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Adverse childhood experiences, diabetes and associated conditions, preventive care practices and health care access: A population-based study. Prev Med 2022; 160:107044. [PMID: 35398366 PMCID: PMC9218745 DOI: 10.1016/j.ypmed.2022.107044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/25/2022] [Accepted: 04/03/2022] [Indexed: 11/20/2022]
Abstract
Our objective was to examine how Adverse Childhood Experiences (ACEs) are associated with diabetes mellitus, diabetes-related conditions, and preventive care practices. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) 2009-2012, a cross-sectional, population-based survey, to assess ACEs, diabetes, and health care access in 179,375 adults. In those with diabetes (n = 21,007), we assessed the association of ACEs with myocardial infarction, stroke, and five Healthy People 2020 (HP2020) diabetes-related preventive-care objectives (n = 13,152). Healthcare access indicators included lack of a regular health care provider, insurance, and difficulty affording health care. Regression analyses adjusted for age, sex, and race. The adjusted odds ratio (AOR) of diabetes increased in a stepwise fashion by ACE exposure, ranging from 1.2 (95% CI 1.1-1.3) for 1 ACE to 1.7 (95% CI 1.6-1.9) for ≥4 ACEs, versus having no ACEs. In persons with diabetes, those with ≥4 ACEs had an elevated adjusted odds of myocardial infarction (AOR = 1.6, 95% CI 1.2-2.0) and stroke (AOR = 1.8, 95% CI 1.3-2.4), versus having no ACEs. ACEs were also associated with a reduction in the adjusted percent of HP2020 diabetes objectives met: 72.9% (95% CI 71.3-74.5) for those with no ACEs versus only 66.5% (95% CI 63.8-69.3%) for those with ≥4 ACEs (p = 0.0002). Finally, ACEs predicted worse health care access in a stepwise fashion for all indicators. In conclusion, ACEs are associated with greater prevalence of diabetes and associated disease conditions, and with meeting fewer HP2020 prevention goals. Implementing ACE screening and trauma-informed health care practices are thus recommended.
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Durbin A, Amaechi BT, Abrams S, Mandelis A, Werb S, Roebuck B, Durbin J, Wang R, Daneshvarfard M, Sivagurunathan K, Bozec L. Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063403. [PMID: 35329091 PMCID: PMC8948931 DOI: 10.3390/ijerph19063403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
Background: The early identification of children who have experienced adversity is critical for the timely delivery of interventions to improve coping and reduce negative consequences. Self-report is the usual practice for identifying children with exposure to adversity. However, physiological characteristics that signal the presence of disease or other exposures may provide a more objective identification strategy. This protocol describes a case–control study that assesses whether exposure to adversity is more common in children with tooth enamel anomalies compared to children without such anomalies. Methods: For 150 mother–child pairs from a pediatric dental clinic in Toronto, Canada, maternal interviews will assess the child’s adverse and resilience-building experiences. Per child, one (exfoliated or extracted) tooth will be assessed for suspected enamel anomalies. If anomalies are present, the child is a case, and if absent, the child is a control. Tooth assessment modalities will include usual practice for dental exams (visual assessment) and modalities with greater sensitivity to identify anomalies. Conclusion: If structural changes in children’s teeth are associated with exposure to adversity, routine dental exams could provide an opportunity to screen children for experiences of adversity. Affected children could be referred for follow-up.
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Affiliation(s)
- Anna Durbin
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Correspondence: ; Tel.: +1-416-824-1078
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA;
| | - Stephen Abrams
- Cliffcrest Dental Office, Four Cell Consulting, Quantum Dental Technologies, Toronto, ON M6B 1L3, Canada;
| | - Andreas Mandelis
- Center for Diffusion-Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Toronto, ON M5T 1R8, Canada; (A.M.); (K.S.)
| | - Sara Werb
- Toronto Children’s Dentistry, Toronto, ON M5T 1R8, Canada;
| | - Benjamin Roebuck
- Victimology Research Centre, Algonquin College, Ottawa, ON K2G 1V8, Canada;
| | - Janet Durbin
- Provincial System Support Program (PSSP), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada;
| | - Ri Wang
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
| | - Maryam Daneshvarfard
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
| | - Konesh Sivagurunathan
- Center for Diffusion-Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Toronto, ON M5T 1R8, Canada; (A.M.); (K.S.)
