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Zhang Y, Coid J. Childhood Adversity Determines the Syndemic Effects of Violence, Substance Misuse, and Sexual Behavior on Psychotic Spectrum Disorder Among Men. Schizophr Bull 2024; 50:684-694. [PMID: 38019938 PMCID: PMC11059794 DOI: 10.1093/schbul/sbad165] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND AND HYPOTHESIS Childhood adversity (CA) increases the risk for several adult psychiatric conditions. It is unclear why some exposed individuals experience psychotic symptoms and others do not. We investigated whether a syndemic explained a psychotic outcome determined by CA. STUDY DESIGN We used self-reported cross-sectional data from 7461 British men surveyed in different population subgroups. Latent class analysis (LCA) identified categorical psychopathological outcomes. LCs were tested by interaction analysis between syndemic factors derived from confirmatory factor analysis according to CA experiences. Pathway analysis using partial least squares path modeling. RESULTS A 4-class model with excellent fit identified an LC characterized by both psychotic and anxiety symptoms (class 4). A syndemic model of joint effects, adducing a 3-component latent variable of substance misuse (SM), high-risk sexual behavior (SH), violence and criminality (VC) showed synergy between components and explained the psychotic outcome (class 4). We found significant interactions between factor scores on the multiplicative scale, specific only to class 4 (psychosis), including SM × SH, SH × VC, and SM × VC (OR > 1, P < .05); and on the additive scale SM × SH (relative excess risk due to interaction >0, P < .05), but only for men who experienced CA. CONCLUSION Multiplicative synergistic interactions between SM, SH, and VC constituted a mechanism determining a psychotic outcome, but not for anxiety disorder, mixed anxiety disorder/depression, or depressive disorder. This was specific to men who had experienced CA along direct and syndemic pathways. Population interventions should target SM and VC in adulthood but prioritize primary prevention strategies for CA.
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Affiliation(s)
- Yamin Zhang
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Major Ppsychiatric Ddisorder Workgroup, Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
| | - Jeremy Coid
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Ye X, Zhu D, He P. The Long-Term Impact of Adversity in Adolescence on Health in Middle and Older Adulthood: A Natural Experiment From the Chinese Send-Down Movement. Am J Epidemiol 2021; 190:1306-1315. [PMID: 33576372 DOI: 10.1093/aje/kwab035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/27/2022] Open
Abstract
The 1950s-1970s Chinese send-down movement can be treated as a natural experiment to study the impact of adolescent exposure on subsequent health. This paper used data from the China Family Panel Studies 2010 to evaluate the long-term impact of the Chinese send-down movement on individual health later in life. Drawing from the life-course perspective, results from difference-in-differences models suggested that the send-down experience had a significant impact on worse self-rated health; the pathways from structural equation models showed that subsequent achievements-age of marriage and educational attainment-had mediating effects linking the send-down experience to worse self-rated health and better mental health, respectively. Taken together, our results highlight the roles of the send-down experience and post-send-down characteristics in shaping health outcomes later in life.
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Guina J, Audu AK, Cameron J, Lemmen A, Mamidipaka A, Kletzka N. Prevalence of Traumas and PTSD Among Individuals Adjudicated Not Guilty by Reason of Insanity. J Am Acad Psychiatry Law 2021; 49:194-201. [PMID: 33579733 DOI: 10.29158/jaapl.200062-20] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Trauma and posttraumatic stress disorder (PTSD) are common among psychiatric and criminal populations, yet there have been few studies among forensic psychiatric populations and no known studies have specifically examined insanity acquittees. This study aimed to identify the prevalence of trauma and to assess recognition of PTSD in forensic settings. Using a cross-sectional self-report survey methodology, we examined traumas, adverse childhood experiences (ACEs), and PTSD in insanity acquittees (n = 107). Most insanity acquittees experienced trauma (86%, averaging 11 events) and ACEs (76%, averaging 3 types). The most commonly experienced traumas were sudden death of a loved one, witnessed death or serious injury, adult physical assault, and motor vehicle accident. Women were significantly more likely to experience any ACE (especially witnessing domestic violence, household members with mental illness, emotional abuse, and emotional neglect) and adult sexual assault. PTSD prevalence was 25 percent, with 97 percent of cases being previously undiagnosed. Sexual traumas and younger age were significantly associated with PTSD. These results suggest that insanity acquittees have high levels of trauma, ACEs, and PTSD. While PTSD was about seven times more common than in previous findings in the general population, it frequently goes undiagnosed in forensic settings. Potential explanations and implications of our findings are discussed.
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Affiliation(s)
- Jeffrey Guina
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI.
| | - Alexandra K Audu
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI
| | - James Cameron
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI
| | - Andrew Lemmen
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI
| | - Anusha Mamidipaka
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI
| | - Nicole Kletzka
- Dr. Guina is Chief Medical Officer, Easterseals Michigan, Auburn Hills, MI, and Psychiatry Residency Program Director, Beaumont Health, Royal Oak, MI. Dr. Audu is a senior resident in psychiatry at the University of Michigan, Ann Arbor, MI. Mr. Cameron is a child care worker at the Hawthorn Center, Northville, MI. Mr. Lemmen is an undergraduate at University of Michigan, Ann Arbor, MI. Ms. Mamidipaka is an undergraduate at Michigan State University, Lansing, MI. Dr. Kletzka is a Forensic Psychologist at the Center for Forensic Psychiatry, Saline, MI
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Thoma MV, Bernays F, Eising CM, Pfluger V, Rohner SL. Health, stress, and well-being in Swiss adult survivors of child welfare practices and child labor: Investigating the mediating role of socio-economic factors. Child Abuse Negl 2021; 111:104769. [PMID: 33160646 DOI: 10.1016/j.chiabu.2020.104769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 05/28/2020] [Revised: 08/24/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND With widespread deprivation in the education of minors affected by child welfare practices (CWP) in the last century, affected individuals often continued a life dominated by socio-economic disadvantage. According to life course theories, the impact of socio-economic disadvantage can accumulate across the life span, leading to worse health in later life. However, the scientific examination of health correlates of CWP in later life and the mediating role of socio-economic factors (SEF) has previously been neglected. OBJECTIVE This study examined whether Swiss survivors of CWP, including former Verdingkinder, have poorer health in later life compared to controls, and whether this association is mediated by socio-economic factors: education, income, satisfaction with financial situation, socio-economic status. PARTICIPANTS AND SETTING Two face-to-face interviews were conducted with N = 257 participants (risk group, RG, n = 132, MAGE = 70.83 years, 58 % male; control group, CG, n = 125, MAGE = 70.6 years, 49 % male). METHODS A broad set of physical health outcomes, stress, well-being, and SEF were assessed with psychometric instruments. RESULTS The RG reported more physical illnesses, vascular risk factors, health symptoms, stress, and lower well-being, compared to the CG. Mediation analyses revealed that SEF were relevant mediators for the significant health and stress disparities between groups. CONCLUSIONS Results suggest that SEF can play a crucial role in mitigating the negative effects and health impairments in individuals formerly affected by CWP. Public health services and policies that target these SEF could improve current welfare practices by providing opportunities to overcome early-life disadvantage and facilitating healthier life trajectories.
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Affiliation(s)
- Myriam V Thoma
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmühlestrasse 14/17, 8050, Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland.
| | - Florence Bernays
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmühlestrasse 14/17, 8050, Zürich, Switzerland
| | - Carla M Eising
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmühlestrasse 14/17, 8050, Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
| | - Viviane Pfluger
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmühlestrasse 14/17, 8050, Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
| | - Shauna L Rohner
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmühlestrasse 14/17, 8050, Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
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5
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Álvarez MJ, Masramom H, Foguet-Boreu Q, Tasa-Vinyals E, García-Eslava JS, Roura-Poch P, Escoté-Llobet S, Gonzalez A. Childhhood Trauma in Schizophrenia Spectrum Disorders: Dissociative, Psychotic Symptoms, and Suicide Behavior. J Nerv Ment Dis 2021; 209:40-48. [PMID: 33079796 DOI: 10.1097/nmd.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Current evidence suggests a high prevalence of childhood trauma (CT) among adult patients diagnosed with schizophrenia spectrum disorders. Exposure to CT might lead to clinical differences eventually observed in these patients. We present a cross-sectional study with 54 patients with schizophrenia spectrum disorder (schizophrenia and schizoaffective disorder). We obtained sociodemographic data, as well as data on CT, dissociation, suicide history, and intensity of positive and negative psychotic symptoms. More than 75% of the patients reported a history of CT. We observed a link between CT and suicidal behavior. Patients showed high rates of dissociation. Dissociative experiences were related to CT, both in terms of intensity of trauma and number of traumas experienced. All CT forms except emotional neglect showed direct correlations with dissociative experiences. We found no correlation between intensity of CT and intensity of positive psychotic symptoms, yet we observed a moderate inverse correlation with negative psychotic symptoms.
