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Benton M, Dicke R, Kapp JM. Interprofessional perspectives on ACEs: Results from a statewide interprofessional training program. CHILD ABUSE & NEGLECT 2024; 154:106911. [PMID: 38943769 DOI: 10.1016/j.chiabu.2024.106911] [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: 12/27/2023] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are pervasive and well-recognized as having lasting deleterious effects on the physical and mental health of those who experience them, particularly with accumulated exposure. OBJECTIVE This study seeks to identify the perspectives of interprofessional health providers on their personal and professional experiences with ACEs, ACEs screening, how to work with people with ACEs, and make recommendations for the field. PARTICIPANTS AND SETTING Sixty-two health professionals and PhD students who completed at least one module of an online course and at least one of the accompanying discussion board sub-prompts. METHODS Responses to five course discussion board assignments, each with multiple sub-prompts, were coded to determine and refine major themes and merged with demographic and other background data. From the 561 responses, six themes were identified and used to analyze response patterns. RESULTS Twenty-nine percent of responses reflected a macro perspective on ACEs; 29 % of responses reflected workplace experiences; 28 % of responses reflected ACEs complexity, 8 % of responses reflected a personal relationship to ACEs, 3 % reflected perspectives on resilience; and 3 % were related to the course. Participants communicated complex understandings of ACEs, demonstrating the relevance and importance of the topic for public health training. CONCLUSIONS Integrating ACEs training into the practice setting provides opportunities to improve the health and lives of those suffering from ACEs, especially when incorporating provider voice and perspectives.
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Affiliation(s)
- Mark Benton
- Center for Health Policy, Department of Public Health, College of Health Sciences, University of Missouri, United States of America.
| | - Rachel Dicke
- Institute of Public Policy, Truman School of Government and Public Affairs, University of Missouri, United States of America
| | - Julie M Kapp
- Department of Public Health, College of Health Sciences, University of Missouri, United States of America
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Miller S, Cobos KL, Rasic N, Long X, Lebel C, Bar Am N, Noel M, Kopala-Sibley D, Mychasiuk R, Miller JV. Adverse childhood experiences, brain efficiency, and the development of pain symptoms in youth. Eur J Pain 2024. [PMID: 39010829 DOI: 10.1002/ejp.4702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 06/10/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are often reported by youths with chronic pain, and both ACEs and chronic pain disrupt how information is processed. However, it is unknown whether changes to shared neural networks underlie the relationship between ACEs and the development of pain symptoms. This study explored the relationships between ACEs, brain efficiency, and pain symptomology in youth. METHODS A community sample of youths aged 14-18 years underwent MRIs, answered trauma and pain questionnaires, and underwent pain sensory testing, twice, 3 months apart (Nbaseline = 44; Nfollow-up = 42). Sensory testing determined thresholds for mechanical and thermal stimuli. Global and local network efficiencies were evaluated using graph theory. Generalized estimating equations were applied to examine whether brain efficiency moderated the relationships between ACEs, pain intensity, and pain sensitivity (i.e., mechanical detection, heat pain, and temperature change thresholds). RESULTS There was a significant interaction between ACEs and global brain efficiency in association with pain intensity (β = -0.31, p = 0.02) and heat pain (β = -0.29, p = 0.004). Lower global brain efficiency exacerbated the relationship between ACEs and pain intensity (θX → Y|W = -1.16 = 0.37, p = 0.05), and heat pain sensitivity (θX → Y|W = -1.30 = 0.44, p = 0.05). Higher global brain efficiency ameliorated the relationship between ACEs and pain intensity (θX → Y|W = 1.75 = -0.53, p = 0.05). CONCLUSIONS The relationship between ACEs and pain symptomology was comparable to chronic pain phenotypes (i.e., higher pain intensity and pain thresholds) and may vary as a function of brain efficiency in youth. This stresses the importance of assessing for pain symptoms in trauma-exposed youth, as earlier identification and intervention are critical in preventing the chronification of pain. SIGNIFICANCE This article explores the relationship between ACEs, pain symptomology, and brain efficiency in youth. ACEs may affect how the brain processes information, including pain. Youths with lower brain efficiencies that were exposed to more ACEs have pain symptomology comparable to youths with chronic pain. Understanding this relationship is important for the earlier identification of pain symptoms, particularly in vulnerable populations such as youths exposed to trauma, and is critical for preventing the chronification of pain.
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Affiliation(s)
- Samantha Miller
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen L Cobos
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nivez Rasic
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Xiangyu Long
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- The Mathison Centre for Mental Health and Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Neta Bar Am
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- The Mathison Centre for Mental Health and Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Kopala-Sibley
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- The Mathison Centre for Mental Health and Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Richelle Mychasiuk
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Jillian Vinall Miller
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- The Mathison Centre for Mental Health and Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
- O'Brien Center, University of Calgary, Calgary, Alberta, Canada
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Tao Y, Wang H, Luo J, Zhang H, Zhang W, Yu M, Ji S, Peng S, Zhang X. The Association between Adverse Childhood Experiences and Frailty: A Systematic Review. J Am Med Dir Assoc 2024; 25:105042. [PMID: 38796164 DOI: 10.1016/j.jamda.2024.105042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Based on life-course theory, adverse childhood experiences (ACEs) have emerged as risk factors for health in later life. This study aimed to explore the association between ACEs and frailty. DESIGN Systematic review. SETTING AND PARTICIPANTS Frail older adults who have experienced ACEs. METHODS We searched 7 databases: PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO, and China National Knowledge Infrastructure (CNKI). The last searched date was October 27, 2023. Included studies should have investigated the association between exposure to at least 1 ACE and frailty. Two researchers independently assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale (NOS) and an adapted version of the NOS scale and also extracted relevant characteristics and outcomes of the included studies. RESULTS A total of 14 studies were finally included. Consistent associations with increased risk of frailty were only shown in studies that assessed family members with mental illness, low neighborhood quality, emotional abuse, sexual abuse, and combinations of ACEs. In addition, women exposed to ACEs were more likely to be at risk for frailty than men, and greater numbers or types of exposure to ACEs were associated with higher odds of frailty. The results of the quality assessment showed a moderate risk of bias in half of the studies. CONCLUSIONS AND IMPLICATIONS This study summarizes for the first time the evidence for an association between ACEs and frailty. Considered collectively, increased attention to ACEs may be one way to prevent frailty, and unhealthy lifestyles resulting from ACEs may serve as a breakthrough in developing interventions.
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Affiliation(s)
- Yanmin Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Jingsong Luo
- Jockey Club School of Public Health and Primary Care School, The Chinese University of Hong Kong, Hong Kong
| | - Hong Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wen Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Meng Yu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shuyang Ji
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sihan Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Xiangeng Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China.
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Aslam MV, Swedo E, Niolon PH, Peterson C, Bacon S, Florence C. Adverse Childhood Experiences Among U.S. Adults: National and State Estimates by Adversity Type, 2019-2020. Am J Prev Med 2024; 67:55-66. [PMID: 38369270 PMCID: PMC11193602 DOI: 10.1016/j.amepre.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Although adverse childhood experiences (ACEs) are associated with lifelong health harms, current surveillance data on exposures to childhood adversity among adults are either unavailable or incomplete for many states. In this study, recent data from a nationally representative survey were used to obtain the current and complete estimates of ACEs at the national and state levels. METHODS Current, complete, by-state estimates of adverse childhood experiences were obtained by applying small area estimation technique to individual-level data on adults aged ≥18 years from 2019-2020 Behavioral Risk Factor Surveillance System survey. The standardized questions about childhood adversity included in the 2019-2020 survey allowed for obtaining estimates of ACE consistent across states. All missing responses to childhood adversity questions (states did not offer such questions or offered them to only some respondents; respondents skipped questions) were predicted through multilevel mixed-effects logistic small area estimation regressions. The analyses were conducted between October 2022 and May 2023. RESULTS An estimated 62.8% of U.S. adults had past exposure to ACEs (range: 54.9% in Connecticut; 72.5% in Maine). Emotional abuse (34.5%) was the most common; household member incarceration (10.6%) was the least common. Sexual abuse varied markedly between females (22.2%) and males (5.4%). Exposure to most types of adverse childhood experiences was lowest for adults who were non-Hispanic White, had the highest level of education (college degree) or income (annual income ≥$50,000), or had access to a personal healthcare provider. CONCLUSIONS Current complete estimates of ACEs demonstrate high countrywide exposures and stark sociodemographic inequalities in the burden, highlighting opportunities to prevent adverse childhood experiences by focusing social, educational, medical, and public health interventions on populations disproportionately impacted.
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Affiliation(s)
- Maria V Aslam
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Elizabeth Swedo
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Phyllis H Niolon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Bacon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Curtis Florence
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Mercera G, Vervoort-Schel J, Offerman E, Pronk S, Wissink I, Lindauer R. Prevalence of Adverse Childhood Experiences in Adolescents with Special Educational and Care Needs in the Netherlands: A Case-File Study of Three Special Educational and Care Settings. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:541-554. [PMID: 38938950 PMCID: PMC11199457 DOI: 10.1007/s40653-024-00613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 06/29/2024]
Abstract
To date, Adverse Childhood Experiences (ACEs) in adolescents with special educational and care needs have received little attention as an important risk factor for their behavioral, emotional, and learning problems. This study provides insight into ACE prevalence and family risk factors in three Dutch special educational and care settings for vulnerable school-aged youth. 268 adolescents (10-18 years old) with severe and persistent problems at individual and family level, from a special educational setting (setting 1; n = 59), a residential care setting (setting 2; n = 86) and an alternative educational setting (setting 3; n = 123) were included. A retrospective cross-sectional study design was used. Data were collected between 2016 and 2019 through structured case-file analysis. A substantial proportion of the adolescents in all settings experienced at least one ACE, with 69.5% in setting 1, 84.9% in setting 2 and 95.1% in setting 3. Family risk factors were relatively common, among which a limited social network in all settings (20-50%) and debts in setting 2 and 3 (25-40%). The substantial ACE prevalence underlines the need for early ACE awareness. Trauma-informed care and education are needed to adequately understand trauma-related behaviors, prevent retraumatization, and enhance learning and healthy development. Given that ACEs regarding household dysfunction and family risk factors seem to be common in adolescents with special educational and care needs, family centered approaches should be implemented as well in the interest of lifelong health and well-being for both adolescents and their families.
