsivity and sensation seeking predicted the number of new traumatic events from age 13 to 18. Prior trauma exposure was associated with high hopelessness at age 13. Adolescents exhibiting high impulsivity or sensation seeking may be at greater risk of experiencing traumatic events. Additionally, early trauma exposure may contribute to the development of a hopelessness personality trait.
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Travers Á, McDonagh T, McLafferty M, Armour C, Cunningham T, Hansen M. Adverse experiences and mental health problems in perpetrators of intimate partner violence in Northern Ireland: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 125:105455. [PMID: 35078089 DOI: 10.1016/j.chiabu.2021.105455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Trauma and adverse experiences among perpetrators of intimate partner violence (IPV) have been associated with more serious patterns of offending. OBJECTIVE To examine 1) how traumatic and adverse experiences cluster together and co-occur among IPV perpetrators, and 2) whether different patterns of trauma exposure are associated with specific mental health problems. PARTICIPANTS AND SETTING The sample consisted of 405 convicted IPV perpetrators from Northern Ireland. METHODS Data was collected between 2018 and 2019. Latent class analysis identified typologies of exposure to traumatic and adverse experiences. A series of binary logistic regression analyses explored associations between the identified classes and five categories of probable mental health problems. RESULTS Three adversity classes were identified: a baseline class (59.2%), characterised by relatively low levels of exposure to most types of adversity; a 'childhood adversity' class (32.9%), with high levels of childhood adversity; and a 'community violence and disadvantage' class (7.9%), which had high probabilities of endorsing adversities related to economic hardship and community violence. Regression analyses showed that the childhood adversity class was significantly associated with increased likelihood of all categories of mental health problems, except for neurodevelopmental disorders (ORs = 1.77-3.25). The community violence and disadvantage class was significantly associated with probable mood and anxiety disorder (ORs 3.92 and 8.42, respectively). CONCLUSIONS Different patterns of exposure to adversities were associated with distinct mental health problems in the present sample. Early intervention to prevent poly-victimisation, the clustering of adversities in childhood and the resulting accumulation of risk may be a useful component of preventive responses for IPV in Northern Ireland.
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Affiliation(s)
- Áine Travers
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Tracey McDonagh
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Margaret McLafferty
- School of Biomedical Science, Ulster University, Magee Campus, Londonderry BT48 7JL, United Kingdom of Great Britain and Northern Ireland.
| | - Cherie Armour
- Centre for Stress, Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, University Rd, Belfast BT7 1NN, United Kingdom of Great Britain and Northern Ireland.
| | - Twylla Cunningham
- Psychology Department, Probation Board for Northern Ireland, 80-90 North St, Belfast BT1 1LD, United Kingdom of Great Britain and Northern Ireland.
| | - Maj Hansen
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
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Tynan M, Wooldridge JS, Rossi F, McLean CL, Gasperi M, Bosch J, Timko C, Herbert M, Afari N. Latent Class Patterns of Adverse Childhood Experiences and Their Relationship to Veteran Status and Sex in the National Epidemiologic Survey of Alcohol and Related Conditions Wave III. Mil Med 2022; 187:304-312. [PMID: 34977940 DOI: 10.1093/milmed/usab536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) are associated with poor psychosocial and health outcomes in adulthood. Veterans and females experience ACEs disproportionately. A greater understanding of this disparity may be achieved by examining the relationship between distinct ACE patterns and these demographic characteristics. Therefore, this study examined distinct ACE patterns and their association with Veteran status, sex, and other demographics in a nationally representative sample of U.S. adults to inform interventions tailored to ACE patterns experienced by specific groups. MATERIALS AND METHODS Latent class analysis (LCA) was conducted with data from the National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative structured diagnostic interview conducted from 2012-2013. The target population was the noninstitutionalized adult population living in the USA. The analytic sample was 36,190 (mean age 46.5 years; 48.1% male). Of these participants, 3,111 were Veterans. Data were analyzed between September 2020 and January 2021. RESULTS Latent class analysis revealed a four-class solution: (1) "Low adversity" (75.3%); (2) "Primarily household dysfunction" (9.0%); (3) "Primarily maltreatment" (10.7%); and (4) "Multiple adversity types" (5.1%). Compared to "Low adversity," members in the other classes were more likely to be Veterans (odds ratio (OR)C2vC1 = 1.33, ORC3vC1 = 1.55, ORC4vC1 = 1.98) and female (ORC2vC1 = 1.58, ORC3vC1 = 1.22, ORC4vC1 = 1.65). While lower education and income were also related to higher adversity class membership, Veteran status and sex were the strongest predictors, even when controlling for education and income. CONCLUSIONS Distinct and meaningful patterns of ACEs identified in this study highlight the need for routine ACE screenings in Veterans and females. As in the current study, operationalizing and clustering ACEs can inform screening measures and trauma-informed interventions in line with personalized medicine. Future work can test if classes are differentially associated with health outcomes.
