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Broekhof R, Nordahl HM, Eikenæs IUM, Selvik SG. Adverse Childhood Experiences Are Associated With Personality Disorder: A Prospective, Longitudinal Study. J Pers Disord 2024; 38:19-33. [PMID: 38324247 DOI: 10.1521/pedi.2024.38.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
There is a lack of studies that have prospectively examined adverse childhood experiences (ACEs) in association with a personality disorder (PD). Data from a sample of 8,199 adolescents first assessed for ACEs were linked with subsequent data from the Norwegian Patient Register in order to obtain diagnoses of a PD in adulthood (after a 14-year follow-up). We used logistic regression analysis. Any type of ACE gave a 3.8-fold higher risk of developing a PD. Abuse, more specifically emotional abuse, came out as one of the strongest predictors. Of the adolescents who developed a PD, approximately 90% had a history of ACE. The results of this study support the importance of assessing ACEs, such as abuse, neglect, and household dysfunction, in the diagnostic procedure and treatment for PD.
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Affiliation(s)
| | - Hans M Nordahl
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs University Hospital, Østmarka, Trondheim, Norway
| | - Ingeborg Ulltveit-Moe Eikenæs
- National Advisory Unit for Personality Psychiatry (NAPP), Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Oslo, Norway
| | - Sara G Selvik
- Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
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2
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Yoon Y, Cederbaum JA, Duan L, Lee JO. Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring. Child Maltreat 2023:10775595231200145. [PMID: 37669686 DOI: 10.1177/10775595231200145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.
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Affiliation(s)
- Yoewon Yoon
- Department of Social Welfare, Dongguk University, Seoul, South Korea
| | - Julie A Cederbaum
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Lei Duan
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Amos RLM, Cresswell K, Hughes K, Bellis MA. ACEtimation-The Combined Effect of Adverse Childhood Experiences on Violence, Health-Harming Behaviors, and Mental Ill-Health: Findings across England and Wales. Int J Environ Res Public Health 2023; 20:6633. [PMID: 37681773 PMCID: PMC10487644 DOI: 10.3390/ijerph20176633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health. Data were from eight cross-sectional surveys conducted in England and Wales between 2012 and 2022. The sample included 21,716 adults aged 18-69 years; 56.6% were female. Exposure to child maltreatment and household dysfunction in isolation were strong predictors of variant outcomes, whereas witnessing violence was not. However, additive models showed that witnessing violence amplified the measured risk beyond expected levels for being a victim or perpetrator of violence. The multiplicative effect of all three ACE categories demonstrated the highest level of risk (RRs from 1.7 to 7.4). Given the increased risk associated with co-occurring ACEs, it is crucial to target individuals exposed to any ACE category to prevent their exposure to additional harm. Implementing universal interventions that safeguard children from physical, emotional, and sexual violence is likely to mitigate a range of subsequent issues, including future involvement in violence.
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Affiliation(s)
| | - Katie Cresswell
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
| | - Karen Hughes
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
| | - Mark A. Bellis
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
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4
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Van der Feltz-Cornelis CM, de Beurs E. The 10-item Adverse Childhood Experience International Questionnaire (ACE-IQ-10): psychometric properties of the Dutch version in two clinical samples. Eur J Psychotraumatol 2023; 14:2216623. [PMID: 37318018 DOI: 10.1080/20008066.2023.2216623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Childhood trauma has been associated with adult mental disorders, physical illness, and early death. The World Health Organization (WHO) supported the development of the Adverse Childhood Experiences International Questionnaire (ACE-IQ) to explore childhood trauma in adults. We report the psychometric properties of the Dutch version of the Adverse Childhood Experiences International Questionnaire 10 items version (ACE-IQ-10) in the Netherlands. METHODS Confirmatory factor analysis was performed in two convenience samples of consecutive patients presenting at an outpatient specialty mental health setting between May 2015 and September 2018: Sample A (N = 298), patients with anxiety and depressive disorders; and sample B (N = 234), patients with Somatic Symptom and Related Disorders (SSRD). Criterion validity of the scales of the ACE-IQ-10 was explored by their correlation with the PHQ-9, the GAD-7, and the SF-36. The correlation between reporting sexual abuse on the ACE-IQ-10 and in a face-to-face interview was assessed as well. RESULTS We found support for a two-factor structure in both samples: one for directly experiencing childhood abuse and another for household dysfunction, but also support for using the total score. The correlation between reporting a sexual trauma in childhood at face-to-face interview and the sexual abuse item of the ACE-IQ-10 was r = .98 (p < .001). CONCLUSIONS The current study provides evidence on the factor structure, reliability, and validity of the Dutch ACE-IQ-10 in two Dutch clinical samples. It shows clear potential of the ACE-IQ-10 for further research and clinical use. Further studies are needed to assess the ACE-IQ-10 in the Dutch general population.
