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Bhattarai A, King N, Dimitropoulos G, Cunningham S, Rivera D, Tough S, Bulloch AGM, Patten SB, Duffy A. Did childhood adversity increase the vulnerability of university students to the negative mental health impact of the COVID-19 pandemic? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38830179 DOI: 10.1080/07448481.2024.2360424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/19/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE To examine a potential synergistic effect of history of childhood adversity and COVID-19 pandemic exposure on the association with mental health concerns in undergraduate students. Participants: We used U-Flourish Survey data from 2019 (pre-pandemic) and 2020 (during-pandemic) first-year cohorts (n = 3,149) identified at entry to a major Canadian University. METHODS Interactions between childhood adversity (physical and sexual abuse, and peer bullying) and COVID-19 pandemic exposure regarding mental health concern (depressive and anxiety symptoms, suicidality, and non-suicidal self-harm) were examined on an additive scale. RESULTS We found a positive additive interaction between physical abuse and pandemic exposure in relation to suicidality (combined effect was greater than additive effect (risk difference 0.54 vs. 0.36)). Conversely, less than additive interactions between peer bullying and pandemic regarding depression and anxiety were observed. CONCLUSIONS Childhood adversities have diverse reactions to adult stressor depending on the nature of the childhood adversity and the mental health outcomes.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Gina Dimitropoulos
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Suzanne Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Anne Duffy
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
- Department of Psychiatry, University of Oxford, Oxford, UK
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Zhen-Duan J, Alvarez K, Zhang L, Cruz-Gonzalez M, Kuo J, Falgas-Bagué I, Bird H, Canino G, Duarte CS, Alegría M. Parental psychopathology and posttraumatic stress in Puerto Ricans: the role of childhood adversity and parenting practices. J Child Psychol Psychiatry 2024; 65:742-752. [PMID: 37850715 PMCID: PMC11024057 DOI: 10.1111/jcpp.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations. METHODS Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four-wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5-13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2-3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model. RESULTS Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2-3 (direct effect b = 1.72, 95% CI = [-0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent-child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology-PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent-child relationship quality scores. CONCLUSIONS Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family-based interventions focused on providing families with the tools to improve parent-child relationships may reduce the negative impact of childhood adversities on mental health across the life course.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kiara Alvarez
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lulu Zhang
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Josephine Kuo
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Irene Falgas-Bagué
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Hector Bird
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Glorisa Canino
- Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, PR, USA
| | - Cristiane S. Duarte
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Abufarsakh B, Okoli CTC, Darville AK, Williams LB, Garcia AR, Martin C. Tobacco use behavior among adults exposed to cumulative adverse childhood experiences: A systematic review and meta analysis. Addict Behav 2024; 152:107948. [PMID: 38277993 DOI: 10.1016/j.addbeh.2023.107948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Tobacco use remains one of the most used substances among adults globally and substantially impacts individuals and society. Adverse childhood experiences (ACEs) contribute to tobacco use. However, the association between cumulative ACEs and tobacco use behaviors (TUB) has not been established in the literature. In this review, we aimed to estimate the prevalence of ACEs among adult tobacco users and evaluated the relationship between cumulative ACEs and TUB. METHODS We identified original articles published before October 2022 by searching PubMed, CINAHL, and Psych INFO databases. Inclusion criteria were: English language, adults and used instruments assessing for cumulative ACEs defined as four or more ACEs. RESULTS Forty-two studies, totaling 674,087 participants; predominantly cohort and cross-sectional in study design (n = 33). Exposure to 4 ≥ ACEs was significantly associated with increasing the odds of current tobacco use (n = 35), ever or former tobacco use (n = 13), tobacco use initiation, (n = 3) nicotine dependence (n = 1), and ever using electronic cigarettes (n = 1). In the meta-analysis, as compared to those without ACEs, those with 4 ≥ ACEs were twice as likely to have ever used tobacco (OR = 2.16, 95 %CI:1.73-2.70) and approximately four times more likely to have used tobacco currently (OR = 3.73, 95 %CI:2.69-5.18). CONCLUSION The cumulative ACEs exposure can increase the risk for TUB. However, the evidence is limited primarily to cigarette use. Ongoing research into the effects of cumulative ACEs on TUB is needed to integrate trauma-informed intervention in treating tobacco use and guide public health initiatives aimed to reduce the prevalence of ACEs and TUB among adults.
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Affiliation(s)
| | | | - Audrey K Darville
- University of Kentucky College of Nursing, Lexington, KY 40536, USA.
| | | | - Antonio R Garcia
- University of Kentucky College of Social Work, Lexington, KY 40508, USA.
| | - Catherine Martin
- University of Kentucky Health Care Good Samaritan Hospital, Lexington, KY 40508, USA.
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Kanagasabai U, Thorsen V, Zhu L, Annor FB, Chiang L, McOwen J, Augusto A, Manuel P, Kambona C, Coomer R, Kamagate F, Ramphalla P, Denhard L, Cain M, Hegle J, de Barros RB, Saenz S, Kamami M, Patel P. Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020. CHILD ABUSE & NEGLECT 2024; 150:106541. [PMID: 38114359 DOI: 10.1016/j.chiabu.2023.106541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been shown to have negative, lasting effects on health including increasing the likelihood of engaging in sexual risk behaviors. OBJECTIVE This study aimed to identify associations between exposures to ACEs and sexual risk behaviors and HIV service utilization among young people. PARTICIPANTS AND SETTING A sample of 8023 sexually active young people (19-24 year olds) from five sub-Saharan African countries participated Violence Against Children and Youth Surveys (VACS). METHODS Descriptive analysis of demographic variables, individual ACEs, cumulative ACEs, sexual risk behaviors, HIV testing, antiretroviral treatment (ART) and Antenatal Care (ANC) attendance were completed. Bivariate and multivariable logistic regression analyses were conducted to assess the associations between both individual and cumulative ACEs, sexual HIV risk behaviors, and service utilization while controlling for important covariates such as demographic, having ever been pregnant, had an STI, and used contraception. RESULTS Exposure to three or more ACEs was higher among males (26.1 %) compared to females (21.3 %); p = 0.003. The most prominent sexual risk behavior for females was having sexual partners who were at least 5 years older (45.7 % compared to males 3.7 %; p < 0.0001) whereas in males it was no or infrequent condom use (45.3 % compared to females 30.1 %; p < 0.0001). Males and females exposed to childhood sexual violence had seven and four times the odds of engaging in transactional sex (aOR = 7.34, 95 % CI: [3.5-15.0]) and (aOR =3.75, 95 % CI: [2.3-6.2], respectively. Females exposed to three or more ACEs were four times more likely to engage in transactional sex (aOR = 4.85, 95 %, CI: [1.6-14.4]) compared to those who did not experience any ACEs. Males exposed to three or more ACEs were two times more likely to engage in early sexual debut (aOR = 2.2, 95 % CI: [1.3-3.4]),]) compared to those who did not experience any ACEs. Females who had witnessed IPV or violence in the community had significantly higher odds of getting tested for HIV (aOR = 2.16, 95 % CI: [1.63-2.87]) and (aOR = 1.36, 95 % CI: [1.03-1.81]), respectively. CONCLUSIONS This study demonstrated that experiencing ACEs during childhood is associated with higher HIV risk behaviors in sub-Saharan Africa (SSA) with unique differences between males and females.
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Affiliation(s)
| | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Meagan Cain
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer Hegle
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Shantal Saenz
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 DOI: 10.1016/j.chiabu.2024.106701] [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: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Lesinskienė S, Karalienė V, Pociūtė K, Šambaras R. Possible Mental Health Interventions for Family Members of a Close Relative Who Has Suicidal Thoughts or Committed Suicide: A Pilot Project at a Mental Health Center. J Clin Med 2024; 13:2032. [PMID: 38610797 PMCID: PMC11012435 DOI: 10.3390/jcm13072032] [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: 01/24/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Suicides are an actual issue, especially in Lithuania, where, despite significant efforts, the number of suicides remains very high. In cases of suicide, society painfully loses its members, and the relatives of the person who committed suicide, engaged in self-harm, or attempted suicide face many negative experiences. Methods: The purpose of this article is to describe the pilot project applied for 2 years in the Mental Health Center (MHC) in the city of Vilnius, Lithuania, in organizing and providing services to people whose relatives committed suicide or attempted suicide or self-harm. This prevention and early intervention program, organized by an interdisciplinary team at an MHC, appeared appropriate, effective, and well-attended. Program clients could participate anonymously and have the opportunity to choose the time and the right services for themselves from the offered program services package. Results: Providing the possibility for family members to receive flexible mental health services at the primary center increased the attractiveness of the program and reduced stigma. Conclusions: The program results demonstrated the applicability of the implementation of such an initiative as a relevant possibility when providing complex help for the relatives of self-harming and/or suicidal people.
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Affiliation(s)
- Sigita Lesinskienė
- Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (V.K.); (K.P.); (R.Š.)
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Ashour R, Halstead EJ, Mangar S, Lin VKQ, Azhari A, Carollo A, Esposito G, Threadgold L, Dimitriou D. Childhood experiences and sleep problems: A cross-sectional study on the indirect relationship mediated by stress, resilience and anxiety. PLoS One 2024; 19:e0299057. [PMID: 38507345 PMCID: PMC10954170 DOI: 10.1371/journal.pone.0299057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/02/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact sleep quality in adult life, which in turn are modulated by the interplay of a variety of factors such as depression, anxiety, resilience and mental health problems. METHODS A cross-sectional observational study was conducted across the UK and the Middle Eastern countries during the COVID-pandemic on 405 participants. An online survey used a combination of questionnaires to assess ACE and BCEs. The following tools were then used to assess the contribution of resilience, stress, depression and anxiety respectively: Brief Resilience Scale (BRS), Perceived Stress Scale (PSS-10), Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) scale on childhood experiences. The extent of sleep disturbances experienced over a period of seven days was assessed using the PROMIS Sleep Disturbance Short-Form Tool. A serial-parallel mediation model was used to evaluate the impact of the mediators on childhood experiences and sleep quality. RESULTS Over 50% of the cohort were from Middle Eastern countries. Four or more BCEs were experienced by 94.3% of the cohort. In contrast, 67.9% of participants experienced at least one ACE before the age of 18 years, with moderate levels of stress, mild depression and anxiety were reported in 3.7%, 13% and 20% of participants respectively. Whilst 25.4% of participants reported having had four or more ACEs, with higher reports in the middle easter countries (32%). ACEs were found to correlate with sleep disturbance whilst BCEs showed an inverse correlation. The relationship between ACE and sleep disturbances was shown to be mediated by stress, and anxiety, but not by resilience or depression. Resilience and stress, and resilience and anxiety serially mediated the interaction between ACE and sleep disturbance. With regards to BCE, an inverse association with sleep disturbance was recorded with similar mediators of stress and anxiety observed. CONCLUSION This study confirms the negative effects of ACEs, and the positive effects of BCEs on sleep in adulthood which are both mediated predominantly by psychological resilience, anxiety and stress. Strategies aimed at improving psychological resilience as well as addressing stress and anxiety may help improve sleep quality.