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Affiliation(s)
- Gabriëlle Mercera
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, Oisterwijk, 5062 JT The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB The Netherlands
| | - Jessica Vervoort-Schel
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, Oisterwijk, 5062 JT The Netherlands
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, 1018 WS The Netherlands
| | - Evelyne Offerman
- Orion, Special Education, Bijlmerdreef 1289-2, Amsterdam 1103 TV The Netherlands
| | - Sanne Pronk
- Academic Workplace Youth at Risk (AWRJ), Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inge Wissink
- Department of Clinical Child & Family Studies, Utrecht University, Heidelberglaan 1, Utrecht, 3584 CS The Netherlands
| | - Ramón Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, Amsterdam, 1105 AZ The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ The Netherlands
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von Känel R, Princip M, Holzgang SA, Giannopoulos AA, Kaufmann PA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Cross-sectional study on the impact of adverse childhood experiences on coronary flow reserve in male physicians with and without occupational burnout. J Psychosom Res 2024; 181:111672. [PMID: 38636300 DOI: 10.1016/j.jpsychores.2024.111672] [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: 01/20/2024] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Physicians face documented challenges to their mental and physical well-being, particularly in the forms of occupational burnout and cardiovascular disease. This study examined the previously under-researched intersection of early life stressors, prolonged occupational stress, and cardiovascular health in physicians. METHODS Participants were 60 practicing male physicians, 30 with clinical burnout, defined by the Maslach Burnout Inventory, and 30 non-burnout controls. They completed the Adverse Childhood Experiences (ACE) Questionnaire asking about abuse, neglect and household dysfunctions before the age of 18, and the Perceived Stress Scale to rate thoughts and feelings about stress in the past month. Endothelium-independent (adenosine challenge) coronary flow reserve (CFR) and endothelium-dependent CFR (cold pressor test) were assessed by positron emission tomography-computed tomography. The segment stenosis score was determined by coronary computed tomography angiography. RESULTS Twenty-six (43%) participants reported at least one ACE and five (8%) reported ≥4 ACEs. A higher ACEs sum score was associated with lower endothelium-independent CFR (r partial (rp) = -0.347, p = .01) and endothelium-dependent CFR (rp = -0.278, p = .04), adjusting for age, body mass index, perceived stress and segment stenosis score. In exploratory analyses, participants with ≥4 ACEs had lower endothelium-independent CFR (rp = -0.419, p = .001) and endothelium-dependent CFR (rp = -0.278, p = .04), than those with <4 ACEs. Endothelium-dependent CFR was higher in physicians with burnout than in controls (rp = 0.277, p = .04). No significant interaction emerged between burnout and ACEs for CFR. CONCLUSION The findings suggest an independent association between ACEs and CFR in male physicians and emphasize the nuanced relationship between early life stressors, professional stress, and cardiovascular health.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Nkwata AK, Smith J. Early learning difficulties, childhood stress, race, and risk of cognitive impairment among US adults over age 50: A cross-sectional analysis. Health Sci Rep 2023; 6:e1756. [PMID: 38093828 PMCID: PMC10716572 DOI: 10.1002/hsr2.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/20/2023] [Accepted: 11/22/2023] [Indexed: 02/01/2024] Open
Abstract
Background and Aims Most literature linking childhood factors to cognitive health outcomes has focused on educational attainment-defined as years of education attained. However, less has been studied about the other aspects of education, such as early learning problems, and stressful family environments. This study examined whether early learning problems and childhood stressors were associated with mid- and later life cognitive impairment among US adults, and if these associations varied by race. Methods We conducted a cross-sectional analysis using the Health and Retirement Study (HRS) along with respondents' early educational experiences from the 2015 to 2017 Life History Mail Survey (N = 9703). Early learning problems were defined as having any of the following: scholastic problems (reading, writing, mathematics), speaking/language issues, and sensorimotor issues- hearing, vision, speech, and motor-coordination. Cognitive status was classified as three levels (normal, cognitively impaired not demented [CIND], and demented) using the HRS Langa-Weir algorithm. Multinomial logistic regression models using generalized logits, estimated relative risk ratios (RRRs), and 95% confidence intervals (CI) with adjustment for sociodemographic factors. Results Having at least one early learning problem was associated with increased risk of later life cognitive impairment (RRR: 1.75, 95% CI: 1.34-2.29 for dementia, RRR: 1.42, 95% CI: 1.20-1.67 for CIND). Parental death before the age of 16 was associated with 17% higher risk of CIND in later life (RRR: 1.17, 95% CI: 1.01-1.34). However, learning problem-related differences in risk of cognitive impairment were dependent on race (learning problems × race, p = 0.0001). In the demented group, Blacks were 2.7 times more likely to be demented (RRR: 2.66, 95% CI: 1.69-4.17) amongst older adults that experienced childhood learning problems. Conclusions Early life exposures predicted risk of cognitive impairment. Policies and interventions that enhance diagnosis of early learning problems and improve childhood social contexts are needed to promote healthy cognitive aging amongst Americans, regardless of race.
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Affiliation(s)
- Allan K. Nkwata
- Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Jacqui Smith
- Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
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Bhattarai A, Dimitropoulos G, Bulloch AGM, Tough SC, Patten SB. Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study. BMC Public Health 2023; 23:2036. [PMID: 37853382 PMCID: PMC10585893 DOI: 10.1186/s12889-023-16935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. METHODS The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994-2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). RESULTS During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. CONCLUSION The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
| | - Gina Dimitropoulos
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
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Compton AB, Panlilio CC, Humphreys KL. What's the matter with ACEs? Recommendations for considering early adversity in educational contexts. CHILD ABUSE & NEGLECT 2023; 142:106073. [PMID: 36774310 PMCID: PMC10293056 DOI: 10.1016/j.chiabu.2023.106073] [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: 09/11/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, some trauma-informed education practices use "ACE scores," a number that represents the sum of endorsed items from a survey derived from the Adverse Childhood Experiences (ACEs) study in 1998. We caution that the survey provides limited information within education, and such scores have limited utility for designing and delivering individualized intervention to support students who have experienced adversity. OBJECTIVE We sought to illustrate why ACEs are not well-suited for use in trauma-informed education, provide definitions for adversity-related terms from which a broader and common understanding of adversity can stem, and provide recommendations for integration of adversity-informed approaches to the educational context. METHODS We compiled definitions of adversity-related constructs and made recommendations based on review of relevant research from the fields of psychology and education. RESULTS Rather than tailoring educational practices to specific children based on the "traumatic" events they experience, we recommend educators focus their efforts on building supportive classrooms geared toward supporting students with best practices drawn from the Science of Learning, and with the understanding that early adversity can influence heterogeneous trajectories in student development and behavior. In addition, further research on educational practices, including the use of a shared language for describing and defining adversity-related experiences, are the concrete steps needed to better support a goal of adversity-informed education.
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Bhattarai A, King N, Adhikari K, Dimitropoulos G, Devoe D, Byun J, Li M, Rivera D, Cunningham S, Bulloch AG, Patten SB, Duffy A. Childhood Adversity and Mental Health Outcomes Among University Students: A Longitudinal Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:510-520. [PMID: 36000272 PMCID: PMC10408556 DOI: 10.1177/07067437221111368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental health concerns are common among university students and maybe elevated among those with specific risk exposures. The study examined the association between childhood adversities and mental health outcomes among undergraduate university students and assessed whether psychosocial and behavioral factors mediate those associations. METHODS The Queen's University Student Well-Being and Academic Success Survey identified two large cohorts of first-year undergraduate students entering university in Fall 2018 and 2019 (n = 5,943). At baseline, students reported sociodemographic information, family-related mental health history, childhood physical abuse, sexual abuse, peer bullying, and parental separation or divorce. Baseline and follow-up surveys in Spring 2019, Fall 2019, and Spring 2020 included validated measures of anxiety (7-item Generalized Anxiety Disorder) and depressive symptoms (9-item Patient Health Questionnaire ), non-suicidal self-harm, and suicidality, along with psychological processes and lifestyle variables. Repeated measures logistic regression using Generalized Estimating Equations was used to characterize the associations between childhood adversities and mental health outcomes and examine potential mediation. RESULTS Adjusting for age, gender, ethnicity, familial mental illness, and parental education, any childhood abuse (odds ratio: 2.89; 95% confidence interval, 2.58 to 3.23) and parental separation or divorce (odds ratio: 1.29; 95% confidence interval, 1.12 to 1.50) were significantly associated with a composite indicator of mental health outcomes (either 9-item Patient Health Questionnaire score ≥10 or 7-item Generalized Anxiety Disorderscore ≥10 or suicidality or self-harm). The association with childhood abuse weakened when adjusted for perceived stress, self-esteem, and insomnia (odds ratio: 2.05; 95% confidence interval, 1.80 to 2.34), and that with parental divorce weakened when adjusted for self-esteem (odds ratio: 1.17; 95% confidence interval, 1.00 to 1.36). CONCLUSION Childhood abuse and parental separation or divorce were associated with mental health concerns among university students. Childhood adversities may impact later mental health through an association with stress sensitivity, self-esteem, and sleep problems. The findings suggest that prevention and early intervention focusing on improving sleep, self-esteem, and coping with stress while considering the individual risk profile of help-seeking students may help support student mental health.
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Affiliation(s)
- Asmita Bhattarai
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Kamala Adhikari
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
| | | | - Dan Devoe
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Jin Byun
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Melanie Li
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Andrew G.M. Bulloch
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott B. Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anne Duffy
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, University of Oxford, Oxford, UK
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11
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Rokach A, Clayton S. The Consequences of Child Abuse. Healthcare (Basel) 2023; 11:healthcare11111650. [PMID: 37297790 DOI: 10.3390/healthcare11111650] [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: 04/06/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
This review provides an overview of the consequences of early adverse experiences across various domains of life. Drawing on the Adverse Childhood Experiences (ACEs) conceptual framework, we discuss the ACE pyramid and the varying degrees of consequences that ACE exposure may elicit. Using online search engines such as Google Scholar, the authors sifted through empirical research to locate relevant articles and research to help prepare this review. This article sheds light on the implications of ACEs for health, socio-emotional and psychosocial well-being, relationships, personality, and cognitive functioning.