| | - Laurent Bozec
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada;
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Differences in functional and structural social support among female and male veterans and civilians. Soc Psychiatry Psychiatr Epidemiol 2021; 56:375-386. [PMID: 32249329 PMCID: PMC8687626 DOI: 10.1007/s00127-020-01862-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Social support is an important correlate of health behaviors and outcomes. Studies suggest that veterans have lower social support than civilians, but interpretation is hindered by methodological limitations. Furthermore, little is known about how sex influences veteran-civilian differences. Therefore, we examined veteran-civilian differences in several dimensions of social support and whether differences varied by sex. METHODS We performed a cross-sectional analysis of the 2012-2013 National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative sample of 34,331 respondents (male veterans = 2569; female veterans = 356). We examined veteran-civilian differences in functional and structural social support using linear regression and variation by sex with interactions. We adjusted for socio-demographics, childhood experiences, and physical and mental health. RESULTS Compared to civilians, veterans had lower social network diversity scores (difference [diff] = - 0.13, 95% confidence interval [CI] - 0.23, - 0.03). Among women but not men, veterans had smaller social network size (diff = - 2.27, 95% CI - 3.81, - 0.73) than civilians, attributable to differences in religious groups, volunteers, and coworkers. Among men, veterans had lower social network diversity scores than civilians (diff = - 0.13, 95% CI - 0.23, - 0.03); while among women, the difference was similar but did not reach statistical significance (diff = - 0.13, 95% CI - 0.23, 0.09). There was limited evidence of functional social support differences. CONCLUSION After accounting for factors that influence military entry and social support, veterans reported significantly lower structural social support, which may be attributable to reintegration challenges and geographic mobility. Findings suggest that veterans could benefit from programs to enhance structural social support and improve health outcomes, with female veterans potentially in greatest need.
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Validation of the Bullying Scale for Adults - Results of the PRONIA-study. J Psychiatr Res 2020; 129:88-97. [PMID: 32623026 DOI: 10.1016/j.jpsychires.2020.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/05/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bullying as a specific subtype of adverse life events is a major risk factor for poor mental health. Although many questionnaires on bullying are available, so far none covers bullying retrospectively throughout school and working life. To close this gap, the Bullying Scale for Adults (BSA) was designed. METHODS Based on data of 622 participants from five European countries collected in the prospective multicenter Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study, we investigated whether the BSA is a reliable and valid measurement for bullying and whether there is a difference across different diagnostic groups of early mental disorders (recent onset depressive/ psychotic patients, patients at clinical high-risk of psychosis) and healthy controls. RESULTS Bullying experiences were significantly less frequent in healthy controls than in patient groups, with no significant differences between the three clinical groups. The BSA exhibited a high item scale discrimination (r > .3) and very good internal consistency (Cronbach's α = .93). Four factors were identified: 1. Sexual harassment, 2. Emotional Abuse, 3. Physical Abuse, 4. Problems at school. The highly significant correlation between bullying, and childhood adversities and trauma (r = .645, p < .001) indicated good concurrent validity. DISCUSSION The BSA is the first validated questionnaire that, in retrospective, reliably records various aspects of bullying (incl. its consequences) not only throughout childhood but also working life. It can be used to assess bullying as a transdiagnostic risk factor of mental disorders in different mental disorders, esp. psychosis and depression.
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Fowler C, Homandberg L, Steele C, Bolt MA, Tintle N, Van De Griend K, Ulrich R, Christians M. Adult correlates of adverse childhood experiences in Ukraine. CHILD ABUSE & NEGLECT 2020; 107:104617. [PMID: 32702584 DOI: 10.1016/j.chiabu.2020.104617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The impact of adverse childhood experiences (ACEs) on adult life outcomes is well-documented by a considerable body of research. This study investigates the relationship between ACEs and both physical and mental health outcomes in a nationally representative sample of Ukrainian adults. OBJECTIVE The aim of this study was to analyze whether ACEs are associated with lifetime physical and mental health outcomes in a nationally representative sample of Ukrainian adults. Participants and Setting In 2002, the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was administered to a national probability sample of Ukrainian adults (n = 4725). METHODS Associations between ACEs and later life physical and mental health outcomes are examined using logistic regression models. RESULTS ACEs were significantly correlated with poor later life mental and physical health. Participants with three or more ACEs were most likely to have chronic pain, cardiovascular disease, other disease, depressive disorders, anxiety disorders, substance abuse disorders, and all disability metrics analyzed. Adjusted odds ratios for these models ranged from 1.80 to 3.81. Additionally, we found a large association between the number of ACES and later negative health outcomes. CONCLUSIONS Our results indicate that in Ukraine, ACEs have a strong negative effect on later life mental and physical health. Further research is needed to explore specific ACEs and examine potential mediators such as social support in the relationship between ACEs and health outcomes.
