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Voith LA, Salas Atwell M, D'Alessio AS, Evans KE, Korsch-Williams A. Examining adverse childhood experiences and Black youth's engagement in a hospital-based violence intervention program using administrative data. Acad Emerg Med 2024. [PMID: 38605493 DOI: 10.1111/acem.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth. METHODS Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data. RESULTS Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups. CONCLUSIONS This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.
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Affiliation(s)
- Laura A Voith
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
| | - Meghan Salas Atwell
- National Association for the Education of Young Children, Washington, DC, USA
| | - Alena Sorensen D'Alessio
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Amy Korsch-Williams
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
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Bauer A, Martins RC, Hammerton G, Hoffmann MS, Cardoso AS, Colvara C, Hartmann CF, Calegaro G, Perrone LR, Aurélio N, Menezes AMB, Murray J. Adverse childhood experiences and crime outcomes in early adulthood: A multi-method approach in a Brazilian birth cohort. Psychiatry Res 2024; 334:115809. [PMID: 38401487 PMCID: PMC10985840 DOI: 10.1016/j.psychres.2024.115809] [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: 12/08/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
This study aimed to investigate alternative approaches to a cumulative risk score in the relationship between adverse childhood experiences (ACEs) and crime. Using data from the 1993 Pelotas (Brazil) Birth Cohort (n = 3236), we measured 12 ACEs up to 15 years, and past-year violent and non-violent crime at 22 years. We used four analytical approaches: single adversities, cumulative risk, latent class analysis, and network analysis. When examined individually, physical abuse, emotional abuse, and domestic violence were associated with both crime outcomes, whereas maternal mental illness and discrimination were associated with violent crime only, and parental divorce and poverty with non-violent crime only. There was a cumulative effect of ACEs on crime. The class with child maltreatment and household challenges was associated with both crime outcomes; exposure to household challenges and social risks was associated with violent crime only. In network models, crime showed conditional associations with physical abuse, maternal mental illness, and parental divorce. Although cumulative ACEs did associate with crime, some individual and combinations of ACEs showed particularly strong and robust effects, which were not captured by the cumulative score. Many ACEs are closely connected and/or cluster together, and the usefulness of the ACE score needs to be further evaluated.
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Affiliation(s)
- Andreas Bauer
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Rafaela Costa Martins
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Gemma Hammerton
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maurício Scopel Hoffmann
- Department of Neuropsychiatry, Federal University of Santa Maria, Santa Maria, Brazil; Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andressa Souza Cardoso
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Camila Colvara
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Gabriel Calegaro
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luciana Rodrigues Perrone
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Nilvia Aurélio
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
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Annett J, Tillson M, Walker M, Webster JM, Staton M. Adverse childhood experiences and mental health among incarcerated women: Self-esteem as a mediating mechanism. CHILD ABUSE & NEGLECT 2023; 146:106486. [PMID: 37788588 PMCID: PMC10841516 DOI: 10.1016/j.chiabu.2023.106486] [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: 04/24/2023] [Revised: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) and mental health problems are interrelated. However, less is known about this relationship in incarcerated women and how self-esteem impacts this relationship. OBJECTIVE To investigate the relationship between ACEs and mental health problems (traumatic stress, depression, and anxiety) in incarcerated women with opioid use disorder (OUD) and, the possible role of self-esteem as a mediator of the relationship. PARTICIPANTS AND SETTING Incarcerated women (N = 500) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed by research staff. METHODS Regression analyses and mediation models were used to examine the relationship between ACEs, mental health, and self-esteem. RESULTS ACEs were positively correlated with present mental health problems (traumatic stress, r = 0.407, p < .001; depression, r = 0.177, p < .001; and anxiety, r = 0.213, p < .001) and negatively correlated with current self-esteem (r = -0.241, p < .001). Linear regression analyses established that ACEs and self-esteem were significantly related to all three mental health variables of interest. Additionally, self-esteem mediated the relationship between ACEs and mental health. CONCLUSION This study shows that incarcerated women's experiences with ACEs are significantly related to poor mental health. Self-esteem plays a critical role in this relationship.
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Affiliation(s)
- Jaxin Annett
- University of Kentucky College of Education, Department of Educational, School, and Counseling Psychology, 597 S. Upper Street, Lexington, KY 40508, USA; University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Martha Tillson
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Meghan Walker
- University of Kentucky College of Medicine, E 1st Ave, Bowling Green, KY 42101, USA.