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Affiliation(s)
- Ami Rokach
- Psychology Department., Faculty of Health, York University, Toronto, ON M3J 1P3, Canada
| | - Shauna Clayton
- Department of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada
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12
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Dowdy R, Estes J, McCarthy C, Onders J, Onders M, Suttner A. The Influence of Occupational Therapy on Self-Regulation in Juvenile Offenders. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:221-232. [PMID: 36340267 PMCID: PMC9628343 DOI: 10.1007/s40653-022-00493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 05/27/2023]
Abstract
Previous studies have shown that experiences of childhood trauma disproportionally impact incarcerated youth and may decrease self-regulation skills including identification of emotions and ability to control behaviors. Purpose: The current study aimed to investigate changes in emotional state identified by incarcerated youth after receiving sensory-based occupational therapy treatment. Methods: A quasi-experimental retrospective chart review design was used in addition to surveys. Results: Participants had an average ACE score of 5.91 traumatic experiences and at least three mental health diagnoses. Results showed a statistically significant change between pre-and post-session emotions via a Likert scale as well as a decrease in the frequency of negative words used to identify emotions. When surveyed, participants reported a calmer body state after occupational therapy and highlighted the importance of learning coping strategies. Conclusion: Results suggest that sensory-based occupational therapy may be an effective, trauma-informed intervention to improve self-regulation and support daily function of these incarcerated youth.
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13
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Oughourlian TC, Tun G, Antony KM, Gupta A, Mays VM, Mayer EA, Rapkin AJ, Labus JS. Symptom-associated alterations in functional connectivity in primary and secondary provoked vestibulodynia. Pain 2023; 164:653-665. [PMID: 35972459 DOI: 10.1097/j.pain.0000000000002754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/02/2022] [Indexed: 10/15/2022]
Abstract
ABSTRACT Primary provoked vestibulodynia (PVD) is marked by the onset of symptoms at first provoking vulvar contact, whereas secondary PVD refers to symptom onset after some period of painless vulvar contact. Different pathophysiological processes are believed to be involved in the development and maintenance of primary PVD and secondary PVD. The primary aim of this study was to test the hypotheses that the resting state functional connectivity of the brain and brain stem regions differs between these subtypes. Deep clinical phenotyping and resting state brain imaging were obtained in a large sample of a women with primary PVD (n = 46), those with secondary PVD (n = 68), and healthy control women (n = 94). The general linear model was used to test for differences in region-to-region resting state functional connectivity and psychosocial and symptom assessments. Direct statistical comparisons by onset type indicated that women with secondary PVD have increased dorsal attention-somatomotor network connectivity, whereas women with primary PVD predominantly show increased intrinsic resting state connectivity within the brain stem and the default mode network. Furthermore, compared with women with primary PVD, those with secondary PVD reported greater incidence of early life sexual abuse, greater pain catastrophizing, greater 24-hour symptom unpleasantness, and less sexual satisfaction. The findings suggest that women with secondary PVD show greater evidence for central amplification of sensory signals, whereas women with primary PVD have alterations in brain stem circuitry responsible for the processing and modulation of ascending and descending peripheral signals.
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Affiliation(s)
- Talia C Oughourlian
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Neuroscience Interdisciplinary Graduate Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Guistinna Tun
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Kevin M Antony
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Gonda (Goldschmied) Neuroscience and Genetics Research Center, Brain Research Institute UCLA, University of California Los Angeles, Los Angeles, CA, United States
| | - Vickie M Mays
- Departments of Psychology and Health Policy & Management, Fielding School of Public Health, BRITE Center for Science, Research & Policy, University of California, Los Angeles, Los Angeles, CA, United States
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Andrea J Rapkin
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Jennifer S Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Gonda (Goldschmied) Neuroscience and Genetics Research Center, Brain Research Institute UCLA, University of California Los Angeles, Los Angeles, CA, United States
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14
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Palusci VJ, Schnitzer PG, Collier A. Social and demographic characteristics of child maltreatment fatalities among children ages 5-17 years. CHILD ABUSE & NEGLECT 2023; 136:106002. [PMID: 36621053 DOI: 10.1016/j.chiabu.2022.106002] [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: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND While risk factors have been identified among infants and young children, less is known about child maltreatment fatalities among older children. OBJECTIVES To describe the social and demographic characteristics of children where abuse or neglect was determined to cause or contribute to their death, compare characteristics and circumstances of the deaths by cause and manner of death and type of maltreatment, and explore the role of abuse and neglect in child suicides. PARTICIPANTS AND SETTING Secondary analysis of deaths due to child abuse or neglect among children ages 5-17 years old occurring during 2009-2018 and documented in the National Fatality Review-Case Reporting System. METHODS Child, family, and social characteristics were compared by child age (5-10 years vs. 11-17 year-olds), and by cause and manner of death. Frequencies and proportions were reported and compared using chi-square statistics. RESULTS 1478 maltreatment-related deaths were identified. Higher proportions of older children were non-Hispanic white, had a history of chronic disease or disability, had problems in school, and had a history of mental health issues. Forty-three percent of the maltreatment deaths were due to homicide and 10 % by suicide. Higher proportions (65 %) of younger children (5-10 years old) died by homicide, compared to older children (35 % among ages 11-17y). While 58 % of deaths overall were related to neglect, 68 % of deaths in older children were related to neglect, including 80 % of suicides. CONCLUSIONS The causes of child maltreatment deaths among children 5-17y vary by age. Child neglect caused and/or contributed to most child suicides.
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Affiliation(s)
| | - Patricia G Schnitzer
- U.S. National Center for Child Fatality Review and Prevention, a program of the Michigan Public Health Institute, Okemos, MI, USA
| | - Abigael Collier
- U.S. National Center for Child Fatality Review and Prevention, a program of the Michigan Public Health Institute, Okemos, MI, USA
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15
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Dar AA, Deb S, Malik MH, Khan W, Haroon AP, Ahsan A, Jahan F, Sumaiya B, Bhat SY, M D, Qasim M. Prevalence of Adverse Childhood Experiences (ACEs) among young adults of Kashmir. CHILD ABUSE & NEGLECT 2022; 134:105876. [PMID: 36152534 DOI: 10.1016/j.chiabu.2022.105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/27/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Studies on the prevalence of adverse childhood experiences (ACEs) in Kashmir, India, are yet to be conducted. This study aims to estimate the prevalence of ACEs among young adults across all the ten districts of Kashmir Valley. METHODS A cross-sectional research strategy was used to assess the prevalence of ACEs by employing a multi-stage sampling method. Data were collected from 800 students studying in different colleges and universities in Kashmir with the help of the "Adverse Childhood Experiences" (ACEs) scale. RESULTS Findings disclosed that less than a quarter of the respondents reported high exposure to ACEs (15.4 %), more than one-tenth of the participants reported extremely high exposure to ACEs (13.4 %), over a quarter of the sample reported moderate exposure to ACEs (26.3 %), one-third of the youth reported low exposure to ACEs (33.0 %) and over one-tenth of the respondents reported no exposure to ACEs (11.8 %). The prevalence of ACEs was found to be 88.2 % (females: 82.7 % and males: 90.8 %) in Kashmir. The ACEs with the highest level of prevalence were "often or very often sworn at, insulted, or put down" (49.8 %), followed by "often or very often acted in a way that made them afraid that they would be physically hurt" (47.6 %), "often or very often pushed, grabbed, shoved, or slapped" (41.6 %), "often or very often hit so hard that they had marks or were injured" (28.3 %) and "touched or sexually fondled" (25.3 %). Thirteen out of 21 adverse events during childhood were significantly associated with gender. CONCLUSION The findings suggest the need to advocate early targeted interventions, reduce ACEs and their impact, and design efficient measures to improve the health and well-being of young adults in Kashmir.
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Affiliation(s)
- Aehsan Ahmad Dar
- Department of Psychology, SRM University, Amaravati, Andhra Pradesh, India; Department of Applied Psychology, Pondicherry University, India.
| | - Sibnath Deb
- Rajiv Gandhi National Institute of Youth Development, Ministry of Youth Affairs and Sports, Government of India, Sriperumbudur, India
| | | | - Waheeda Khan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | | | - Amra Ahsan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Farhat Jahan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Bushra Sumaiya
- Faculty of Education, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Shaheen Yawar Bhat
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dhamodharan M
- Department of Psychology, SRM University, Amaravati, Andhra Pradesh, India
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16
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Zarei K, Kahle L, Buckman DW, Choi K, Williams F. Parent-Child Nativity, Race, Ethnicity, and Adverse Childhood Experiences Among U.S. Children. J Pediatr 2022; 251:190-195.e4. [PMID: 35944710 PMCID: PMC9729360 DOI: 10.1016/j.jpeds.2022.07.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/23/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022]
Abstract
We examined the relationship between parent-child nativity, race/ethnicity, and adverse childhood experiences (ACEs) among US children. We found that a high proportion of Black/Hispanic children experienced ACEs, with variation by generation for Hispanic but not Black children, and a lower but increasing proportion of White children experienced ACEs by generation.
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Affiliation(s)
- Kasra Zarei
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD.
| | - Lisa Kahle
- Information Management Services, Inc, Calverton, MD
| | | | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
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17
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Brewerton TD. Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span. J Eat Disord 2022; 10:162. [PMID: 36372878 PMCID: PMC9661783 DOI: 10.1186/s40337-022-00696-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality. METHODS In keeping with this Special Issue's goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable. RESULTS At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide. CONCLUSIONS The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
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18
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Upenieks L, Thomas PA. Matters of the Heart: Childhood Maltreatment, Religious Transitions, and Cardiovascular-Related Problems over the Life Course. J Aging Health 2022; 35:405-418. [PMID: 36321397 DOI: 10.1177/08982643221135689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: Childhood maltreatment is associated with a higher risk of cardiovascular-related problems, the leading cause of death in the United States. Drawing from cumulative inequality theory, this study considers whether transitions in religious attendance moderate the deleterious impact of childhood maltreatment on long-term cardiovascular risk. Methods: We utilize over 35 years of prospective panel data from the National Longitudinal Study of Youth from the United States (1979–2015). Results: Our findings suggest that decreases in religious attendance between adolescence and adulthood (from high to low, and high to moderate attendance) were associated with elevated cardiovascular-related risk for those abused as children. Neither stable high attendance nor increases in attendance buffered against the impact of childhood abuse on cardiovascular-related problems. Discussion: We illustrate the importance of incorporating the role of stability and change in religious attendance across the life course and suggest directions for future research.