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Affiliation(s)
- Rola Ashour
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Elizabeth J. Halstead
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Stephen Mangar
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
- Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - Vanessa Khoo Qi Lin
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Atiqah Azhari
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Laura Threadgold
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
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Vinberg M, McIntyre RS, Giraldi A, Coello K. Struggling Can Also Show on the Inside: Current Knowledge of the Impact of Childhood Maltreatment on Biomarkers in Mood Disorders. Neuropsychiatr Dis Treat 2024; 20:583-595. [PMID: 38496323 PMCID: PMC10944138 DOI: 10.2147/ndt.s383322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
The link between childhood maltreatment and mood disorders is complex and involves multiple bio-psycho-social factors that affect multiple molecular pathways. The present narrative review aims to clarify the current understanding of the impact of childhood maltreatment on biomarkers in patients with mood disorders and their first-degree relatives. Neurotransmitters, such as serotonin, dopamine, norepinephrine, and hormones (eg the stress hormone cortisol), play a crucial role in regulating mood and emotion. Childhood maltreatment can alter and affect the levels and functioning of these neurotransmitters in the brain; further, childhood maltreatment can lead to structural and connectivity changes in the brain, hence contributing to the development of mood disorders and moderating illness presentation and modifying response to treatments. Childhood maltreatment information, therefore, appears mandatory in treatment planning and is a critical factor in therapeutic algorithms. Further research is needed to fully understand these pathways and develop new treatment modalities for individuals with mood disorders who have experienced childhood maltreatment and effective preventive interventions for individuals at risk of developing mood disorders.
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Affiliation(s)
- Maj Vinberg
- Mental Health Centre Northern Zealand, the Early Multimodular Prevention, and Intervention Research Institution (EMPIRI) – Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Annamaria Giraldi
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg, Denmark
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Chipalo E. Adverse Childhood Experiences and Mental Distress Among Adolescents and Youth in Zimbabwe. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241234660. [PMID: 38444122 DOI: 10.1177/08862605241234660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Adverse childhood experiences (ACEs) are a global public health crisis associated with physical and poor mental health outcomes. The current study examined the prevalence and association between individual and cumulative ACEs with mental distress among adolescents and youth in Zimbabwe. Data from the 2017 Violence Against Children and Youth Survey were utilized (13-25 years old, n = 8,715). Bivariate analysis was conducted using chi-square tests to obtain the prevalence estimates. Two sets of logistic regression models were conducted to determine significant associations between independent variables (i.e., experiencing childhood physical, emotional, and sexual violence; witnessing intimate partner violence (IPV) and community violence; orphan status; and cumulative ACE exposure) and the dependent variable (i.e., mental distress in the past 30 days as measured by Kelser 6). 28.4% of the adolescents and youth reported experiencing mental distress in the past 30 days. Regarding ACEs, cumulative ACE exposure (34.7%; adjusted odds ratio [AOR] = 2.13) and individual ACEs (i.e., experiencing childhood physical violence [39.3%; AOR = 1.41], emotional violence [55.8%; AOR = 2.67], sexual violence [50.8%; AOR = 2.00], witnessing community violence [47.3%; AOR = 1.52], witnessing IPV [43.1%; AOR = 1.47], and being orphaned during childhood [33.6%; AOR = 1.24]) were significantly associated with higher prevalence rates and odds of experiencing mental distress in the past 30 days among adolescents and youth in Zimbabwe. These findings show that ACEs are highly prevalent and increases the risk of mental distress for vulnerable adolescents and youth in Zimbabwe. Effective interventions to reduce violence exposure in families, schools, and communities are essential to mitigate the negative consequences of ACEs and mental distress of adolescents and youth in Zimbabwe. Strengthening child protection policies and involving social workers, psychologists, and mental health workers are also crucial for safeguarding vulnerable children who might be impacted by ACEs in Zimbabwe. Implications for future research are further discussed.
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Sheng Z, Xiao W, Zhu S, Hao J, Ma J, Yao L, Song P. The association between adverse childhood experiences and sensory impairment in middle-aged and older adults: Evidence from a nationwide cohort study in China. CHILD ABUSE & NEGLECT 2024; 149:106598. [PMID: 38158282 DOI: 10.1016/j.chiabu.2023.106598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Sensory impairment (SI), as prevalent condition among the elderly, presents a substantial public health burden. OBJECTIVES To investigate the association of cumulative and individual adverse childhood experiences (ACEs) with SI. METHODS Chinese residents aged 45 years and above were recruited from the China Health and Retirement Longitudinal Study 2011-2018, using stratified random sampling. The number of ACEs was classified into "0 ACE", "1 to 3 ACEs", and "≥4 ACEs". SI was assessed with self-rated visual or hearing status. SI categories included single sensory impairment (SSI), which can be divided into single vision impairment and single hearing impairment. Possessing both vision impairment and hearing impairment was considered as dual sensory impairment (DSI). Longitudinal SI progression encompassed "maintained no SI", "no SI to SSI", "no SI to DSI", "maintained SSI", "SSI to DSI", and "maintained DSI". Logistic regression and restricted cubic splines models were used for analysis. RESULTS A total of 6812 participants entered the cross-sectional analysis and 5299 entered the longitudinal analysis. Compared to 0 ACE, ≥4 ACEs had a positive association with DSI (OR = 1.57, 95 % CI = 1.20-2.06) but not with single vision impairment (OR = 1.17, 95 % CI: 0.88-1.55) or single hearing impairment (OR = 1.10, 95 % CI: 0.71-1.70), and this association was observed only in females (OR = 1.73, 95 % CI = 1.20-2.51). A linear association was found between cumulative ACEs and both single vision impairment (p = 0.044) and DSI (p < 0.001). Compared to 0 ACE, ≥4 ACEs was associated with a higher risk of progression from SSI to DSI (OR = 1.71, 95 % CI = 1.03-2.84), and the maintained DSI (OR = 2.23, 95 % CI =1.37-3.65). CONCLUSION ACEs were found to be associated with an increased risk and more severe progression of SI later in life. It is imperative to address different types of ACE and incorporate sex-specific measures to mitigate the enduring sensory impact of ACEs.
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Affiliation(s)
- Ziyue Sheng
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenhan Xiao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Siyu Zhu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiajun Hao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiaying Ma
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lingzi Yao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Luo S, Feng X, Lin L, Li J, Chen W, Guo VY. Association of adverse and positive childhood experiences with health-related quality of life in adolescents. Public Health 2024; 228:92-99. [PMID: 38340507 DOI: 10.1016/j.puhe.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/28/2023] [Accepted: 01/07/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the independent impacts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) on the health-related quality of life (HRQOL) of Chinese adolescents, and to explore the potential moderating role of PCEs in the association between ACEs and HRQOL. STUDY DESIGN This was a cross-sectional study. METHODS We surveyed 6982 students aged 11-20 in Guangzhou, China, from November to December 2021. Adolescents self-reported their ACEs, PCEs, and HRQOL by the Childhood Trauma Questionnaire Short Form, the Adverse Childhood Experiences-International Questionnaire, the Benevolent Childhood Experiences Scale, and the Paediatric Quality of Life Inventory Version 4.0, respectively. Multivariable linear regressions were performed to examine the associations between ACEs, PCEs, and HRQOL controlled for adolescents' age, gender, single-child status, boarding school attendance, primary caregivers, as well as parental age and occupational status. Likelihood-ratio tests were further applied to explore the moderating role of PCEs. RESULTS In the models that considered both ACEs and PCEs, ACEs were significantly associated with lower HRQOL scores in all dimensions, summary scales, and total scale (β = -13.88, 95% confidence interval [CI]: -14.82, -12.94 for total scale). Conversely, exposure to an above-average number of PCEs was associated with higher HRQOL scores in all measured aspects (β = 7.20, 95%CI: 6.57, 7.84 for total scale). PCEs significantly moderated the association between ACEs and all HRQOL dimensions, summary scales, and total scale, except school functioning. CONCLUSION ACEs and PCEs exert independent and opposite impacts on adolescents' HRQOL. PCEs could mitigate the negative impacts of ACEs. Enhancing resilience, like PCEs, may contribute to improving the HRQOL among adolescents who have exposed to ACEs.
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Affiliation(s)
- S Luo
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - X Feng
- Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - L Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - J Li
- Department of Biostatistics, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - W Chen
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - V Y Guo
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China.
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12
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Osibogun O, Erinoso O, Li W, Kalan ME, Bursac Z, Osibogun A. Adverse Childhood Experiences and Tobacco Use Patterns Among Adults in the United States: Exploring sex differences. HEALTH EDUCATION & BEHAVIOR 2024; 51:54-61. [PMID: 37329281 DOI: 10.1177/10901981231178696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States. METHODS This was a cross-sectional analysis of data from adults aged ≥18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes-1 or no/never-0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or ≥4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders. RESULTS Although we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported ≥4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49-8.63]), cigarette (2.57 [1.72-3.83]) and dual use (3.25 [1.79-5.91]) relative to nonuse. Males with ≥4 ACEs had higher odds of cigarette (1.75 [1.15-2.65]) and dual use (7.64 [3.95-14.79]). CONCLUSION Our findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults.
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Affiliation(s)
| | | | - Wei Li
- Yale School of Medicine, New Haven, CT, USA
| | | | - Zoran Bursac
- Florida International University, Miami, FL, USA
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13
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Liu J, Guo T, Han B, Cheng X, Qu S, Wang R, Dong X, Fang J, Wang J, Tang M, Yao Y, Jin L. Adverse childhood experiences and human immunodeficiency virus testing among adults with human immunodeficiency virus risk behaviours. Stress Health 2024; 40:e3262. [PMID: 37226429 DOI: 10.1002/smi.3262] [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: 09/08/2022] [Revised: 02/28/2023] [Accepted: 04/25/2023] [Indexed: 05/26/2023]
Abstract
Adverse childhood experiences (ACEs) have been associated with poor HIV testing in adulthood yet, they have not been extensively described in those at increased risk for HIV. Cross-sectional analysis data (n = 204,231) on ACEs and HIV testing were obtained from the 2019-2020 Behavioural Risk Factor Surveillance Survey. Weighted logistic regression models were used to access the association of ACEs exposure, ACEs score, and ACEs type with HIV testing among adults with HIV risk behaviours, and stratified analysis was also performed to examine gender differences. The results indicated the overall rate of HIV testing was 38.8% and was higher among those with HIV risk behaviours (64.6%) than those without (37.2%). In populations with HIV risk behaviours, the negative association of HIV testing with ACEs exposure, ACEs score, and ACEs type was identified. Relative to those without ACEs, adults who were exposed to ACEs might decrease the rate of HIV testing, participants with ≥4 ACEs scores were less likely to have HIV testing, and childhood exposure to sexual abuse had the greatest impact on HIV testing. For both males and females, childhood exposure to ACEs was associated with lower odds of HIV testing and ACEs score ≥4 had the most robust associations with HIV testing. For males, those who experienced witnessed domestic violence had the lowest odds of HIV testing but the odds of engaging in HIV testing for females were the lowest among those who experienced childhood sexual abuse.