| | - J Matthew Webster
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
| | - Michele Staton
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
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Folk JB, Ramaiya M, Holloway E, Ramos L, Marshall BDL, Kemp K, Li Y, Bath E, Mitchell DK, Tolou-Shams M. The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact. Res Child Adolesc Psychopathol 2023; 51:1857-1870. [PMID: 36565372 PMCID: PMC10290175 DOI: 10.1007/s10802-022-01009-w] [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] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
A growing body of literature has documented high rates of adverse childhood experiences (ACEs) and their effects on behavioral health among adolescents impacted by the juvenile legal system. Most research with justice-impacted youth assesses the ten standard ACEs, encompassing abuse, neglect, and household dysfunction. This body of work has largely ignored the five expanded ACEs which assess social and community level adversity. Justice-impacted youth commonly experience expanded ACEs (racial discrimination, placement in foster care, living in a disadvantaged neighborhood, witnessing violence, bullying), and inclusion of these adversities may enhance predictive utility of the commonly used ACEs score. The current study examined the prospective impact of total ACEs (standard and expanded) on alcohol and cannabis use, substance-related consequences, and psychiatric symptoms during the year following first ever contact with the juvenile court. Results indicate justice-impacted youth experience multiple expanded ACEs prior to first court contact. The expanded ACEs did not predict any of the behavioral health outcomes assessed, over and above the standard ACEs. Inclusion of expanded ACEs in the standard ACEs score may not increase utility in identifying prospective behavioral health outcomes among youth in first time contact with the juvenile legal system.
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Evan Holloway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lili Ramos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Daphne Koinis Mitchell
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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5
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Pinto-Cortez C, Peñaloza-Díaz G, Martínez N, Díaz S, Valdovino N, Zavala M, Muzatto-Negrón P, Zapata-Sepúlveda P. Adverse childhood experiences and psychopathology in adolescents from northern Chile: the moderating role of the attachment style. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:37. [PMID: 38015372 PMCID: PMC10684444 DOI: 10.1186/s41155-023-00273-z] [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: 04/23/2023] [Accepted: 09/28/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life. OBJECTIVE The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships- Relationship Structures (ECR-RS), and Youth Self Report (YSR-18). RESULTS The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = -0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models. CONCLUSION In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.
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Affiliation(s)
| | - Gabriel Peñaloza-Díaz
- Universidad de Tarapacá, Arica, Chile.
- Programa de Doctorado en Psicología, Universidad de Tarapacá, Universidad Católica del Norte, Arica, Chile.
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Ahrens K, Blackburn N, Aalsma M, Haggerty K, Kelleher K, Knight DK, Joseph E, Mulford C, Ryle T, Tolou-Shams M. Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:99-110. [PMID: 37393415 PMCID: PMC10961647 DOI: 10.1007/s11121-023-01566-6] [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] [Accepted: 06/11/2023] [Indexed: 07/03/2023]
Abstract
Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUD prevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUD treatments, test novel structural and interpersonal strategies to prevent opioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention® to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.
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Affiliation(s)
- Kym Ahrens
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA.
| | | | - Matthew Aalsma
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kevin Haggerty
- University of Washington Social Development Research Group, Seattle, WA, USA
| | | | - Danica K Knight
- Texas Christian University Karyn Purvis Institute of Child Development, Fort Worth, TX, USA
| | - Elizabeth Joseph
- Texas Christian University Institute of Behavioral Research, Fort Worth, TX, USA
| | | | - Ted Ryle
- Washington State Dept. of Children, Youth and Families/Juvenile Rehabilitation, Olympia, WA, USA
| | - Marina Tolou-Shams
- University of California San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
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7
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Janczewski C, Mersky J, Plummer Lee C. Intergenerational transmission of child protective services involvement: Exploring the role of ACEs and domestic violence among families who receive home visiting services. CHILD ABUSE & NEGLECT 2023; 144:106384. [PMID: 37542996 DOI: 10.1016/j.chiabu.2023.106384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with negative outcomes over the life course and across generations, including domestic violence (DV) and child maltreatment. However, no studies have examined the connection between parents' ACEs and their child's risk of child protective services (CPS) involvement or possible mechanisms of transmission. OBJECTIVE In addition to describing the prevalence and correlates of CPS involvement, our primary aims are to test whether parental adversity in childhood is associated with CPS involvement and whether DV victimization mediates the ACE-CPS association. PARTICIPANTS AND SETTING The sample included 3039 primary caregivers and 3343 children served by home visiting programs in Wisconsin between 2014 and 2019. METHODS Using matched home visiting and CPS records, we generated prevalence estimates of screened-in CPS reports and assessed bivariate associations between CPS involvement and ACEs, DV, and household demographics. We then conducted a two-stage path analysis to test the association between ACEs and CPS involvement and whether DV mediated the ACE-CPS association. RESULTS Overall, 22.8 % of caregivers had a screened-in report. Prevalence rates were higher among women who endured ACEs and DV, and they varied by demographic characteristics. ACEs were directly linked to DV and CPS involvement, and there was an indirect pathway linking ACEs to CPS involvement through DV exposure. CONCLUSIONS Home visiting programs serve families that frequently interact with the child welfare system. By enhancing the trauma-responsive potential of these interventions, it may be possible to interrupt intergenerational mechanisms that contribute to child abuse and neglect and CPS involvement.