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Affiliation(s)
- Christina M Van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
- York Biomedical Research Institute (YBRI), University of York, York, UK
- Institute of Health Informatics, University College London, London, UK
| | - Edwin de Beurs
- Social and Behavioral Sciences, Psychology Department, Leiden University, Leiden, the Netherlands
- Arkin GGZ, Amsterdam, the Netherlands
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Albers LD, Grigsby TJ, Benjamin SM, Rogers CJ, Unger JB, Forster M. Adverse childhood experiences and sleep difficulties among young adult college students. J Sleep Res 2022; 31:e13595. [PMID: 35366024 PMCID: PMC9788170 DOI: 10.1111/jsr.13595] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/06/2022] [Accepted: 03/06/2022] [Indexed: 12/30/2022]
Abstract
Although adverse childhood experiences (traumatic events such as maltreatment and household dysfunction) are associated with increased risk for sleep difficulties among adults, the association between adverse childhood experiences and poor sleep health among young adult college populations is understudied. This study examined the adverse childhood experience-sleep health (self-reported sleep difficulty and diagnosis of insomnia or "other" sleep disorder) association among college students. Data are from the 2018/2019 American College Health Association-National College Health Assessment II (ACHA-NCHA-II) survey administered at public universities in California (n = 3606) and Texas (n = 407). Logistic regression models investigated the relative effect of adverse childhood experiences (maltreatment only, household dysfunction only, and maltreatment + household dysfunction) on three sleep health indicators. Approximately 40% of the sample reported adverse childhood experiences: 11% maltreatment only, 14% household dysfunction only, and 17% both. Compared with students with no adverse childhood experience history, students who reported only household dysfunction or only maltreatment had higher odds of experiencing sleep difficulty in the past year [adjusted odds ratios: 1.52-2.40; 95% confidence intervals: 1.26-2.97]. Additionally, students who reported maltreatment only had 2.47 times the odds of receiving an insomnia diagnosis [95% confidence interval: 1.52, 4.01]. However, students who reported both had higher odds of all three sleep health indicators: past-year sleep difficulty, insomnia diagnosis, and "other" sleep disorder diagnosis [adjusted odds ratios: 2.53-3.10; 95% confidence intervals: 1.51-4.66]. Sleep is an important facet of health among the college student population, and plays a crucial role in overall well-being, psychosocial processes, attention and academic success. Results point toward a need for sleep health programmes and interventions on college campuses focused on healthy sleep behaviours in order to mitigate further negative health effects.
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Affiliation(s)
- Larisa D. Albers
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Timothy J. Grigsby
- Department of Social and Behavioral HealthUniversity of NevadaLas VegasUSA
| | | | - Christopher J. Rogers
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jennifer B. Unger
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Myriam Forster
- Department of Health SciencesCalifornia State UniversityNorthridgeCaliforniaUSA
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Corona K, Chavez T, Stewart K, Toledo-Corral CM, Farzan SF, Habre R, Grubbs B, Al-Marayati L, Lurvey N, Lerner D, Eckel SP, Lagomasino I, Breton CV, Bastain TM. Adverse childhood experiences and prenatal depression in the maternal and development risks from environmental and social stressors pregnancy cohort. J OBSTET GYNAECOL 2022; 42:3014-3020. [PMID: 36178435 PMCID: PMC9851371 DOI: 10.1080/01443615.2022.2125298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The aim of this study was to examine the association between adverse childhood experiences (ACEs) and risk for depression among 480 predominantly low-income Hispanic/Latina women in the Maternal and Development Risks from Environmental and Social Stressors pregnancy cohort. Models were fitted to evaluate associations between ACEs and prenatal probable depression measured by the Center for Epidemiologic Studies-Depression Scale adjusting for recruitment site, age, income, race/ethnicity, marital status and parity. The ACEs Questionnaire parameterised experiences as counts (0-10), categories (0, 1-3 and 4+ ACEs) and domains. Participants had a significantly higher likelihood of prenatal probable depression per unit increase in ACEs count or if they reported 4+ ACEs relative to 0 ACEs. Higher likelihood of probable