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Elrefaay SMM, Elyzal AS. Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation. J Psychosoc Nurs Ment Health Serv 2024; 62:45-54. [PMID: 37527517 DOI: 10.3928/02793695-20230726-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].
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Sánchez-Jáuregui T, Téllez A, Almaraz D, Valdez A, Hinojosa-Fernández R, García-Balvaneda H, Juárez-García DM. Adverse Childhood Experiences in Mexico: Prevalence and Association with Sociodemographic Variables and Health Status. PSYCHOLOGY IN RUSSIA: STATE OF ART 2023; 16:48-62. [PMID: 37830078 PMCID: PMC10567057 DOI: 10.11621/pir.2023.0204] [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: 03/22/2023] [Accepted: 06/07/2023] [Indexed: 10/14/2023] Open
Abstract
Background Adverse Childhood Experiences (ACEs) refer to a semantic field of negative childhood events that, in conjunction with insufficient personal, family, or contextual coping resources, have the potential of becoming traumatic. Objective To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with sociodemographic variables and physical and mental illnesses in a Mexican sample. Design A cross-sectional design was used. The sample included 917 Mexican adults who responded to the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Most of the participants were female (79.3%) with an average age of 37 years, a monthly income between 500 and 2,500 USD (59.2%), had completed university education (45.6%) and were married or in a common-law marriage (53.1%). Data was collected through Google Forms, and the link to the form was shared through electronic social networks. Results A total of 48.3% of the participants presented seven to nine types of ACEs. Among their responses, the most prevalent categories were emotional neglect (95.1%), family violence (83.3%), and emotional abuse (78.6%). A significant association was found between the number of ACEs and the mental illness diagnosis (x2(20) = 15.16; p<001). Women were found to report more experiences of sexual abuse (z = -6.62, p<. 001), whereas men reported more experiences of community violence (z= -4.27, p < .001) and collective violence (z = -3.94, p<.001). Conclusions The prevalence of ACEs in the Mexican population is high. However, men and women reported differences in certain types of ACEs. It was found that people with a diagnosis and family history of mental illnesses presented a higher number of ACE categories.
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Affiliation(s)
| | | | - Diana Almaraz
- Autonomous University of Nuevo Leon, Monterrey, Mexico
| | - Arturo Valdez
- Autonomous University of Nuevo Leon, Monterrey, Mexico
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Alhowaymel FM, Kalmakis KA, Chiodo LM, Kent NM, Almuneef M. Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1651. [PMID: 36674405 PMCID: PMC9863315 DOI: 10.3390/ijerph20021651] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/30/2022] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health.
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Affiliation(s)
- Fahad M. Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra 11911, Saudi Arabia
| | - Karen A. Kalmakis
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Lisa M. Chiodo
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Nicole M. Kent
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Maha Almuneef
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
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Fekih-Romdhane F, Dabbous M, Hallit R, Malaeb D, Sawma T, Obeid S, Hallit S. Development and validation of a shortened version of the Child Abuse Self Report Scale (CASRS-12) in the Arabic language. Child Adolesc Psychiatry Ment Health 2022; 16:100. [PMID: 36494699 PMCID: PMC9737702 DOI: 10.1186/s13034-022-00533-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/19/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND All available scales to screen for child abuse may be challenging to administer due to their length. Indeed, a higher number of items is associated with more administration time and less motivation to engage in responding. We aimed through this study to examine the psychometric properties of a brief Arabic version of the Child Abuse Self Report Scale (CASRS-12) in terms of factorial structure, internal consistency, divergent validity, and correlations with measures of bullying victimization, eating attitudes and perceived social support. METHODS We performed a cross-sectional, web-based study among Community Lebanese adolescents; where two samples have been used (Sample 1: N = 852, aged 15.34 ± 1.18 years, 54.8% females; Sample 2: N = 404, aged 16.60 ± 1.51 years, 57.2% females). The construct validity was tested using both exploratory and confirmatory factor analyses. RESULTS Results revealed that both EFA and CFA yielded a four-factor structure for the CASRS-12 that mirrors the original four factors captured by the original CASRS. The scale also showed a good internal consistency as evidenced through McDonald's ω values ranging from 0.87 to 0.93 for the four subscales; and configural, metric, and scalar invariance across gender. Finally, we found that all CASRS-12 dimensions were significantly and positively correlated with more inappropriate eating attitudes and lower social support; and that psychological, physical, and sexual abuse correlated with higher bullying victimization CONCLUSION: In light of these findings, we potentially encourage clinicians and researchers to use this scale as a valid and reliable measure of child abuse among Arabic-speaking populations.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia ,grid.12574.350000000122959819Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Mariam Dabbous
- grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon ,Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon ,Department of Infectious Disease, Notre Dame des Secours University Hospital, Byblos, Postal Code 3 Lebanon
| | - Diana Malaeb
- grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon ,grid.411884.00000 0004 1762 9788College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Toni Sawma
- grid.411323.60000 0001 2324 5973School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Applied Science Research Center, Applied Science Private University, Amman, Jordan. .,Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
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Mlouki I, Bouanene I, Sioud I, Bchir A, al'Absi M, El Mhamdi S. Impulsivity mediates the impact of early life adversity on high risk behaviors among Tunisian adolescents. Prev Med Rep 2021; 23:101424. [PMID: 34150480 PMCID: PMC8190465 DOI: 10.1016/j.pmedr.2021.101424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/20/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022] Open
Abstract
Adverse childhood experience (ACE) has become an alarming phenomenon exposing youth at a great risk of developing mental health issues. Several studies have examined the mechanism by which ACE affects adolescent's engagement in risky behaviors. However, little is known about these associations in the Tunisian/African context. We investigated the role of impulsivity in the link between ACE and health risk behaviors among schooled adolescents in Tunisia. We performed a cross sectional study among 1940 schooled adolescents in the city of Mahdia (Tunisia) from January to February 2020. To measure ACE, we used the validated Arabic version of the World Health Organization ACE questionnaire. The Barratt Impulsivity Scale and the Internet Addiction Test were used as screening tools for impulsivity and internet addiction. A total of 2520 adolescents were recruited. Of those, 1940 returned the questionnaires with an overall response rate of 77%. The majority (97.5%) reported experiencing at least one ACE. Emotional neglect (83.2%) and witnessing community violence (73.5%) were the most reported intra-familial ACEs. Males had higher rates of exposure to social violence than females. The most common risky behavior was internet addiction (50%, 95%CI = [47.9-52.3%]). Our survey revealed that ACEs score predict problematic behaviors through impulsiveness (% mediated = 16.7%). Specifically, we found a major mediating role of impulsivity between the exposure to ACE and the risk of internet addiction (% mediated = 37.5%). Our results indicate the role of impulsivity in translating the risk associated with ACE leading to engagement in high risk behaviors.
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Affiliation(s)
- Imen Mlouki
- Department of Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Tunisia
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar of Mahdia, Tunisia
- Research laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Tunisia
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Tunisia
- Research laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Tunisia
| | - Imen Sioud
- Department of Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Tunisia
| | - Abdallah Bchir
- Department of Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Tunisia
- Research laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Tunisia
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Sana El Mhamdi
- Department of Community Medicine, Faculty of Medicine of Monastir, University of Monastir, Tunisia
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar of Mahdia, Tunisia
- Research laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Tunisia
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Alhowaymel F, Kalmakis K, Jacelon C. Developing the Concept of Adverse Childhood Experiences: A Global Perspective. J Pediatr Nurs 2021; 56:18-23. [PMID: 33181368 DOI: 10.1016/j.pedn.2020.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/02/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The relationship between health and adverse childhood experiences (ACEs) has been a major topic in the field of healthcare. In recent years, the study ACEs and health has expanded internationally. PURPOSE The purpose of this study was to further develop the concept of ACEs using a global perspective. METHOD Rodgers' Evolutionary Model guided the study. PubMed, CINAHL, and PsychINFO databases were searched. A total of 39 publications were selected for review. FINDINGS Development of the concept was achieved using a wide global lens. ACEs are influenced by diverse cultural, social, environmental, and economic factors that affect individuals' health worldwide. DISCUSSION The developed ACEs concept described in this paper includes a global perspective, adding context to the existing definition, thus broadening its application, and expanding its usefulness in international research. A clear concept for ACEs is valuable to nurses who care for children, adolescents and young adults around the world, who have suffered from ACEs and seek health care.