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Affiliation(s)
- Colleen Janczewski
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America.
| | - Joshua Mersky
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America
| | - CheinTi Plummer Lee
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America
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Yohros A. Examining the Relationship Between Adverse Childhood Experiences and Juvenile Recidivism: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1640-1655. [PMID: 35166600 DOI: 10.1177/15248380211073846] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
While the impact of trauma on delinquency and offending has been studied in great depth, less is known about the cumulative effects of adverse childhood experiences and how these experiences impact recidivism or reoffending outcomes of youth who already have justice system involvement. The main aim of this paper is to report on the results of a systematic review and meta-analysis on the relationship between Adverse Childhood Experiences and juvenile recidivism. Of particular interest, the paper examines to what extent, if any, ACEs can be used to predict youth reoffending outcomes, as well as investigates the nature of this relationship. The study utilizes quantitative metanalytical techniques to estimate the overall impact of Adverse Childhood Experiences on youth reoffending. Sixteen studies were selected after a comprehensive search of electronic databases covering the fields of social science, criminology, psychology, or related fields. Key findings demonstrate that Adverse Childhood Experiences increase the risk of youth recidivism, with effects varying amongst sample sizes. Narrative synthesis also shows key gender, racial, and ethnic differences as well as potential mechanisms in the cumulative trauma-reoffending relationship. These findings can further guide research and policy in the areas of trauma, juvenile justice, and crime prevention.
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Affiliation(s)
- Alexis Yohros
- School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
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Astridge B, Li WW, McDermott B, Longhitano C. A systematic review and meta-analysis on adverse childhood experiences: Prevalence in youth offenders and their effects on youth recidivism. CHILD ABUSE & NEGLECT 2023; 140:106055. [PMID: 37142357 DOI: 10.1016/j.chiabu.2023.106055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been found to be more prevalent among youth involved with the criminal justice system compared to their counterparts in the general population. The present study aims to systematically review the existing empirical studies to provide a comprehensive understanding of the prevalence of ACEs among youth offenders aged between 10 and 19 years, and the effects of both cumulative ACEs and individual ACE items on youth recidivism. METHOD A systematic review approach was employed. Narrative synthesis and meta-analysis were performed to synthesise the data in 31 included studies. RESULTS The pooled prevalence of cumulative ACEs was 39.4 %. The pooled prevalence of individual ACEs ranged between 13.7 % to 51.4 %. Cumulative ACEs and neglect were positively associated with youth recidivism, with OR = 1.966, 95%CI [1.582, 2.444] and OR = 1.328, 95%CI [1.078, 1.637], respectively. Physical and sexual abuse were not significantly associated with youth recidivism. Regarding the mechanisms underlying the relationship between ACEs and recidivism; moderators included gender, positive childhood experiences, strong social bonds, and empathy. Mediators included child welfare placement, emotional and behavioural problems, drug use, mental health problems, and negative emotionality. CONCLUSION Developing programs to youth offenders aiming to address the impact of cumulative and individual ACE exposure, strengthen the protective factors and weaken the risk factors would be useful to reduce youth recidivism.
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Affiliation(s)
- Belinda Astridge
- James Cook University, Townsville, 1 James Cook Drive, Townsville, QLD 4818, Australia
| | - Wendy Wen Li
- James Cook University, Townsville, 1 James Cook Drive, Townsville, QLD 4818, Australia.
| | - Brett McDermott
- James Cook University, Townsville, 1 James Cook Drive, Townsville, QLD 4818, Australia; Child and Adolescent Mental Health Service, Department of Health, GPO Box 125, Hobart, TAS 7001, Australia
| | - Carlo Longhitano
- James Cook University, Townsville, 1 James Cook Drive, Townsville, QLD 4818, Australia
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Mueller KC, Cavitt J, Carey MT. Future orientation in justice-involved youth: The effects of adverse and positive childhood experiences, and being dual-status. CHILD ABUSE & NEGLECT 2023; 141:106230. [PMID: 37167659 DOI: 10.1016/j.chiabu.2023.106230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/23/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Justice-involved youth face diverse challenges and are likely to experience more adverse childhood experiences (ACEs) and fewer positive childhood experiences (PCEs), which can have implications for their orientation toward their future. Future orientation is thought to influence behavior, but little is known about how it is shaped. While future orientation and its correlates likely matter for all justice-involved youth, the recently recognized subcategory of Dual Status Youths (DSYs) might be especially sensitive to influences on future orientation. OBJECTIVE This study explores the effects of cumulative adverse childhood experiences (ACEs), cumulative positive childhood experiences (PCEs), and DSY classification on the likelihood of having a positive orientation toward the future. PARTICIPANTS AND SETTING The researchers analyze a sample of 3604 justice-involved youth on probation in a large metropolitan area in Texas. METHOD The sample includes juveniles who received the full Positive Achievement Change Tool (PACT) risk/needs assessment. The analytical plan included t-tests and two logistic regression analyses. RESULTS Findings were that DSY are exposed to more ACEs and fewer PCEs than non-dual status justice-involved youth. Results indicated that a greater number of PCEs is associated with future orientation, but DSY status and ACEs are not. CONCLUSIONS Juvenile justice programming must strive to cultivate PCEs in justice-involved youth prior to the completion of their probation supervision.