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Affiliation(s)
| | - Lydia Homandberg
- Auburn University, 182 S College St, Auburn, Alabama 36849, USA.
| | - Christina Steele
- University of Pennsylvania, 1 College Hall, Room 1, Philadelphia, PA 19104-6376, USA.
| | - Matthew A Bolt
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
| | - Nathan Tintle
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
| | | | - Rachel Ulrich
- Montana State University, Culbertson Hall, 100, Bozeman, MT 59717, USA.
| | - Mark Christians
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
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Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels. JAMA Pediatr 2019; 173:e193007. [PMID: 31498386 PMCID: PMC6735495 DOI: 10.1001/jamapediatrics.2019.3007] [Citation(s) in RCA: 240] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/14/2019] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health. OBJECTIVE To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels. DESIGN, SETTING, AND PARTICIPANTS Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019. MAIN OUTCOMES AND MEASURES The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used. RESULTS In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES. CONCLUSIONS AND RELEVANCE Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.
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Affiliation(s)
- Christina Bethell
- Johns Hopkins Bloomberg School of Public Health and Child and Adolescent Health Measurement Initiative, Baltimore, Maryland
| | - Jennifer Jones
- Alliance for Strong Families and Communities, Milwaukee, Wisconsin
| | - Narangerel Gombojav
- Johns Hopkins Bloomberg School of Public Health and Child and Adolescent Health Measurement Initiative, Baltimore, Maryland
| | | | - Robert Sege
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
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Youth exposure to violence involving a gun: evidence for adverse childhood experience classification. J Behav Med 2019; 42:646-657. [PMID: 31367930 DOI: 10.1007/s10865-019-00053-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/30/2019] [Indexed: 01/13/2023]
Abstract
Adverse childhood experiences (ACEs) have historically included child maltreatment, household dysfunction, and other critical issues known to impact children negatively. Although youth experiences with violence are broadly captured in some ACE measures, youth exposure to violence involving a gun has not been included specifically in the operationalizing, and therefore scientific study, of ACEs. There are numerous implications of this omission, including limiting access to ACE interventions that are currently available and resources for individuals who have been exposed to gun violence. Thus, and given the persistent prevalence of gun violence in the US, we conducted a systematic review of the literature over the past two decades on the assessment of and response to ACEs and gun violence. Eighty-one journal articles across four search engines met our inclusion criteria. Our findings provide evidence that youth gun violence exposure should be classified as an ACE. In addition to increasing access to resources for youth affected by gun violence, these findings may improve the likelihood of funding and research into gun violence, with direct implications for prevention and intervention efforts.
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Salonsalmi A, Pietiläinen O, Lahelma E, Rahkonen O. Childhood adversities, parental education and disability retirement among Finnish municipal employees. PLoS One 2019; 14:e0219421. [PMID: 31323034 PMCID: PMC6641080 DOI: 10.1371/journal.pone.0219421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 11/19/2022] Open
Abstract
Background There is increasing evidence that childhood socioeconomic position and childhood adversities influence adult health. However, the potential contribution of these factors to disability retirement is poorly understood. This study aimed to examine the associations between childhood adversities, parental education and disability retirement. Methods Data on parental education and childhood adversities were derived from the Helsinki Health Study baseline survey, conducted in 2000–02 among 40- to 60-year old employees of the City of Helsinki, Finland. Data on disability retirement and their diagnoses were obtained from the Finnish Centre of Pensions and followed until the end of 2016. The analyses included 5992 employees. The associations of parental education and childhood adversities with disability retirement due to any cause, musculoskeletal diseases and mental disorders were analysed using Cox regression analysis. Results Low parental education was associated with an increased risk of disability retirement due to any cause (maternal education: HR 1.74, 95% CI 1.16–2.62; paternal education: 1.86, 1.38–2.51) and due to musculoskeletal