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Affiliation(s)
- Fahad Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Saudi Arabia.
| | - Karen Kalmakis
- College of Nursing, University of Massachusetts, Amherst, USA.
| | - Cynthia Jacelon
- College of Nursing, University of Massachusetts, Amherst, USA.
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Chegeni M, Haghdoost A, Shahrbabaki ME, Shahrbabaki PM, Nakhaee N. Validity and reliability of the Persian version of the Adverse Childhood Experiences Abuse Short Form. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:140. [PMID: 32766325 PMCID: PMC7377151 DOI: 10.4103/jehp.jehp_15_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIM Measuring child abuse and adverse experiences is a critical task with regard to its long-term impact on the health of individuals and communities. The purpose of this study was to validate the Persian version of the International Adverse Childhood Experiences Abuse Short Form (ACE-ASF) in Iranian society. MATERIALS AND METHODS This cross-sectional study was conducted in Kerman, southeast of Iran, in 2019, on 494 students from Kerman University of Medical Sciences, selected by convenience sampling method. Psychometric properties of the questionnaire were examined after the forward and backward translation processes. The factor structure of the questionnaire was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The concurrent validity of the questionnaire was assessed using the childhood trauma questionnaire (CTQ). Cronbach's alpha and corrected item-total correlation were used to measure reliability. RESULTS The mean age of participants was 24.3 ± 5.3 years. Based on EFA, two physical-emotional abuse and sexual abuse factors were obtained. The CFA fit indices well supported two extracted factors. The CFA showed acceptable factor loadings. The internal consistency coefficient of Cronbach's alpha was 0.75 for the physical-emotional abuse factor and 0.77 for the sexual abuse factor. The correlation coefficient of ACE-ASF and CTQ was r = 0.56. The reliability index of intraclass correlation coefficient was 0.73 (95% confidence interval: 0.60-0.84). CONCLUSION The Persian version of the ACE-ASF questionnaire has acceptable psychometric properties.
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Affiliation(s)
- Maryam Chegeni
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Aliakbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Eslami Shahrbabaki
- Neuroscience Research Center, Department of Psychiatry, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Department of Medical Surgical Nursing, Nursing Research Center, Faculty of Nursing and Midwifery Razi, Kerman University of Medical Sciences, Kerman, Iran
| | - Nouzar Nakhaee
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Hashemi SM, Yousefichaijan P, Salehi B, Almasi-Hashiani A, Rafiei M, Zahedi S, Khedmati Morasae E, Maghsoudlou F. Comparison of child abuse history in patients with and without functional abdominal pain: a case-control study. BMC Psychiatry 2020; 20:258. [PMID: 32448192 PMCID: PMC7247203 DOI: 10.1186/s12888-020-02675-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/18/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Gastrointestinal (GI) disorders are ranked first amongst medical diseases as a trigger of requests for mental health counselling. Child abuse has been regarded as one of the main causes of the development of functional abdominal pain (FAP) in children. This study aimed, therefore, to compare the prevalence of child abuse experience among two groups of patients with and without FAP. METHODS A case-control study of children in Arak, Iran, in which experience of child abuse was compared in children with (n = 100) and without functional abdominal pain (n = 100). Three categories of child abuse - emotional abuse, physical abuse, and neglect - were assessed using the Child Abuse Questionnaire. The data were analyzed using Stata software. RESULTS After adjusting for potential confounders, there were group differences in emotional abuse (96% vs. 81%, aOR = 5.13, 95% CI: 1.3-20.3, p = 0.017), neglect (28% vs. 8%, aOR = 4.27, 95% CI: 1.8-11.8, p = 0.001) and total child abuse score (98% vs. 84%, aOR = 8.2, 95% CI: 1.5-43.8, p = 0.014) but not in physical abuse (57% vs. 46%, aOR = 1.47, 95% CI: 0.81-2.60, p = 0.728). CONCLUSIONS As the prevalence of child abuse is higher in patients with FAP, child abuse appears to be related to the occurrence of FAP in children. However, the results of this study cannot be generalized to Iranian society generally and further longitudinal studies are recommended.