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Affiliation(s)
- Kyle Curtis Mueller
- Research Analyst at Harris County Juvenile Probation Department (HCJPD), United States of America.
| | - Joslyn Cavitt
- Research Analyst at Harris County Juvenile Probation Department (HCJPD), United States of America; University of Houston, Department of Psychology, Graduate Research Assistant, United States of America
| | - Marcus Tyler Carey
- Assistant Professor of Criminal Justice at Texas A&M International University, Laredo, TX, United States of America
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Bellis MA, Hughes K, Cresswell K, Ford K. Comparing relationships between single types of adverse childhood experiences and health-related outcomes: a combined primary data study of eight cross-sectional surveys in England and Wales. BMJ Open 2023; 13:e072916. [PMID: 37068903 PMCID: PMC10111913 DOI: 10.1136/bmjopen-2023-072916] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) show strong cumulative associations with ill-health across the life course. Harms can arise even in those exposed to a single ACE type but few studies examine such exposure. For individuals experiencing a single ACE type, we examine which ACEs are most strongly related to different health harms. DESIGN Secondary analysis of combined data from eight cross-sectional general population ACE surveys. SETTING Households in England and Wales. PARTICIPANTS 20 556 residents aged 18-69 years. MEASURES Ten self-reported outcomes were examined: smoking, cannabis use, binge drinking, obesity, sexually transmitted infection, teenage pregnancy, mental well-being, violence perpetration, violence victimisation and incarceration. Adjusted ORs and percentage changes in outcomes were calculated for each type of ACE exposure. RESULTS Significance and magnitude of associations between each ACE and outcome varied. Binge drinking was associated with childhood verbal abuse (VA), parental separation (PS) and household alcohol problem (AP), while obesity was linked to sexual abuse (SA) and household mental illness. SA also showed the biggest increase in cannabis use (25.5% vs 10.8%, no ACEs). Household AP was the ACE most strongly associated with violence and incarceration. PS was associated with teenage pregnancy (9.1% vs 3.7%, no ACEs) and 5 other outcomes. VA was associated with 7 of the 10 outcomes examined. CONCLUSION Exposure to a single ACE increases risks of poorer outcomes across health-harming behaviours, sexual health, mental well-being and criminal domains. Toxic stress can arise from ACEs such as physical and SA but other more prevalent ACEs (eg, VA, PS) may also contribute substantively to poorer life course health.
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Affiliation(s)
- Mark A Bellis
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
- WHO Collaborating Centre for Investment in Health & Well-being, Public Health Wales, Wrexham, UK
| | - Karen Hughes
- WHO Collaborating Centre for Investment in Health & Well-being, Public Health Wales, Wrexham, UK
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Katie Cresswell
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Kat Ford
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Bangor, UK
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Jackson DB, Jones MS, Semenza DC, Testa A. Adverse Childhood Experiences and Adolescent Delinquency: A Theoretically Informed Investigation of Mediators during Middle Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3202. [PMID: 36833897 PMCID: PMC9959059 DOI: 10.3390/ijerph20043202] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The purposes of this study are twofold. First, we explore the associations between cumulative ACEs at ages 5 and 7 and delinquency at age 14 in a national sample of youth in the United Kingdom (UK). Second, we explore the role of five theoretically relevant mediators in explaining this relationship. METHODS Analyses were based on data from the UK Millennium Cohort Study-a prospective, longitudinal birth-cohort study of more than 18,000 individuals in the United Kingdom. RESULTS The results indicate that early ACEs are significantly associated with adolescent delinquency, with effects becoming significantly larger as ACEs accumulate. Findings also reveal that child property delinquency, substance use, low self-control, unstructured socializing, and parent-child attachment at age 11 all significantly mediate the relationship between early ACEs and delinquency in adolescence, with early delinquency and low self-control emerging as the most robust mediators. CONCLUSIONS Findings point to a need for early ACEs screening and a Trauma-Informed Health Care (TIC) approach in early delinquency prevention efforts. Early intervention efforts that bolster child self-control and curtail early-onset problem behaviors may also disrupt pathways from ACEs to adolescent delinquency.