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Affiliation(s)
- Mara Tynan
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92120, USA
| | - Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Fernanda Rossi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.,Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Caitlin L McLean
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Marianna Gasperi
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Jeane Bosch
- National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA
| | - Christine Timko
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Matthew Herbert
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.,VA San Diego Center of Excellent for Stress and Mental Health, San Diego, CA 92161, USA
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Panagou C, MacBeth A. Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences. Clin Psychol Psychother 2022; 29:1626-1654. [PMID: 35266603 PMCID: PMC9790303 DOI: 10.1002/cpp.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022]
Abstract
Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.
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Affiliation(s)
- Corinna Panagou
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
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Elma JHL, Hautalab D, Abrahamson-Richardsa T, Wallsb ML. Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes. CHILD ABUSE & NEGLECT 2021; 122:105326. [PMID: 34627041 PMCID: PMC8784163 DOI: 10.1016/j.chiabu.2021.105326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/29/2021] [Accepted: 09/03/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Extensive research demonstrates that Adverse Childhood Experiences (ACEs) are highly interconnected and have numerous health consequences well into adulthood. Yet, there is a dearth of focused research that examines ACEs and health inequities for American Indians (AIs). OBJECTIVE To assesses the prevalence of ten types of childhood adversities, explore constellations of exposures, and examine whether there are differential risks of mental health outcomes according to sub-group classification. PARTICIPANTS AND SETTING Adult AIs with type 2 diabetes from five reservation-based tribal communities in the Great Lakes region of the U.S. METHODS Prevalence was estimated using a modified version of the World Health Organization's ACE-International Questionnaire. To examine heterogeneity in ACEs exposures, latent class analysis was used. Risk of mental health outcomes was calculated by class. RESULTS The four most common ACEs reported were residing with someone who abused substances, witnessing household violence, incarceration of a household member, and sexual abuse. Three latent classes were identified: low risk (56.7%), family maladjustment with high probabilities of household violence, incarceration, and substance abuse (27.1%), and complex trauma (16.3%) with moderate to high probabilities of exposure to all ACEs. The most consistent differences in mental health outcomes were between the low risk and complex trauma classes. CONCLUSIONS Identification of a high number of participants in the low-risk class helps structure a more wholistic image of AI families, as negative stereotypes of AIs are abundant. For the minority of individuals in the complex trauma class, risk for chronic mental health challenges and co-morbidities appears to be high.
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Affiliation(s)
- Jessica H L Elma
- University of Washington, United States of America; Johns Hopkins University, United States of America.
| | - Dane Hautalab
- University of Washington, United States of America; Johns Hopkins University, United States of America
| | | | - Melissa L Wallsb
- University of Washington, United States of America; Johns Hopkins University, United States of America
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Anyigbo C, Tarini BA, Wang J, Lanier P. Clusters of adverse childhood experiences and unmet need for care coordination. CHILD ABUSE & NEGLECT 2021; 122:105334. [PMID: 34571356 PMCID: PMC8612971 DOI: 10.1016/j.chiabu.2021.105334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 08/04/2021] [Accepted: 09/14/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND The lack of consensus on how to measure ACEs limits our estimation of their impact on health outcomes and understanding of which ACE clusters drive unmet care coordination (CC) needs. OBJECTIVES 1) Identify latent classes of ACEs among a representative group of U.S. children; 2) Examine the association between these classes and unmet needs for CC. PARTICIPANT AND SETTING Using the 2016-2017 National Survey of Children's Health, we sampled children ages 0-17 the who had seen >1 healthcare provider within 12 months (n = 38,758). METHODS We conducted latent class analyses and weighted logistic regression analyses to examine associations between latent classes and unmet need for CC. RESULTS We identified seven distinct classes: household poverty and parental divorce, household poverty and parental death, household poverty only, household substance abuse and witnessing violence, multiple ACEs, household poverty and child discrimination, and household poverty and household mental illness. Children in the following classes had the greatest odds of unmet need for CC: household poverty only (AOR 2.0; 95% CI, 1.42-2.84), household poverty and household mental illness (AOR 1.67; 95% CI, 1.15-2.44), multiple ACEs (AOR 2.31; 95% CI, 1.53-3.50), and household poverty and child discrimination (AOR 3.55; 95% CI, 1.71-7.37). CONCLUSIONS Children who experienced specific combinations of ACEs, have an increased risk of unmet need for CC, with those experiencing both poverty and discrimination having the highest odds of unmet need for CC. Discrimination widens the gap of unmet CC need for poor children.