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Affiliation(s)
| | | | | | - Elisabet Tasa-Vinyals
- Department of Psychiatry and Mental Health, Osona Salut Mental, Consorci Hospitalari de Vic
| | | | | | - Santiago Escoté-Llobet
- Department of Psychiatry and Mental Health, Osona Salut Mental, Consorci Hospitalari de Vic
| | - Anabel Gonzalez
- Mental Health Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
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6
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Voith LA, Russell K, Lee H, Anderson RE. Adverse Childhood Experiences, Trauma Symptoms, Mindfulness, and Intimate Partner Violence: Therapeutic Implications for Marginalized Men. Fam Process 2020; 59:1588-1607. [PMID: 32134514 DOI: 10.1111/famp.12533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/10/2023]
Abstract
Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field's scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men's physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men's victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.
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Affiliation(s)
- Laura A Voith
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
| | - Katie Russell
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
| | - Hyunjune Lee
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
| | - RaeAnn E Anderson
- Department of Psychology, University of North Dakota, Grand Forks, ND
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Palloni A, McEniry M, Huangfu Y, Beltran-Sanchez H. Impacts of the 1918 flu on survivors' nutritional status: A double quasi-natural experiment. PLoS One 2020; 15:e0232805. [PMID: 33079928 PMCID: PMC7575088 DOI: 10.1371/journal.pone.0232805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/18/2020] [Indexed: 12/25/2022] Open
Abstract
Robust empirical evidence supports the idea that embryonic and, more generally, intrauterine disruptions induced by the 1918-flu pandemic had long-term consequences on adult health status and other conditions. In this paper we assess the 1918-flu long-term effects not just of in utero exposure but also during infancy and early childhood. A unique set of events that took place in Puerto Rico during 1918-1919 generated conditions of a "double quasi-natural experiment". We exploit these conditions to empirically identify effects of exposure to the 1918 flu pandemic and those of the devastation left by an earthquake-tsunami that struck the island in 1918. Because the earthquake-tsunami affected mostly the Western coast of the island whereas early (in utero and postnatal) exposure to the flu was restricted to those born in the interval 1917-1920, we use geographic variation to identify the effects of the quake and timing of birth variation to identify those of the flu. We benefit from availability of information on markers of nutritional status in a nationally representative sample of individuals aged 75 and older in 2002. We make two contributions. First, unlike most fetal-origins research that singles out early nutritional status as a determinant of adult health, we hypothesize that the 1918 flu damaged the nutritional status of adult survivors who, at the time of the flu, were in utero or infants. Second, we target markers of nutritional status largely set when the adult survivors were infants and young children. Estimates of effects of the pandemic are quite large mostly among females and those who were exposed to the earthquake-tsunami. Impacts of the flu in areas less affected by the earthquake are smaller but do vary by area flu severity. These findings constitute empirical evidence supporting the conjecture that effects of the 1918 flu and/or the earthquake are associated not just with disruption experienced during the fetal period but also postnatally.
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Affiliation(s)
- Alberto Palloni
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Mary McEniry
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Yiyue Huangfu
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Hiram Beltran-Sanchez
- Population Research Center, University of California at Los Angeles, Los Angeles, CA, United States of America
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8
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Fowler K, Wholeben M. COVID-19: Outcomes for trauma-impacted nurses and nursing students. Nurse Educ Today 2020; 93:104525. [PMID: 32659536 PMCID: PMC7340040 DOI: 10.1016/j.nedt.2020.104525] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Karen Fowler
- The University of Texas at El Paso, 500 W. University Avenue, El Paso, Texas 79968, United States of America.
| | - Melissa Wholeben
- The University of Texas at El Paso, 500 W. University Avenue, El Paso, Texas 79968, United States of America.
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9
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Selous C, Kelly-Irving M, Maughan B, Eyre O, Rice F, Collishaw S. Adverse childhood experiences and adult mood problems: evidence from a five-decade prospective birth cohort. Psychol Med 2020; 50:2444-2451. [PMID: 31583986 DOI: 10.1017/s003329171900271x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Retrospectively recalled adverse childhood experiences (ACEs) are associated with adult mood problems, but evidence from prospective population cohorts is limited. The aims of this study were to test links between prospectively ascertained ACEs and adult mood problems up to age 50, to examine the role of child mental health in accounting for observed associations, and to test gender differences in associations. METHODS The National Child Development Study is a UK population cohort of children born in 1958. ACEs were defined using parent or teacher reports of family adversity (parental separation, child taken into care, parental neglect, family mental health service use, alcoholism and criminality) at ages 7-16. Children with no known (n = 9168), single (n = 2488) and multiple (n = 897) ACEs were identified in childhood. Adult mood problems were assessed using the Malaise inventory at ages 23, 33, 42 and 50 years. Associations were examined separately for males and females. RESULTS Experiencing single or multiple ACEs was associated with increased rates of adult mood problems after adjustment for childhood psychopathology and confounders at birth [2+ v. 0 ACEs - men: age 23: odds ratio (OR) 2.36 (95% confidence interval (CI) 1.7-3.3); age 33: OR 2.40 (1.7-3.4); age 42: OR 1.85 (1.4-2.4); age 50: OR 2.63 (2.0-3.5); women: age 23: OR 2.00 (95% CI 1.5-2.6); age 33: OR 1.81 (1.3-2.5); age 42: OR 1.59 (1.2-2.1); age 50: OR 1.32 (1.0-1.7)]. CONCLUSIONS Children exposed to ACEs are at elevated risk for adult mood problems and a priority for early prevention irrespective of the presence of psychopathology in childhood.
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Affiliation(s)
- Camilla Selous
- Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, Wales, UK
| | - Michelle Kelly-Irving
- French Institute of Health and Medical Research (INSERM), Unit of Epidemiology and Public Health Analysis, UMR1027, Toulouse, France
| | - Barbara Maughan
- King's College London, MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, Wales, UK
| | - Frances Rice
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, Wales, UK
| | - Stephan Collishaw
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, Wales, UK
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10
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Abstract
Individuals with economic disadvantage experience greater (a) adverse childhood experiences (ACE), (b) risk for low relationship quality and relationship dissolution, and (c) disparity in physical and mental health. Thus, a critical need exists to understand the connections between areas of disparity in family and relational health on physical and mental health for those most vulnerable to the deleterious effects. The researchers therefore tested a dyadic model for the mediation of ACE and health by relationship quality with data from 503 couples with economic disadvantage and a racial or ethnic minority background (76.9%). The data fit the proposed model and explained a majority of the variance in health, 82.3% of the variance in men's health and 56.5% in women's health-both large effects. Moreover, the significant indirect pathway between ACE and health through relationship quality contributed 98.05% and 57.40% of the total effects for men and women, respectively. Overall, a significant relationship existed between ACE, relationship quality, and health for men and women at the actor-level and the dyadic influence between members of a couple contributed to the overall model fit. Results add to support for the role of relationship quality as a dyadic social determinant of health disparities with implications for prevention and intervention.
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Affiliation(s)
- Naomi J Wheeler
- Department of Counseling and Special Education, Virginia Commonwealth University, Richmond, VA
| | - Sejal M Barden
- Department of Counselor Education and School Psychology, University of Central Florida, Orlando, FL
| | - Andrew P Daire
- School of Education, Virginia Commonwealth University, Richmond, VA
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11
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Hinesley J, Krist A. A Primary Care Approach to Adverse Childhood Experiences. Am Fam Physician 2020; 102:55-57. [PMID: 32603065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jennifer Hinesley
- Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA, USA
| | - Alex Krist
- Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA, USA
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12
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Sweeting JA, Garfin DR, Holman EA, Silver RC. Associations between exposure to childhood bullying and abuse and adulthood outcomes in a representative national U.S. sample. Child Abuse Negl 2020; 101:104048. [PMID: 31945515 DOI: 10.1016/j.chiabu.2019.104048] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 10/22/2018] [Revised: 04/09/2019] [Accepted: 06/12/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Negative childhood experiences are associated with poor health and psychosocial outcomes throughout one's lifespan. OBJECTIVE We examined associations between childhood bullying and maltreatment and several adulthood outcomes: psychological distress, functional impairment, generalized fear, and physician-diagnosed mental and physical health ailments. The potential mediating role of recent negative life events was also explored. PARTICIPANTS AND SETTING Data were collected through web-based surveys of a U.S. representative national sample of adults. METHODS At Wave 1 (N = 3,598), participants reported exposure to negative childhood experiences; at Wave 2 (N = 3,497), physician-diagnosed mental and physical health ailments were provided; at Wave 3 (N = 2,906), participants reported exposure to recent negative life events and psychosocial outcomes. RESULTS Of the sample, 26.29% (weighted n = 946) reported childhood bullying, 15.02% (weighted n = 540) reported physical abuse, 15.56% (weighted n = 560) reported witnessing parental violence, 11.42% (weighted n = 411) reported sexual abuse, and 8.64% (weighted n = 311) reported parental neglect. Respondents who reported bullying, physical abuse, or sexual abuse during childhood reported greater distress, functional impairment, and fear of the future in adulthood, as mediated through recent negative life events, compared to those who did not (ßs: 0.04-.06). Those reporting bullying, neglect, physical abuse, or sexual abuse in childhood reported more mental health ailments in adulthood (IRRs: 1.44-1.66) compared to those who did not. Those reporting bullying or sexual abuse in childhood reported more physical health ailments (IRRs: 1.25-1.39). CONCLUSIONS Specific negative childhood experiences have unique links with poor outcomes in adulthood. Recent negative life events partially mediate these associations.