diseases (maternal education: 4.44, 1.66–11.92; paternal education: 3.81, 2.02–7.17). However, adjustment for own education mainly abolished the associations. Economic difficulties in the childhood family, parental alcohol problems and having been bullied at school or by peers increased the risk of disability retirement due to all studied diagnostic groups, whereas parental death or divorce had no effect. Childhood illness (1.53, 1.20–1.95) and parental mental illness (1.68, 1.28–2.20) were associated with disability retirement due to any cause and due to mental disorders (1.65, 1.05–2.59; 3.60, 2.46–5.26). The associations between childhood adversities and disability retirement remained after adjustment for own education, whereas working conditions, and weight and health behaviours somewhat attenuated the associations. Conclusions Parental education and childhood adversities contributed to disability retirement even in midlife. Policy actions investing in children’s well-being might promote work ability in midlife.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Laditka JN, Laditka SB. Lifetime Disadvantages after Childhood Adversity: Health Problems Limiting Work and Shorter Life. THE ANNALS OF THE AMERICAN ACADEMY OF POLITICAL AND SOCIAL SCIENCE 2018; 680:259-277. [PMID: 31031404 PMCID: PMC6481962 DOI: 10.1177/0002716218795436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examine how childhood adversity relates to work disability and life expectancy, using 1999-2015 data from the Panel Study of Income Dynamics. We estimate the probabilities of work disability and death, adjusting for age, sex, race/ethnicity, and education in a nationally representative sample of African American, Hispanic, and white women and men. We find that people in all these groups who experienced high adversity childhoods (individuals with four or more of six adversity indicators) had significantly more work disability and shorter lives than those who experienced no adversity. These findings provide evidence that childhood adversity is associated with substantial disability, and a reduction in life expectancy of at least a decade. Childhood adversity was generally associated with more lost years of life for men than for women, and more disability for women than for men. The results are robust, even when controlling for diabetes, heart disease, depression, obesity, and sedentary behavior.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223,
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223,
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Hardcastle K, Bellis MA, Ford K, Hughes K, Garner J, Ramos Rodriguez G. Measuring the relationships between adverse childhood experiences and educational and employment success in England and Wales: findings from a retrospective study. Public Health 2018; 165:106-116. [PMID: 30388488 DOI: 10.1016/j.puhe.2018.09.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/09/2018] [Accepted: 09/16/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Educational and employment outcomes are critical elements in determining the life course of individuals, yet through health and other mechanisms, those who suffer adverse childhood experiences (ACEs) may experience barriers to achieve in these domains. This study examines the association between ACEs and poor educational outcomes, before considering the impact of ACEs and education on employment in adulthood. STUDY DESIGN Retrospective cross-sectional surveys were conducted in England and Wales using a random stratified sampling methodology. METHODS During face-to-face household interviews (n = 2881), data were collected on demographic factors, ACEs, self-rated childhood affluence, the highest qualification level attained and the current employment status. RESULTS While respondents with ≥4 ACEs were significantly more likely to have no formal qualifications (adjusted odds ratio [AOR] = 2.18; P < 0.001), among those who did achieve secondary level qualifications, the presence of ACEs did not further impact subsequent likelihood of going on to attain college or higher qualifications. However, results suggest a persisting independent impact of high (≥4) ACEs, which were found to be significantly associated with both current unemployment (AOR = 2.52, P < 0.001) and long-term sickness and disability (AOR = 3.94, P < 0.001). Modelled levels of not being in employment ranged from as little as 3% among those with 0 or 1 ACE and higher qualifications to 62% among those with no qualifications and ≥4 ACEs (adjusted for age, gender and childhood affluence effects). CONCLUSIONS Compulsory education may play a pivotal role in mitigating the effects of adversity, supporting the case for approaches within schools that build resilience and tackle educational inequalities. However, adults with ACEs should not be overlooked and efforts should be considered to support them in achieving meaningful employment.