depression was also associated with higher counts of each ACEs domains: abuse, neglect and household dysfunction. Findings suggest systematic screening for depressive symptoms in those with a history of childhood adversities may be important in prenatal care practice.Impact StatementWhat is already known on this subject? Experiencing depression during pregnancy has been associated with later adverse maternal mental and physical health outcomes. Emerging studies indicate that adverse childhood experiences (ACEs) may maintain or increase the predisposition to prenatal depression.What do the results of this study add? Although prenatal depressive symptoms are prevalent among racial/ethnic minority samples including Hispanic/Latinas, research determining whether the association between ACEs and prenatal depression varies by nativity is scarce. Overall, ACEs were common among Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) participants and were associated with a higher likelihood of probable depression during pregnancy. These patterns did not significantly differ among the foreign-born versus U.S.-born Hispanic/Latina women, although the associations were stronger among U.S.-born Hispanic/Latina women.What are the implications of these findings for clinical practice and/or further research? Research should continue to focus on the effects of ACEs in communities that have been historically excluded in perinatal mental health services such as pregnant women from racial and ethnic minority groups. It may be important for clinicians to routinely screen for mental health during pregnancy as an adverse, psychological environment may impact both women and children. These findings suggest a need for improvement in systematic screening for depressive symptoms in those with a history of childhood adversities.
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Affiliation(s)
- Karina Corona
- Department of Population and Public Health Sciences, University of Southern California
| | - Thomas Chavez
- Department of Population and Public Health Sciences, University of Southern California
| | - Kennedy Stewart
- Department of Health Sciences, California State University, Northridge
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, University of Southern California
- Department of Health Sciences, California State University, Northridge
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, University of Southern California
| | - Rima Habre
- Department of Population and Public Health Sciences, University of Southern California
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, University of Southern California
| | | | | | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, University of Southern California
| | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, University of Southern California
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, University of Southern California
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Camacho S, Clark Henderson S. The Social Determinants of Adverse Childhood Experiences: An Intersectional Analysis of Place, Access to Resources, and Compounding Effects. Int J Environ Res Public Health 2022; 19:10670. [PMID: 36078386 PMCID: PMC9518506 DOI: 10.3390/ijerph191710670] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Children across all races/ethnicities and income levels experience adverse childhood experiences (ACEs); however, historically excluded children and families must contend with added adversities across ecological levels and within higher-risk conditions due to systemic inequality. In this grounded theory study, the authors examined how health and social service providers (N = 81) from rural and urban counties in Tennessee provided services to low-income families, children exposed to opioids, and children of immigrants. Guided by an intersectional framework, the authors examined how rural and urban settings shaped higher risk conditions for ACEs and impeded access to resources at the individual, group, and community levels. Findings from this study identified additionally marginalized subpopulations and demonstrated how inequitable environments intersect and compound the effects of ACEs. The authors present their Intersectional Nature of ACEs Framework to showcase the relationship between high-risk conditions and sociopolitical and economic circumstances that can worsen the effects of ACEs. Ultimately, the Intersectional Nature of Aces Framework differentiates between ACEs that are consequences of social inequities and ACEs that are inflicted directly by a person. This framework better equips ACEs scholars, policymakers, and stakeholders to address the root causes of inequality and mitigate the effects of ACEs among historically excluded populations.