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Affiliation(s)
- Jun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Tingting Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Baihui Han
- Chaoyang Center for Disease Control and Prevention, Beijing, China
| | - Xiaowei Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Shifang Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ruying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Mengyao Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Mlouki I, Majdoub M, Hariz E, Silini A, Mrabet HE, Rezg N, El Mhamdi S. Gender differences in adverse childhood experiences, resilience and internet addiction among Tunisian students: Exploring the mediation effect. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002556. [PMID: 38236830 PMCID: PMC10795992 DOI: 10.1371/journal.pgph.0002556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/16/2023] [Indexed: 01/22/2024]
Abstract
Adverse Childhood Experiences (ACEs) are a common public health issue with a variety of consequences, including behavioral addiction such as Internet Addiction (IA). Despite widespread recognition of this issue, the underlying mechanisms are not well studied in recent literature. Additionally, studies have indicated gender disparities in the prevalence and manifestation of ACEs and IA. The objective of this study was to investigate the mediating effect of resilience on the link between ACEs and IA among high-school students according to gender in Mahdia city (Tunisia). We conducted a cross-sectional survey for two months (January- February 2020), among 2520 schooled youth in Mahdia city (Tunisia). The Arabic-language edition of the World Health Organisation ACE questionnaire was used. The validated Arabic versions of the Adolescent Psychological Resilience Scale and the Internet Addiction Test were the screening tools for resilience and IA. Data were analyzed according to gender. The majority of youth (97.5%) were exposed to at least one ACE with the most prevalent being emotional neglect (83.2%). Exposure to extra-familial ACEs was also high reaching 86.9% with higher rates among boys for all types of social violence. Internet addiction was common among students (50%) with higher prevalence for boys (54.4% vs 47.7%for girls, p = 0.006). Resilience scores were86.43 ± 9.7 for girls vs 85.54 ± 9.79 for boys. The current study showed that resilience mediated the link between ACEs, especially intrafamilial violence, and internet addiction (%mediated = 15.1). According to gender, resilience had a significant mediating role on internet addiction for girls (%mediated = 17) and no significant role for boys. The mediating effect of resilience in the relationship between ACEs and cyberaddiction among schooled adolescents in the region of Mahdia (Tunisia) has been identified.
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Affiliation(s)
- Imen Mlouki
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
- Research Laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Monastir, Tunisia
| | - Mariem Majdoub
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Emna Hariz
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Ahlem Silini
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | | | - Nejla Rezg
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Sana El Mhamdi
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
- Research Laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Monastir, Tunisia
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15
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Zhu B, Xiao C, Ding C, Yan H, Wang L, Jiang Q, Tian J, Wei L. Adverse childhood experiences and depressive symptoms among lesbian and bisexual women in China. BMC Womens Health 2023; 23:679. [PMID: 38114972 PMCID: PMC10731884 DOI: 10.1186/s12905-023-02686-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Despite the relationship between Adverse childhood experiences (ACEs) and depressive symptoms, which has been well researched in general populations, little is known about homosexual and bisexual populations, especially lesbian and bisexual women in China. This study aims to investigate the prevalence of ACEs and depressive symptoms and to analyze the relationship between them among lesbian and bisexual women in China. METHODS The eligible participants were aged 16 years or older who report their sexual orientation as homosexual or bisexual. The data was collected through anonymous questionnaires with the help of Lespark in Beijing from July 18 to December 29, 2018, and all participants had informed consent to this study. Univariate analysis and multiple linear regression analyses were performed to explore the relationship between ACEs and depressive symptoms among lesbian and bisexual women. All statistical analyses were conducted by the software of SPSS 22.0. RESULTS Among 301 lesbian and bisexual women, 81.4% were lesbian, 18.4% were bisexual women, and the majority were 21-30 years. As for ACEs, 51.5% reported at least one ACE, in which emotional neglect (22.6%) and emotional abuse (22.3%) were common ACEs. As for depressive symptoms of lesbian and bisexual women, the detection rate was 56.1%. The multiple linear regression analyses showed that abuse (β = 2.95, 95%CI:1.07-4.83) and neglect (β = 3.21, 95%CI:1.09-5.31) were positively associated with depressive symptoms and lesbian and bisexual women with three (β = 4.11, 95%CI: 0.99-7.22) or more (β = 6.02, 95%CI: 3.23-8.78) ACEs suffered from more depressive symptoms than others. CONCLUSION Adverse childhood experiences (ACEs) and depressive symptoms were at high prevalence among lesbian and bisexual women in China. ACEs were associated with depressive symptoms, especially childhood abuse and neglect experiences that have a significant effect on lesbian and bisexual women mental health.
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Affiliation(s)
- Biao Zhu
- School of Public Health, Wuhan University, Wuhan, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | | | - Changmian Ding
- Department of Medical Record, The People's Hospital of Dehong, Dehong, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, China.
| | - Liyin Wang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, China
| | - Liqing Wei
- School of Public Health, Wuhan University, Wuhan, China
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16
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Juarez PD. Economic Determinants of Health Disparities and the Role of the Primary Care Provider. Prim Care 2023; 50:561-577. [PMID: 37866831 DOI: 10.1016/j.pop.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
The economic determinants of adverse personal health outcomes and population level disparities pose a daunting challenge for primary care providers in promoting health for persons experiencing poverty and neighborhood deprivation. Until they are addressed, however, the health and economic well-being of persons experiencing neighborhood deprivation is not likely to be improved. There is growing evidence of effective interventions that primary care providers can adopt to address social and economic determinants of health. Primary care providers can participate in clinic and community-based approaches that target individual, neighborhood and social level drives of health and disparities.
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Affiliation(s)
- Paul D Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 Dr. DB Todd Jr. Boulevard, Nashville, TN 37208, USA.
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17
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al'Absi M, DeAngelis B, Borodovsky J, Sofis MJ, Fiecas M, Budney A. Early life adversity and substance use: The mediating role of mood and the moderating role of impulsivity. J Psychiatr Res 2023; 168:38-44. [PMID: 37883864 PMCID: PMC10872790 DOI: 10.1016/j.jpsychires.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 08/13/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Early life adversity (ELA) is a risk factor for substance use and misuse, and multiple factors mediate and moderate this association. We examined whether moods mediate the relationships between ELA and nicotine use, cannabis use, and co-use, and whether these mediation effects varied as a function of delay discounting. METHODS A total of 2555 adults completed a delay discounting task and responded to questions related to demographics, ELA, mood, and substance use. Data were analyzed using Pearson correlations and moderated mediation using Hayes' PROCESS macro (V3.4, Model 15). RESULTS ELA was positively associated with cannabis use, nicotine use, co-use of both substances, depressed and stressed moods, and it was negatively associated with positive mood. While cannabis use was associated negatively with stressed and depressed moods and positively with positive mood, nicotine use was associated negatively with positive mood. Moderated mediation analyses indicated that positive mood mediated the relationship between ELA and cannabis use for those with average and above average delay discounting. Positive mood also mediated the relationship between ELA and co-use among those with above average delay discounting. CONCLUSION The results suggest that ELA's associations with cannabis use and cannabis-nicotine co-use may be partially attributable to ELA's effects on positive mood among those who are predisposed to moderately to highly impulsive decision making.
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Affiliation(s)
| | | | | | | | - Mark Fiecas
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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18
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Yao K, Chen P, Zhou H, Ruan J, Chen D, Yang X, Zhou Y. The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress. BMC Psychiatry 2023; 23:865. [PMID: 37990217 PMCID: PMC10664623 DOI: 10.1186/s12888-023-05348-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk. METHODS A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk. RESULTS The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001). CONCLUSION The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.
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Affiliation(s)
- Kaimin Yao
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Peiyi Chen
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, Guangdong, China
| | - Hui Zhou
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Jiajia Ruan
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Dan Chen
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China.
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
| | - You Zhou
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Sebalo I, Königová MP, Sebalo Vňuková M, Anders M, Ptáček R. The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review. Subst Abuse 2023; 17:11782218231193914. [PMID: 38025908 PMCID: PMC10631312 DOI: 10.1177/11782218231193914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023]
Abstract
Introduction Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years. Methods The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022. Results The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review. Conclusion This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.
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Affiliation(s)
- Ivan Sebalo
- Centre of Research and Education in Forensic Psychology, School of Psychology, University of Kent, Canterbury, UK
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Michaela Poslt Königová
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Martina Sebalo Vňuková
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Martin Anders
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Radek Ptáček
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
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Kuunibe N, Bountogo M, Ouermi L, Sié A, Bärnighausen T, Harling G. Effects of education and age on the experience of youth violence in a very low-resource setting: a fixed-effects analysis in rural Burkina Faso. BMJ Open 2023; 13:e071104. [PMID: 37852761 PMCID: PMC10603425 DOI: 10.1136/bmjopen-2022-071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/31/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE The study aimed to investigate the effects of education and age on the experience of youth violence in low-income and middle-income country settings. DESIGN Using a standardised questionnaire, our study collected two waves of longitudinal data on sociodemographics, health practices, health outcomes and risk factors. The panel fixed-effects ordinary least squares regression models were used for the analysis. SETTINGS The study was conducted in 59 villages and the town of Nouna with a population of about 100 000 individuals, 1 hospital and 13 primary health centres in Burkina Faso. PARTICIPANTS We interviewed 1644 adolescents in 2017 and 1291 respondents in 2018 who participated in both rounds. OUTCOME AND EXPOSURE MEASURES We examined the experience of physical attacks in the past 12 months and bullying in the past 30 days. Our exposures were completed years of age and educational attainment. RESULTS A substantial minority of respondents experienced violence in both waves (24.1% bullying and 12.2% physical attack), with males experiencing more violence. Bullying was positively associated with more education (β=0.12; 95% CI 0.02 to 0.22) and non-significantly with older age. Both effects were stronger in males than females, although the gender differences were not significant. Physical attacks fell with increasing age (β=-0.18; 95% CI -0.31 to -0.05) and this association was again stronger in males than females; education and physical attacks were not substantively associated. CONCLUSIONS Bullying and physical attacks are common for rural adolescent Burkinabe. The age patterns found suggest that, particularly for males, there is a need to target violence prevention at younger ages and bullying prevention at slightly older ones, particularly for those remaining in school. Nevertheless, a fuller understanding of the mechanisms behind our findings is needed to design effective interventions to protect youth in low-income settings from violence.
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Affiliation(s)
- Naasegnibe Kuunibe
- Department of Economics, Faculty of Social Science and Arts, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
| | - Mamadou Bountogo
- Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso
- Université de Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Guy Harling
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
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21
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Brühl A, Ward CL, Lachman JM, Foran HM, Raleva M, Baban A, Heinrichs N. Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe. Violence Against Women 2023; 29:2439-2463. [PMID: 37475529 PMCID: PMC10496420 DOI: 10.1177/10778012231188090] [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] [Indexed: 07/22/2023]
Abstract
This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N1 = 112, N2 = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Motheŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence.