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Affiliation(s)
- Seyed Mojtaba Hashemi
- Department of Pediatric Gastroenterology, Arak University of Medical Sciences, Arak, Iran
| | - Parsa Yousefichaijan
- Department of Pediatric Nephrology, Arak University of Medical Sciences, Arak, Iran
| | - Bahman Salehi
- Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Rafiei
- Department of Biostatistics, Arak University of Medical Sciences, Arak, Iran
| | - Sima Zahedi
- Student Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Esmaeil Khedmati Morasae
- Department of Health Services Research, National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC), Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, UK
| | - Fereshteh Maghsoudlou
- Student Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Al Shawi AF, Sarhan YT, Altaha MA. Adverse childhood experiences and their relationship to gender and depression among young adults in Iraq: a cross-sectional study. BMC Public Health 2019; 19:1687. [PMID: 31842837 PMCID: PMC6916082 DOI: 10.1186/s12889-019-7957-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022] Open
Abstract
Background Adverse childhood experiences (ACEs) are considered as universal public health problem that associate with mental disorders and risky behaviors during adulthood. The aims of the paper are to estimate the prevalence of Adverse childhood experiences (ACEs) among young adults in Iraq as well as to estimate the association between ACEs and depression. Methods A convenience sample of young adults of 18–20 years was chosen from centre and west of Iraq, mainly from universities. The adverse childhood experiences were measured by Adverse Childhood Experiences Questionnaire. A depression scale was derived from the Depression, Anxiety and Stress Scales (DASS). Statistical tests: chi square was used to measure the association between adverse childhood experiences and other variables like gender and depression. Odds ratios were computed to estimate the risk for depression. A P value of less than 0.05 was considered statistically significant. Results The total number of participants was 401, 38.9% of the subjects were men, while 61.1% were women. The mean age of the participants was 18.88 ± 0.745. The results revealed that the most common forms of ACEs among the subjects were physical neglect (19.8%) and emotional neglect (19.2%) followed by physical abuse (17.21%) while sexual abuse was 7.52%. There was statistically significant association between most forms of adverse childhood experiences especially emotional abuse, emotional neglect, physical abuse and physical neglect with depression. Conclusion ACEs are not uncommon among young adults in Iraq and are associated with depression in adulthood. National programmes to support mental health rehabilitation might be necessary to reduce the effect of ACEs among Iraqi people, especially for adolescents and young adults.
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Affiliation(s)
- Ameel F Al Shawi
- Department of Community & Family Medicine, College of Medicine, University of Fallujah, Fallujah, Iraq.