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Affiliation(s)
- Josiah A Sweeting
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Dana Rose Garfin
- Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - E Alison Holman
- Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - Roxane Cohen Silver
- Department of Psychological Science, University of California, Irvine, CA, USA; Department of Medicine, University of California, Irvine, CA, USA; Program in Public Health, University of California, Irvine, CA, USA.
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13
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Scheidell JD, Dyer TP, Severe M, Tembunde YE, Young KE, Khan MR. Childhood Traumatic Experiences and Receptive Anal Intercourse Among Women. Perspect Sex Reprod Health 2020; 52:23-30. [PMID: 32096340 PMCID: PMC8034482 DOI: 10.1363/psrh.12129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/01/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Receptive anal intercourse (RAI), which has become increasingly common among U.S. heterosexual women, is associated with STDs, including HIV, when it is unprotected and coercive. Childhood traumatic experiences may increase sexual risk behavior, but the relationship between childhood trauma and RAI among women has not been examined. METHODS Data from 4,876 female participants in Waves 1 (1994-1995), 3 (2001-2002) and 4 (2007-2008) of the National Longitudinal Study of Adolescent to Adult Health were used to examine associations between nine self-reported childhood traumas (neglect; emotional, physical and sexual abuse; parental binge drinking and incarceration; and witnessing, being threatened with and experiencing violence) and RAI during adulthood using modified Poisson regression analysis. Whether depression, low self-esteem, drug use, relationship characteristics or sex trade involvement mediated the relationship between trauma and RAI was also explored. RESULTS Forty percent of the sample reported having engaged in receptive anal intercourse. After adjustment for sociodemographic characteristics, eight of the nine childhood traumas were associated with increased risk of RAI (adjusted prevalence ratios, 1.2-1.5); the strongest association was with experience of violence. Each unit increase in the number of traumas yielded a 16% increase in RAI prevalence. In mediation analyses, only drug use and relationship factors slightly attenuated the association between childhood trauma and RAI (1.2 for each). CONCLUSIONS Women with a history of childhood trauma may be at increased risk of engaging in RAI, highlighting the importance of screening and trauma-informed education in sexual health settings. Pathways linking childhood trauma and RAI among women are complex and warrant further research.
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Affiliation(s)
- Joy D Scheidell
- Department of Population Health, New York University School of Medicine, New York
| | - Typhanye P Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park
| | - MacRegga Severe
- Department of Population Health, New York University School of Medicine, New York
| | - Yazmeen E Tembunde
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park
| | - Kailyn E Young
- Department of Population Health, New York University School of Medicine, New York
| | - Maria R Khan
- Department of Population Health, New York University School of Medicine, New York
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Guinn AS, Ports KA, Ford DC, Breiding M, Merrick MT. Associations between adverse childhood experiences and acquired brain injury, including traumatic brain injuries, among adults: 2014 BRFSS North Carolina. Inj Prev 2019; 25:514-520. [PMID: 30317219 PMCID: PMC6462254 DOI: 10.1136/injuryprev-2018-042927] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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] [Received: 07/13/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 01/31/2023]
Abstract
Adverse childhood experiences (ACEs) can negatively affect lifelong health and opportunity. Acquired brain injury (ABI), which includes traumatic brain injury (TBI) as well as other causes of brain injury, is a health condition that affects millions annually. The present study uses data from the 2014 North Carolina Behavioral Risk Factor Surveillance System to examine the relationship between ACEs and ABI. The study sample included 3454 participants who completed questions on both ABI and ACEs. Multivariable logistic regression models were used to determine the relationship between ACEs and ABI as well as ACEs and TBI. Sexual abuse, emotional abuse, physical abuse, household mental illness and household substance abuse were significantly associated with ABI after adjusting for age, race/ethnicity, gender and employment. Compared with those reporting no ACEs, individuals reporting three ACEs had 2.55 times the odds of having experienced an ABI; individuals reporting four or more ACEs had 3.51 times the odds of having experienced an ABI. Examining TBI separately, those who experienced sexual abuse, physical abuse, household mental illness and had incarcerated household members in childhood had greater odds of reported TBI, after adjusting for age, race/ethnicity, gender and income. Respondents reporting three ACEs (AOR=4.16, 95% CI (1.47 to 11.76)) and four or more ACEs (AOR=3.39, 95% CI (1.45 to 7.90)) had significantly greater odds of reporting TBI than respondents with zero ACEs. Prevention of early adversity may reduce the incidence of ABI; however, additional research is required to elucidate the potential pathways from ACEs to ABI, and vice versa.
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Affiliation(s)
- Angie S Guinn
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katie A Ports
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Derek C Ford
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matt Breiding
- Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa T Merrick
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Merrick MT, Ford DC, Ports KA, Guinn AS, Chen J, Klevens J, Metzler M, Jones CM, Simon TR, Daniel VM, Ottley P, Mercy JA. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention - 25 States, 2015-2017. MMWR Morb Mortal Wkly Rep 2019; 68:999-1005. [PMID: 31697656 PMCID: PMC6837472 DOI: 10.15585/mmwr.mm6844e1] [Citation(s) in RCA: 294] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. Methods Behavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences. Results Nearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression. Conclusions and implications for public health practice Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.
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Dalsklev M, Cunningham T, Travers Á, McDonagh T, Shannon C, Downes C, Hanna D. Childhood trauma as a predictor of reoffending in a Northern Irish probation sample. Child Abuse Negl 2019; 97:104168. [PMID: 31494351 DOI: 10.1016/j.chiabu.2019.104168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/18/2019] [Revised: 08/05/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND It is well-documented that there is a high prevalence rate of childhood trauma experiences among the prison population, and studies have found a link between childhood trauma and later acts of violence. OBJECTIVE The aim of the current study was to investigate whether childhood trauma (i.e., physical, sexual, emotional abuse and physical neglect) among offenders who have served a life sentence in Northern Ireland was associated with general and violent reoffending patterns. The study also explored the relationship between childhood trauma resulting from the sectarian conflict "The Troubles" in the region and its impact on reoffending. METHOD The casefiles of 100 offenders were coded for trauma experiences and official reoffending data was extracted. Logistic regression analysis was performed to explore the relationship between trauma and reoffending. RESULTS The most common form of childhood trauma were emotional abuse and/or emotional neglect (n = 43), conflict-related trauma (n = 43) and physical abuse (n = 40). Only age (OR .91) and conflict-related trauma (OR 5.57) emerged as significant predictors (p < .05) of general reoffending at any time post release. Similarly, only age (OR .92) and conflict-related trauma (OR 4.57) emerged as significant predictors (p < .05) of violent reoffending. Although it did not reach significance (p = .09), childhood physical abuse was related to an increase in the odds of violently reoffending, of a large magnitude (OR 4.09). CONCLUSIONS Conflict-related trauma significantly predicted general and violent reoffending among offenders with previous violent convictions.
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Affiliation(s)
- Madeleine Dalsklev
- Queens University Belfast, School of Psychology, David Keir Building BT7 1NN, Northern Ireland.
| | - Twylla Cunningham
- Probation Board for Northern Ireland, 1D Monaghan St., Newry, BT35 6BB, Northern Ireland.
| | - Áine Travers
- University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Tracey McDonagh
- University of Southern Denmark, Department of Psychology, University of Southern Denmark, Campusvej 55, Odense M - DK-523, Denmark.
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Gurteen House, Antrim, BT41 2RJ, Northern Ireland.
| | - Ciara Downes
- Scaffold Service, Southern Health and Social Care Trust, Bocombra Lodge, Portadown BT635SG, Northern Ireland.
| | - Donncha Hanna
- Queens University Belfast, School of Psychology, David Keir Building BT7 1NN, Northern Ireland; School of Psychology, Queens University Belfast, and Centre for Evidence and Social Innovation, Queens University Belfast, Northern Ireland.