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Affiliation(s)
- Antonia Brühl
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Catherine L. Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jamie M. Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Centre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Heather M. Foran
- Department of Health Psychology, University of Klagenfurt, Klagenfurt, Carinthia, Austria
| | - Marija Raleva
- Department of Psychiatry and Medical Psychology, Medical Faculty, University of Skopje, Skopje,
North Macedonia
| | - Adriana Baban
- Department of Psychology, Babeș-Bolyai University, Cluj County, Cluj-Napoca, Romania
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
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22
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Bhattarai A, King N, Adhikari K, Dimitropoulos G, Devoe D, Byun J, Li M, Rivera D, Cunningham S, Bulloch AG, Patten SB, Duffy A. Childhood Adversity and Mental Health Outcomes Among University Students: A Longitudinal Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:510-520. [PMID: 36000272 PMCID: PMC10408556 DOI: 10.1177/07067437221111368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental health concerns are common among university students and maybe elevated among those with specific risk exposures. The study examined the association between childhood adversities and mental health outcomes among undergraduate university students and assessed whether psychosocial and behavioral factors mediate those associations. METHODS The Queen's University Student Well-Being and Academic Success Survey identified two large cohorts of first-year undergraduate students entering university in Fall 2018 and 2019 (n = 5,943). At baseline, students reported sociodemographic information, family-related mental health history, childhood physical abuse, sexual abuse, peer bullying, and parental separation or divorce. Baseline and follow-up surveys in Spring 2019, Fall 2019, and Spring 2020 included validated measures of anxiety (7-item Generalized Anxiety Disorder) and depressive symptoms (9-item Patient Health Questionnaire ), non-suicidal self-harm, and suicidality, along with psychological processes and lifestyle variables. Repeated measures logistic regression using Generalized Estimating Equations was used to characterize the associations between childhood adversities and mental health outcomes and examine potential mediation. RESULTS Adjusting for age, gender, ethnicity, familial mental illness, and parental education, any childhood abuse (odds ratio: 2.89; 95% confidence interval, 2.58 to 3.23) and parental separation or divorce (odds ratio: 1.29; 95% confidence interval, 1.12 to 1.50) were significantly associated with a composite indicator of mental health outcomes (either 9-item Patient Health Questionnaire score ≥10 or 7-item Generalized Anxiety Disorderscore ≥10 or suicidality or self-harm). The association with childhood abuse weakened when adjusted for perceived stress, self-esteem, and insomnia (odds ratio: 2.05; 95% confidence interval, 1.80 to 2.34), and that with parental divorce weakened when adjusted for self-esteem (odds ratio: 1.17; 95% confidence interval, 1.00 to 1.36). CONCLUSION Childhood abuse and parental separation or divorce were associated with mental health concerns among university students. Childhood adversities may impact later mental health through an association with stress sensitivity, self-esteem, and sleep problems. The findings suggest that prevention and early intervention focusing on improving sleep, self-esteem, and coping with stress while considering the individual risk profile of help-seeking students may help support student mental health.
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Affiliation(s)
- Asmita Bhattarai
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Kamala Adhikari
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
| | | | - Dan Devoe
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Jin Byun
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Melanie Li
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Andrew G.M. Bulloch
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott B. Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anne Duffy
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, University of Oxford, Oxford, UK
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23
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Lansing AE, Romero NJ, Siantz E, Silva V, Center K, Casteel D, Gilmer T. Building trust: Leadership reflections on community empowerment and engagement in a large urban initiative. BMC Public Health 2023; 23:1252. [PMID: 37380973 DOI: 10.1186/s12889-023-15860-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/10/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Trust is essential for healthy, reciprocal relationships; creating safe environments; engaging in transparent interactions; successfully negotiating power differentials; supporting equity and putting trauma informed approaches into practice. Less is known, however, about the ways that trust-building may be at the forefront of consideration during community capacity building efforts, what trust-building elements are perceived as essential for optimally engaging communities, and what practices might support these efforts. METHODS The present study examines an evolving understanding of trust-building over the course of 3 years, from qualitative data derived during interviews with nine agency leads from a large and diverse urban community, who are spearheading community-based partnerships to create more trauma-informed communities and foster resiliency. RESULTS Data reflected fourteen trust-building elements, captured by three themes: 1) Building relationships and engagement (e.g., behavioral practices such as meeting people "where they are at" and creating safe spaces), 2) Embodying core values of trustworthiness (e.g., traits such as being transparent and embodying benevolence), and 3) Sharing decision-making, championing autonomy, and addressing barriers to trust (e.g., collaborative practices such as creating a shared vision and goals and addressing systemic inequities). These trust-building elements are presented in the Community Circle of Trust-Building, which provides an accessible, visual format that can facilitate capacity building efforts within organizations and with the broader community; guide the selection of training opportunities that support healthy interpersonal relationships; and aid in the identification of relevant, supporting frameworks (e.g., health equity, trauma-informed practices, inclusive leadership models). CONCLUSIONS Community engagement and trust are essential for overall health and well-being, increasing equitable access to resources, and supporting an effective and connected citizenry. These data shed light on opportunities for trust-building and thoughtful engagement among agencies working directly with community members in large urban areas.
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Affiliation(s)
- Amy E Lansing
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
- Department of Sociology, San Diego State University, San Diego, CA, USA.
| | - Natalie J Romero
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | | | - Vivianne Silva
- Department of Education and Information Studies, University of California, Los Angeles, Los Angeles, USA
| | - Kimberly Center
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Danielle Casteel
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Todd Gilmer
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
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24
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Ouma S, Abbo C, Natala N, McCoy M, Kroupina M. Victimization among adolescents of female sex workers: findings from the children of at-risk parents (CARP) study in Uganda. BMC Pediatr 2023; 23:311. [PMID: 37340336 DOI: 10.1186/s12887-023-04131-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 06/14/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Female sex workers (FSWs) live and work in high-risk environments, experience high levels of adversity, and have multigenerational trauma that can negatively affect their children. Yet not much is known about the prevalence of victimization (i.e., exposure to maltreatment and trauma) among children of FSWs. This study compared the prevalence of lifetime victimization among adolescents of FSWs and adolescents of non-FSWs in Gulu City, Northern Uganda. METHODS A comparative cross-sectional study was conducted among adolescents (10-17 years) enrolled in the Children of At-Risk Parents (CARP) study. This study included 147 adolescents of FSWs and 147 adolescents of non-FSWs selected for comparison in Gulu City, Northern Uganda. The adolescents of FSWs were identified through their mothers using respondent-driven sampling. Data on the residence of FSWs guided a proportionate stratified sampling of adolescents of non-FSWs. Using the Juvenile Victimization Questionnaire, we screened for 34 different types of victimization during participants' lifetimes. Percentage point differences within groups of adolescents and comparison between adolescents of FSWs and non-FSWs were calculated using STATA version 14.1. Statistical significance was set to p < 0.05. RESULTS 99.3% of the participants experienced at least one form of lifetime victimization. The median number of lifetime victimizations was 12.4. Overall, lifetime victimization was higher among adolescents of FSWs than non-FSWs (13.4 vs. 11.5), male vs. female adolescents (13.4 vs. 11.9), and older [14-17 years] vs. younger (10-13 years) adolescents (14.0 vs. 11.7). Further, more adolescents of FSWs experienced lifetime victimization in the following domains and subdomains, all of which were statistically significant: kidnap (15.8% vs. 4.8%), emotional abuse (65.8% vs. 50.0%), emotional neglect (37.4% vs. 21.1%), physical intimidation (10.2% vs. 4.1%), relational aggression (36.4% vs. 18.4%), verbal aggression (68.7% vs. 46.9%), sexual victimization (31.3% vs. 17.7%), verbal sexual harassment (20.4% vs. 5.4%), exposure to murder scene (42.9% vs. 26.5%), witness to domestic violence (39.5% vs. 26.5%), and witness to the murder of relatives (31.3% vs. 21.1%). Conversely, more adolescents of non-FSWs experienced caregiver victimization than the adolescents of FSWs (98.0 vs. 92.5; p < 0.05). CONCLUSIONS Childhood victimization is highly prevalent in Northern Uganda and disproportionately affects the adolescents of FSWs. Therefore, government and development partners should urgently develop policies and interventions targeting prevention, early detection, and timely management of victimization in this vulnerable population.
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Affiliation(s)
- Simple Ouma
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
- Department of Research, The AIDS Support Organization (TASO), Kampala, Uganda.
| | - Catherine Abbo
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Nakita Natala
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minnesota, USA
| | - Molly McCoy
- Department of Pediatrics, University of Minnesota, Minnesota, USA
| | - Maria Kroupina
- Department of Pediatrics, University of Minnesota, Minnesota, USA
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25
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Cheng F, Shi L, Wang S, Jin Q, Xie H, Wang B, Zhang W. The relationship between childhood traumatic experience and suicidal tendency in non-suicidal self-injury behavior patients. BMC Psychiatry 2023; 23:401. [PMID: 37277735 DOI: 10.1186/s12888-023-04863-0] [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: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Individuals with non-suicidal self-injury (NSSI) behavior are usually prone to repeated, intentional, direct harm to their own bodies that is not allowed by society without suicidal ideation. Under this behavior guidance, childhood traumatic experience may easily cause a series of psychological comorbidity symptoms, such as anxiety and depression, finally leading to a suicidal tendency. METHODS A total of 311 adolescent NSSI behavioral patients were recruited at the Ningbo Kangning hospital, Zhejiang Province according to the DSM-5 diagnostic criteria. Demographic data, childhood abuse and neglect, internet addiction, self-esteem, anxiety, and suicidal tendency were evaluated. A structural equation model with a path induction mechanism was constructed to evaluate the relationship between distal and proximal factors related to suicidal tendencies due to childhood traumatic experiences in NSSI behavioral individuals. RESULTS Among the 311 subjects included in the survey, 250 (80.39%) suffered traumatic experiences, such as emotional abuse/physical abuse/sexual abuse/emotional neglect or physical neglect in their childhood, 303 (97.43%) had suicidal ideation, 271 (87.14%) showed the total score of self-esteem, 148 (47.59%) had different degrees of Internet addiction tendency, and 286 (91.96%) showed obvious anxiety. The established path model fit well (GFI = 0.996, RMSEA = 0.03), and the model showed that self-esteem, anxiety, and childhood traumatic experience had standardized coefficients of -0.235 (z = -4.742, p < 0.01), 0.322 (z = 6.296, p < 0.01), 0.205 (z = 4.047, p < 0.01), respectively, with suicidal ideation path, suggesting that self-esteem, Internet addiction, and anxiety showed significant mediating effects in the process of childhood traumatic experience affecting suicidal ideation. CONCLUSION In the context of childhood traumatic experience, it is often accompanied by a series of regulatory behaviors such as Internet addiction, self-esteem, and so on, which finally leads to anxiety, mental symptoms, and even suicidal tendencies. The results provide effective support for the structural equation modeling to evaluate the multi-level influence of NSSI behavior individuals and emphasize that childhood familial factors may lead to psychiatric comorbidity symptoms and suicidal behavior.
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Affiliation(s)
- Fang Cheng
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Linwei Shi
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350116, China
| | - Shujun Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Qiong Jin
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Huabing Xie
- Department of General Medicine, People's Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Beini Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China.
| | - Wenwu Zhang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China.