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Affiliation(s)
- Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Melissa S. Jones
- Sociology Department, College of Family, Home, and Social Sciences, Brigham Young University, Provo, UT 84602, USA
| | - Daniel C. Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers, Camden, The State University of New Jersey, 405-7 Cooper Street, Camden, NJ 08102, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Heerde JA, Merrin GJ, Le VT, Toumbourou JW, Bailey JA. Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1711. [PMID: 36767076 PMCID: PMC9914820 DOI: 10.3390/ijerph20031711] [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: 11/27/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
People who experience social marginalization and vulnerability have uniquely complex health needs and are at risk of poor health outcomes. Regression analyses using longitudinal data from a cross-national, population-based sample of young adults participating in the International Youth Development Study, tested associations between social marginalization and vulnerabilities and physical health, mental health, and substance use outcomes. Participants from Victoria, Australia, and Washington State in the US were surveyed at ages 25 (2014) and 29 years (2018; N = 1944; 46.7% male). A history of adverse childhood experiences (ACEs), LGBT identity, financial insecurity, and justice system involvement at age 25 predicted poor health outcomes at age 28, including lower perceived health status, risk for chronic illness, depression and anxiety symptoms, and diagnosed mental health/substance use disorders. Tests of model equivalence across states showed that a history of ACEs was more strongly related to health status and serious injury at age 28 and justice system involvement at age 25 was more strongly related to age 28 serious injury in Victoria than in Washington State. Findings strengthen the case for future population-based research identifying life-course interventions and state policies for reducing poor health and improving health equity among members of socially marginalized groups.
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Affiliation(s)
- Jessica A. Heerde
- Department of Paediatrics, The University of Melbourne, Parkville 3052, Australia
- Department of Social Work, The University of Melbourne, Parkville 3010, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Gabriel J. Merrin
- Department of Human Development and Family Science, Syracuse University, Syracuse, NY 13244, USA
| | - Vi T. Le
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA 98115, USA
| | - John W. Toumbourou
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville 3052, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood 3125, Australia
| | - Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA 98115, USA
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Novak A, Fagan AA. The conditioning effects of positive experiences on the ACEs-offending relationship in adolescence. CHILD ABUSE & NEGLECT 2022; 134:105915. [PMID: 36228391 DOI: 10.1016/j.chiabu.2022.105915] [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: 05/19/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Research shows that adverse childhood experiences (ACEs) are problematic and may impact delinquency and arrest in adolescence. However, resiliency theories suggest the association between ACEs and delinquency/arrest may be mitigated by positive childhood experiences (PCEs). OBJECTIVE This study tests the hypothesis that an accumulation of PCEs ameliorates the relationship between ACEs and delinquency and arrest during adolescence. PARTICIPANTS AND SETTING Prospective data were collected from approximately 800 participants in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHODS Self-report data from 16-year-old participants were used to measure the two dependent variables: the number of delinquent acts committed and having at least one arrest in the past year. Count measures reflected the number of ACEs and PCEs, with the former based on reports from child protective services, caregivers, and youth collected from ages 4-12, and the latter based on self-reports at age 12. Negative binomial models analyzed delinquency outcomes, logistic regression models examined arrest, and interaction terms assessed moderating effects. RESULTS ACEs were associated with significantly more delinquent acts but not arrest, and PCEs were associated with significantly fewer delinquent acts but not arrest. PCEs significantly reduced the relationship between ACEs and delinquency but only for youth with moderate levels of ACEs. CONCLUSIONS Findings indicate a need for additional research measuring the moderating effects of a variety of PCEs and to the need to enhance positive experiences for youth to prevent delinquency.
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Affiliation(s)
- Abigail Novak
- University of Mississippi, United States of America.
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15
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Jackson DB, Jindal M, Testa A, Ganson KT, Fix RL, Nagata JM. Adverse Childhood Experiences and Adolescent Police Contact in the United Kingdom. Pediatrics 2022; 150:189565. [PMID: 36161331 DOI: 10.1542/peds.2021-055889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are prevalent in the population and yield several adverse consequences for child health and development as they accumulate. The objective of the current study is to examine the association between ACEs and adolescent police contact using a national, longitudinal study of adolescents born in the United Kingdom. METHODS Data come from a sample of 11 313 adolescents who participated in the UK Millennium Cohort Study (MCS), which is a national, longitudinal study of adolescents born in the United Kingdom between 2000 and 2002. Accumulating ACEs were measured at ages 5 and 7 years and reports of police contact were measured at age 14 years, including being stopped and questioned, warned/cautioned, and arrested. RESULTS Accumulating ACEs at ages 5 and 7 years are associated with a significant increase in the odds of experiencing police stops by age 14 years, with 3 or more ACEs corresponding to a 100% increase in the odds of police stops. Additional analyses reveal that behavioral health factors at age 11 years explain 58.5% to 78.1% of the association between ACEs and adolescent police stops, with externalizing behavior explaining the largest portion of the association. Finally, accumulating ACEs were most relevant to being warned/cautioned or arrested by police. CONCLUSIONS A history of accumulating ACEs during early childhood elevates the likelihood of police contact by age 14 years, in part by undermining behavioral health. Findings highlight the potential for early interventions in the lives of ACE-exposed adolescents to curtail justice system involvement.