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Affiliation(s)
- Chidiogo Anyigbo
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Division of General Pediatrics and Community Health, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States of America.
| | - Beth A Tarini
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Children's National Research Institute, Children's National Hospital, 1 Inventa Place Silver Spring, MD 20910, United States of America.
| | - Jichuan Wang
- Center for Translational Science, Children's Research Institute, 1 Inventa Place Silver Spring, MD 20910, United States of America.
| | - Paul Lanier
- School of Social Work, The University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building 548-K, 325 Pittsboro Street, Chapel Hill, NC 27599, United States of America.
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Lee KA, Sacco P, Bright CL. Adverse childhood experiences (ACEs), excessive alcohol use and intimate partner violence (IPV) perpetration among Black men: A latent class analysis. CHILD ABUSE & NEGLECT 2021; 121:105273. [PMID: 34419899 DOI: 10.1016/j.chiabu.2021.105273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/20/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been linked to subsequent intimate partner violence (IPV) perpetration and alcohol use. Although higher rates of ACEs are found in racial/ethnic minority populations, there is a paucity of research examining ACEs patterns and risk for IPV perpetration and excessive alcohol use among Black men. OBJECTIVE To identify homogeneous subgroups based on ACEs among Black men using latent class analysis and assessing risk for later IPV perpetration and excessive alcohol consumption in adulthood. METHODS Using a sample of Black men (n = 2306) from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), we conducted latent class analysis (LCA) to examine their ACEs patterns based on 10 domains. ACE classes were used in logistic regression models to predict IPV perpetration and unhealthy alcohol use. RESULTS LCA revealed three classes: (1) High Household Dysfunction & Physical Neglect; (2) Physical/Emotional Abuse; and (3) Low ACEs. Men in the High Household Dysfunction & Physical Abuse (OR = 3.95, p < 0.001), and Physical/Emotional Abuse (OR = 2.37, p < 0.001) classes had increased risk for IPV perpetration (ref: Low ACEs class) controlling for sociodemographic factors. No significant association was found between class membership and unhealthy alcohol use. CONCLUSIONS Our findings highlight the need for interventions aimed at addressing ACEs among Black boys as they increase risk for negative outcomes in adulthood. Future research should explore heterogeneity in ACEs among youth and risk of IPV and explore possible causal mechanisms in the development of IPV among adults who have experienced ACEs.
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Affiliation(s)
- Kerry A Lee
- Graduate School of Social Work & Social Research, Bryn Mawr College, 300 Airdale Road, Bryn Mawr, PA 19010, United States of America.
| | - Paul Sacco
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD 21201, United States of America.
| | - Charlotte Lyn Bright
- School of Social Work, Colorado State University, 137 Education, 1586 Campus Delivery, Fort Collins, CO 80523-1586, United States of America.