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26
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Basu D, Ghosh A, Naskar C, Balachander S, Fernandes G, Vaidya N, Kumaran K, Krishna M, Barker GJ, Sharma E, Murthy P, Holla B, Jain S, Orfanos DP, Kalyanram K, Purushottam M, Bharath RD, Varghese M, Thennarasu K, Chakrabarti A, Singh RL, Singh RL, Nanjayya SB, Ahuja CK, Kartik K, Krishnaveni G, Kuriyan R, Kurpad SS, Desrivieres S, Iyengar U, Zhang Y, Hickman M, Spiers A, Toledano M, Schumann G, Benegal V. Risk clustering and psychopathology from a multi-center cohort of Indian children, adolescents, and young adults. Dev Psychopathol 2023; 35:800-808. [PMID: 35393927 DOI: 10.1017/s0954579422000050] [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] [Indexed: 11/06/2022]
Abstract
Developmental adversities early in life are associated with later psychopathology. Clustering may be a useful approach to group multiple diverse risks together and study their relation with psychopathology. To generate risk clusters of children, adolescents, and young adults, based on adverse environmental exposure and developmental characteristics, and to examine the association of risk clusters with manifest psychopathology. Participants (n = 8300) between 6 and 23 years were recruited from seven sites in India. We administered questionnaires to elicit history of previous exposure to adverse childhood environments, family history of psychiatric disorders in first-degree relatives, and a range of antenatal and postnatal adversities. We used these variables to generate risk clusters. Mini-International Neuropsychiatric Interview-5 was administered to evaluate manifest psychopathology. Two-step cluster analysis revealed two clusters designated as high-risk cluster (HRC) and low-risk cluster (LRC), comprising 4197 (50.5%) and 4103 (49.5%) participants, respectively. HRC had higher frequencies of family history of mental illness, antenatal and neonatal risk factors, developmental delays, history of migration, and exposure to adverse childhood experiences than LRC. There were significantly higher risks of any psychiatric disorder [Relative Risk (RR) = 2.0, 95% CI 1.8-2.3], externalizing (RR = 4.8, 95% CI 3.6-6.4) and internalizing disorders (RR = 2.6, 95% CI 2.2-2.9), and suicidality (2.3, 95% CI 1.8-2.8) in HRC. Social-environmental and developmental factors could classify Indian children, adolescents and young adults into homogeneous clusters at high or low risk of psychopathology. These biopsychosocial determinants of mental health may have practice, policy and research implications for people in low- and middle-income countries.
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Affiliation(s)
- Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Abhishek Ghosh
- Drug Deaddiction and Treatment Center, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Chandrima Naskar
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Gwen Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nilakshi Vaidya
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
- Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Kalyanaraman Kumaran
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health, Mysore, India
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Eesha Sharma
- Department of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Kartik Kalyanram
- Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Meera Purushottam
- Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kandavel Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Amit Chakrabarti
- Centre on Non-Communicable Diseases Division of Non-Communicable Diseases (NCD) Indian Council of Medical Research (ICMR), Kolkata, India
| | - Rajkumar Lenin Singh
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Roshan Lourembam Singh
- Department of Psychology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | - Chirag Kamal Ahuja
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kamakshi Kartik
- Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Ghattu Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bangalore, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Udita Iyengar
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Yuning Zhang
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | | | - Alex Spiers
- Department for Epidemiology and Biostatistics, School of Public Health, Imperial College of Science, London, UK
| | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry and Psychotherapy and PONS Centre, Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
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27
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Žukauskienė R, Bakaitytė A, Kaniušonytė G, Segal A, Ustinavičiūtė-Klenauskė L, Santtila P. The lifetime prevalence of child sexual abuse assessed in young adults in Lithuania. CHILD ABUSE & NEGLECT 2023; 138:106061. [PMID: 36708656 DOI: 10.1016/j.chiabu.2023.106061] [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: 06/02/2022] [Revised: 11/29/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We examined the prevalence of different types of childhood sexual abuse (CSA) in Lithuania focusing on how these experiences were related to victim's age and relationship to the perpetrator. METHODS The participants came from a representative household survey of youth aged 18-29 and the sample consisted of 2000 participants (47.7 % women) with a mean age of 23.9 years (SD = 3.6). The ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R, Dunne et al., 2009) for young adults was used to investigate childhood exposure to CSA. Both current sociodemographic information and information on circumstances during childhood (e.g., number of siblings, family members with whom the participant lived between 7 and 12 year of age) were collected. RESULTS The prevalence of any CSA experience before the age of 18 was 15.9 %, with higher rates for women (13.5 % and 18.5 % for men and women, respectively). Being spoken to in a sexual way or sexual things being written about the person was the most prevalent form of CSA. In contrast, number of victims that reported sexual intercourse was much lower. The most common type of perpetrator was another young person. Intrafamilial CSA was rare with higher risk in step-relationships. CONCLUSIONS Our study provides representative prevalence estimates of the CSA in a region for which such estimates were not previously available. These Lithuanian estimates correspond well with previous literature. Importantly, the findings point to peers being an important perpetrator group in CSA cases. This and other findings can inform the planning of relevant policy measures and actions to both prevent CSA and investigate cases effectively.
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Affiliation(s)
- Rita Žukauskienė
- Mykolas Romeris University, Ateities str. 20, Vilnius, LT 08303, Lithuania.
| | - Aistė Bakaitytė
- Mykolas Romeris University, Ateities str. 20, Vilnius, LT 08303, Lithuania
| | - Goda Kaniušonytė
- Mykolas Romeris University, Ateities str. 20, Vilnius, LT 08303, Lithuania
| | - Aleksandr Segal
- Mykolas Romeris University, Ateities str. 20, Vilnius, LT 08303, Lithuania
| | | | - Pekka Santtila
- Mykolas Romeris University, Ateities str. 20, Vilnius, LT 08303, Lithuania; New York University Shanghai, 1555 Shiji Blvd, Pudong, Shanghai 200122, China
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Fonagy P, Campbell C, Luyten P. Attachment, Mentalizing and Trauma: Then (1992) and Now (2022). Brain Sci 2023; 13:brainsci13030459. [PMID: 36979268 PMCID: PMC10046260 DOI: 10.3390/brainsci13030459] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field of attachment about the impact of trauma and the inter-generational transmission of trauma, the review then considers recent neurobiological work on mentalizing and trauma and suggests areas of new development and implications for clinical practice.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
- Correspondence:
| | - Chloe Campbell
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
- Faculty of Psychology and Educational Sciences, KU Leuven, B-3000 Leuven, Belgium
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Gnanapragasam SN, Astill Wright L, Pemberton M, Bhugra D. Outside/inside: social determinants of mental health. Ir J Psychol Med 2023; 40:63-73. [PMID: 34193324 DOI: 10.1017/ipm.2021.49] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Individuals' mental health and wellbeing are dependent on many social factors including housing, employment, education and adequate nutrition among others. These factors can influence at personal, family and community levels. The interlinked and cumulative impact of these social determinants needs to be ascertained to aid appropriate patient management, as well as to establish prevention and health education programmes. Some of these determinants also have to be recognised at policy level. It is crucial for clinicians to understand the role social determinants play in the genesis and perpetuation of mental and physical illnesses, so that appropriate social interventions can be set in place. Clinicians have a role to play in their clinical practice, as well as advocates for their patients and policy leaders. In order to ensure that health is joined up with other sectors, such as education, employment, judiciary and housing, policy-makers must avoid silos. Every policy must have an impact assessment on physical health and mental health. Policy-makers need to understand scientific evidence and must work with researchers, clinicians, communities and patients to help develop and implement rights-based policies.
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Affiliation(s)
- Sam Nishanth Gnanapragasam
- Academic Clinical Fellow, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laurence Astill Wright
- Academic Clinical Fellow, Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Max Pemberton
- Specialist Trainee, Camden and Islington NHS Foundation Trust, London, UK
| | - Dinesh Bhugra
- Professor Emeritus Mental Health and Cultural Diversity, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Solberg MA, Peters RM, Resko SM, Templin TN. Does Coping Mediate the Relationship Between Adverse Childhood Experiences and Health Outcomes in Young Adults? JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-13. [PMID: 36844997 PMCID: PMC9944421 DOI: 10.1007/s40653-023-00527-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Adverse childhood experiences (ACEs) affect 22-75% of American young adults. ACEs are associated with adverse health outcomes that begin in young adulthood. Yet, scant research has examined if coping can mediate the relationship between ACEs and adverse outcomes. The current study determined if coping mediates the relationship between ACEs and body mass index (BMI), substance use, and mental health outcomes in young adults. A community sample of 100 White and 100 Black young adults 18-34 years of age participated in a cross-sectional study conducted via Zoom conferencing. Participants provided demographic data, height/weight, and completed measures of ACEs, coping, substance use, and mental health outcomes. Coping was measured using an established three-factor model consisting of adaptive, support, and disengaged coping. Structural equation modeling (SEM) examined the relationships of ACEs to outcomes as mediated by coping. Participants were predominantly female (n = 117; 58.5%) and mid-young adult (M = 25.5 years; SD = 4.1). SEM results indicated good model fit: (CMIN/df = 1.52, CFI = 0.94, RMSEA = 0.05 [90% CI = 0.03-0.07], SRMR = 0.06). Only disengaged coping mediated the ACE and substance use (β = 0.36, p = .008), smoking (β = 0.13, p = .004), and mental health (β=-0.26, p = .008) relationships. Disengaged coping styles may be a critical mechanism in developing adverse mental health and substance use outcomes among ACE-exposed individuals. Future ACE and health outcomes research should examine the role of coping. Interventions focusing on adaptive coping may improve the health of individuals exposed to ACEs.
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Affiliation(s)
- Marvin A. Solberg
- College of Nursing, Wayne State University, 5557 Cass Avenue, 48202 Detroit, MI USA
| | - Rosalind M. Peters
- College of Nursing, Wayne State University, 5557 Cass Avenue, 48202 Detroit, MI USA
| | - Stella M. Resko
- School of Social Work, Wayne State University, 5447 Woodward Avenue, 48202 Detroit, MI USA
- Merrill Palmer Skillman Institute, Wayne State University, 71 E Ferry Street, 48202 Detroit, MI USA
| | - Thomas N. Templin
- College of Nursing, Wayne State University, 5557 Cass Avenue, 48202 Detroit, MI USA
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Majid M, Ab Rahman A, Taib F. Adverse Childhood Experiences and Health Risk Behaviours among the Undergraduate Health Campus Students. Malays J Med Sci 2023; 30:152-161. [PMID: 36875202 PMCID: PMC9984113 DOI: 10.21315/mjms2023.30.1.13] [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: 03/24/2022] [Accepted: 07/22/2022] [Indexed: 03/05/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) are linked with health risk behaviours (HRBs). The study aimed to evaluate ACEs in the undergraduate health campus of a public university located in the northeast of Malaysia and determine their association with HRBs. Methods A cross-sectional study was performed by recruiting 973 undergraduate students at the health campus of a public university from December 2019 to June 2021. The World Health Organization (WHO) ACE-International Questionnaire and the Youth Risk Behaviour Surveillance System questionnaire were distributed using simple random sampling according to year of study and the selected batch of students. Descriptive statistics were used for demographic findings and logistic regression analyses were performed to determine the association between ACE and HRB. Results The 973 participants (male [n = 245] and female [n = 728]) had a median age of 22 years old. The prevalence of child maltreatment among the study population was 30.2%, 29.2%, 28.7%, 9.1% and 6.1% for emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse, respectively, among both sexes. The most commonly reported household dysfunctions were parental divorce/separation (5.5%). Community violence was 39.3% among the surveyed participants. The highest prevalence of HRBs among respondents was 54.5% from physical inactivity. The findings confirmed that those exposed to ACEs were at risk of HRBs and that a higher number of ACEs was associated with a higher number of HRBs. Conclusion ACEs were highly prevalent among participating university students, ranging from 2.6%-39.3%. Hence, child maltreatment is an important public health problem in Malaysia.