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19
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Fujiwara T. Impact of adverse childhood experience on physical and mental health: A life-course epidemiology perspective. Psychiatry Clin Neurosci 2022; 76:544-551. [PMID: 36002401 DOI: 10.1111/pcn.13464] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) have been shown to have long-term effects on physical and mental health, not only in the US, but also other countries, including Japan. In this paper, measurement of assessment of ACEs has been discussed, that is, concept (what is ACEs), inquiry (how to ask about ACEs), scoring (how to count the number of ACEs), and prevalence (how many ACEs do we have). In addition, a possible mechanism on how ACEs affect health was summarized from a life-course perspective, using the critical/sensitive period model, pathway model, and cumulative model with recent evidence on neurological findings. Intergenerational transmission, that is, maternal ACEs affecting the health of the offspring was also reviewed. Finally, future directions on how to prevent and remedy the impact of ACEs on health was discussed.
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Affiliation(s)
- Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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20
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McKay MT, Healy C, Chambers D, Dodd P, O'Donnell L, Cannon M, Clarke MC. The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data. Assessment 2022:10731911221116573. [PMID: 35996849 DOI: 10.1177/10731911221116573] [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: 11/15/2022]
Abstract
This study assessed the feasibility of a multi-domain measure of the occurrence, impact, and timing of childhood/adolescent psychological adversity exposure, the Subjective Impact and Timing of Adversity Scale (SITA). Participants were from among those who had previously participated in two waves of data collection when aged approximately 14 and 21 years. Internal consistency estimates at both online and interview stages were acceptable for all SITA domains (with the exception of parental loss). SITA domain scores correlated meaningfully with scores on other scales and psychological measures, supporting convergent validity. Those with lifetime psychiatric diagnoses scored significantly higher on SITA domains than those not meeting diagnostic threshold. There was evidence of the importance of both the subjective impact and timing of adversity with regard to psychiatric diagnoses. The study demonstrates the viability of the SITA; however, further studies are required to substantiate these findings in larger samples.
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Affiliation(s)
- Michel T McKay
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Laurie O'Donnell
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Cannon
- RCSI University of Medicine and Health Sciences and Beaumont Hospital, Dublin, Ireland
| | - Mary C Clarke
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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21
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Adverse Childhood Experiences and Current Psychosocial Stressors: Exploring Effects on Mental Health and Parenting Outcomes from a Mother-Baby Partial Hospital Program. Matern Child Health J 2022; 26:289-298. [PMID: 34993753 DOI: 10.1007/s10995-021-03345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can detrimentally impact perinatal mental health, birth outcomes, and parenting behaviors. Proximal psychosocial stressors also increase risks to perinatal health and wellbeing. Additional research on effective perinatal mental health programs is needed, especially for individuals and families with historical and concurrent adversity, and those with moderate to severe symptoms. METHODS The Mother-Baby Day Hospital at Hennepin County Medical Center provides trauma-informed, multi-generation treatment for perinatal women. Data were collected from patients between January 2016 and September 2019. Self-reported depression, anxiety, and maternal functioning assessments were administered pre- and post-treatment. Patients completed the ACE questionnaire and indicators of current psychosocial stressors (i.e., food insecurity, housing insecurity, and social support) at intake. A series of bivariate tests and hierarchical regression models examined relationships among variables, including whether distal and proximal adversity predicted post-treatment symptoms. RESULTS 159 Perinatal patients consented to research and completed the ACEs questionnaire at first admission. High proportions of patients reported 4+ ACEs and current psychosocial stressors. Effect sizes for associations between ACEs, psychosocial stressors, and self-report symptoms were small to moderate. Individuals with food or housing insecurity entered treatment with higher anxiety. In regression models, the most robust predictors of post-treatment symptoms were pre-treatment symptoms. Effects of ACEs on post-treatment depression and food insecurity on post-treatment maternal functioning approached the adjusted significance cut-off (p < .01). CONCLUSIONS FOR PRACTICE: Current psychosocial stressors and ACEs did not substantially limit post-treatment depression, anxiety, and maternal functioning outcomes. High prevalence of ACEs and psychosocial stressors highlight the need for trauma-informed, multi-generation treatments to improve maternal mental health and parenting capacity.
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22
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First-time exploration of adverse childhood experiences among adults in Delaware using BRFSS data: A cross-sectional study. PUBLIC HEALTH IN PRACTICE 2022; 3:100233. [PMID: 36101758 PMCID: PMC9461508 DOI: 10.1016/j.puhip.2022.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/21/2021] [Accepted: 01/21/2022] [Indexed: 11/29/2022] Open
Abstract
Objective In 2019, for the first time, Delaware collected adverse childhood experiences (ACEs) data through the population-based Behavioral Risk Factor Surveillance System (BRFSS). The main objective of this study was to explore and delineate the prevalence of ACEs and determine their association with select chronic conditions/risk behaviors. Study design A cross-sectional population-based study. Methods Delaware BRFSS 2019 data (N = 3,879) were analyzed. This includes 2,015 respondents with at least one ACE and 1,882 without ACE. Logistic regression was performed using SAS complex weighting procedures to compare the prevalence odds of selected conditions while controlling for age, gender, and race/ethnicity in Delawareans with and without ACEs. Delaware BRFSS participant response rate was 38.2% comparable to other federal survey responses. Results Nearly one in four adults reported high ACEs scores (≥3). Emotional abuse was the most common ACE. ACEs were significantly associated with poorer health outcomes. High ACE scores were more prevalent among women, multiracial/minority race groups, bisexual, lesbian/gay sexually oriented, younger age group, and less educated. Associations between high ACEs score and selected health conditions/behaviors remained statistically significant even after controlling for socio-demographic characteristics. Conclusion Reporting of ACEs data is critical for Delaware's progress towards a Trauma-Informed State. A particularly disturbing finding was that a high number of young adults reported 3 or more ACEs. Strong association with chronic conditions, particularly mental health was a significant cause for concern. Study results present a first-time expansive coverage, providing stakeholders with a unique opportunity to prioritize evidence-based decisions in Trauma-Informed Delaware.
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23
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Chen MA, LeRoy AS, Majd M, Chen JY, Brown RL, Christian LM, Fagundes CP. Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan. Front Psychol 2021; 12:788351. [PMID: 34899540 PMCID: PMC8662704 DOI: 10.3389/fpsyg.2021.788351] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/04/2021] [Indexed: 12/17/2022] Open
Abstract
Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at a greater risk for morbidity and premature mortality than those not exposed to childhood adversity. Several mechanisms likely contribute to the relationship between childhood adversity and health across the lifespan (e.g., health behaviors, cardiovascular reactivity). In this paper, we review a large body of research within the field of psychoneuroimmunology, demonstrating the relationship between early life stress and alterations of the immune system. We first review the literature demonstrating that childhood adversity is associated with immune dysregulation across different indices, including proinflammatory cytokine production (and its impact on telomere length), illness and infection susceptibility, latent herpesvirus reactivation, and immune response to a tumor. We then summarize the growing literature on how childhood adversity may alter epigenetic processes. Finally, we propose future directions related to this work that have basic and applied implications.
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Affiliation(s)
- Michelle A Chen
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Angie S LeRoy
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Jonathan Y Chen
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ryan L Brown
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Lisa M Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX, United States.,Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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Huq T, Alexander EC, Manikam L, Jokinen T, Patil P, Benjumea D, Das I, Davidson LL. A Systematic Review of Household and Family Alcohol Use and Childhood Neurodevelopmental Outcomes in Low- and Middle-Income Countries. Child Psychiatry Hum Dev 2021; 52:1194-1217. [PMID: 33369706 PMCID: PMC8528783 DOI: 10.1007/s10578-020-01112-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 12/14/2022]
Abstract
Childhood exposure to alcohol misuse by household adults has been related to childhood developmental delay, cognitive impacts, mental illness, and problem behaviours. Most evidence comes from high income countries. This systematic review only included studies from low- and middle-income countries (LMICs). Five databases were searched from 1990-2020. Twenty-eight studies of children 0-12 years were included, with 42,599 participants from 11 LMICs. The most common outcome was behavioural problems/disorders (19 studies). Despite varying study designs, this review found that alcohol misuse by household members in LMICs is associated with adverse child neurodevelopmental outcomes, although casual inferences cannot be drawn in the absence of well conducted prospective studies. Statistically significant correlations were described between parental alcohol misuse and child emotional and behavioural difficulties, cognitive delay, and risky behaviours. In future, prospective cohort studies are recommended, with adjustment for confounders.
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Affiliation(s)
- Tausif Huq
- GKT School of Medical Education, King's College London, London, UK
| | - Emma C Alexander
- Paediatric Liver, GI and Nutrition Centre and Mowatlabs, King's College Hospital, London, UK
- Aceso Global Health Consultants Limited, London, UK
| | - Logan Manikam
- Aceso Global Health Consultants Limited, London, UK.