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Affiliation(s)
- Sayil Camacho
- Equity Research Cooperative, 2929 Arch Street Suite 1700-#3207, Philadelphia, PA 19104, USA
| | - Sarah Clark Henderson
- Department of Health Policy, Vanderbilt University School of Medicine, 1211 Medical Center Drive, Nashville, TN 37232, USA
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8
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Fraga S, Soares S, Peres FS, Barros H. Household Dysfunction Is Associated With Bullying Behavior in 10-year-old Children: Do Socioeconomic Circumstances Matter? J Interpers Violence 2022; 37:NP13877-NP13901. [PMID: 34784812 PMCID: PMC9326806 DOI: 10.1177/08862605211006352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study measured the prevalence of bullying behavior in 10-year-old children and investigated the effect of the socioeconomic context on the impact of household dysfunction on bullying. We studied 5,338 members of the Portuguese Generation XXI birth cohort. Information on involvement in bullying, socioeconomic characteristics, and household dysfunction was collected by trained interviewers using structured questionnaires. Being a victim of bullying was reported by 14.4% of participants, being a bully by 1.4%, and being a bully-victim by 3.9%. Being a victim or both bully-victim, simultaneously, was more frequent among children from medium-high income families. Also, children from low-income families who reported household substance abuse, witnessed parents' intimate partner violence, and were victims of physical violence, were more frequently victims of bullying; and those who experienced family violence were more frequently involved as bully-victims. Among children from medium-high income families, all these household adversity experiences significantly increased the odds of being victim, bully, or bully-victim. Thus, although children from medium-high income families are less likely to experience adversity at home, when it happens, there is a greater effect on their behavior, suggesting that better socioeconomic circumstances do not seem to act as a protective factor.
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Affiliation(s)
- Sílvia Fraga
- EPIUnit - Instituto de Saúde Pública
da Universidade do Porto, Portugal
| | - Sara Soares
- EPIUnit - Instituto de Saúde Pública
da Universidade do Porto, Portugal
| | | | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública
da Universidade do Porto, Portugal
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Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. Int J Environ Res Public Health 2022; 19:668. [PMID: 35055490 PMCID: PMC8775782 DOI: 10.3390/ijerph19020668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.
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Affiliation(s)
- Ingyu Moon
- School of Social Work, Nyack College, New York, NY 10004, USA
| | - Junghee Han
- Department of Social Work, University of Southern Indiana, Evansville, IN 47712, USA;
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10
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Abstract
Batterer intervention programs' (BIPs) curriculum have been criticized for their one-size-fits-all approach to rehabilitation with recent research suggesting specialized and client-centric approaches to batterer intervention may be more effective than traditional programming. Adverse childhood experiences (ACEs) have been examined as a risk factor for intimate partner violence (IPV) perpetration and numerous studies suggest a relationship between ACEs and low mental health treatment engagement. However, absent from the conversation is how ACEs may influence BIP treatment engagement and more specifically how ACEs influence BIP program attendance and attrition. The current study used administrative data from a sample of 268 men enrolled in a county-operated BIP to explore this question. BIP participants who experienced any ACEs, only household dysfunction ACEs, and/or both household dysfunction ACEs and child abuse/neglect ACEs had decreased odds of BIP attrition compared to participants with no ACEs. These findings have practical implications regarding screening, service delivery, and BIP curricula and highlight additional research needed on this topic.
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Affiliation(s)
- Mary Ann Priester
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Shanti Kulkarni
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Annelise Mennicke
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Bethany A Bell
- College of Social Work, University of South Carolina, Columbia, South Carolina
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Westermair AL, Stoll AM, Greggersen W, Kahl KG, Hüppe M, Schweiger U. All Unhappy Childhoods Are Unhappy in Their Own Way-Differential Impact of Dimensions of Adverse Childhood Experiences on Adult Mental Health and Health Behavior. Front Psychiatry 2018; 9:198. [PMID: 29875707 PMCID: PMC5974933 DOI: 10.3389/fpsyt.2018.00198] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/30/2018] [Indexed: 12/16/2022] Open
Abstract
Adverse childhood experiences have consistently been linked with poor mental and somatic health in adulthood. However, due to methodological restraints of the main lines of research using cumulative or selective models, little is known about the differential impact of different dimensions of adverse childhood experiences. Therefore, we gathered data from 396 psychiatric in-patients on the Adverse Childhood Experiences (ACE) questionnaire, extracted dimensions using factor analysis and compared this dimensional model of adverse childhood experiences to cumulative and selective models. Household Dysfunction (violence against the mother, parental divorce, substance abuse or incarceration of a household member) was associated with poor health behaviors (smoking, alcohol dependency and obesity as proxy marker for an imbalance between energy intake and physical activity) and with poorer socio-economic achievement (lower education and income) in adulthood. The previously reported associations of maltreatment and sexual abuse with these outcome criteria could not be corroborated. Both Maltreatment (emotional and physical neglect and abuse) and Sexual Abuse predicted BPD, PTSD and suicidal behavior. However, the two ACE dimensions showed sufficiently divergent validity to warrant separate consideration in future studies: Maltreatment was associated with affective and anxiety disorders such as social phobia, panic disorder and major depressive disorder, whereas Sexual Abuse was associated with dysregulation of bodily sensations such as pain intensity and hunger/satiation. Also, we found both quantitative and qualitative evidence for the superiority of the dimensional approach to exploring the consequences of adverse childhood experiences in comparison to the cumulative and selective approaches.