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Affiliation(s)
- K Hardcastle
- Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK.
| | - M A Bellis
- Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK; Hot House, College of Human Sciences, BIHMR, Bangor University, Wrexham, LL13 7YP, UK
| | - K Ford
- Hot House, College of Human Sciences, BIHMR, Bangor University, Wrexham, LL13 7YP, UK
| | - K Hughes
- Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK; Hot House, College of Human Sciences, BIHMR, Bangor University, Wrexham, LL13 7YP, UK
| | - J Garner
- Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK
| | - G Ramos Rodriguez
- Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK
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Ma Z, Bayley MT, Perrier L, Dhir P, Dépatie L, Comper P, Ruttan L, Lay C, Munce SEP. The association between adverse childhood experiences and adult traumatic brain injury/concussion: a scoping review. Disabil Rehabil 2018; 41:1360-1366. [DOI: 10.1080/09638288.2018.1424957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Zechen Ma
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, Toronto, Canada
| | - Mark T. Bayley
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, Toronto, Canada
| | - Laure Perrier
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Priya Dhir
- Faculty of Medicine, University of Toronto, Toronto, Canada
- The Hospital for Sick Children, Toronto, Canada
| | | | - Paul Comper
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, Toronto, Canada
| | - Lesley Ruttan
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, Toronto, Canada
| | - Christine Lay
- Centre for Headache, Women’s College Hospital, Toronto, Canada
| | - Sarah E. P. Munce
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, Toronto, Canada
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Ma Z, Bayley MT, Perrier L, Dhir P, Dépatie L, Comper P, Ruttan L, Munce SE. The association between adverse childhood experiences and traumatic brain injury/concussion in adulthood: A scoping review protocol. BMJ Open 2017; 7:e018425. [PMID: 29025849 PMCID: PMC5652488 DOI: 10.1136/bmjopen-2017-018425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Exposure to adverse childhood experiences (ACEs) is a significant risk factor for physical and mental illnesses later in life. Concussion or traumatic brain injury is a challenging condition where preinjury factors may interact to affect recovery. The association between ACEs and traumatic brain injury/concussion is not well mapped in any previous reviews of the literature. Using a scoping review methodology, the research question that will be addressed is: what is known from the existing literature about the association between ACEs and traumatic brain injury/concussion in adults? METHODS AND ANALYSIS The methodological frameworks outlined by Arksey and O'Malley and Levac et al will be used. All original studies in English published since 2007 investigating ACEs and traumatic brain injury/concussion outcomes will be included with no limitations on study type. Literature search strategies will be developed using medical subject headings and text words related to ACEs and traumatic brain injury/concussions. Multiple electronic databases will be searched. Two independent reviewers will screen titles and abstracts for full-text review and full texts for final inclusion. Two independent reviewers will extract data on study characteristics for ACE exposure and traumatic brain injury/concussion outcomes. Extracted data will be summarised quantitatively using numerical counts and qualitatively using thematic analysis. DISSEMINATION This review will identify knowledge gaps on the associations between ACEs and traumatic brain injury/concussion and promote further research. Knowledge translation will occur throughout the review process with dissemination of project findings to stakeholders at the local, national and international levels.
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Affiliation(s)
- Zechen Ma
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Mark T Bayley
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Laure Perrier
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Priya Dhir
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lana Dépatie
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Comper
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Lesley Ruttan
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sarah Ep Munce
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Einstein EH, Klepacz L. What Influences Mental Illness? Discrepancies Between Medical Education and Conception. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2017; 4:2382120517705123. [PMID: 29349333 PMCID: PMC5736266 DOI: 10.1177/2382120517705123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/27/2017] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This preliminary study examined the differences between what was taught during a formal medical education and medical students' and psychiatry residents' conceptions of notions regarding the causes and determinants of mental illness. METHODS The authors surveyed 74 medical students and 11 residents via convenience sampling. The survey contained 18 statements which were rated twice based on truthfulness in terms of a participant's formal education and conception, respectively. Descriptive statistics and a Wilcoxon signed rank test determined differences between education and conception. RESULTS Results showed that students were less likely to perceive a neurotransmitter imbalance to cause mental illness, as opposed to what was emphasized during a formal medical education. Students and residents also understood the importance of factors such as systemic racism and socioeconomic status in the development of mental illness, which were factors that did not receive heavy emphasis during medical education. Furthermore, students and residents believed that not only did mental illnesses have nonuniform pathologies, but that the Diagnostic and Statistical Manual of Mental Disorders also had the propensity to sometimes arbitrarily categorize individuals with potentially negative consequences. CONCLUSIONS If these notions are therefore part of students' and residents' conceptions, as well as documented in the literature, then it seems appropriate for medical education to be further developed to emphasize these ideas.
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Affiliation(s)
- Evan Hy Einstein
- New York Medical College, Valhalla, NY, USA
- Evan Hy Einstein, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA.
| | - Lidia Klepacz
- Department of Psychiatry, Westchester Medical Center, Valhalla, NY, USA
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