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Affiliation(s)
- Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Alexander Testa
- The University of Texas Health Science Center at Houston, Houston, Texas
| | | | - Rebecca L Fix
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jason M Nagata
- University of California, San Francisco, San Francisco, California
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Testa A, Jackson DB, Ganson KT, Nagata JM. Adverse Childhood Experiences and Criminal Justice Contact in Adulthood. Acad Pediatr 2022; 22:972-980. [PMID: 34752957 DOI: 10.1016/j.acap.2021.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess the relationship between adverse childhood experiences (ACEs) and formal criminal justice system processing during young adulthood and middle adulthood. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 8531). Logistic regression, multinomial logistic regression, and Poisson regression models were used to assess the relationship between accumulating ACEs (0, 1, 2, 3, or 4 or more) and criminal justice system processing during young adulthood (24-32) and middle adulthood (33-43). RESULTS Accumulating ACEs -especially 4 or more ACEs- was significantly associated with various forms of criminal justice contact during young and middle adulthood, including having been arrested, experiencing a greater number of arrests, having been incarcerated in adulthood, having been incarcerated multiple times, and having spent longer periods of time incarcerated. CONCLUSIONS This study documents that the association between ACEs and formal criminal justice extends into young and middle adulthood. Considering the consequences of both ACEs and criminal justice system contact for a variety of life domains, the findings suggest the need for developing and employing early interventions to disrupt pathways to criminal justice system involvement.
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Affiliation(s)
- Alexander Testa
- The University of Texas at San Antonio, San Antonio (A Testa), Tex.
| | | | - Kyle T Ganson
- University of Toronto, Toronto, Ontario (KT Ganson), Canada
| | - Jason M Nagata
- University of California, San Francisco (JM Nagata), Calif
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Salo M, Appleton AA, Tracy M. Childhood Adversity Trajectories and Violent Behaviors in Adolescence and Early Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13978-NP14007. [PMID: 33858246 PMCID: PMC8521560 DOI: 10.1177/08862605211006366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention.
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Affiliation(s)
- Madeleine Salo
- University at Albany School of Public Health, State University of New York, USA
| | - Allison A. Appleton
- University at Albany School of Public Health, State University of New York, USA
| | - Melissa Tracy
- University at Albany School of Public Health, State University of New York, USA
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18
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Testa A, Jackson DB. Adverse Childhood Experiences and Perceived Unfair Police Treatment: Differences by Race and Ethnicity. J Adolesc Health 2022; 70:804-809. [PMID: 35131166 DOI: 10.1016/j.jadohealth.2021.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE The purpose of the study was to examine racial/ethnic heterogeneity in the relationship between adverse childhood experiences (ACEs) and perceived unfair police treatment in the United States. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (n = 8,876). Logistic regression models were used to assess the relationship between accumulating ACEs and perceived unfair police treatment. Moderation analyses were conducted to assess interactions between ACEs, race, and ethnicity. RESULTS Those with four or more ACEs were 3.4 times as likely to report perceived unfair police treatment by adulthood, relative to individuals with zero ACEs (odds ratio = 3.411, 95% confidence interval = 2.634, 4.418). Still, Black individuals have the highest probability of experiencing unfair police contact, and this pattern remains relatively stable irrespective of the number of ACEs. The probability of perceived unfair police treatment significantly increases alongside accumulating ACEs for all other racial and ethnic groups. DISCUSSION Exposure to accumulating ACEs substantially elevates the likelihood of perceived unfair police treatment. However, perceived unfair police treatment is so common in the lives of Black Americans; it occurs at considerably high rates irrespective of ACE exposure.
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Affiliation(s)
| | - Dylan B Jackson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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19
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Pettus C, Renn T, Tripodi S, Tamburri S. Study protocol paper for the multisite randomized controlled trial of comprehensive trauma informed reentry services for moderate to high-risk young males releasing from state prisons. Contemp Clin Trials 2022; 117:106766. [DOI: 10.1016/j.cct.2022.106766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/03/2022]
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Bellis MA, Hughes K, Ford K, Madden HCE, Glendinning F, Wood S. Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study. BMJ Open 2022; 12:e053915. [PMID: 35105582 PMCID: PMC8829847 DOI: 10.1136/bmjopen-2021-053915] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy. DESIGN National cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group. SETTING Households in Wales during national COVID-19 restrictions (December 2020 to March 2021). PARTICIPANTS 2285 Welsh residents aged ≥18 years. MEASURES Nine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination). RESULTS Increasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18-29 years. CONCLUSIONS ACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.