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Affiliation(s)
- Anna L. Westermair
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
| | - Anne M. Stoll
- Department of Internal Medicine I, University of LübeckLübeck, Germany
| | - Wiebke Greggersen
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Michael Hüppe
- Department of Anesthesiology and Intensive Care, University of LübeckLübeck, Germany
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
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12
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Abstract
Studies of adverse childhood experiences (ACEs) have gauged severity using a cumulative risk (CR) index. Few studies have focused on the nature of the context of adversity and their association with psychosocial outcomes. The objective of this study was to examine the patterning of ACEs and to explore the resultant patterns' association with HIV risk-taking, problem drinking, and depressive symptoms in adulthood. Latent class analysis (LCA) was used to identify homogeneous, mutually exclusive "classes" of 11 of the most commonly used ACEs. The LCA resulted in four high-risk profiles and one low-risk profile, which were labeled: (1) highly abusive and dysfunctional (3.3%; n = 1,983), (2) emotionally abusive alcoholic with parental conflict (6%, n = 3,303), (3) sexual abuse only (4.3%, n = 2,260), (4) emotionally abusive and alcoholic (30.3%, n = 17,460), and (5) normative, low risk (56.3%, n = 32,950). Compared to the low-risk class, each high-risk profile was differentially associated with adult psychosocial outcomes even when the conditional CR within that class was similar. The results further our understanding about the pattern of ACEs and the unique pathways to poor health. Implications for child welfare systems when dealing with individuals who have experienced multiple forms of early childhood maltreatment and/or household dysfunction are discussed.
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Affiliation(s)
- Gia Elise Barboza
- 1 College of Social Science and Humanities, Northeastern University, Boston, MA, USA
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13
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Li L, Denholm R, Power C. Child maltreatment and household dysfunction: associations with pubertal development in a British birth cohort. Int J Epidemiol 2014; 43:1163-73. [PMID: 24706731 DOI: 10.1093/ije/dyu071] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We aimed to establish the association between adverse childhood experiences (maltreatment and household dysfunction) and pubertal maturation, which is associated with later health outcome(s). METHODS The 1958 British birth cohort (n = 17 638) includes all born in one week, March 1958, followed up to mid adulthood. Pubertal stage was rated by medical personnel at 11 and 16 years of age (y). Childhood maltreatment (neglect or abuse) and household dysfunction scores were constructed from information ascertained in childhood and at 45 y. RESULTS Childhood neglect, assessed at 7 y, was associated with late pubertal development on several markers after adjusting for early life circumstances: relative risk ratio (RRRadjusted) was 1.13 (95% CI: 1.06,1.21) and 1.06 (1.00,1.12) for late menarche and breast development (females) per unit increase in neglect score ranging 0-7, respectively; 1.14 (1.08,1.20) for late voice change and 1.07 (1.02,1.13) for pubic hair growth (males). The RRRadjusted for late pubic hair (females) and genitalia and facial hair (males) development was 1.04 (P = 0.052 to 0.085). Abuse score (0-3, for physical, sexual or psychological abuse) was associated in females with late menarche [RRRadjusted = 1.17 (1.01,1.36)] and in males with late pubic hair growth [RRRadjusted = 1.16 (1.01,1.34)] per unit increase, but not with other pubertal markers. Neither score (neglect or abuse) was associated with early puberty, but sexual abuse was associated with early [RRRadjusted = 1.86 (1.06,3.29)] as well as late menarche [RRRadjusted = 1.66 (1.02,2.71)] and witnessing abuse with early genitalia development [RRRadjusted = 1.57 (1.02,2.41)]. Household dysfunction score was not associated consistently with pubertal markers. CONCLUSIONS Cumulative neglect by 7 y was associated with delayed development of several pubertal markers. The underlying role of pubertal development in linking childhood neglect with future adult health warrants further consideration.
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Affiliation(s)
- Leah Li
- MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London
| | - Rachel Denholm
- MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London
| | - Chris Power
- MRC Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London
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