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Abstract
BACKGROUND Adverse childhood experiences (ACE) are associated with an array of health consequences in later life, but few studies have examined the effects of ACEs on women's birth outcomes. METHODS We analyzed data gathered from a sample of 1848 low-income women who received services from home visiting programs in Wisconsin. Archival program records from a public health database were used to create three birth outcomes reflecting each participant's reproductive health history: any pregnancy loss; any preterm birth; any low birthweight. Multivariate logistic regressions were performed to test the linear and non-linear effects of ACEs on birth outcomes, controlling for age, race/ethnicity, and education. RESULTS Descriptive analyses showed that 84.4% of women had at least one ACE, and that 68.2% reported multiple ACEs. Multivariate logistic regression analyses showed that cumulative ACE scores were associated with an increased likelihood of pregnancy loss (OR = 1.12; 95% CI = 1.08-1.17), preterm birth (OR = 1.07; 95% CI = 1.01-1.12), and low birthweight (OR = 1.08; 95% CI = 1.03-1.15). Additional analyses revealed that the ACE-birthweight association deviated from a linear, dose-response pattern. CONCLUSIONS Findings confirmed that high levels of childhood adversity are associated with poor birth outcomes. Alongside additive risk models, future ACE research should test interactive risk models and causal mechanisms through which childhood adversity compromises reproductive health.
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Affiliation(s)
- Joshua P Mersky
- Institute for Child and Family Well-being, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave, Milwaukee, WI, 53211, USA.
| | - ChienTi Plummer Lee
- Institute for Child and Family Well-being, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave, Milwaukee, WI, 53211, USA
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Bellis MA, Hughes K, Ford K, Ramos Rodriguez G, Sethi D, Passmore J. Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Health 2019; 4:e517-e528. [PMID: 31492648 PMCID: PMC7098477 DOI: 10.1016/s2468-2667(19)30145-8] [Citation(s) in RCA: 388] [Impact Index Per Article: 77.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND An increasing number of studies are identifying associations between adverse childhood experiences (ACEs) and ill health throughout the life course. We aimed to calculate the proportions of major risk factors for and causes of ill health that are attributable to one or multiple types of ACE and the associated financial costs. METHODS In this systematic review and meta-analysis, we searched for studies in which risk data in individuals with ACEs were compared with these data in those without ACEs. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, Applied Social Sciences Index and Abstracts, Criminal Justice Databases, and the Education Resources Information Center) for quantitative studies published between Jan 1, 1990, and July 11, 2018, that reported risks of health-related behaviours and causes of ill health in adults that were associated with cumulative measures of ACEs (ie, number of ACEs). We included studies in adults in populations that did not have a high risk of ACEs, that had sample sizes of at least 1000 people, and that provided ACE prevalence data. We calculated the pooled RR for risk factors (harmful alcohol use, illicit drug use, smoking, and obesity) and causes of ill health (cancer, diabetes, cardiovascular disease, respiratory disease, anxiety, and depression) associated with ACEs. RRs were used to estimate the population-attributable fractions (PAFs) of risk attributable to ACEs and the disability-adjusted life-years (DALYs) and financial costs associated with ACEs. This study was prospectively registered in PROSPERO (CRD42018090356). FINDINGS Of 4387 unique articles found following our initial search, after review of the titles (and abstracts, when the title was relevant), we assessed 880 (20%) full-text articles. We considered 221 (25%) full-text articles for inclusion, of which 23 (10%) articles met all selection criteria for our meta-analysis. We found a pooled prevalence of 23·5% of individuals (95% CI 18·7-28·5) with one ACE and 18·7% (14·7-23·2) with two or more ACEs in Europe (from ten studies) and of 23·4% of individuals (22·0-24·8) with one ACE and 35·0% (31·6-38·4) with two or more ACEs in north America (from nine studies). Illicit drug use had the highest PAFs associated with ACEs of all the risk factors assessed in both regions (34·1% in Europe; 41·1% in north America). In both regions, PAFs of causes of ill health were highest for mental illness outcomes: ACEs were attributed to about 30% of cases of anxiety and 40% of cases of depression in north America and more than a quarter of both conditions in Europe. Costs of cardiovascular disease attributable to ACEs were substantially higher than for most other causes of ill health because of higher DALYs for this condition. Total annual costs attributable to ACEs were estimated to be US$581 billion in Europe and $748 billion in north America. More than 75% of these costs arose in individuals with two or more ACEs. INTERPRETATION Millions of adults across Europe and north America live with a legacy of ACEs. Our findings suggest that a 10% reduction in ACE prevalence could equate to annual savings of 3 million DALYs or $105 billion. Programmes to prevent ACEs and moderate their effects are available. Rebalancing expenditure towards ensuring safe and nurturing childhoods would be economically beneficial and relieve pressures on health-care systems. FUNDING World Health Organization Regional Office for Europe.
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Affiliation(s)
- Mark A Bellis
- Policy and International Health Directorate, World Health Organization Collaborating Centre on Investment for Health and Wellbeing, Public Health Wales, Wrexham, UK; College of Human Sciences, Bangor University, Wrexham, UK.
| | - Karen Hughes
- Policy and International Health Directorate, World Health Organization Collaborating Centre on Investment for Health and Wellbeing, Public Health Wales, Wrexham, UK; College of Human Sciences, Bangor University, Wrexham, UK
| | - Kat Ford
- College of Human Sciences, Bangor University, Wrexham, UK
| | - Gabriela Ramos Rodriguez
- Policy and International Health Directorate, World Health Organization Collaborating Centre on Investment for Health and Wellbeing, Public Health Wales, Wrexham, UK
| | - Dinesh Sethi
- Violence and Injury Prevention, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Jonathon Passmore
- Violence and Injury Prevention, World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Hinojosa R, Nguyen J, Sellers K, Elassar H. Barriers to college success among students that experienced adverse childhood events. J Am Coll Health 2019; 67:531-540. [PMID: 30230975 DOI: 10.1080/07448481.2018.1498851] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/24/2017] [Revised: 05/18/2018] [Accepted: 07/06/2018] [Indexed: 06/08/2023]
Abstract
Objective: This study examines the relationship between adverse childhood experiences (ACEs) and academic barriers to college success. Participants: College students (n = 525) were surveyed about exposure to ACEs and academic barriers on a large university campus in the Southeast. Methods: Multivariate regression was used to model the academic barriers among college students for students with different levels of ACEs exposure controlling for depression, health and family barriers, and sociodemographic characteristics. Results: Students with ACEs reported more family difficulties and health problems compared with those without ACEs. Depressive symptomology, poorer health ratings, and other health and family issues significantly predicted higher counts of academic barriers. Conclusions: Students with ACEs face greater difficulty with relation to health and family barriers which in turn impacts academic barriers.
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Affiliation(s)
- Ramon Hinojosa
- a Department of Sociology, University of Central Florida , Orlando , FL
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Reid GM, Holt MK, Felix ED, Greif Green J. Perceived consequences of hazing exposure during the first year of college: Associations with childhood victimization. J Am Coll Health 2019; 67:402-409. [PMID: 29979939 DOI: 10.1080/07448481.2018.1484363] [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: 09/13/2017] [Revised: 04/19/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
Objective: This study investigates the association between histories of childhood victimization and perceived consequences of college hazing. Participants: First-year college students at four US universities (N = 120). Method: Participants completed Web-based surveys asking about childhood victimization (eg, child maltreatment), peer victimization, and perceived consequences of hazing during college. Results: Results indicated that college students with childhood victimization histories perceived hazing to be negative. In particular, physical dating violence and a greater total number of childhood victimization exposures were related to a higher number of perceived negative consequences. Conclusion: Past victimization exposures confer risk on college students who experience hazing, in that these students are more likely to perceive negative consequences of hazing. Hazing-related policies and outreach efforts should consider these potential negative consequences, and counselors should be aware of the link between past victimization and how hazing might be experienced.
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Affiliation(s)
- Gerald M Reid
- a Boston University School of Education , Boston , MA , USA
| | - Melissa K Holt
- a Boston University School of Education , Boston , MA , USA
| | - Erika D Felix
- b Santa Barbara Gevirtz School of Education , University of California , Santa Barbara , CA , USA
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Love HA, Torgerson CN. Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity. J Marital Fam Ther 2019; 45:508-520. [PMID: 30009525 DOI: 10.1111/jmft.12348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self-medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma-related symptoms via alcohol or drug use. The purpose of this study is to identify through which specific PTSD symptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N = 627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma-informed approaches that aim to decrease arousal/reactivity and subsequently substance use.
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Banford Witting A, Busby D. The Long Arm of Trauma During Childhood: Associations with Resources in Couple Relationships. J Marital Fam Ther 2019; 45:534-549. [PMID: 30168162 DOI: 10.1111/jmft.12354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Traumatic experiences within and outside the family of origin in childhood may disrupt couple functioning later in life. Using a sample of 3,958 couples assessed through the Relationship Evaluation Questionnaire (RELATE), an actor-partner independence model was fit to test direct and indirect associations between negative impact from one's family of origin (accounting for physical violence and sexual abuse) and resources in couple relationships. Resources were defined using intervention principles derived from the Conservation of Resources (COR) theory. Actor and partner effects suggested negative family impact associates with relationship instability and is mediated through negative couple communication. Actor effects suggested negative family impact associates with less calmness in one's self and is also mediated through negative couple communication.