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Positive Functioning Moderates the Association between Classes of Adverse Childhood Experiences and Adolescent Depressive Symptoms. ACTA ACUST UNITED AC 2021; 2:157-168. [PMID: 34532713 DOI: 10.1007/s42844-021-00033-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with short- and long-term psychological health, but most research, to date, relies on retrospective self-reports during adulthood to test this association. Moreover, there is limited evidence on how ACEs group together and differentially influence mental health, as well as factors that promote positive outcomes in the context of ACEs. The present study used secondary data of children and their biological parents from the Fragile Families and Child Wellbeing Study (N = 3,487; M age = 9.30, SD = .40 years; 52% male) to test if meaningful subgroups of ACE exposure existed at age 9, and if positive adolescent functioning moderated the association between ACE exposure class membership at age 9 and adolescent depressive symptoms at age 15. Results revealed three distinct classes: an impoverished and interpersonally abused class, a single-parent and impoverished class, and a low adversity class. Positive adolescent functioning moderated the association between class membership and depressive symptoms. Specifically, individuals in the impoverished and interpersonally abused and low adversity classes had the highest levels of depressive symptoms at low levels of positive functioning, and the lowest levels of depressive symptoms at high levels of positive functioning. Results support prior evidence that children experiencing interpersonal abuse group together into a latent class and provide a nuanced perspective on factors that promote positive functioning in the context of various constellations of ACEs.
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Childhood adversities and mental health outcomes: Does the perception or age of the event matter? Dev Psychopathol 2021; 33:778-791. [PMID: 32366345 DOI: 10.1017/s0954579420000048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study extends knowledge regarding the individual contribution of different adverse experiences to mental health symptoms in late adolescence by including the perception of how upsetting each experience was to the adolescent and the age at the first occurrence. We also sought to move beyond sum scores of adverse experiences by using a person-centered approach to classifying individuals with similar co-occurrence of adversities. The data came from a longitudinal study of maltreatment on adolescent development (N = 454). Self-reported childhood adversities were assessed at Wave 4 (average of 7 years postbaseline) and examined with respect to current mental health symptoms (depression, PTSD, anxiety, and externalizing). Although the adversity sum score was a potent predictor of all mental health outcomes, the results indicated that the use of a sum score obscures information about the importance of individual adversities. Additionally, the influence of age of occurrence varied based on the adversity and outcome, while the perception of the event did not add much unique variance. Finally, the latent class analyses provided unique information about the patterns of co-occurring adversity in this sample, and that membership in either of the multiple-adversity classes was associated with more mental health symptoms.
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Barboza GE, Schiamberg L. Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model. Infant Ment Health J 2021; 42:636-654. [PMID: 34378809 DOI: 10.1002/imhj.21937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.
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Affiliation(s)
- Gia Elise Barboza
- School of Public Affairs, University of Colorado Colorado Springs, Colorado, USA
| | - Lawrence Schiamberg
- Human Development and Family Studies, Michigan State University, Michigan, USA
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How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood. J Youth Adolesc 2021; 50:1234-1253. [PMID: 33948830 DOI: 10.1007/s10964-021-01440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.
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An Examination of Post-Traumatic Stress Symptoms and Aggression among Children with a History of Adverse Childhood Experiences. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09884-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns. J Affect Disord 2021; 280:30-38. [PMID: 33221605 DOI: 10.1016/j.jad.2020.11.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/15/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. METHODS Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. RESULTS For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class. LIMITATIONS The cross-sectional survey design did not allow to conclude any causality. CONCLUSIONS The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.
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Negriff S. Expanding our Understanding of Intergenerational Exposure to Adversity. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105369. [PMID: 33132471 PMCID: PMC7592700 DOI: 10.1016/j.childyouth.2020.105369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study examined the intergenerational continuity of adverse childhood experiences (ACEs) for parents and their adolescent offspring. Data were from a longitudinal study of the effects of maltreatment on adolescent development. Only biological parents (n=185) and one adolescent per parent (n=164) were included in the analytic sample. Self-reported retrospective data on childhood adversities was obtained at the 3rd wave for parents and the 4th wave for adolescents (M age=18.16). For siblings in the study, one was randomly chosen to be included. Latent class analysis was used to examine 1-4 class solutions for parents and adolescents separately and crosstabs were used to show the concordance between assignment to similar classes for the parent and child. Results indicated 2 class solutions for both the parent and child: a high ACEs class characterized by witnessing intimate partner violence and all maltreatment types and a low ACES class characterized by no adversities. Concordance was highest for both parent and child being assigned to the low ACEs class (52% of the dyads). There were 9% of the dyads who were concordant for being assigned to the high ACEs class, indicating less continuity of adversity than expected. Overall the findings show some intergenerational continuity of adversity, but further work should be done to characterize the different patterns of concordance/discordance between parent and child ACEs.