- UCL Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK.
| | - Tahir Jokinen
- GKT School of Medical Education, King's College London, London, UK
| | - Priyanka Patil
- Aceso Global Health Consultants Limited, London, UK
- UCL Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Darrin Benjumea
- Mailman School of Public Health, Columbia University, New York, USA
| | - Ishani Das
- Mailman School of Public Health, Columbia University, New York, USA
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Wang L, Zhang Y, Zhang X, Fan X, Qiong L, Hu C. The Potential Impact of Childhood Traumatic Experiences on Coping Styles and Emotion Regulation of Nurse Practitioners During the COVID-19 Outbreak. Front Psychol 2021; 12:718780. [PMID: 34764907 PMCID: PMC8576184 DOI: 10.3389/fpsyg.2021.718780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: During an epidemic of a novel infectious disease, frontline medical staff suffer from high psychological stress. Previous studies have found that traumatic childhood experiences are associated with mental and physical health in adulthood. Anxiety and depression were measured and analyzed in relation to childhood trauma and coping styles. This study aims to explore the correlational study between traumatic childhood experiences and coping styles among nurse practitioners. Method: This study sampled 278 nurse practitioners from hospitals designated for the treatment of the novel coronavirus in Sichuan Province. The study measures included the Simplified Coping Style Questionnaire and the Childhood Trauma Questionnaire-Short Form. This research intends to use correlational study methods to explore the relationship between the two factors. Results: Statistical analysis showed that there was no statistically significant difference in the general demographic data between the two groups. Conclusion: Childhood traumatic experiences have a significant impact on the active coping of nurse practitioners, and active coping may be emotionally protective for nurse practitioners.
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Affiliation(s)
- Liyuanke Wang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Yan Zhang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Xiaoli Zhang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Xiwang Fan
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Luo Qiong
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Chengping Hu
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
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Senehi N, Flykt M, Biringen Z, Laudenslager ML, Watamura SE, Garrett BA, Kominsky TK, Wurster HE, Sarche M. Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021:10.1007/s11121-021-01307-7. [PMID: 34773574 DOI: 10.1007/s11121-021-01307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.
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Affiliation(s)
- Neda Senehi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA.
| | - Marjo Flykt
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Faculty of Medicine/Psychology, University of Helsinki, Helsinki, Finland
| | - Zeynep Biringen
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA
| | | | | | | | - Hannah E Wurster
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Michelle Sarche
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, USA
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Life History Evolution Forms the Foundation of the Adverse Childhood Experience Pyramid. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2021. [DOI: 10.1007/s40806-021-00299-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cprek SE, Fisher BS, McDonald MJ, McDaniel HM, Williamson L, Williams CM. Adverse childhood experiences and interpersonal violence among college students: does a relationship exist? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:913-920. [PMID: 31995457 PMCID: PMC8893598 DOI: 10.1080/07448481.2020.1715413] [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: 06/25/2019] [Revised: 11/22/2019] [Accepted: 12/22/2019] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Previous research has found women who experience eight or more Adverse Childhood Experiences (ACEs) are 3.5 times as likely to be victims of adult IPV. This study examined the relationship between ACEs and IPV (physical violence, sexual violence, psychological violence, and stalking) among college students. PARTICIPANTS This study was conducted among undergraduate students (N = 2,900) at two large, non-profit, public universities in the United States. METHODS Students completed a web-based survey addressing self-reported ACEs and violence that occurred within the current academic year. Chi-square tests and logistic regression models were used to evaluate the relationship between ACEs and violence. RESULTS College students with higher ACE scores were more likely to experience violence. Students with ACE scores of four or higher were between 1.9-4.9 times more likely to experience violence. A dose response relationship was found between ACE score and experiences of violence. CONCLUSIONS Campus violence prevention programs may benefit from incorporating discussion of ACEs into programing.
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Affiliation(s)
- Sarah E Cprek
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Bonnie S Fisher
- School of Criminal Justice, University of Cincinnati, Cincinnati, Ohio, USA
| | - Madelyn J McDonald
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Honour M McDaniel
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Lucy Williamson
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Corrine M Williams
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
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van Roessel L, Racine N, Dobson K, Killam T, Madigan S. Does screening for maternal ACEs in prenatal care predict pregnancy health risk above and beyond demographic and routine mental health screening? CHILD ABUSE & NEGLECT 2021; 121:105256. [PMID: 34416473 DOI: 10.1016/j.chiabu.2021.105256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs), including abuse, neglect, and/or household dysfunction, are associated with physical and mental health difficulties in pregnancy and the postpartum period. These associations have prompted the adoption of screening for ACEs in prenatal care settings; however, little is known about whether asking about ACEs in the prenatal care context is additive to other forms of routine prenatal demographic and mental health screening. OBJECTIVE To identify whether ACEs are predictive of cumulative pregnancy health risk and identify whether ACEs predict maternal health risks in pregnancy above and beyond screening for financial stress, depression, and anxiety. PARTICIPANTS AND SETTING The electronic medical records of three hundred and thirty-eight patients who accessed prenatal care at a low-risk primary care maternity clinic were included. METHODS Women retrospectively self-reported their ACEs during their second prenatal primary care visit (~20 weeks' gestation) and reported financial stress as well as their depressive and anxious symptoms using the PHQ-2 and GAD-2. Health risk factors and complications were documented by healthcare providers in the files at birth. Approximately 32% of patients reported at least one ACE. RESULTS Regression analyses revealed that after accounting for financial stress, neither depression nor anxiety predicted cumulative health risk in the antenatal period. ACEs significantly predicted cumulative health risk (B = 0.14, p = .02) and an additional 1.7% of variance in the outcome. However, the model only accounted for 5.0% of the variance in cumulative health risk. CONCLUSIONS The total health risk predicted by demographic and ACEs screening is modest in this low-risk sample. Additional research on the implications of broader trauma-informed approaches is needed to evaluate their impact.
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Affiliation(s)
- Logan van Roessel
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Nicole Racine
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, T2N 4N1, Canada
| | - Keith Dobson
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Teresa Killam
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Riley Park Maternity Clinic, 130 1402 8 Ave NW, Calgary, AB T2N 1B9, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, T2N 4N1, Canada.
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Relationship between adverse childhood experiences and mental health: Implications for a nationwide school mental health program. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02342-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Sterling S, Chi F, Lin J, Padalkar P, Vinayagasundaram U, Iturralde E, Young-Wolff K, Metz VE, Herz A, Negusse R, Jackson-Morris M, Espinas P. Physical, Mental Health and Developmental Conditions, and Sociodemographic Characteristics Associated With Adverse Childhood Experiences Among Young Children in Pediatric Primary Care. J Pediatr Health Care 2021; 35:491-499. [PMID: 34226089 DOI: 10.1016/j.pedhc.2021.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/19/2021] [Accepted: 04/13/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION To examine associations between patient characteristics and adverse childhood experiences (ACEs) in a population-based sample of pediatric primary care patients, using electronic health records and clinical, administrative data. METHOD An observational study was conducted in an integrated health care delivery system. Children ages 1-5 years (N = 13,370) were screened for ACEs at routine well-child visits between September 1, 2018 and May 31, 2019 in three pediatrics clinics. Multivariate models examined associations between patient characteristics (age, gender, race/ethnicity, insurance type, neighborhood income and education level, physical, mental health and developmental diagnoses, weight status) and any ACEs, and ≥ 3 ACEs exposure. RESULTS Prevalence and severity of ACE exposure varied by race/ethnicity. Older age, Medicaid insurance, epilepsy/seizure disorder, sleeping disorders, adjustment disorders, and feeding disorders were associated with higher odds of ACEs exposure, higher-income with lower odds. DISCUSSION Understanding relationships between ACEs and patient features can provide information to clinicians for early detection and appropriate interventions.
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Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children. CHILDREN-BASEL 2021; 8:children8090761. [PMID: 34572191 PMCID: PMC8471662 DOI: 10.3390/children8090761] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between "household challenge" ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. DATA METHOD This study used data from the 2016-2019 National Survey of Children's Health, a nationwide, population-based, cross-sectional survey. Seven household challenge ACEs (not including child maltreatment) were reported by parents/guardians: parental death, incarceration, divorce/separation, family violence, mental illness, substance abuse, and poverty. Logistic regression with sample weights was used to estimate the odds ratio (OR) for 15 parent-reported neurodevelopmental and behavioral health conditions, by the number of reported ACEs. A dose-response relationship was examined by applying tests of orthogonal polynomial contrasts to fitted logistic regression models. RESULTS Down syndrome, Tourette syndrome and cerebral palsy were not associated with household challenge ACEs, whereas behavior/conduct problems, depression, and substance abuse were strongly associated, with adjusted ORs ranging from 6.36 (95% confidence interval (CI) 5.53, 7.32) to 9.19 (95% CI 7.79, 10.84). Other neurodevelopmental conditions not traditionally associated with childhood adversity showed moderate yet robust associations with ACEs, including autism (adjusted OR 2.15, 95% CI 1.64, 2.81), learning disability (adjusted OR 3.26, 95% CI 2.80, 3.80), and attention deficit hyperactivity disorder (adjusted OR 3.95, 95% CI 3.44, 4.53). The ORs increased with the number of ACEs, showing significant positive linear trends. CONCLUSION We found significant dose-dependent or cumulative associations between ACEs and multiple neurodevelopmental and behavioral conditions.
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McKeen H, Hook M, Podduturi P, Beitzell E, Jones A, Liss M. Mindfulness as a mediator and moderator in the relationship between adverse childhood experiences and depression. CURRENT PSYCHOLOGY 2021; 42:6576-6586. [PMID: 34177211 PMCID: PMC8215089 DOI: 10.1007/s12144-021-02003-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 12/11/2022]
Abstract
Adverse childhood experiences (ACEs) have been associated with a variety of negative physical and psychological health outcomes. The mechanisms by which this occurs and potential protective factors present in this relationship are understudied. Mindfulness is a cognitive resource that may protect individuals against symptoms of psychological distress. It has five core facets and encourages a nonjudgmental acceptance of the present moment. The purpose of this study was to explore the role of mindfulness in the relationship between ACEs and depression, both as a mediator and as a moderator, or protective factor. We hypothesized that the aware, describe, and non-judgement facets of mindfulness would be key factors in both sets of analyses. Participants at a university (N = 279) were given the Five Factor Mindfulness Questionnaire (FFMQ), the Adverse Childhood Experiences Scale (ACES), and the Patient Health Questionnaire (PHQ-8) to measure depression. Results indicated that the describe CI [.02, .11], aware CI [.05, .17], and non-judgement CI [.06, .18] facets of mindfulness significantly mediated the relationship between ACEs and depression. Additionally, the aware facet of mindfulness was also a significant moderator in this relationship, [t (interaction) = -3.22, p < 0.01], such that individuals with a high level of awareness had no increase in depression even as the number of ACEs increased. Negative cognitions associated with ACEs may harm one's ability to effectively describe their feelings and to be fully aware of the present moment, which may contribute to symptoms of depression. Implications for mindfulness-based interventions (MBIs) are discussed.