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Affiliation(s)
- Mark A Bellis
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Karen Hughes
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Kat Ford
- College of Human Sciences, Bangor University, Bangor, UK
| | - Hannah C E Madden
- College of Human Sciences, Bangor University, Bangor, UK
- School of Social Sciences, Liverpool Hope University, Liverpool, UK
| | | | - Sara Wood
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
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Schmid M, Fegert JM, Clemens V, Seker S, d’Huart D, Binder M, Schröder M, Friden L, Boonmann C, Jenkel N, Schmeck K, Bürgin D. Misshandlungs- und Vernachlässigungserfahrungen in der Kindheit: Ein Risikofaktor für die soziale Teilhabe ehemals außerfamiliär platzierter junger Erwachsener. KINDHEIT UND ENTWICKLUNG 2022. [DOI: 10.1026/0942-5403/a000366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Eine Reihe von Studien zeigen soziale Folgen von Misshandlung und Vernachlässigung in der Kindheit im weiteren Lebenslauf. Fragestellung: Diese Studie zielt darauf ab, die langfristigen Auswirkungen von Misshandlungs- und Vernachlässigungserfahrungen auf die soziale Teilhabe in einer Stichprobe von ehemals fremdplatzierten jungen Erwachsenen in der Schweiz zu untersuchen. Methode: Im Rahmen der Studie wurden 218 ehemals fremdplatzierte junge Erwachsene ( MAlter=26.1, 32.6 % weiblich) mit einer psychometrischen Testbatterie befragt. Dabei wurden Misshandlungserfahrungen in der Kindheit erfasst sowie die soziale Teilhabe bezüglich psychischer Gesundheit, Legalbewährung, sozio-ökonomische Lage und Beziehungen untersucht. Ergebnisse: Die Ergebnisse zeigen die hohe Prävalenz und negativen Folgen von kumulierten Misshandlungserfahrungen bei ehemals fremdplatzierten jungen Menschen. Eine höhere Anzahl von Misshandlungserfahrungen ging mit signifikant mehr Problemen in gesundheitlichen, finanziellen und sozialen Lebensbereichen einher. Diskussion und Schlussfolgerung: Die gravierenden Folgen von Misshandlungserfahrungen in der Kindheit unterstreichen die Bedeutung der Prävention und frühzeitigen Intervention. Sie zeigen aber auch, dass viele schwer betroffene junge Menschen neben therapeutischen auch konkrete und lebensweltorientierte Hilfen benötigen, um ihre Entwicklungsaufgaben adäquat zu bewältigen und erfolgreich an der Gesellschaft teilzuhaben.
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Affiliation(s)
- Marc Schmid
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Jörg M. Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitäre Kliniken Ulm, Universität Ulm
| | - Vera Clemens
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitäre Kliniken Ulm, Universität Ulm
| | - Süheyla Seker
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Delfine d’Huart
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Melanie Binder
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Martin Schröder
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Liz Friden
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Cyril Boonmann
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Nils Jenkel
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - Klaus Schmeck
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
| | - David Bürgin
- Forschungsabteilung der Klinik für Kinder und Jugendliche, Universitäre Psychiatrische Kliniken Basel
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Hughes K, Ford K, Bellis MA, Glendinning F, Harrison E, Passmore J. Health and financial costs of adverse childhood experiences in 28 European countries: a systematic review and meta-analysis. Lancet Public Health 2021; 6:e848-e857. [PMID: 34756168 PMCID: PMC8573710 DOI: 10.1016/s2468-2667(21)00232-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with increased health risks across the life course. We aimed to estimate the annual health and financial burden of ACEs for 28 European countries. METHODS In this systematic review and meta-analysis, we searched MEDLINE, CINAHL, PsycINFO, Applied Social Sciences Index and Abstracts, Criminal Justice Databases, and Education Resources Information Center for quantitative studies (published Jan 1, 1990, to Sept 8, 2020) that reported prevalence of ACEs and risks of health outcomes associated with ACEs. Pooled relative risks were calculated for associations between ACEs and harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular disease, stroke, and respiratory disease. Country-level ACE prevalence was calculated using available data. Country-level population attributable fractions (PAFs) due to ACEs were generated and applied to 2019 estimates of disability-adjusted life-years. Financial costs (US$ in 2019) were estimated using an adapted human capital approach. FINDINGS In most countries, interpersonal violence had the largest PAFs due to ACEs (range 14·7-53·5%), followed by harmful alcohol use (15·7-45·0%), illicit drug use (15·2-44·9%), and anxiety (13·9%-44·8%). Harmful alcohol use, smoking, and cancer had the highest ACE-attributable costs in many countries. Total ACE-attributable costs ranged from $0·1 billion (Montenegro) to $129·4 billion (Germany) and were equivalent to between 1·1% (Sweden and Turkey) and 6·0% (Ukraine) of nations' gross domestic products. INTERPRETATION Availability of ACE data varies widely between countries and country-level estimates cannot be directly compared. However, findings suggest ACEs are associated with major health and financial costs across European countries. The cost of not investing to prevent ACEs must be recognised, particularly as countries look to recover from the COVID-19 pandemic, which interrupted services and education, and potentially increased risk factors for ACEs. FUNDING WHO Regional Office for Europe.