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Affiliation(s)
- Sonya Negriff
- Kaiser Permanente Southern California, 100 S Los Robles Ave, Pasadena, CA 91101, United States
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Nidey N, Bowers K, Ammerman RT, Shah AN, Phelan KJ, Clark MJ, Van Ginkel JB, Folger AT. Combinations of adverse childhood events and risk of postpartum depression among mothers enrolled in a home visiting program. Ann Epidemiol 2020; 52:26-34. [PMID: 33010417 DOI: 10.1016/j.annepidem.2020.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/30/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to examine how combinations of adverse childhood events (ACEs) contribute to the risk of postpartum depression and the mediating role of prenatal social support. METHODS The Adverse Childhood Experiences Scale Questionnaire and the Edinburgh Postnatal Depression Scale Questionnaire were used to measure the study's exposure and outcome. Among a cohort of 419 mothers enrolled in a home visiting (HV) program, latent class analyses were used to identify classes of ACEs exposure. General linear models assessed the risk of postpartum depression, and prenatal social support was examined as a mediator. RESULTS Four distinct classes of ACE exposure were identified. On the Edinburgh Postnatal Depression scale, mothers who were classified in Classes 1-3 scored higher by 2.6-4.4 points compared with women in Class 0. ACE class was found to be indirectly associated with postpartum depression scores through prenatal social support. CONCLUSIONS Identifying combinations of ACEs in an HV program has the potential to improve the characterization of ACEs among low-income perinatal women in the United States. Elucidating how these combinations contribute to the risk of postpartum depression has the potential to identify women at increased risk, which can help HV programs prioritize prevention efforts.
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Affiliation(s)
- Nichole Nidey
- Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Katherine Bowers
- Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Robert T Ammerman
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH
| | - Anita N Shah
- Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kieran J Phelan
- The Permanente Medical Group, Kaiser Permanente Pediatrics, San Rafael, CA
| | - Margaret J Clark
- Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH
| | - Judith B Van Ginkel
- Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH
| | - Alonzo T Folger
- Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Every Child Succeeds Program, Cincinnati, OH.
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Adverse childhood experiences (ACEs) on mental disorders in young adulthood: Latent classes and community violence exposure. Prev Med 2020; 134:106039. [PMID: 32097756 DOI: 10.1016/j.ypmed.2020.106039] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/09/2020] [Accepted: 02/22/2020] [Indexed: 11/20/2022]
Abstract
Adverse childhood experiences (ACEs) have significant impacts on mental health outcomes. There is a growing interest in expanding the scope of ACEs beyond household environments. To date, few studies examine multidimensional ACEs with community violence. This study aims to (1) identify underlying ACE classes including exposure to community violence, and (2) investigate the associations of ACE classes with mental disorders in adulthood: depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). We employed Latent Class Analysis (LCA) and logistic regression analyses using the data from the National Longitudinal Study of Adolescent and Adult Health (Add Health). The LCA identified four heterogeneous ACE classes: (1) child maltreatment (17.47%), (2) household dysfunction (14.39%), (3) community violence (5.36%), and (4) low adversity (62.79%). Three logistic analyses showed that the "child maltreatment" class was more likely to report a depression (OR = 1.56, CI = 1.26-1.92), anxiety (OR = 1.31, CI = 1.06-1.62), and PTSD (OR = 1.97, CI = 1.35-2.87) in adulthood compared to the "low adversity" class. Also, the "community violence" class was more likely to have PTSD (OR = 2.15, CI = 1.14-4.06) in adulthood, compared to the "low adversity" class. However, the "household dysfunction" class was not significantly different in all three mental disorders from the "low adversity" class. Findings supported the differences in mental disorders in young adulthood by types of exposures to ACEs. The study highlights the importance of considering types of ACEs exposure for promoting mental health of young adults.
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The Role of Social Support in the Association between Childhood Adversity and Adolescent Self-injury and Suicide: Findings from a Statewide Sample of High School Students. J Youth Adolesc 2020; 49:1195-1208. [DOI: 10.1007/s10964-020-01235-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/27/2020] [Indexed: 12/28/2022]
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