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Atzl VM, Narayan AJ, Rivera LM, Lieberman AF. Adverse childhood experiences and prenatal mental health: Type of ACEs and age of maltreatment onset. J Fam Psychol 2019; 33:304-314. [PMID: 30802085 DOI: 10.1037/fam0000510] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Childhood adversity can have long-term deleterious effects on adulthood mental health outcomes, but more research is needed examining how type and timing of childhood adversity affect mental health specifically during pregnancy. The current study examined the effects of total adverse childhood experiences (ACEs) on depression and posttraumatic stress disorder (PTSD) symptoms during pregnancy, unpacked effects of total adversity into childhood maltreatment versus family dysfunction experiences, and assessed age of onset effects of child maltreatment-specific experiences. Participants were 101 low-income pregnant women (M = 29.10 years, SD = 6.56, range = 18-44; 37% Latina, 22% African American, 20% White, 13% biracial/multiracial, 8% other; 26% Spanish-speaking) who completed instruments on childhood adversity, PTSD and depression symptoms during pregnancy, and demographics. Results indicated that total ACEs predicted elevated PTSD and depression symptoms during pregnancy, as did maltreatment ACEs, but not family dysfunction ACEs. Early childhood onset of maltreatment significantly predicted elevated PTSD symptoms during pregnancy, whereas middle childhood and adolescent onset did not. No age of onset of maltreatment variable significantly predicted depression symptoms during pregnancy. Findings underscore the importance of differentiating between childhood maltreatment versus family dysfunction ACEs and examining the timing and accumulation of maltreatment experiences during childhood, because these factors affect mental health during pregnancy. Findings also support universal prenatal screening for PTSD symptoms to identify at-risk pregnant women who could benefit from interventions to disrupt the intergenerational transmission of risk and give families the healthiest possible beginning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Alicia F Lieberman
- Department of Psychiatry/Child Trauma Research Program, University of California, San Francisco
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Abstract
OBJECTIVE Childhood trauma has been related to adverse behavioral, mental, and health outcomes later in life. Sleep may be a potential mechanism through which childhood trauma is related to adverse health. The current retrospective study aimed to characterize the relationship between childhood trauma exposure and sleep health, a novel multidimensional measure of sleep. METHODS Participants (N = 161; mean [standard deviation] age = 59.85 [9.06] years; 67.7% female) retrospectively reported trauma exposure using the Trauma History Questionnaire. Childhood trauma was defined as the number of reported traumatic events before 18 years of age. Trauma exposure after 18 years of age and across the life-span was also recorded. Sleep health was derived both from diary- and actigraphy-assessed measures of sleep regularity, timing, efficiency, and duration, subjective sleep satisfaction, and daytime sleepiness from the Epworth Sleepiness Scale. The relationships between childhood trauma exposure and sleep health were examined using hierarchical linear regression, controlling for relevant covariates. RESULTS In unadjusted models, a greater number of childhood trauma exposures were associated with poorer diary- and actigraphy-measured sleep health in adulthood. After adjustment for current stress, depression history, and other sociodemographic covariates, greater childhood trauma remained significantly associated with poorer sleep health (diary: β = -0.20, ΔR = 0.032; actigraphy: β = -0.19, ΔR = 0.027). Trauma exposure after 18 years of age and across the life-span did not relate to diary- or actigraphy-based sleep health. CONCLUSIONS Childhood trauma may affect sleep health in adulthood. These findings align with the growing body of evidence linking childhood trauma to adverse health outcomes later in life.
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Affiliation(s)
| | | | | | - Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh
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Bae D, Wickrama KAS. Pathways linking early socioeconomic adversity to diverging profiles of romantic relationship dissolution in young adulthood. J Fam Psychol 2019; 33:23-33. [PMID: 30394761 DOI: 10.1037/fam0000465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although studies on romantic relationships are abundant, cumulative experiences in intimate relationship dissolution (i.e., dissolution of cohabitation and marriage) during young adulthood is not yet completely understood. Using a nationally representative sample of 9,275 young adults, we investigated heterogeneity in timing and frequency of relationship dissolution during young adulthood, as well as its developmental precursors to dissolution. Results indicated four distinct relationship-dissolution classes that ranged from those who maintained stable romantic relationships to those who experienced multiple cohabitation dissolutions and divorces from ages 18 to 30 years. Early socioeconomic adversity predicted relationship-dissolution trajectories directly and indirectly through psychosociodemographic mechanisms in adolescence, including disrupted transitions to adulthood, conflict in dating relationships, and low levels of future orientation. Our findings highlight the heterogeneous romantic relationship trajectories of young adults and support the importance of the person-centered approach in elucidating developmental pathways underlying the longitudinal transitions in romantic relationships. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Dayoung Bae
- Center for Family Research, University of Georgia
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Lussier P, Chouinard-Thivierge S, McCuish E, Nadeau D, Lacerte D. Early life adversities and polyvictimization in young persons with sexual behavior problems: A longitudinal study of child protective service referrals. Child Abuse Negl 2019; 88:37-50. [PMID: 30445335 DOI: 10.1016/j.chiabu.2018.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/22/2018] [Revised: 08/19/2018] [Accepted: 10/28/2018] [Indexed: 06/09/2023]
Abstract
There is scarce research on children and youth with sexual behavior problems (SBP) and their developmental antecedents and the research that does exist is mostly retrospective and correlational. While prior research focused on the central role of sexual victimization, recent research suggests that young persons with SBP are exposed to a series of adversities not limited to child sexual victimization and require multifaceted assessment and intervention using a developmental life course perspective. The current study includes an examination of the complete longitudinal sequence of child protective service (CPS) investigations involving young persons with SBP. The study is based on a sample of 957 youth referred to the CPS in Quebec, Canada. The data include their longitudinal sequence of referrals from birth to age 18. Semi-parametric analyses identified four trajectories of referrals with significant differences in terms of onset, frequency, types of life adversity, and polyvictimization. The trajectories suggest that a range of developmental profiles characterize young persons with SBP, with SBP often occurring after CPS contacts for compromising issues other than sexual victimization, especially parental neglect and serious behavior problems. Of importance, polyvictimization was relatively common for this group throughout childhood and adolescence, which highlights the multiintervention needs of this population.
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Affiliation(s)
| | | | | | - Danielle Nadeau
- Centre de Recherche Universitaire sur les Jeunes et les Familles du CIUSSS de la Capitale-Nationale, Canada
| | - Denis Lacerte
- Centre de Recherche Universitaire sur les Jeunes et les Familles du CIUSSS de la Capitale-Nationale, Canada
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Abstract
Purpose International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population. Although social determinants of health have been found to affect the mental health of a population, less information is available regarding the impact of social determinants on physical health, especially among offenders. The purpose of this paper is to examine the relationship between social determinants and the physical health status of federal Canadian offenders. Design/methodology/approach The study included all men admitted to federal institutions between 1 April 2012 and 30 September 2012 ( n=2,273) who consented to the intake health assessment. Logistic regression analyses were used to explore whether age group, Aboriginal ancestry, and each of the individual social determinants significantly predicted a variety of health conditions. Findings The majority of men reported having a physical health condition and had experienced social determinants associated with adverse health outcomes, especially men of Aboriginal ancestry. Two social determinants factors in particular were consistently related to the health of offenders, a history of childhood abuse, and the use of social assistance. Research limitations/implications The study is limited to the use of self-report data. Additionally, the measures of social determinants of health were indicators taken from assessments that provided only rough estimates of the constructs rather than from established measures. Originality/value A better understanding of how these factors affect offenders can inform strategies to address correctional health issues and reduce the impact of chronic conditions through targeted correctional education and intervention programmes.