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Affiliation(s)
- Mardhiah Majid
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Fahisham Taib
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kelantan, Malaysia.,Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Williams B. Understanding the effects of adverse childhood experiences on older people. Nurs Older People 2023; 35:37-42. [PMID: 36475401 DOI: 10.7748/nop.2022.e1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 12/12/2022]
Abstract
There is increasing recognition that adverse childhood experiences are linked to suboptimal mental and physical health in later life. Despite this, there has been little research into the effects of adverse childhood experiences on older people. This article gives an overview of the long-term mental and physical effects of adverse childhood experiences and discusses how childhood trauma may manifest in older people. The author also discusses how nurses and unpaid family carers may themselves have been exposed to adverse childhood experiences and how this may affect their caring role. It is crucial that nurses adopt a trauma-informed approach to the care of older people to take account of possible adverse childhood experiences and prevent re-traumatisation.
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Affiliation(s)
- Bronwen Williams
- Bronwen Williams Training, Education and Development, Malvern, Worcestershire, England
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Dar AA, Deb S, Malik MH, Khan W, Haroon AP, Ahsan A, Jahan F, Sumaiya B, Bhat SY, M D, Qasim M. Prevalence of Adverse Childhood Experiences (ACEs) among young adults of Kashmir. CHILD ABUSE & NEGLECT 2022; 134:105876. [PMID: 36152534 DOI: 10.1016/j.chiabu.2022.105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/27/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Studies on the prevalence of adverse childhood experiences (ACEs) in Kashmir, India, are yet to be conducted. This study aims to estimate the prevalence of ACEs among young adults across all the ten districts of Kashmir Valley. METHODS A cross-sectional research strategy was used to assess the prevalence of ACEs by employing a multi-stage sampling method. Data were collected from 800 students studying in different colleges and universities in Kashmir with the help of the "Adverse Childhood Experiences" (ACEs) scale. RESULTS Findings disclosed that less than a quarter of the respondents reported high exposure to ACEs (15.4 %), more than one-tenth of the participants reported extremely high exposure to ACEs (13.4 %), over a quarter of the sample reported moderate exposure to ACEs (26.3 %), one-third of the youth reported low exposure to ACEs (33.0 %) and over one-tenth of the respondents reported no exposure to ACEs (11.8 %). The prevalence of ACEs was found to be 88.2 % (females: 82.7 % and males: 90.8 %) in Kashmir. The ACEs with the highest level of prevalence were "often or very often sworn at, insulted, or put down" (49.8 %), followed by "often or very often acted in a way that made them afraid that they would be physically hurt" (47.6 %), "often or very often pushed, grabbed, shoved, or slapped" (41.6 %), "often or very often hit so hard that they had marks or were injured" (28.3 %) and "touched or sexually fondled" (25.3 %). Thirteen out of 21 adverse events during childhood were significantly associated with gender. CONCLUSION The findings suggest the need to advocate early targeted interventions, reduce ACEs and their impact, and design efficient measures to improve the health and well-being of young adults in Kashmir.
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Affiliation(s)
- Aehsan Ahmad Dar
- Department of Psychology, SRM University, Amaravati, Andhra Pradesh, India; Department of Applied Psychology, Pondicherry University, India.
| | - Sibnath Deb
- Rajiv Gandhi National Institute of Youth Development, Ministry of Youth Affairs and Sports, Government of India, Sriperumbudur, India
| | | | - Waheeda Khan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | | | - Amra Ahsan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Farhat Jahan
- Department of Clinical Psychology, Faculty of Behavioural Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Bushra Sumaiya
- Faculty of Education, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurugram, Delhi, NCR, India
| | - Shaheen Yawar Bhat
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dhamodharan M
- Department of Psychology, SRM University, Amaravati, Andhra Pradesh, India
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The Associations Between Adverse Childhood Experiences, Physical and Mental Health, and Physical Activity: A Scoping Review. J Phys Act Health 2022; 19:847-854. [PMID: 36318916 DOI: 10.1123/jpah.2022-0298] [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: 06/02/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) may be associated with worse physical and mental health in adulthood, and low physical activity engagement, but the relationships are not fully understood. OBJECTIVES To establish the scope of the literature exploring associations between ACEs, physical activity, and physical and mental health. METHODS We conducted this scoping review according to PRISMA-ScR guidelines. We searched MEDLINE, Scopus, SPORTDiscus, and PsycInfo for relevant articles. RESULTS Eighteen studies were included, 17 observational and 1 randomized controlled trial. The majority of studies were cross-sectional and employed self-reported physical activity and ACE measures. Six studies explored physical health, 9 explored mental health, and 3 explored both. Associations between ACEs and poor physical health outcomes (poor self-reported physical health, inflammation, high resting heart rate, and obesity) were consistently weaker or attenuated among those who were physically active. Physical activity may also moderate the associations between ACEs and depressive symptoms, psychological functioning, and health-related quality of life. CONCLUSION Associations between ACEs and poor physical and mental health were observed in those with less frequent physical activity engagement, though the majority of evidence relies on cross-sectional observational designs with self-report instruments. Further research is required to determine whether physical activity can prevent or treat poor physical and mental health in the presence of ACEs.
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Heris CL, Kennedy M, Graham S, Bennetts SK, Atkinson C, Mohamed J, Woods C, Chennall R, Chamberlain C. Key features of a trauma-informed public health emergency approach: A rapid review. Front Public Health 2022; 10:1006513. [PMID: 36568798 PMCID: PMC9771594 DOI: 10.3389/fpubh.2022.1006513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
COVID-19 is a major threat to public safety, and emergency public health measures to protect lives (e.g., lockdown, social distancing) have caused widespread disruption. While these measures are necessary to prevent catastrophic trauma and grief, many people are experiencing heightened stress and fear. Public health measures, risks of COVID-19 and stress responses compound existing inequities in our community. First Nations communities are particularly at risk due to historical trauma, ongoing socio-economic deprivation, and lack of trust in government authorities as a result of colonization. The objective of this study was to review evidence for trauma-informed public health emergency responses to inform development of a culturally-responsive trauma-informed public health emergency framework for First Nations communities. We searched relevant databases from 1/1/2000 to 13/11/2020 inclusive, which identified 40 primary studies (and eight associated references) for inclusion in this review. Extracted data were subjected to framework and thematic synthesis. No studies reported evaluations of a trauma-informed public health emergency response. However, included studies highlighted key elements of a "trauma-informed lens," which may help to consider implications, reduce risks and foster a sense of security, wellbeing, self- and collective-efficacy, hope and resilience for First Nations communities during COVID-19. We identified key elements for minimizing the impact of compounding trauma on First Nations communities, including: a commitment to equity and human rights, cultural responsiveness, good communication, and positive leadership. The six principles guiding trauma-informed culturally-responsive public health emergency frameworks included: (i) safety, (ii) empowerment, (iii) holistic support, (iv) connectedness and collaboration, (v) compassion and caring, and (vi) trust and transparency in multi-level responses, well-functioning social systems, and provision of basic services. These findings will be discussed with First Nations public health experts, together with data on the experiences of First Nations families and communities during COVID-19, to develop a trauma-integrated public health emergency response framework or "lens" to minimize compounding trauma for First Nations communities.
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Affiliation(s)
- Christina L. Heris
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Murdoch Children's Research Institute, Parkville, VIC, Australia
| | | | | | - Cindy Woods
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Chennall
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Lowitja Institute, Collingwood, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia,Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA, Australia,*Correspondence: Catherine Chamberlain
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Fujiwara T. Impact of adverse childhood experience on physical and mental health: A life-course epidemiology perspective. Psychiatry Clin Neurosci 2022; 76:544-551. [PMID: 36002401 DOI: 10.1111/pcn.13464] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) have been shown to have long-term effects on physical and mental health, not only in the US, but also other countries, including Japan. In this paper, measurement of assessment of ACEs has been discussed, that is, concept (what is ACEs), inquiry (how to ask about ACEs), scoring (how to count the number of ACEs), and prevalence (how many ACEs do we have). In addition, a possible mechanism on how ACEs affect health was summarized from a life-course perspective, using the critical/sensitive period model, pathway model, and cumulative model with recent evidence on neurological findings. Intergenerational transmission, that is, maternal ACEs affecting the health of the offspring was also reviewed. Finally, future directions on how to prevent and remedy the impact of ACEs on health was discussed.
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Affiliation(s)
- Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Lee N, Massetti GM, Perry EW, Self-Brown S. Adverse Childhood Experiences and Associated Mental Distress and Suicide Risk: Results From the Zambia Violence Against Children Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21244-NP21265. [PMID: 34906001 PMCID: PMC9192820 DOI: 10.1177/08862605211056726] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose: Adverse childhood experiences (ACEs) are a global public health concern. Little research exists on the prevalence and health consequences of ACEs in Zambia. The current study examined associations between individual and cumulative ACEs, mental distress, and suicide risk among Zambian youth. Methods: Data from Zambia Violence Against Children and Youth Survey were used (18-24 years old, n=1034). Bivariate and adjusted logistic models were performed with independent variables (i.e., experienced physical violence (PV), sexual violence (SV), and emotional violence (EV); witnessed intimate partner violence (IPV) and community violence (CV); orphan status; cumulative ACE exposure) and dependent variables (i.e., mental distress and suicide risk). Adjusted models controlled for demographic and social characteristics. Results: 76.8% of Zambian youth experienced one or more ACEs, and more than 30% witnessed CV (38.4%) or IPV (30.2%), or experienced PV (35.1%), prior to age 18. 27.5% were orphans, and less than 20% experienced EV (17.3%) or SV (15.4%) in childhood. 42.4% experienced mental distress in the past 30 days, and 12.5% reported lifetime suicidal thoughts or suicide attempts. PV, EV, cumulative ACE exposure, older age, being single, and stronger friendships were significantly related to experiencing mental distress. Cumulative ACEs exposure was associated with significantly higher suicide risk. Conclusions: Preventing ACEs can reduce mental distress and suicide risk among Zambian youth. Youth with cumulative ACE exposure can be prioritized for mental health intervention. More research is warranted to investigate the broad-based prevention of ACEs, especially PV and EV, and protective factors that can promote resilience among youth who have experienced ACEs.