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Affiliation(s)
- Karen Hughes
- WHO Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Kat Ford
- College of Human Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- WHO Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.
| | | | - Emma Harrison
- College of Human Sciences, Bangor University, Wrexham, UK; Psychology Department, Glyndwr University, Wrexham, UK
| | - Jonathon Passmore
- WHO Regional Office for Europe, United Nations Campus, Bonn, Germany
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Jahic I, Trulson CR, Caudill JW, Bonner T, Slemaker A, DeLisi M. Adverse Childhood Experiences and Forensic Typologies: Getting Specific about Trauma among Institutionalized Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111307. [PMID: 34769825 PMCID: PMC8583621 DOI: 10.3390/ijerph182111307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
Adverse childhood experiences (ACEs) are linked to various conduct and behavior problems within juvenile delinquents, but fewer studies focused on these associations among specific forensic typologies of offending. Utilizing data from 3382 institutionalized delinquents in Texas, logistic regression models indicated multiple associations between ACEs and forensic typologies in both adjusted and unadjusted models, with sexual abuse and physical abuse emerging as the most consistent and robust predictors. Supplemental sensitivity models confirmed the associations between sexual abuse and physical abuse among youth who fit multiple forensic typologies. Models fared poorly at identifying youth who are engaged in fire setting. Implications for total and singular ACEs are discussed, along with how those relate to more clinically meaningful, forensic forms of juvenile delinquency.
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Affiliation(s)
- Ilma Jahic
- Department of Sociology and Criminal Justice, Iowa State University, Ames, IA 50011, USA; (I.J.); (T.B.); (A.S.)
| | - Chad R. Trulson
- Department of Criminal Justice, University of North Texas, Denton, TX 76203, USA;
| | - Jonathan W. Caudill
- School of Public Affairs, University of Colorado, Colorado Springs, CO 80918, USA;
| | - Taea Bonner
- Department of Sociology and Criminal Justice, Iowa State University, Ames, IA 50011, USA; (I.J.); (T.B.); (A.S.)
| | - Alexandra Slemaker
- Department of Sociology and Criminal Justice, Iowa State University, Ames, IA 50011, USA; (I.J.); (T.B.); (A.S.)
| | - Matt DeLisi
- Department of Sociology and Criminal Justice, Iowa State University, Ames, IA 50011, USA; (I.J.); (T.B.); (A.S.)
- Correspondence:
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Liu M, Luong L, Lachaud J, Edalati H, Reeves A, Hwang SW. Adverse childhood experiences and related outcomes among adults experiencing homelessness: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e836-e847. [PMID: 34599894 DOI: 10.1016/s2468-2667(21)00189-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/05/2021] [Accepted: 07/30/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are strong risk factors for homelessness and poor health and functioning. We aimed to evaluate the lifetime prevalence of ACEs and their associations with health-related and functioning-related outcomes among homeless adults. METHODS In this systematic review and meta-analysis, we searched from database inception to Nov 11, 2020, for original and peer-reviewed studies in English that documented lifetime prevalence of ACEs or associations between ACEs and health-related or functioning-related outcomes. We selected studies if they included a definable group of homeless adults and measured at least four ACE categories. We calculated pooled estimates of lifetime prevalence of one or more ACEs and four or more ACEs with random-effects models. We used the leave-one-out method in sensitivity analyses and studied meta-regressions to explore potential moderators of ACE prevalence. We also did a narrative summary of associations between ACEs and health-related and functioning-related outcomes, as there were too few studies on each outcome for quantitative meta-analysis. This study is registered with PROSPERO, CRD42020218741. FINDINGS We identified 2129 studies through systematic search, of which 29 studies (16 942 individuals) were included in the systematic review, 20 studies (10 034 individuals) were included in the meta-analysis for one or more ACEs, and 15 studies (5693 individuals) were included in the meta-analysis for four or more ACEs. Studies included samples of adults experiencing homelessness in the USA, Canada, and the UK; participants in the included studies were predominantly male (65·2%) and mean ages ranged between 18·3 and 58·1 years, but many studies did not report race, ethnicity, and sexual and gender minority data. Lifetime prevalence of one or more ACEs among homeless adults was 89·8% (95% CI 83·7-93·7) and the lifetime prevalence of four or more ACEs was 53·9% (45·9-61·7). Considerable heterogeneity was identified in both meta-analyses (I2>95%). Of the potential moderators analysed, the ACE measurement tool significantly moderated the estimated lifetime prevalence of one or more ACEs and four or more ACEs, and age also significantly moderated the estimated lifetime prevalence of four or more ACEs. In the narrative synthesis, ACEs were consistently positively associated with high suicidality (two studies), suicide attempt (three studies), major depressive disorder (two studies), substance misuse (two studies), and adult victimisation (two studies). INTERPRETATION The lifetime prevalence of ACEs is substantially higher among homeless adults than among the general population, and ACE exposure might be associated with prevalence of mental illness, substance misuse, and victimisation. Policy efforts and evidence-based interventions are urgently needed to prevent ACEs and address associated poor outcomes among this population. FUNDING Rhodes Trust and Canadian Institutes of Health Research.
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Affiliation(s)
- Michael Liu
- Harvard Medical School, Boston, MA, USA; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
| | - Linh Luong
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - James Lachaud
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Hanie Edalati
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
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