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Affiliation(s)
- Lynn A Stewart
- Correctional Service Canada, Government of Canada, Ottawa, Canada
| | - Amanda Nolan
- Correctional Service Canada, Government of Canada, Ottawa, Canada
| | - Jennie Thompson
- Correctional Service Canada, Government of Canada, Ottawa, Canada
| | - Jenelle Power
- Correctional Service Canada, Government of Canada, Ottawa, Canada
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Morrill MI, Schulz MS, Nevarez MD, Preacher KJ, Waldinger RJ. Assessing within- and between-family variations in an expanded measure of childhood adversity. Psychol Assess 2019; 31:660-673. [PMID: 30628820 DOI: 10.1037/pas0000691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Previous measures of childhood adversity have enabled the identification of powerful links with later-life wellbeing. The challenge for the next generation of childhood adversity assessment is to better characterize those links through comprehensive, fine-grained measurement strategies. The expanded, retrospective measure of childhood adversity presented here leveraged analytic and theoretical advances to examine multiple domains of childhood adversity at both the microlevel of siblings and the macrolevel of families. Despite the fact that childhood adversity most often occurs in the context of families, there is a dearth of studies that have validated childhood adversity measures on multiple members of the same families. Multilevel psychometric analyses of this childhood adversity measure administered to 1,194 siblings in 500 families indicated that the additional categories of childhood adversity were widely endorsed, and increased understanding of the sources and sequalae of childhood adversity when partitioned into within- and between-family levels. For example, multilevel confirmatory factor analyses (MCFAs) indicated that financial stress, unsafe neighborhood, and parental unemployment were often experienced similarly by siblings in the same families and stemmed primarily from family wide (between-family) sources. On the other hand, being bullied and school stressors were often experienced differently by siblings and derived primarily from individual (within-family) processes. Multilevel structural equation modeling (MSEM) further illuminated differential criterion validity correlations between these categories of childhood adversity with midlife psychological, social, and physical health. Expanded, multidomain, and multilevel measures of childhood adversity appear to hold promise for identifying layered causes and consequences of adverse childhood experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Rønningen R, Wammer ACP, Grabner NH, Valderhaug TG. Associations between Lifetime Adversity and Obesity Treatment in Patients with Morbid Obesity. Obes Facts 2019; 12:1-13. [PMID: 30654360 PMCID: PMC6465708 DOI: 10.1159/000494333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Received: 06/18/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bariatric surgery is associated with greater and more sustainable weight loss compared with lifestyle intervention programs. On the other hand, bariatric surgery may also be associated with physical and psychosocial complications. The influence of psychological evaluation on treatment choice, however, is not known. We aimed to examine variables associated with treatment choice and, specifically, if self-reported lifetime adversity influenced obesity treatment, i.e. bariatric surgery, high-intensive lifestyle treatment or low-intensive lifestyle treatment in primary care. METHODS We consecutively included 924 patients from the registry study of patients with morbid obesity at Akershus University Hospital, Lørenskog, Norway. Treatment selection was made through a shared decision-making process. Self-reported lifetime adversity was registered by trained personnel. Logistic regression models were used to assess the associations between obesity treatment and possible predictors. RESULTS Patients who chose bariatric surgery were more likely to have type 2 diabetes (DM2) compared with patients who chose lifestyle treatment (bariatric surgery: 35%, high-intensive lifestyle treatment: 26%, and low-intensive lifestyle treatment: 26%; p = 0.035). Patients who chose bariatric surgery were less likely than patients who chose lifestyle intervention to report lifetime adversity (bariatric surgery: 39%, high-intensive lifestyle treatment: 47%, and low-intensive lifestyle treatment: 51%; p = 0.004). After multivariable adjustments, increasing BMI, having DM2, and joint pain were associated with choosing bariatric surgery over non-surgical obesity treatment (odds ratio [95% CI]: BMI 1.03 [1.01-1.06], DM2 1.47 [1.09-1.99], and joint pain 1.46 [1.08-1.96]). Self-reported lifetime adversity was furthermore associated with lower odds of choosing bariatric surgery in patients with morbid obesity (0.67 [0.51-0.89]). CONCLUSION This study shows that increasing BMI, DM2, and joint pain were all associated with treatment choice for obesity. In addition, self-reported lifetime adversity was associated with the patients' treatment choice for morbid obesity. Consequently, we suggest that decisions concerning obesity treatment should include dialogue-based assessments of the patients' lifetime adversity.
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Affiliation(s)
- Reidun Rønningen
- Department of Endocrinology, Akershus University Hospital HF, Lørenskog, Norway
| | | | - Nina Holte Grabner
- Department of Psychiatry, Unit for Consultation-Liason Psychiatry, Akershus University Hospital, Lørenskog, Norway
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30
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Abstract
Adverse childhood experiences (ACEs) include exposures such as abuse and household dysfunction. These exposures are associated with long-term sequelae and unfavorable health outcomes in adulthood. NPs working in primary care can help to reduce the impact of ACEs in adulthood by identifying individuals with these experiences and implementing trauma-informed care strategies.
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Affiliation(s)
- Jana L Esden
- Jana L. Esden is an associate professor at Frontier Nursing University in Hyden, Ky., and a family nurse practitioner at Partnership Community Health Center in Appleton, Wis
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31
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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 Soc Care 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Krammer S, Eisenbarth H, Fallegger C, Liebrenz M, Klecha D. Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland. Int J Offender Ther Comp Criminol 2018; 62:3815-3833. [PMID: 29284379 DOI: 10.1177/0306624x17749638] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The present study describes a much understudied group-namely, female prisoners under forensic-psychiatric care in the German-speaking part of Switzerland-to improve understanding of their risks and their needs. Data were derived from internal databases of a Forensic-Psychiatric Service. Data were collected in the form of their sociodemographic characteristics, prevalence of aversive and traumatic events, type of offence committed, and mental health conditions. Based on a full-sample approach, a total of 1,571 files were analysed. Results reveal that two thirds of the participants were not in a stable relationship, more than half did not complete a school degree, and three quarters were without stable employment prior to their incarceration. Two thirds were mothers and about one third did not grow up with their parents. Almost half grew up with an alcohol abusing parent, about half experienced violence and/or neglect in childhood, and about a quarter of the cases sexual abuse. About 95% had a mental health diagnosis according to International Classification of Diseases-Version 10 (ICD-10), and the most prevalent mental and behavioural disorder was due to psychoactive substance abuse. The most frequent offence type was drug-related crimes. Women convicted for drug-related crimes were more likely to have an ICD-10 F1 disorder compared with those convicted for other crimes. Conversely, women with violent offences were less likely to suffer from ICD-10 F1 disorder than those who had committed nonviolent offences. Findings have implications for practitioners and policy makers, and contribute to the cycle of violence theory discussion. In conclusion, future research areas are suggested.
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Affiliation(s)
- Sandy Krammer
- 1 Department of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Switzerland
| | | | - Carole Fallegger
- 1 Department of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Switzerland
| | - Michael Liebrenz
- 1 Department of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Switzerland
| | - Dorothee Klecha
- 1 Department of Forensic Psychiatry, Institute of Legal Medicine, University of Bern, Switzerland
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Hanson JL, Knodt AR, Brigidi BD, Hariri AR. Heightened connectivity between the ventral striatum and medial prefrontal cortex as a biomarker for stress-related psychopathology: understanding interactive effects of early and more recent stress. Psychol Med 2018; 48:1835-1843. [PMID: 29248021 PMCID: PMC6301079 DOI: 10.1017/s0033291717003348] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The experience of childhood maltreatment is a significant risk factor for the development of depression. This risk is particularly heightened after exposure to additional, more contemporaneous stress. While behavioral evidence exists for this relation, little is known about biological correlates of these stress interactions. Identifying such correlates may provide biomarkers of risk for later depression. METHODS Here, we leverage behavioral, experiential, and neuroimaging data from the Duke Neurogenetics Study to identify potential biomarkers of stress exposure. Based on the past research, we were specifically interested in reward-related connectivity and the interaction of early and more recent stress. We examined psychophysiological interactions between the ventral striatum and other brain regions in relation to these stress variables, as well as measures of internalizing symptomatology (n = 926, participant age range = 18-22 years of age). RESULTS We found relatively increased reward-related functional connectivity between the left ventral striatum and the medial prefrontal cortex in individuals exposed to greater levels of childhood maltreatment who also experienced greater levels of recent life stress (β = 0.199, p < 0.005). This pattern of functional connectivity was further associated with elevated symptoms of depression (β = 0.089, p = 0.006). Furthermore, using a moderated mediation framework, we demonstrate that this functional connectivity provides a biological link between cumulative stress exposure and internalizing symptomatology. CONCLUSIONS These findings suggest a novel biomarker linking cumulative stress exposure with the later experience of depressive symptoms. Our results are discussed in the context of past research examining stress exposure in relation to depression.
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Affiliation(s)
- Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Annchen R Knodt
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Bartholomew D Brigidi
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
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Elklit A, Murphy S, Jacobsen C, Jensen MK. Clinical and Personality Disorders in a Danish Treatment-Seeking Sample of Intimate Partner Violence Perpetrators. Int J Offender Ther Comp Criminol 2018; 62:3322-3336. [PMID: 29144189 DOI: 10.1177/0306624x17741603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/07/2023]
Abstract
Intimate partner violence (IPV) is a global public health concern with profound psychological consequences. Perpetrators often have a history of childhood trauma and a range of co-occurring psychiatric problems, which may have implications for treatment. This study examines the prevalence of psychiatric and personality disorders (PD) among perpetrators and the association between a range of demographic, childhood trauma, and adult criminality variables for the most prominent disorders. Data were collected from IPV perpetrators ( n = 529) engaging in a treatment program, ' Dialogue Against Violence'. High rates of childhood trauma were observed. There was significant variation in the prevalence of clinical disorders and PDs, with Antisocial PD and Anxiety Disorder being the most common. A clinical disorder was the strongest predictor of PDs, likewise a PD was the strongest predictor of clinical disorders. Findings demonstrated that IPV perpetrators have a number of personality and clinical disorders and traumatic histories that need to be considered within a treatment perspective.