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Affiliation(s)
- NaeHyung Lee
- Copial Business Strategists, Chamblee, GA, USA
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Greta M. Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth W. Perry
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Physical activity mitigates the link between adverse childhood experiences and depression among U.S. adults. PLoS One 2022; 17:e0275185. [PMID: 36223342 PMCID: PMC9555628 DOI: 10.1371/journal.pone.0275185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) include potentially traumatic exposures to neglect, abuse, and household problems involving substance abuse, mental illness, divorce, incarceration, and death. Past study findings suggest ACEs contribute to depression, while physical activity alleviates depression. Little is known about the link between ACEs and physical activity as it relates to depression among U.S. adults. This research had a primary objective of determining the role of physical activity within the link between ACEs and depression. The significance of this study involves examining physical activity as a form of behavioral medicine. METHODS Data from the 2020 Behavioral Risk Factor Surveillance System were fit to Pearson chi-square and multivariable logistic regression models to examine the links between ACEs and depression, ACEs and physical activity, and physical activity and depression among U.S. adults ages 18-and-older (n = 117,204) from 21 states and the District of Columbia, while also determining whether physical activity attenuates the association between ACEs and depression. RESULTS Findings from chi-square analyses indicated that ACEs are related to physical activity (χ2 = 19.4, df = 1; p<0.01) and depression (χ2 = 6,841.6, df = 1; p<0.0001). Regression findings suggest ACEs were linked to depression (AOR = 1.050; 95% CI = 1.049, 1.051). ACEs and physical activity (AOR = 0.994; 95% CI = 0.992, 0.995) and physical activity and depression (AOR = 0.927; 95% CI = 0.922, 0.932) were both inversely related. Physical activity mitigated the link between ACEs and depression (AOR = 0.995; 95% CI = 0.993, 0.996). CONCLUSIONS This research addressed a critical knowledge gap concerning how ACEs and physical activity contribute to depression outcomes among U.S. adults. Findings suggest physical activity mitigates the effect of ACEs on depression. Future studies should apply physical activity interventions to alleviate depression among U.S. adults with high ACEs.
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Bager L, Laursen TM, Palic S, Nordin L, Høgh Thøgersen M. Adverse childhood experiences among children of parents who are refugees affected by trauma in Denmark: a register-based cohort study. THE LANCET PUBLIC HEALTH 2022; 7:e825-e833. [DOI: 10.1016/s2468-2667(22)00194-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 12/17/2022] Open
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M.S. SP, Joseph. JK, Vardhanan YS. Exploration of Adverse Childhood Experiences (ACEs) and Health Risk Behaviors (HRBs) in Male Recidivist Violent Offenders: Indian Scenario. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:639-652. [PMID: 35958729 PMCID: PMC9360396 DOI: 10.1007/s40653-021-00434-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 06/15/2023]
Abstract
Aggression and violent behavior are widespread in the world and cause serious threats to public safety. Violent criminal recidivism rates remain very high among certain groups of offenders. In India, the quantum of total violent crimes is continuously increasing from 2009 to 2019. Adverse childhood experiences can affect the development of a child in many ways, leading to highly maladaptive behaviors, such as serious, violent, and chronic (SVC) delinquency. This study was done as a case-control method among recidivist violent offenders and controls to examine the effects of adverse childhood experiences (ACEs) on violent criminality. The questionnaire included the World Health Organization Adverse Childhood Experiences International Questionnaire (ACE- IQ) and standardized measures of Health Risk Behaviors (HRBs). Thirteen categories of adverse childhood experiences of the recidivist violent offenders and controls were measured. Bivariate analysis showed that there was a significant relation (p < 0.001) between ACEs and violent criminality in cases (M = 72.14, SD = 6.80, N = 35) and controls (M = 44.91, SD = 5.39, N = 32). The largest correlation was found between collective violence and household violence (r = 0.813). Bivariate correlation analyses were highly significant between total ACE score and criminality (r (35) = 0.927, p < 0.001). The results reveal that household violence, community violence and collective violence experienced by recidivist violent offenders were nearly double the rate of the control group. Findings emphasize the need for evaluations of ACEs in recidivist offenders for better rehabilitation strategies and also the necessity for preventive efforts at all levels. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-021-00434-1.
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Affiliation(s)
- Siva Prasad M.S.
- Assistant Professor, M.Sc. Forensic Science Programme, University of Calicut, Kerala Police Academy, Thrissur, 680631 Kerala India
| | | | - Y. Shibu Vardhanan
- Associate Professor, Department of Zoology, University of Calicut, Malappuram, 673635 Kerala India
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Akamine AA, Rusch GDS, Nisihara R, Skare TL. Adverse childhood experiences in patients with psoriasis. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 44:e20210251. [PMID: 33984200 PMCID: PMC10039716 DOI: 10.47626/2237-6089-2021-0251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/06/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) have been linked to occurrence of autoimmune diseases in adults, including psoriasis. OBJECTIVES To study the prevalence of ACEs in psoriasis patients, comparing them with a sample from the general population. METHODS Three hundred and eighteen individuals were included (104 psoriasis patients and 214 controls). Patients and controls answered questions on an ACE study questionnaire about experiences of childhood abuse, negligence, domestic violence, and household dysfunction. Questionnaire scores range from zero (best result) to 8 (worst scenario). Psoriasis patients' charts were reviewed for epidemiological, clinical, and treatment data. A Psoriasis Area Severity Index (PASI) was calculated from measurements taken when the questionnaire was administered. RESULTS Psoriasis patients reported a median of 4 ACEs (interquartile range [IQR] = 3-5) while controls had a median of 3 (IQR = 2-4) with p < 0.0001. The number of ACEs was not associated with PASI, age of disease onset, or presence of associated arthritis (all p > 0.5). Female psoriasis patients had more ACEs than males (p = 0.04). CONCLUSION Patients with psoriasis have more ACEs than controls and ACEs were more common in female patients.
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Affiliation(s)
| | | | - Renato Nisihara
- Faculdade Evangélica Mackenzie de Medicina, Curitiba, PR, Brazil
| | - Thelma L Skare
- Faculdade Evangélica Mackenzie de Medicina, Curitiba, PR, Brazil
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Farrell D, Fadeeva A, Zat Z, Knibbs L, Miller P, Barron I, Matthess H, Matthess C, Gazit N, Kiernan MD. A Stage 1 Pilot Cohort Exploring the Use of EMDR Therapy as a Videoconference Psychotherapy During COVID-19 With Frontline Mental Health Workers: A Proof of Concept Study Utilising a Virtual Blind 2 Therapist Protocol. Front Psychol 2022; 13:901855. [PMID: 35874361 PMCID: PMC9298740 DOI: 10.3389/fpsyg.2022.901855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
Objective The COVID-19 pandemic has had a major impact on the delivery of psychological treatment. Due to social distancing requirements, the provision moved to videoconferencing psychotherapy (VCP). There is a paucity of empirical data supporting the efficacy of EMDR therapy as a VCP. This stage 1 pilot study tested an EMDR therapy scripted protocol, such as Virtual Blind 2 Therapist (VB2Tr), on frontline mental health workers as a VCP regarding fitness for purpose, distinctiveness, relevance, and efficiency. Methods A total of 24 participants were recruited for the study. The design included a one-session treatment intervention with pre, post, 1-month, and 6-month follow-up (FU) measurements. This treatment session used a “Blind 2 Therapist” EMDR therapy scripted protocol as videoconference psychotherapy that involves non-disclosure of traumatic memory. The research explored the treatment effect on the core characteristics of trauma memory, including subjective disturbance, belief systems, memory intensity (MI), vividness, and levels of emotionality. Additionally, the research explored participants’ experiences of adverse and benevolent childhood experiences (ACEs/BCEs) during their childhood. Results Regarding the four tests, namely, fitness for purpose, distinctiveness, relevance, and efficiency, results are favourably suggesting potential clinical benefits of using EMDR as videoconference psychotherapy. Although this is a proof-of-concept study showing positive results, no clinical population or control group was used. The purpose of the study is to explore the potential for scalability toward a larger clinical trial. The treatment intervention was achieved irrespective of either ACEs/BCEs during childhood. Conclusion The research tentatively supports the case for EMDR therapy as a credible treatment when used as video conference psychotherapy and in using the Blind 2 Therapist protocol. However, more research is needed to scale toward a clinical trial. Clinical Trial Registration Clinical Trial Registration:https://www.isrctn.com/ISRCTN12099530, identifier ISRCTN12099530.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Anastasia Fadeeva
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul Miller
- Mirabilis Health Institute, Newtownabbey, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Helga Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Cordula Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | | | - Matthew D Kiernan
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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Andrade CRD, Avanci JQ, Oliveira RDVCD. [Adverse childhood experiences, sociodemographic characteristics, and depressive symptoms in adolescents in a municipality in Rio de Janeiro, Brazil]. CAD SAUDE PUBLICA 2022; 38:e00269921. [PMID: 35830088 DOI: 10.1590/0102-311xpt269921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 03/18/2022] [Indexed: 11/22/2022] Open
Abstract
The study aimed to identify patterns in adverse childhood experiences among teenage schoolchildren in a municipality (county) in Rio de Janeiro State, Brazil, according to sociodemographic characteristics (sex, skin color, and socioeconomic status) and depressive symptoms. It adopted a cross-sectional design with a sample of 1,117 teenage schoolchildren 13 to 19 years of age in São Gonçalo, Rio de Janeiro State. Depression was assessed with the Childhood Depression Inventory, and adverse childhood experiences were investigated. The study used bivariate analyses and multiple correspondence analysis (MCA) of adverse childhood experiences, sociodemographic variables (sex, skin color, socioeconomic status), and depressive symptoms. The results reveal the organization of eight groups: lower-income female children and adolescents and adverse childhood experiences related to the environment; boys, with higher socioeconomic status, and not having experienced adverse childhood experiences; adolescents with depressive symptoms and adverse childhood experiences against themselves or their families; white adolescents, with depressive symptoms, and that had not experienced adverse childhood experiences; black, brown, Asian-descendant, and indigenous adolescents that had adverse experiences in the family and community; adolescents that had lost their father and/or mother from death, and lack of food at home; adolescents that had experienced psychological violence; and adolescents with a history of sexual experiences involving their parents. The findings call attention to the need for close and early attention to exposure to adverse childhood experiences to care for these youngsters, intervene, and mitigate the negative effects both at present, over the course of life, and in future generations.
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Affiliation(s)
- Célia Regina de Andrade
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Joviana Quintes Avanci
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Soares S, Abrahamyan A, Amorim M, Santos AC, Fraga S. Prevalence of Adverse Childhood Experiences in the First Decade of Life: A Study in the Portuguese Cohort, Generation XXI. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148344. [PMID: 35886196 PMCID: PMC9324541 DOI: 10.3390/ijerph19148344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023]
Abstract
Adverse childhood experiences (ACEs) are a modifiable risk factor for diseases throughout life. This study estimates the prevalence of ACEs in children, addressing associated sociodemographic characteristics and examining the relationship of ACEs with the child’s health and behaviors. We used information on 5295 participants at 10 years old, of the birth cohort Generation XXI, established in Porto, Portugal. Children answered a self-administered questionnaire on ACEs, based on the original ACEs study. Principal component analysis was used to group correlated ACEs, and a score was computed to assess their cumulative effect. Overall, 96.2% of children reported having been exposed to at least one ACE. The most prevalent ACE was a household member shouting, yelling, or screaming at the child (57.7%). Boys were more likely than girls to report “abuse”, “school problems”, and “death/severe disease”. Low parental education, income, and unemployment were associated with an increased risk of “school problems”, “death/severe disease”, and “household dysfunction”. We observed that the dimensions of ACEs could be identified at 10 years of age. A disadvantaged socioeconomic environment was associated with dimensions of ACEs. These data illustrate the natural history of dimensions of ACEs and their potential social patterning.