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Affiliation(s)
- Haley McKeen
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Megan Hook
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Purnaja Podduturi
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Emily Beitzell
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Amelia Jones
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
| | - Miriam Liss
- grid.266671.20000 0000 9565 4349Department of Psychological Science, University of Mary Washington, 1301 College Avenue, Fredericksburg, VA 22401 USA
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Vervoort-Schel J, Mercera G, Wissink I, Van der Helm P, Lindauer R, Moonen X. Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103935. [PMID: 33756254 DOI: 10.1016/j.ridd.2021.103935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/12/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are an overlooked risk factor for behavioural, mental and physical health disparities in children with intellectual disabilities (ID) and borderline intellectual functioning (BIF). AIMS To gain insight into the presence of the 10 original Wave II ACEs and family context risk variables in a convenience sample of children with ID and BIF in Dutch residential care. METHODS AND PROCEDURES 134 case-files of children with ID (n = 82) and BIF (n = 52) were analysed quantitatively. OUTCOMES AND RESULTS 81.7 % of the children with ID experienced at least 1 ACE, as did 92.3 % of the children with BIF. The average number of ACEs in children with ID was 2.02 (range 0-8) and in children with BIF 2.88 (range 0-7). About 20 % of the children with moderate and mild ID experienced 4 ACEs or more. Many of their families faced multiple and complex problems (ID: 69.5 %; BIF 86.5 %). Multiple regression analysis indicated an association between family context risk variables and the number of ACEs in children. CONCLUSIONS AND IMPLICATIONS The prevalence of ACEs in children with ID and BIF appears to be considerably high. ACEs awareness in clinical practice is vital to help mitigate negative outcomes.
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Affiliation(s)
- Jessica Vervoort-Schel
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands.
| | - Gabriëlle Mercera
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands
| | - Inge Wissink
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| | - Peer Van der Helm
- Expert Centre Social Work and Applied Psychology, Professional University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, the Netherlands; Fier, National Expertise and Treatment Centre, Holstmeerweg 1, 8936 AS Leeuwarden, the Netherlands; Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Ramón Lindauer
- Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Xavier Moonen
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
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Horino M, Yang W. Impact of adverse childhood experiences and fruit and vegetable intake in adulthood. Public Health Nutr 2021; 24:1034-1041. [PMID: 32319883 PMCID: PMC8025088 DOI: 10.1017/s1368980019004932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/25/2019] [Accepted: 11/22/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess the association between adverse childhood experiences (ACE) and behaviours of fruit and vegetable consumption among adults. DESIGN Cross-sectional analysis. Weighted χ2 and weighted multiple logistic regression analyses were conducted to determine the association between ACE and low fruit and vegetable consumption. SETTING The 2017 Nevada Behavioral Risk Factor Surveillance System. PARTICIPANTS The sample consisted of 2939 adults. RESULTS After controlling for potential confounders, exposure to three or more ACE (adjusted OR (AOR) 1·42, 95 % CI 1·02, 2·00) and experiencing parental divorce/separation (AOR 1·50, 95 % CI 1·13, 1·98) were significantly associated with low fruit and vegetable consumption. The study did not find a dose-response relationship between the number of ACE and fruit and vegetable consumption. CONCLUSIONS The study suggests that participants who experienced three or more ACE or parental divorce/separation were at increased risk for low fruit and vegetable consumption. The findings highlight the continuing need for public health interventions and policies that decrease exposure to ACE and increase fruit and vegetable intake among the populations with ACE.
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Affiliation(s)
- Masako Horino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD20205, USA
- Department of Environmental Sciences, University of Nevada, Reno, Reno, NV89557, USA
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo113-0033, Japan
- United Nations Relief and Works Agency for the Palestine Refugees in the Near East, Jordan, Amman
| | - Wei Yang
- School of Community Health Sciences, Division of Epidemiology, Biostatistics, and Environmental Health, University of Nevada, Reno, Reno, NV89557, USA
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Gold AL, Meza E, Ackley SF, Mungas DM, Whitmer RA, Mayeda ER, Miles S, Eng CW, Gilsanz P, Glymour MM. Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline. BMJ Open 2021; 11:e042125. [PMID: 33550246 PMCID: PMC7925876 DOI: 10.1136/bmjopen-2020-042125] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Evidence on adverse childhood experiences (ACEs) and late-life cognitive outcomes is inconsistent, with little research among diverse racial/ethnic groups. We investigated whether ACE exposures were associated with worse late-life cognition for all racial/ethnic groups and at different ages of exposure. DESIGN Covariate-adjusted mixed-effects linear regression models estimated associations of: (1) total number of ACEs experienced, (2) earliest age when ACE occurred and (3) type of ACE with overall cognition. SETTING Kaiser Permanente Northern California members aged 65 years and older, living in Northern California. PARTICIPANTS Kaiser Healthy Aging and Diverse Life Experiences study baseline participants, aged 65 years and older (n=1661; including 403 Asian-American, 338 Latino, 427 Black and 493 white participants). RESULTS Most respondents (69%) reported one or more ACE, most frequently family illness (36%), domestic violence (23%) and parental divorce (22%). ACE count was not adversely associated with cognition overall (β=0.01; 95% CI -0.01 to 0.03), in any racial/ethnic group or for any age category of exposure. Pooling across all race/ethnicities, parent's remarriage (β=-0.11; 95% CI -0.20 to -0.03), mother's death (β=-0.18; 95% CI -0.30 to -0.07) and father's death (β=-0.11; 95% CI -0.20 to -0.01) were associated with worse cognition. CONCLUSION Adverse childhood exposures overall were not associated with worse cognition in older adults in a diverse sample, although three ACEs were associated with worse cognitive outcomes.
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Affiliation(s)
- Audra L Gold
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Erika Meza
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Dan M Mungas
- Public Health Sciences, University of California Davis, Davis, California, USA
| | - Rachel A Whitmer
- Public Health Sciences, University of California Davis, Davis, California, USA
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA
| | - Sunita Miles
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Chloe W Eng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Godoy LC, Frankfurter C, Cooper M, Lay C, Maunder R, Farkouh ME. Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life: A Review. JAMA Cardiol 2021; 6:228-235. [PMID: 33263716 DOI: 10.1001/jamacardio.2020.6050] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Adverse childhood experiences (ACEs) are potentially harmful events that occur during childhood, spanning neglect, physical or sexual abuse, parental separation, or death, among others. At least 50% of the US adult population has experienced 1 or more ACEs before the age of 18 years, but in clinical practice, ACEs remain underrecognized. Adults who have experienced ACEs are at increased risk of developing health risk behaviors and, ultimately, cardiovascular disease (CVD). This review summarizes the evidence regarding the association of ACEs with CVD and the accompanying diagnostic and therapeutic approaches in the adult population. Observations ACEs are commonly classified into 3 domains: abuse (psychological, physical, or sexual), household dysfunction (eg, substance use by household members, mental illness, parental separation), and neglect. These experiences elicit chronic activation of the stress response system, leading to autonomic, neuroendocrine, and inflammatory dysfunction. The subsequent development of traditional risk factors, such as diabetes, hypertension, smoking, and obesity, results in the onset of CVD and premature mortality. Adults with 4 or more ACEs compared with those with none have a more than 2-fold higher risk of developing CVD and an almost 2-fold higher risk of premature mortality. Conclusions and Relevance Identifying methods of mitigating the health consequences of ACEs may lead to better cardiovascular outcomes. Inquiry into ACE exposure during clinical encounters and subsequent referral to psychological services when appropriate may be helpful, but strategies aimed at CVD prevention via management of ACEs in adults continue to lack adequate evidence.
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Affiliation(s)
- Lucas C Godoy
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada.,Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Claudia Frankfurter
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Matthew Cooper
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christine Lay
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Robert Maunder
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
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Kalia V, Knauft K, Hayatbini N. Cognitive flexibility and perceived threat from COVID-19 mediate the relationship between childhood maltreatment and state anxiety. PLoS One 2020; 15:e0243881. [PMID: 33306748 PMCID: PMC7732062 DOI: 10.1371/journal.pone.0243881] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/29/2020] [Indexed: 12/31/2022] Open
Abstract
Converging empirical evidence indicates that exposure to adversity in childhood is associated with increased vulnerability to mental health problems in adulthood. As early life adversity has the potential to alter an individual’s appraisal of threat, we hypothesized that individuals exposed to adversity in childhood may also exhibit increased threat from environmental stressors, which in turn may impact their state anxiety levels. We examined the relations between adverse childhood experiences, assessed using the Adverse Childhood Experiences Scale (ACEs), perceived threat from COVID-19, and state anxiety in a sample of adults. Additionally, flexibility is implicated in adaptive coping with life’s stressors so we also assessed participants’ cognitive flexibility. Parallel mediation regression analyses revealed that both perceived threat from COVID-19 and flexibility in the appraisal of challenges mediated the influence of maltreatment, but not household dysfunction, on state anxiety. Our data indicate that experience with early life adversity in the form of maltreatment is associated with increased perceived threat from COVID-19, which results in higher anxiety levels for the individual. In contrast, childhood maltreatment is associated with reduced flexibility in appraising challenges, which in turn mediates the relationship between maltreatment and anxiety. The findings of this study adds to the limited literature on the impact of early life adversity on cognitive flexibility and highlights the psychological toll of COVID-19 on individuals who have been exposed to adverse childhood experiences.