| | - Yassen T Sarhan
- Department of Community & Family Medicine, College of Medicine, Anbar University, Ramadi, Iraq
| | - Mahasin A Altaha
- Department of Community & Family Medicine, College of Medicine, Anbar University, Ramadi, Iraq
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Kim S, Watt T, Ceballos N, Sharma S. Adverse childhood experiences and neuroinflammatory biomarkers-The role of sex. Stress Health 2019; 35:432-440. [PMID: 31099473 DOI: 10.1002/smi.2871] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/12/2019] [Accepted: 05/07/2019] [Indexed: 12/20/2022]
Abstract
Despite the growing interest in adverse childhood experiences and biomarkers, less attention has been paid to multiple biomarkers as representing interrelated systems among college students. Guided by the neuroinflammatory pathway hypothesis, the current project takes the initial step in examining the link between three types of childhood adversity and biomarkers of neuroplasticity (brain-derived neurotropic factor [BDNF]) and low-grade inflammation (C-reactive protein [CRP]) in an overarching model and whether this link may differ in men and women. Undergraduate students (n = 85) were recruited through multiple departments from a state university. The participants responded to the detailed online survey questionnaire on childhood adversity and provided one blood sample via venous blood draw. Given that CRP and BDNF represent two interrelated systems, structural equation models were considered the most suitable for the analyses. The findings partially support neural and inflammatory pathways, such that childhood adversity and particularly family dysfunction have a significant positive effect on BDNF (b = 30.41, p < .01). The link between family dysfunction and CRP was stronger in female students (b = 0.57, p < .05). Results suggest that interventions for college students with family dysfunctions may need to target different physiological and behavioral outcomes for male and female students.
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Affiliation(s)
- Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos, Texas
| | - Toni Watt
- Department of Sociology, Texas State University, San Marcos, Texas
| | - Natalie Ceballos
- Department of Psychology, Texas State University, San Marcos, Texas
| | - Shobhit Sharma
- Department of Biology, Texas State University, San Marcos, Texas
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El Mhamdi S, Lemieux A, Abroug H, Ben Salah A, Bouanene I, Ben Salem K, al'Absi M. Childhood exposure to violence is associated with risk for mental disorders and adult's weight status: a community-based study in Tunisia. J Public Health (Oxf) 2019; 41:502-510. [PMID: 30137394 DOI: 10.1093/pubmed/fdy149] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/30/2018] [Accepted: 08/03/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We sought to investigate the relationship between social violence and adult overweight/obesity and the role of common mental disorders (CMD) in mediating this relationship. METHODS A cross-sectional study was conducted from January to June 2016 in Tunisia. Participants were selected from randomly selected Primary Health Care Centers. The Arabic version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used. RESULTS A total of 2120 participants were included. Women exposed to social ACEs had higher rates of overweight/obesity than men (13.5 versus 9.5%; P = 0.004). For women, statistically significant partial mediation effects of CMD were observed for exposure to community violence (% mediated = 17.7%). For men, partial mediation was found for the exposure to peer violence (% mediated = 12.5%). CONCLUSION Our results provide evidence of the independent increase of overweight/obesity after exposure to social ACEs. Efforts to uncover and address underlying trauma in health care settings may increase the effectiveness of obesity interventions.
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Affiliation(s)
- Sana El Mhamdi
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia, Tunisia.,Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir,Tunisia.,Research Laboratory, 'Epidemiology Applied to Maternal and Child Health', Tunisia
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Hela Abroug
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir,Tunisia
| | - Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir,Tunisia.,Research Laboratory, 'Epidemiology Applied to Maternal and Child Health', Tunisia
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir,Tunisia.,Research Laboratory, 'Epidemiology Applied to Maternal and Child Health', Tunisia
| | - Kamel Ben Salem
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia, Tunisia.,Department of Community Medicine, Faculty of Medicine, University of Monastir, Monastir,Tunisia
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
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Abstract
Iraq has suffered 40 years of continual conflict, with large-scale traumatic events including successive wars, economic sanctions, sectarian conflict, terrorism, and organized crime. Population health and the health systems and other services and infrastructure that support a population's health usually suffer severe consequences in conflict-affect countries and Iraq has been no exception. In this article we aim to provide a historical narrative of the four decades of successive wars in Iraq and present some of the consequences of this particular situation of persistent violence and how it has reflected on the health status of the Iraqi people, as indicated by increasing morbidity, mortality, injuries, mental health problems and displacement. Continutation of the current situation of insecurity is anathema for health as war and health can never be compatible, it is a choice between war or health.