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Affiliation(s)
- Ask Elklit
- 1 University of Southern Denmark, Odense, Denmark
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35
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Manyema M, Norris SA, Richter LM. Stress begets stress: the association of adverse childhood experiences with psychological distress in the presence of adult life stress. BMC Public Health 2018; 18:835. [PMID: 29976168 PMCID: PMC6034311 DOI: 10.1186/s12889-018-5767-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/26/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACES) have been linked to poor health and well-being outcomes, including poor mental health such as psychological distress. Both ACEs and psychological distress pose a significant public health burden, particularly in low to middle income countries. Contemporaneous stress events in adulthood may also impact psychological distress. The aims of this study were to describe the prevalence of ACEs and psychological distress and to assess the separate and cumulative effect of ACEs on psychological distress, while accounting for the effect of adult stress. METHODS In this cross-sectional study, we used retrospectively measured ACEs from a sample of 1223 young adults aged between 22 and 23 years (52% female) from the Birth to Twenty Plus Study. Psychological distress and adult life stress were measured with a six-month recall period. Hierarchical logistic regression was employed to assess the associations between the exposures and outcome. RESULTS Nearly 90% of the sample reported at least one ACE and 28% reported psychological distress. The median number of ACEs reported was three (range 0-11). After accounting for demographic and socio-economic factors, all ACEs were individually associated with psychological distress except for parental divorce and unemployment. The individual ACEs increased the odds of PD by between 1.42 and 2.79 times. Compared to participants experiencing no ACEs, those experiencing one to five ACEs were three times more likely to report psychological distress (AOR 3.2 95% CI: 1.83-5.63), while participants who experienced six or more ACEs had nearly eight times greater odds of reporting psychological distress (AOR 7.98 95% CI: 4.28-14.91). Interaction analysis showed that in the absence of adult life stress, the effect of low ACEs compared to high ACEs on PD was not significantly different. DISCUSSION AND CONCLUSION The prevalence of ACEs in this young adult population is high, similar to other studies in young adult populations. A significant direct association exists between ACEs and psychological distress. Adult life stress seems to be a mediator of this relationship. Interventions targeted at psychological distress should address both early life adversity and contemporary stress.
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Affiliation(s)
- Mercy Manyema
- DST-NRF Center of Excellence in Human Development, University of the Witwatersrand, 1st Floor School of Public Health Building, Wits Education Campus, 7 York Road, Parktown, Johannesburg, 2193 South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Corner College & Clinic Road, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Corner College & Clinic Road, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M. Richter
- DST-NRF Center of Excellence in Human Development, University of the Witwatersrand, 1st Floor School of Public Health Building, Wits Education Campus, 7 York Road, Parktown, Johannesburg, 2193 South Africa
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36
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Karatekin C, Ahluwalia R, Desir M. Tailoring health-related messages for young adults with adverse childhood experiences (ACEs). Child Abuse Negl 2018; 80:194-202. [PMID: 29625325 DOI: 10.1016/j.chiabu.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/02/2018] [Revised: 03/05/2018] [Accepted: 03/10/2018] [Indexed: 06/08/2023]
Abstract
The goal was to identify factors that might affect likelihood of seeking health-related interventions for young adults with adverse childhood experiences (ACEs). We tested whether ACEs were associated with (1) regulatory focus (tendency toward promoting good outcomes versus preventing bad outcomes), and (2) patient activation (the intention to take active charge of one's health). We further tested whether promotion and prevention and patient activation were associated with each other and with health. Students at a public university (N = 321) completed online questionnaires assessing ACEs, regulatory focus, patient activation, and health. Greater childhood adversity showed small but significant associations with being a less activated patient and being less focused on promoting good outcomes. In contrast, greater childhood adversity had a much stronger association with focusing on preventing negative outcomes. Students with a more significant mental health history were more likely to have been exposed to childhood adversity, to be less activated patients, and to focus more on prevention. Results suggest that using a prevention focus may be effective in health messages aimed to reach individuals with high levels of ACEs. Furthermore, individuals with high levels of ACEs may benefit from interventions aimed at increasing patient activation.
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Affiliation(s)
- Canan Karatekin
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA.
| | - Rohini Ahluwalia
- Department of Marketing, Carlson School of Management, University of Minnesota, 321 19th Avenue South, Minneapolis, MN 55455, USA.
| | - Michelle Desir
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA.
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Randhawa G, Azarbar A, Dong H, Milloy MJ, Kerr T, Hayashi K. Childhood Trauma and the Inability to Access Hospital Care Among People who Inject Drugs. J Trauma Stress 2018; 31:383-390. [PMID: 29924415 PMCID: PMC6026062 DOI: 10.1002/jts.22286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/20/2018] [Accepted: 01/31/2018] [Indexed: 12/12/2022]
Abstract
Childhood traumatic experiences can disrupt attachment, influence personality development, and precipitate chronic disease. Although the repercussions of these experiences may also pose a barrier to healthcare, few studies have examined the association between childhood trauma and access to healthcare. Therefore, we sought to investigate whether a history of childhood trauma is associated with self-reported inability to access hospital care among persons who inject drugs (PWID). Data were derived from two prospective cohorts of PWID in Vancouver, Canada. We used multivariable generalized estimating equations to examine associations between five types of childhood trauma and self-reported inability to access hospital care, both overall and specifically due to perceived mistreatment by hospital staff. In total, 300 participants (18.3%) reported having tried but being unable to access hospital care in the previous 6 months at some point during the study period; the primary reason was perceived mistreatment by hospital staff (32.1%). In multivariable analyses, childhood emotional abuse was independently associated with self-reported inability to access hospital care, adjusted odds ratio (AOR) = 1.51, 95% CI [1.03, 2.20]. Childhood physical neglect was also independently associated with inability to access care due to perceived mistreatment by hospital staff, AOR = 1.80, 95% CI [1.11, 2.93]. This suggests potentially damaging consequences of early trauma in adult PWID populations. Further, this study emphasizes the need for trauma-informed models of care as well as the need to improve therapeutic alliances with survivors of childhood trauma in the PWID population.
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Affiliation(s)
- Gurdeeshpal Randhawa
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Ataa Azarbar
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Huiru Dong
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - MJ Milloy
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Thomas Kerr
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, British Columbia, Canada
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Kanna Hayashi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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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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Stevens AL, Herrenkohl TI, Mason WA, Smith GL, Klevens J, Merrick MT. Developmental effects of childhood household adversity, transitions, and relationship quality on adult outcomes of socioeconomic status: Effects of substantiated child maltreatment. Child Abuse Negl 2018; 79:42-50. [PMID: 29407855 PMCID: PMC6134210 DOI: 10.1016/j.chiabu.2018.01.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 01/06/2018] [Accepted: 01/31/2018] [Indexed: 05/30/2023]
Abstract
The degree to which child maltreatment interacts with other household adversities to exacerbate risk for poor adult socioeconomic outcomes is uncertain. Moreover, the effects of residential, school, and caregiver transitions during childhood on adult outcomes are not well understood. This study examined the relation between household adversity and transitions in childhood with adult income problems, education, and unemployment in individuals with or without a childhood maltreatment history. The potential protective role of positive relationship quality in buffering these risk relationships was also tested. Data were from the Lehigh Longitudinal Study (n = 457), where subjects were assessed at preschool, elementary, adolescent, and adult ages. Multiple group path analysis tested the relationships between childhood household adversity; residential, school, and caregiver transitions; and adult socioeconomic outcomes for each group. Caregiver relationship quality was included as a moderator, and gender as a covariate. Household adversity was negatively associated with education level and positively associated with income problems for non-maltreated children only. For both groups, residential transitions was negatively associated with education level and caregiver transitions was positively associated with unemployment problems. Relationship quality was positively associated with education level only for non-maltreated children. For children who did not experience maltreatment, reducing exposure to household adversity is an important goal for prevention. Reducing exposure to child maltreatment for all children remains an important public health priority. Results underscore the need for programs and policies that promote stable relationships and environments.
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Affiliation(s)
- Amy L Stevens
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Todd I Herrenkohl
- University of Washington School of Social Work, Box 354900, Seattle, WA, 98195-4900, USA.
| | - W Alex Mason
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Gail L Smith
- Boys Town National Research Institute, 14100 Crawford Street, Boys Town, NE, 68010, USA.
| | - Joanne Klevens
- Centers for Disease Control and Prevention, 1600 Clifton Road Atlanta, GA, 30329-4027, USA.
| | - Melissa T Merrick
- Centers for Disease Control and Prevention, 1600 Clifton Road Atlanta, GA, 30329-4027, USA.
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40
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Zarnello L. The ACE effect: A case study of adverse childhood experiences. Nursing 2018; 48:50-54. [PMID: 29561370 DOI: 10.1097/01.nurse.0000530408.46074.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Lisa Zarnello
- Lisa Zarnello is an RN in the ED at Highland Hospital in Rochester, N.Y
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McLafferty M, O'Neill S, Murphy S, Armour C, Bunting B. Population attributable fractions of psychopathology and suicidal behaviour associated with childhood adversities in Northern Ireland. Child Abuse Negl 2018; 77:35-45. [PMID: 29294415 DOI: 10.1016/j.chiabu.2017.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/11/2017] [Accepted: 12/14/2017] [Indexed: 06/07/2023]
Abstract
Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004-2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives.