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Affiliation(s)
- Vrinda Kalia
- Psychology Department, Miami University, Oxford, Ohio, United States of America
- * E-mail:
| | - Katherine Knauft
- Psychology Department, Miami University, Oxford, Ohio, United States of America
| | - Niki Hayatbini
- Psychology Department, Miami University, Oxford, Ohio, United States of America
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Smith BE, Miles TP, Elkins J, Barkin JL, Ebell MH, Ezeamama AE. The Impact of Stressful Life Events on the Incidence of Type 2 Diabetes in U.S. Adults From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2020; 75:640-649. [PMID: 29635530 DOI: 10.1093/geronb/gby040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES We evaluated the association between cumulative stressful life events (SLE) and type of stress (lifetime vs recent) and incident diabetes (Type 2 diabetes mellitus [T2DM]) in middle-aged U.S. adults. METHODS Data from the 2006-2014 waves of the Health and Retirement Study (HRS) were analyzed (n = 7,956). Stress-related differences in age at T2DM diagnosis were estimated using Cox proportional hazards models. RESULTS The adjusted risk of T2DM significantly increased by 6% per unit increase in cumulative SLE (95% confidence interval [CI] = 1.03, 1.11), by 5% per unit increase in lifetime stress (95% CI = 1.00, 1.09), and by 23% per unit increase in recent stress (95% CI = 1.12, 1.36). Each level of cumulative SLE (1, 2, 3, and ≥4 events) and recent stress (1 and ≥2 events) compared to no stress was significantly associated with an increased risk of T2DM. Each level of lifetime stress compared to no stress was significantly associated with an elevated risk of T2DM except for 3 events. DISCUSSION Cumulative SLE and type of stress were associated with incident T2DM in middle-aged adults. Reducing the direct effect of stress with management interventions may reduce the indirect effect of developing T2DM and warrants further investigation.
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Affiliation(s)
- Betsy E Smith
- Department of Internal Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Toni P Miles
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens
| | | | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Mark H Ebell
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens
| | - Amara E Ezeamama
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing
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Rubinstein TB, Bullock DR, Ardalan K, Mowrey WB, Brown NM, Bauman LJ, Stein REK. Adverse Childhood Experiences Are Associated with Childhood-Onset Arthritis in a National Sample of US Youth: An Analysis of the 2016 National Survey of Children's Health. J Pediatr 2020; 226:243-250.e2. [PMID: 32553837 DOI: 10.1016/j.jpeds.2020.06.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To determine whether there is an association between adverse childhood experiences (ACEs) and childhood-onset arthritis, comparing youth with arthritis to both healthy youth and youth with other acquired chronic physical diseases (OCPD); and to examine whether ACEs are associated with disease-related characteristics among children with arthritis. STUDY DESIGN In a cross-sectional analysis of data from the 2016 National Survey of Children's Health we examined whether ACEs were associated with having arthritis vs either being healthy or having a nonrheumatologic OCPD. ACE scores were categorized as 0, 1, 2-3, ≥4 ACEs. Multinomial logistic regression models examined associations between ACEs and health status while adjusting for age, sex, race/ethnicity, and poverty status. Among children with arthritis, associations between ACEs and disease-related characteristics were assessed by Pearson χ2 analyses. RESULTS Compared with children with no ACEs, children with 1, 2-3, and ≥4 ACEs had an increased odds of having arthritis vs being healthy (adjusted OR for ≥4 ACEs, 9.4; 95% CI, 4.0-22.1) and vs OCPD (adjusted OR for ≥4 ACEs, 3.7; 95% CI-1.7, 8.1). Among children with arthritis, ACEs were associated with worse physical impairment. CONCLUSIONS Children with higher numbers of ACEs are more likely to have arthritis, when arthritis status is compared either with being healthy or with having OCPD. Further studies are needed to determine the direction of the association between ACEs and childhood arthritis, its impact on disease course, and potential intervention targets that might mitigate these effects.
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Affiliation(s)
- Tamar B Rubinstein
- Division of Pediatric Rheumatology, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Division of Pediatric Rheumatology, Children's Hospital at Montefiore, Bronx, NY.
| | - Danielle R Bullock
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Kaveh Ardalan
- Division of Pediatric Rheumatology, Department of Pediatrics, Duke University School of Medicine, Durham, NC; Division of Rheumatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Wenzhu B Mowrey
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Nicole M Brown
- Albert Einstein College of Medicine, Bronx, NY; Strong Children Wellness Medical Group Jamaica, NY
| | - Laurie J Bauman
- Division of Academic General Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Bronx, NY
| | - Ruth E K Stein
- Division of Developmental Medicine, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; Division of Developmental Medicine, Children's Hospital at Montefiore, Bronx, NY
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Hair sampling for cortisol analysis with mother-toddler dyads living in low-income homes. Infant Behav Dev 2020; 61:101499. [PMID: 33068954 DOI: 10.1016/j.infbeh.2020.101499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 08/15/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND A first step to advance stress science research in young children is understanding the relationship between chronic stress in a mother and chronic stress in her child. One non-invasive measure of chronic stress is hair cortisol. However, little is known about strategies for hair sampling in mother-toddler dyads living in low-income homes in the U.S. To address prior limitations, the purpose of this study was to understand the feasibility of sampling hair for cortisol analysis in mother-toddler dyads living in low-income homes in the U.S. We examined feasibility related to participation, eligibility, and gathering an adequate hair sample weight. METHODS We approached 142 low-income, racially diverse, urban-dwelling mothers who were participating in an ongoing longitudinal birth cohort study for informed consent to cut approximately 150 hairs from the posterior vertex of their scalp and their toddlers' (20-24 months) scalp. We demonstrated the process of sampling hair with a hairstyling doll during home visits to the mother and toddler using rounded-end thinning shears. RESULTS Overall, 94 of 142 mother-toddler dyads (66 %) participated in hair sampling. The most common reason for participation refusal was related to hairstyle. All but three hair samples were of adequate weight for cortisol extraction. DISCUSSION The findings from this study can help researchers address sampling feasibility concerns in hair for cortisol analysis research in mother-toddler dyads living in low-income homes in the U.S.
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McCloskey LA, Eloff I, Doran K. Determinants of intergenerational sexual relationships and HIV risk among South African women outpatients in Gauteng. AIDS Care 2020; 33:654-662. [PMID: 32964726 DOI: 10.1080/09540121.2020.1823311] [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] [Indexed: 10/23/2022]
Abstract
Age-discrepant sexual relationships may place women at risk for HIV infection in South Africa. Results are based on medical records and case-control interview data of 889 sexually experienced women outpatients aged 15-29 in a Gauteng township. Women with partners at least ten years older (intergenerational) show an elevated chance of having an early sexual debut, concurrent and transactional partners, and intimate partner violence. Hardship during childhood including parental loss, food insecurity and abuse are related to age asymmetric relationships. HIV is two times more likely (aOR=1.96) with an intergenerational partner. Transactional sex increases the odds of HIV independently (aOR=1.76) as does intimate partner violence (aOR=1.6). To the extent that transactional and intergenerational sex overlap the chance of contracting HIV increases more than two-fold (uOR=4.57). Girls (15-19) with intergenerational partners face the highest chance of HIV (uOR=8.55) compared to other age groups. They are also five times more likely than controls to have lived with a cross-age partner. Our findings indicate there are multiple pathways emanating from childhood leading to women's choice of intergenerational partners, and the link to HIV is strongest among the youngest women.
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Affiliation(s)
- Laura Ann McCloskey
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Irma Eloff
- Department of Educational Psychology, University of Pretoria School of Education, Pretoria, South Africa
| | - Kelly Doran
- UNH Institute on Disability, College of Health and Human Services, University of New Hampshire, Durham, NH, USA
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Giano Z, Wheeler DL, Hubach RD. The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health 2020; 20:1327. [PMID: 32907569 PMCID: PMC7488299 DOI: 10.1186/s12889-020-09411-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adversity experienced during childhood manifests deleteriously across the lifespan. This study provides updated frequency estimates of ACEs using the most comprehensive and geographically diverse sample to date. METHODS ACEs data were collected via BRFSS (Behavioral Risk Factor Surveillance System). Data from a total of 211,376 adults across 34 states were analyzed. The ACEs survey is comprised of 8 domains: physical/emotional/sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation/divorce. Frequencies were calculated for each domain and summed to derive mean ACE scores. Findings were weighted and stratified by demographic variables. Group differences were assessed by post-estimation F-tests. RESULTS Most individuals experienced at least one ACE (57.8%) with 21.5% experiencing 3+ ACEs. F-tests showed females had significantly higher ACEs than males (1.64 to 1.46). Multiracial individuals had a significantly higher ACEs (2.39) than all other races/ethnicities, while White individuals had significantly lower mean ACE scores (1.53) than Black (1.66) or Hispanic (1.63) individuals. The 25-to-34 age group had a significantly higher mean ACE score than any other group (1.98). Generally, those with higher income/educational attainment had lower mean ACE scores than those with lower income/educational attainment. Sexual minority individuals had higher ACEs than straight individuals, with significantly higher ACEs in bisexual individuals (3.01). CONCLUSION Findings highlight that childhood adversity is common across sociodemographic, yet higher in certain categories. Identifying at-risk populations for higher ACEs is essential to improving the health outcomes and attainment across the lifespan.
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Affiliation(s)
- Zachary Giano
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA.
| | - Denna L Wheeler
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
| | - Randolph D Hubach
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
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LaBrenz CA, O'Gara JL, Panisch LS, Baiden P, Larkin H. Adverse childhood experiences and mental and physical health disparities: the moderating effect of race and implications for social work. SOCIAL WORK IN HEALTH CARE 2020; 59:588-614. [PMID: 32975500 DOI: 10.1080/00981389.2020.1823547] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 09/05/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
Adverse childhood experiences (ACEs) have been linked to mental and physical health problems, leading to ACEs being viewed as a public health concern. Yet, less research has focused on the prevalence and impact of ACEs among diverse racial and ethnic groups. Given the increasing diversity in the USA, coupled with research that has found certain racial and ethnic groups to experience larger-scale adversity such as poverty or discrimination more frequently than White individuals, it is important to understand how ACEs are experienced by people of color. The current study examined the prevalence of ACEs among diverse racial and ethnic groups, and associations between ACE score and mental and physical health. Even after adjusting for sociodemographic factors, ACE scores of 3 or higher were linked to more physical and mental health problems. Furthermore, there was a significant interaction effect between ACE score and race on physical health, while none of the interaction terms were significant between ACE score and race on mental health. This suggests that higher ACE scores have a more detrimental impact on physical health for people of color. Implications for social work include implementing community-level ACE-informed responses, especially in communities that serve traditionally marginalized populations.