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Affiliation(s)
- Riyadh K Lafta
- Department of Family and Community Medicine, College of Medicine, Mustansiriya University, Baghdad, Iraq
| | - Maha A Al-Nuaimi
- Department of Family and Community Medicine, College of Medicine, Mustansiriya University, Baghdad, Iraq
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Kidman R, Smith D, Piccolo LR, Kohler HP. Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents. CHILD ABUSE & NEGLECT 2019; 92:139-145. [PMID: 30974257 PMCID: PMC6513701 DOI: 10.1016/j.chiabu.2019.03.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). OBJECTIVE In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. PARTICIPANTS AND SETTING Four hundred and ten adolescents (age 10-16 years old) from Malawi. METHODS The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). RESULTS Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01). CONCLUSION Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States.
| | - Dylan Smith
- Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States
| | - Luciane R Piccolo
- Program in Public Health, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States
| | - Hans-Peter Kohler
- Department of Sociology and Population Studies Center, University of Pennsylvania, 3718 Locust Walk (272 McNeil Building), Philadelphia, PA 19104-6298, United States
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El Mhamdi S, Lemieux A, Ben Salah A, Bouanene I, Ben Salem K, al'Absi M. Exposure to community and collective violence during childhood and tobacco use patterns among young adults in Tunisia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:935-945. [PMID: 30047613 DOI: 10.1111/hsc.12623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/30/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
Accumulating evidence demonstrates that experiencing intrafamilial adversities (abuse, neglect and household dysfunction) during childhood is linked to addictive behaviours. However, the impact of social adversities (peer, community and collective violence) as well as gender, on tobacco initiation and dependence has received much less attention. The aim of this study was to examine the relationships between social childhood adversities and tobacco use patterns by gender among young adults in Tunisia. We performed a cross-sectional study from May to December, 2014 on 1,200 respondents using the validated Arabic version of the World Health Organization Adverse Childhood Experiences-International questionnaire (WHO ACE-IQ). Data on smoking characteristics among current smokers were also collected. Data analysis was performed using logistic and linear regression models. The rate of current tobacco use was significantly higher for males (43.9%) than for females (9.3%). Female and male respondents differed significantly on almost every examined adversity. Males were more likely to have experienced all types of social violence than females. The odds of tobacco use were significantly higher regardless the mental health status and the occurrence of intrafamilial early life adversity for both genders. Smokers exposed to social violence during childhood had a strong association between nicotine dependence and the overall burden of adversity. That is, 74 and 58% of nicotine dependence was explained by the number of childhood social adversities in females and males respectively. The findings underscore the role of community and collective violence in addictive behaviours among young adults. Multisectorial and population-based strategies are needed to minimise the occurrence of social early life adversity and related tobacco patterns.
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Affiliation(s)
- Sana El Mhamdi
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia, Tunisia
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
| | - Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Kamel Ben Salem
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
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Meinck F, Cosma AP, Mikton C, Baban A. Psychometric properties of the Adverse Childhood Experiences Abuse Short Form (ACE-ASF) among Romanian high school students. CHILD ABUSE & NEGLECT 2017; 72:326-337. [PMID: 28869880 DOI: 10.1016/j.chiabu.2017.08.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 05/12/2023]
Abstract
Child abuse is a major public health problem. In order to establish the prevalence of abuse exposure among children, measures need to be age-appropriate, sensitive, reliable and valid. This study aimed to investigate the psychometric properties of the Adverse Childhood Experiences Questionnaire Abuse Short Form (ACE-ASF). The ACE-ASF is an 8-item, retrospective self-report questionnaire measuring lifetime physical, emotional and sexual abuse. Data from a nationally representative sample of 15-year-old, school-going adolescents (n=1733, 55.5% female) from the Romanian Health Behavior in School-Based Children Study 2014 (HBSC) were analyzed. The factorial structure of the ACE-ASF was tested with Exploratory Factor Analysis (EFA) and confirmed using Confirmatory Factor Analysis (CFA). Measurement invariance was examined across sex, and internal reliability and concurrent criterion validity were established. Violence exposure was high: 39.7% physical, 32.2% emotional and 13.1% sexual abuse. EFA established a two-factor structure: physical/emotional abuse and sexual abuse. CFA confirmed this model fitted the data well [χ2(df)=60.526(19); RMSEA=0.036; CFI/TLI=0.990/0.986]. Metric invariance was supported across sexes. Internal consistency was good (0.83) for the sexual abuse scale and poor (0.57) for the physical/emotional abuse scale. Concurrent criterion validity confirmed hypothesized relationships between childhood abuse and health-related quality of life, life satisfaction, self-perceived health, bullying victimization and perpetration, externalizing and internalizing behaviors, and multiple health complaints. Results support the ACE-ASF as a valid measure of physical, emotional and sexual abuse in school-aged adolescents. However, the ACE-ASF combines spanking with other types of physical abuse when this should be assessed separately instead. Future research is needed to replicate findings in different youth populations and across age groups.