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Affiliation(s)
- Sara Soares
- EPI Unit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (S.S.); (A.A.); (M.A.); (A.C.S.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Armine Abrahamyan
- EPI Unit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (S.S.); (A.A.); (M.A.); (A.C.S.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Mariana Amorim
- EPI Unit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (S.S.); (A.A.); (M.A.); (A.C.S.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Ana Cristina Santos
- EPI Unit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (S.S.); (A.A.); (M.A.); (A.C.S.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Sílvia Fraga
- EPI Unit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; (S.S.); (A.A.); (M.A.); (A.C.S.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Correspondence:
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Luft HS, Mersky JP, Choi C, Canario Guzmán JA, Quezada Ortiz MV, Sehi GT, Temple JR. Prevalence of adverse childhood experiences (ACEs) and association with dating violence and symptoms of mental illness among adolescents in the Dominican Republic. CHILD ABUSE & NEGLECT 2022; 129:105668. [PMID: 35617753 DOI: 10.1016/j.chiabu.2022.105668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adolescent dating violence (ADV) and mental illness are highly prevalent, interrelated public health priorities. Increasingly, scholars are looking to adverse childhood experiences (ACEs) to explain risk for these health concerns. OBJECTIVES Determine prevalence of ACEs, ADV perpetration and victimization, and anxiety and depression symptoms among adolescents in the Dominican Republic (DR). Evaluate the association of ACEs with these ADV and mental health outcomes. PARTICIPANTS AND SETTING Cross-sectional survey data were collected from 142 adolescents at middle and high schools in the DR. METHODS We assessed ACEs using the Childhood Experiences Survey, ADV using the Conflict in Dating Relationships Inventory, and depression/anxiety symptoms using Patient-Reported Outcomes Measurement Information System scales. Linear and logistic regressions were performed to test dose-response relationships between a cumulative ACE score and ADV and mental health outcomes while adjusting for age, gender, and rural/urban residence. RESULTS 80.6% of students reported at least one ACE. The most prevalent ACEs reported were physical abuse (49%) and witnessing domestic violence (48%). After adjusting for covariates, cumulative ACE scores were significantly associated with depression symptoms, anxiety symptoms, physical and emotional ADV perpetration, and physical and emotional ADV victimization. CONCLUSIONS Structural and community-based interventions to prevent ADV and promote mental health for adolescents in the DR should address ACEs.
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Affiliation(s)
- Heidi S Luft
- University of Wisconsin-Milwaukee, 1921 E Hartford Ave, Milwaukee, WI 53211, United States of America; University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United States of America.
| | - Joshua P Mersky
- University of Wisconsin-Milwaukee, 1921 E Hartford Ave, Milwaukee, WI 53211, United States of America.
| | - Changyong Choi
- Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, United States of America; Gachon University, 1342, Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Julio Arturo Canario Guzmán
- Instituto de Salud Mental y Telepsicología, Plaza Amer, Rómulo Betancourt 1212, Apto 404 A, Dominican Republic.
| | - María Violeta Quezada Ortiz
- Programa SUPERATE de la Presidencia de la República Dominicana, Ave. Leopoldo Navarro #61, Edif. San Rafael, 6to. Nivel. Ensanche San Juan Bosco, Santo Domingo, Dominican Republic.
| | - Gaelle T Sehi
- University of Wisconsin-Milwaukee, 1921 E Hartford Ave, Milwaukee, WI 53211, United States of America.
| | - Jeff R Temple
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United States of America.
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Haugland SH, Stea TH. Commentary on Welford, Danielsson & Manhica: The complexity of life conditions among offspring exposed to parental SUD. Addiction 2022; 117:2057-2058. [PMID: 35307883 PMCID: PMC9310837 DOI: 10.1111/add.15870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Siri H. Haugland
- Department of Psychosocial HealthUniversity of AgderGrimstadNorway
| | - Tonje H. Stea
- Department of Health and Nursing ScienceUniversity of AgderKristiansandNorway,Department of Child and Adolescence Mental HealthSørlandet HospitalKristiansandNorway
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McCutchen C, Hyland P, Shevlin M, Cloitre M. The occurrence and co-occurrence of ACEs and their relationship to mental health in the United States and Ireland. CHILD ABUSE & NEGLECT 2022; 129:105681. [PMID: 35643057 DOI: 10.1016/j.chiabu.2022.105681] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have various deleterious effects on mental health but few studies have been conducted in Ireland. OBJECTIVE The primary objective was to determine if there were significant differences in occurrences of ACEs in U.S. and Irish adults. We also sought to determine if there were unique associations between individual and multiple ACE events and mental health. PARTICIPANTS AND SETTING Preexisting nationally representative adult samples from the U.S. (n = 1893) and Ireland (n = 1020) were utilized for analysis. METHOD To determine if there were significant differences in the occurrence of specific ACE events and the mean number of ACEs experienced by U.S. and Irish adults, chi-square difference tests and an independent samples t-test were used, respectively. Binary logistic regression was used to examine the unique associations between ACE events and major depressive disorder (MDD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and Complex PTSD (CPTSD). Nationality, sex, age, and educational level were included as covariates and adjusted odds ratios are reported. RESULTS Irish respondents had a higher rate of ACEs, were more likely to experience specific ACEs, and to meet diagnostic requirements for MDD, GAD, and CPTSD than U.S. RESPONDENTS Emotional neglect was more strongly related to mental health than all other ACEs, and there was an exceptionally strong dose-response association between ACEs and CPTSD. CONCLUSIONS ACEs seem to be more common in Ireland than the U.S., and efforts to minimize exposure to ACEs through public policies may lead to beneficial mental health effects.
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Affiliation(s)
| | - Philip Hyland
- Maynooth University, Department of Psychology, Kildare, Ireland
| | - Mark Shevlin
- Ulster University, School of Psychology, Derry, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
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Myat Zaw AM, Win NZ, Thepthien BO. Adolescents’ academic achievement, mental health, and adverse behaviors: Understanding the role of resilience and adverse childhood experiences. SCHOOL PSYCHOLOGY INTERNATIONAL 2022. [DOI: 10.1177/01430343221107114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the relationship between exposure to adverse childhood experiences (ACEs) and health in adolescents with high or low levels of resilience. Data came from the 2020 Bangkok Behaviour Surveillance Survey (BBSS). Multivariate logistic regression analyses examined associations between ACEs and health conditions overall, and for adolescents with low versus high resilience on the Grotberg’s Resilience Scale. Overall, 54.9% of adolescents reported 0 ACEs. Compared to adolescents with no ACEs, it was found that those with ≥ 1 ACE were more likely to experience insomnia, sadness, suicide attempt, depression, and excess alcohol consumption. Those with a history of four or more ACEs had worse mental health, higher total undesirable behaviour, and lower academic achievement. When the sample was divided into high resilience (60.2%) and low resilience (39.8%), having at least 1 ACEs (vs. 0 ACEs) was associated with worse mental health and undesirable behaviour in adolescents with low resilience. History of ACEs can predict adverse health conditions and undesirable behaviour among adolescents, and the strongest correlation is among adolescents with low resilience. Future studies are needed to develop strategies and interventions to increase adolescent resilience, and test whether improvements in resilience reduce the adverse impact of ACEs on adolescent mental/behavioural health.
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Affiliation(s)
- Aye Myat Myat Zaw
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Nay Zar Win
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Bang-on Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
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Yuan M, Qin F, Xu C, Fang Y. Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study. BMJ Open 2022; 12:e060477. [PMID: 35688592 PMCID: PMC9189840 DOI: 10.1136/bmjopen-2021-060477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To identify the heterogeneity of adverse childhood experiences (ACEs) as well as their association with cognitive function in an elderly Chinese population. DESIGN A retrospective cohort study. PARTICIPANTS The data were from the latest wave of the China Health and Retirement Longitudinal Study and a total of 7222 participants aged ≥60 were included. PRIMARY AND SECONDARY OUTCOME MEASURES Latent class analysis was used to identify the classes characterised by 11 types of ACEs. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined by education-specific threshold MMSE scores. Logistic models were constructed to examine the relationship between ACE classes and cognitive impairment. Several childhood and adulthood confounding factors were considered. RESULTS Three ACE latent classes were identified. Of them, 76.09% were in the 'Low ACEs' class, 15.43% were in the 'Household dysfunction' class and 8.49% were in the 'Child maltreatment' class. The people in the 'Low ACEs' class seemed to have better childhood family financial situations and higher education levels. The population in the 'Household dysfunction' class tended to live in rural areas and have a higher proportion of men, whereas people in the 'Child maltreatment' class showed a significantly higher proportion of women and higher levels of chronic diseases. 'Child maltreatment' was related to a higher risk of cognitive impairment (OR=1.37, 95% CI: 1.12 to 1.68), while the risk of 'Household dysfunction' was not significantly different from that of the 'Low ACEs' participants (OR=1.06, 95% CI: 0.90 to 1.26). CONCLUSIONS The findings supported differences in cognitive function in elderly Chinese people exposed to different types of ACEs.
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Affiliation(s)
- Manqiong Yuan
- School of Public Health, Xiamen University, Xiamen, China
- School of Public Health, Xiamen University, Xiamen, China
| | - Fengzhi Qin
- School of Public Health, Xiamen University, Xiamen, China
| | - Chuanhai Xu
- School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, China
- School of Public Health, Xiamen University, Xiamen, China
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Datta BK, Tiwari A, Fazlul I. Child marriage and risky health behaviors: an analysis of tobacco use among early adult and early middle-aged women in India. BMC Womens Health 2022; 22:206. [PMID: 35655201 PMCID: PMC9164419 DOI: 10.1186/s12905-022-01781-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Though the harmful impacts of child marriage have been evaluated across several domains, evidence on the relationship between child marriage and health behaviors over the life course is limited. In this paper, we examined whether getting married as a child is associated with one of the most common risky health behaviors, tobacco use, in adulthood. METHODS Using nationally representative data from India, we compared the odds in favor of tobacco use among early adult (age 22-34) and early middle-aged (age 35-44) women who were married before age 18 with that of those who were married as youths (age 18-21). We estimated univariate and multivariable logistic regressions to obtain odds ratios in favor of any tobacco-use and relative risk ratios in favor of mutually exclusive types of tobacco use (smoking-only, smokeless-only, and dual-use). We also explored the intensive margin of the relationship by assessing if the odds of tobacco use in adulthood were affected by how early (13 or less, 14-15, or 16-17) a child bride was married. RESULTS We find that the adjusted odds of tobacco use for those who were married as a child were 1.3 and 1.2 times that of those who were married as a youth among early adult and early middle-aged women, respectively. The younger was the child bride when married, the higher were the odds of tobacco use as an adult. The relative risks of different types of tobacco use were also higher for child brides than their peers. CONCLUSIONS These results are the first evidence of the association between child marriage and a major risky health behavior, tobacco use, over the life course. These findings will inform policies to strengthen child marriage prevention efforts and targeted tobacco control initiatives in the low-and-middle income countries.
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Affiliation(s)
- Biplab K Datta
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, USA. .,Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Ashwini Tiwari
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, USA
| | - Ishtiaque Fazlul
- Department of Economics, University of Missouri, Columbia, MO, USA.,Coles College of Business, Kennesaw State University, Kennesaw, GA, USA
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