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Affiliation(s)
- Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | | | - Lisa S Panisch
- University of Rochester Medical Center , Rochester, New York
| | - Philip Baiden
- School of Social Work, The University of Texas at Arlington , Albany, NY, USA
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Kim HG, Kuendig J, Prasad K, Sexter A. Exposure to Racism and Other Adverse Childhood Experiences Among Perinatal Women with Moderate to Severe Mental Illness. Community Ment Health J 2020; 56:867-874. [PMID: 31955289 DOI: 10.1007/s10597-020-00550-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/10/2020] [Indexed: 02/03/2023]
Abstract
We sought to determine the prevalence and correlates of conventional and expanded adverse childhood experiences (ACEs), including exposure to violence and racism, in perinatal women with mental illness. 133 perinatal women with mental illness completed the original ACEs (conventional ACEs) survey and the 6-question adverse environmental experiences (expanded ACEs) survey from the Philadelphia ACEs study. Associations between racial groups and ACE scores, mental health and psychosocial variables were evaluated. Subjects were predominantly white (68%) and married/partnered (66%), and 57% had at least 4 conventional ACEs. Compared to White women, Black women were significantly more likely to report conventional and expanded ACEs including experiencing racism and witnessing violence. Early life adversity was exceedingly common among pregnant and postpartum women with moderate to severe mental illness. Childhood exposure to racism and environmental trauma are important risk categories for perinatal mental illness.
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Affiliation(s)
- Helen G Kim
- Mother-Baby Program, Department of Psychiatry, and Redleaf Center for Family Healing, Hennepin Healthcare, Minneapolis, MN, USA.
| | - Jessica Kuendig
- Mother-Baby Program, Department of Psychiatry, and Redleaf Center for Family Healing, Hennepin Healthcare, Minneapolis, MN, USA
| | - Kriti Prasad
- Mother-Baby Program, Department of Psychiatry, and Redleaf Center for Family Healing, Hennepin Healthcare, Minneapolis, MN, USA
| | - Anne Sexter
- Chronic Disease Research Group, Minneapolis, MN, USA
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Kalia V, Knauft K. Emotion regulation strategies modulate the effect of adverse childhood experiences on perceived chronic stress with implications for cognitive flexibility. PLoS One 2020; 15:e0235412. [PMID: 32589644 PMCID: PMC7319341 DOI: 10.1371/journal.pone.0235412] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/15/2020] [Indexed: 12/22/2022] Open
Abstract
Exposure to early life adversity is associated with chronic stress and a range of stress-related health problems in adulthood. Since chronic stress debilitates activity in the prefrontal cortex (pFC), maladaptive regulatory strategies in response to stress have been proposed as one explanation for the impact of early life adversity on health outcomes in adulthood. We conducted a study to examine the impact of adverse childhood experiences (ACEs) on cognitive flexibility, a key executive function implicated in activity in the pFC, in a sample of adults (N = 486). Additionally, we investigated whether perceptions of chronic stress in adulthood would mediate the influence of ACEs on cognitive flexibility. However, stress is a subjective experience, and emotion regulation strategies can attenuate the stress response. So, we also examined if individual differences in emotion regulation strategies would modulate the relationship between ACEs and chronic stress. Our results demonstrate that early life adversity, as characterized by ACEs, is associated with decreased cognitive flexibility in adulthood. Additionally, number of ACEs was positively correlated with perceived stress, which in turn was negatively correlated with cognitive flexibility. But, individual differences in the habitual use of emotion regulation strategies moderated the influence of ACEs on chronic stress. Specifically, habitual use of cognitive reappraisal attenuated the stress levels whereas habitual use of expressive suppression exacerbated stress levels. Overall, our study highlights the importance of examining emotion regulation in individuals who have experienced early life adversity.
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Affiliation(s)
- Vrinda Kalia
- Department of Psychology, Miami University, Oxford, Ohio, United States of America
| | - Katherine Knauft
- Department of Psychology, Miami University, Oxford, Ohio, United States of America
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Berent D, Wojnar M. The role of adverse childhood experiences in risky behaviors, health care utilization, and generalized self-efficacy in the general adult Polish population. Arch Med Sci 2020; 20:769-789. [PMID: 39050174 PMCID: PMC11264082 DOI: 10.5114/aoms.2020.96343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 12/21/2019] [Indexed: 07/27/2024] Open
Abstract
Introduction The present study evaluated whether adverse childhood experiences (ACEs) are significantly and independently associated with six key outcomes in the Polish general population: (1) lifetime suicide attempt, (2) self-mutilation, (3) potential problem drinking, (4) use of street drugs, (5) visiting a psychologist/psychotherapist, and (6) visiting a psychiatrist. We also investigated whether ACEs explain a significant proportion of variability in generalized self-efficacy. Material and methods Six hundred and fifty-nine individuals completed the ACE Study questionnaire (physical, verbal, and sexual abuse; neglect; select family dysfunctions) and three additional questions [ACE (13) questionnaire]: witnessing (1) a family member's suicide attempt or (2) death due to any cause except completed suicide, and (3) a stranger's death due to any cause (e.g., traffic accident). Generalized self-efficacy was assessed with the Generalized Self-Efficacy Scale. Results The likelihood of lifetime use of street drugs, potential problem drinking, and visiting a psychologist/psychotherapist and psychiatrist increased as ACE and ACE (13) score increased. As compared to scores of < 4, ACE (13) scores of ≥ 4 were associated with a 10.8-fold increased likelihood of self-mutilation, a 3.26-fold increased likelihood of potential problem drinking, a 5.72-fold increased likelihood of visiting a psychologist/psychotherapist, and a 6.71-fold increased likelihood of visiting a psychiatrist. ACE (13) score explained 1.2% of the variability in generalized self-efficacy. Conclusions The present study identified a strong association between childhood adversity and increased likelihood of lifetime self-mutilation, potential problem drinking, visiting a psychologist/psychotherapist, and visiting a psychiatrist. Generalized self-efficacy may be an important target for secondary intervention following childhood adversity.
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Affiliation(s)
- Dominika Berent
- Masovian Regional Psychiatric Hospital Drewnica, Ząbki, Poland
| | - Marcin Wojnar
- Medical University of Warsaw, Warsaw, Poland
- University of Michigan, Ann Arbor, MI, USA
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Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7060057. [PMID: 32503310 PMCID: PMC7346200 DOI: 10.3390/children7060057] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Minorities' diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. AIM To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8-11 years old. MATERIALS AND METHODS In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8-11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. RESULTS Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. CONCLUSION The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources.
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Biglan A, Elfner K, Garbacz SA, Komro K, Prinz RJ, Weist MD, Wilson DK, Zarling A. A Strategic Plan for Strengthening America's Families: A Brief from the Coalition of Behavioral Science Organizations. Clin Child Fam Psychol Rev 2020; 23:153-175. [PMID: 32347415 PMCID: PMC7186188 DOI: 10.1007/s10567-020-00318-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Despite significant progress in research on the treatment and prevention of psychological, behavioral, and health problems, the translation of this knowledge into population-wide benefit remains limited. This paper reviews the state of America's children and families, highlighting the influence of stressful contextual and social conditions on child and family well-being and the concentration of disadvantage in numerous neighborhoods and communities throughout the nation. It then briefly reviews the progress that has been made in pinpointing policies that can reduce stressful contextual conditions such as poverty, discrimination, and the marketing of unhealthful foods and substances. It also describes numerous family and school interventions that have proven benefit in preventing psychological and behavioral problems as diverse as tobacco, alcohol, and other drug use; depression; antisocial behavior; academic failure; obesity prevention; and early childbearing. We argue that progress in translating existing knowledge into widespread benefit will require a nationwide effort to intervene comprehensively in neighborhoods and communities of concentrated disadvantage. We present a strategic plan for how such an effort could be organized. The first step in this organizing would be the creation of a broad and diverse coalition of organizations concerned with advancing public health and well-being. Such a coalition could increase public support both for the policies needed to focus on these disadvantaged areas and the research needed to incrementally improve our ability to help these areas.
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Affiliation(s)
| | - Karen Elfner
- Department of Child & Family Studies, University of South Florida, Tampa, FL, USA
| | | | - Kelli Komro
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ronald J Prinz
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Mark D Weist
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Amie Zarling
- Human Development & Family Studies, Iowa State University, Ames, IA, USA
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Nelson BW, Wright DB, Allen NB, Laurent HK. Maternal stress and social support prospectively predict infant inflammation. Brain Behav Immun 2020; 86:14-21. [PMID: 31077776 DOI: 10.1016/j.bbi.2019.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 12/27/2022] Open
Abstract
Maternal stress has been suggested to be a risk factor for offspring health, while social support has been shown to be a protective factor for offspring functioning. Currently, research has yet to investigate how both of these factors may relate to infant inflammatory processes and associated biological aging in the first years of life. In 48 mother-infant dyads, we investigated whether maternal parenting stress and social support when infants were 12 and 18 months of age were cross-sectionally associated with infant salivary C-reactive protein (sCRP) during these times. In addition, we investigated whether parenting stress and social support were prospectively associated with later sCRP and changes in sCRP from 12 to 18 months of age, as well as whether those changes in sCRP were associated with subsequent infant salivary telomere length (sTL), a marker of biological aging. Analyses revealed that while there were no cross-sectional associations between maternal factors and infant sCRP, maternal parenting stress and social support when infants were 12 months of age predicted infant sCRP at 18 months of age. Further, maternal social support predicted changes in infant sCRP from 12 to 18 months of age. We observed a null association between infant sCRP and sTL. Implications for the ways that maternal mental health and social support may impact biological mechanisms related to disease processes in infants are discussed.
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Affiliation(s)
| | | | | | - Heidemarie K Laurent
- Department of Psychology, University of Oregon, Eugene, OR, USA; Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA
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