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Affiliation(s)
- Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, United Kingdom; OPTENTIA, School of Behavioural Sciences, North-West University, 1174 Hendrick Van Eck Boulevard, 1900 Vanderbeijlpark, South Africa.
| | - Alina Paula Cosma
- School of Medicine, University of St. Andrews, Medical & Biological Sciences, North Hough, St. Andrews, Fife, KY16 9TF, United Kingdom.
| | - Christopher Mikton
- Department of Health and Social Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, United Kingdom.
| | - Adriana Baban
- Department of Psychology, Babes Bolyai University, 37 Republicii, 400015 Cluj Napoca, Romania.
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Franchek-Roa KM, Tiwari A, Connor ALO, Campbell J. Impact of Childhood Exposure to Intimate Partner Violence and Other Adversities. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.3.156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
| | - Agnes Tiwari
- Li Ka Shing Faculty of Medicine, The University of Hong Kong School of Nursing, Hong Kong, China
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El Mhamdi S, Lemieux A, Bouanene I, Ben Salah A, Nakajima M, Ben Salem K, al'Absi M. Gender differences in adverse childhood experiences, collective violence, and the risk for addictive behaviors among university students in Tunisia. Prev Med 2017; 99:99-104. [PMID: 28216378 DOI: 10.1016/j.ypmed.2017.02.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/04/2023]
Abstract
Adverse childhood experiences (ACE) have been linked to a variety of addictive behaviors. The recent adaptation of the ACE measure by the World Health Organization (WHO) allows for the assessment of the negative role of additional adverse experiences, such as extra-familial violence. To date, the relationship between extra-familial violence and addictive behaviors has not been assessed. We report the contribution of ACEs, including the new scales for extra-familial violence, on the risk for mental health problems and addictive behaviors by gender in a sample of young adults in Tunisia. We conducted a cross sectional study in Tunisia during 2014, where we recruited 1200 young university adults who completed the validated Arabic version of the WHO ACE questionnaire in a university setting. Results indicated that intra-familial adversities were associated with increased risk for addictive behaviors, particularly in males. ACEs were also associated with increased risk for mental health problems with women showing more difficulties than men. Exposure to peer, community and collective violence was higher in males than in females and logistic regression confirms that exposure to extra-familial violence increased the risk for addictive behaviors both in male and females by two to three-fold. Mental health problems were associated with peer violence and substance abuse in males, but not in females. Results demonstrate for the first time the contribution of exposure to extra-familial violence on risk for addictive behaviors. Results highlight the need for addressing mental health and addiction in a community with high burden of adversity and violence.
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Affiliation(s)
- Sana El Mhamdi
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia.
| | - Andrine Lemieux
- Duluth Global Health Institute, University of Minnesota, USA
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | - Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | | | - Kamel Ben Salem
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "12SP17", Tunisia
| | - Mustafa al'Absi
- Duluth Global Health Institute, University of Minnesota, USA
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