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Affiliation(s)
- Margaret McLafferty
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom.
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom.
| | - Sam Murphy
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom
| | - Cherie Armour
- School of Psychology, Ulster University, Coleraine Campus, Cromore Road, Coleraine, N. Ireland, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom
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Caleyachetty R, Hardy R, Cooper R, Richards M, Howe LD, Anderson E, Kuh D, Stafford M. Modeling Exposure to Multiple Childhood Social Risk Factors and Physical Capability and Common Affective Symptoms in Later Life. J Aging Health 2018; 30:386-407. [PMID: 28553793 PMCID: PMC5915301 DOI: 10.1177/0898264316680434] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 11/16/2022]
Abstract
OBJECTIVE This study presents three approaches, that is, cumulative risk, factor analysis, and latent class analysis, to summarize exposure to multiple childhood social risk factors and to compare their utility when examining associations with physical capability and common affective symptoms in adults aged 60 to 64 years. METHODS Data came from the U.K. Medical Research Council (MRC) National Survey of Health and Development, with prospective childhood social risk factor data collected in 1950 to 1957 and retrospectively in 1989. Physical capability and common affective symptom data were collected in 2006 to 2011. RESULTS The cumulative risk approach and factor analysis provided evidence that children who were exposed to multiple social risk factors had lower levels of physical capability and more symptoms of common affective symptoms in later life. DISCUSSION The cumulative social risk approach and the use of factor analysis to identify contexts of social risk, may offer viable methods for linking multiple childhood social risk exposure to aging outcomes.
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Affiliation(s)
- Rishi Caleyachetty
- MRC Unit for Lifelong Health and Ageing, University College London, UK
- Institute of Applied Health Research, University of Birmingham, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Laura D. Howe
- MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Emma Anderson
- MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, UK
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Mersky JP, Janczewski CE. Racial and ethnic differences in the prevalence of adverse childhood experiences: Findings from a low-income sample of U.S. women. Child Abuse Negl 2018; 76:480-487. [PMID: 29272816 DOI: 10.1016/j.chiabu.2017.12.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [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: 04/16/2017] [Revised: 12/09/2017] [Accepted: 12/12/2017] [Indexed: 05/18/2023]
Abstract
Despite great interest in adverse childhood experiences (ACEs), there has been limited research on racial and ethnic differences in their prevalence. Prior research in the United States suggests that the prevalence of ACEs varies along socioeconomic lines, but it is uncertain whether there are racial/ethnic differences in ACE rates among low-income populations. This study examined the distribution of ACEs in a sample of 1523 low-income women in Wisconsin that received home visiting services. Participants ranging in age from 16 to 50 years were coded into five racial/ethnic groups, including Hispanics and four non-Hispanic groups: blacks, whites, American Indians, and other race. Following measurement conventions, ten dichotomous indicators of child maltreatment and household dysfunction were used to create a composite ACE score. Five other potential childhood adversities were also assessed: food insecurity, homelessness, prolonged parental absence, peer victimization, and violent crime victimization. Results from bivariate and multivariate analyses revealed that, while rates of adversity were high overall, there were significant racial/ethnic differences. Total ACE scores of American Indians were comparable to the ACE scores of non-Hispanic whites, which were significantly higher than the ACE scores of non-Hispanic blacks and Hispanics. Whites were more likely than blacks to report any abuse or neglect, and they were more likely than blacks and Hispanics to report any household dysfunction. The results underscore the need to account for socioeconomic differences when making racial/ethnic comparisons. Potential explanations for the observed differences are examined.
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Affiliation(s)
- Joshua P Mersky
- Helen Bader School of Social Welfare, Institute for Child and Family Well-being, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53201, United States.
| | - Colleen E Janczewski
- Helen Bader School of Social Welfare, Institute for Child and Family Well-being, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53201, United States
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Logue MW, van Rooij SJH, Dennis EL, Davis SL, Hayes JP, Stevens JS, Densmore M, Haswell CC, Ipser J, Koch SBJ, Korgaonkar M, Lebois LAM, Peverill M, Baker JT, Boedhoe PSW, Frijling JL, Gruber SA, Harpaz-Rotem I, Jahanshad N, Koopowitz S, Levy I, Nawijn L, O'Connor L, Olff M, Salat DH, Sheridan MA, Spielberg JM, van Zuiden M, Winternitz SR, Wolff JD, Wolf EJ, Wang X, Wrocklage K, Abdallah CG, Bryant RA, Geuze E, Jovanovic T, Kaufman ML, King AP, Krystal JH, Lagopoulos J, Bennett M, Lanius R, Liberzon I, McGlinchey RE, McLaughlin KA, Milberg WP, Miller MW, Ressler KJ, Veltman DJ, Stein DJ, Thomaes K, Thompson PM, Morey RA. Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia. Biol Psychiatry 2018; 83:244-253. [PMID: 29217296 PMCID: PMC5951719 DOI: 10.1016/j.biopsych.2017.09.006] [Citation(s) in RCA: 272] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Many studies report smaller hippocampal and amygdala volumes in posttraumatic stress disorder (PTSD), but findings have not always been consistent. Here, we present the results of a large-scale neuroimaging consortium study on PTSD conducted by the Psychiatric Genomics Consortium (PGC)-Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) PTSD Working Group. METHODS We analyzed neuroimaging and clinical data from 1868 subjects (794 PTSD patients) contributed by 16 cohorts, representing the largest neuroimaging study of PTSD to date. We assessed the volumes of eight subcortical structures (nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen, thalamus, and lateral ventricle). We used a standardized image-analysis and quality-control pipeline established by the ENIGMA consortium. RESULTS In a meta-analysis of all samples, we found significantly smaller hippocampi in subjects with current PTSD compared with trauma-exposed control subjects (Cohen's d = -0.17, p = .00054), and smaller amygdalae (d = -0.11, p = .025), although the amygdala finding did not survive a significance level that was Bonferroni corrected for multiple subcortical region comparisons (p < .0063). CONCLUSIONS Our study is not subject to the biases of meta-analyses of published data, and it represents an important milestone in an ongoing collaborative effort to examine the neurobiological underpinnings of PTSD and the brain's response to trauma.
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Affiliation(s)
- Mark W Logue
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts; Department of Biomedical Genetics, Boston University School of Medicine, Boston, Massachusetts; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Emily L Dennis
- Imaging Genetics Center, Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Sarah L Davis
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina
| | - Jasmeet P Hayes
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Maria Densmore
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Courtney C Haswell
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina
| | - Jonathan Ipser
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Saskia B J Koch
- Brain Imaging Center, Academic Medical Center, Amsterdam, the Netherlands
| | - Mayuresh Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, Sydney, Australia
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Harvard University, Belmont, Massachusetts
| | - Matthew Peverill
- Department of Psychology, University of Washington, Seattle, Washington
| | - Justin T Baker
- McLean Hospital, Harvard University, Belmont, Massachusetts
| | - Premika S W Boedhoe
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Jessie L Frijling
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Staci A Gruber
- McLean Hospital, Harvard University, Belmont, Massachusetts
| | - Ilan Harpaz-Rotem
- Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut HealthCare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Neda Jahanshad
- Imaging Genetics Center, Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Sheri Koopowitz
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Ifat Levy
- Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut HealthCare System, West Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Laura Nawijn
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Lauren O'Connor
- Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York, New York; Graduate Center, City University of New York, New York, New York
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, Arq National Trauma Center, Diemen, the Netherlands
| | - David H Salat
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts; Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina
| | - Jeffrey M Spielberg
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | - Mirjam van Zuiden
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Jonathan D Wolff
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Harvard University, Belmont, Massachusetts
| | - Erika J Wolf
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, Ohio
| | - Kristen Wrocklage
- Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut HealthCare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Chadi G Abdallah
- Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut HealthCare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Richard A Bryant
- Department of Psychology, University of New South Wales, Sydney, Australia
| | - Elbert Geuze
- Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Harvard University, Belmont, Massachusetts
| | - Anthony P King
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - John H Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, VA Connecticut HealthCare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jim Lagopoulos
- Neuroimaging Brain & Mind Research Institute, University of Sydney, Sydney, Australia
| | - Maxwell Bennett
- Neuroimaging Brain & Mind Research Institute, University of Sydney, Sydney, Australia
| | - Ruth Lanius
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, Massachusetts; Geriatric Research, Educational and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - William P Milberg
- Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, Massachusetts; Geriatric Research, Educational and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Kerry J Ressler
- McLean Hospital, Harvard University, Belmont, Massachusetts; Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Kathleen Thomaes
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Mary and Mark Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Rajendra A Morey
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina.
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Wingenfeld K, Kuehl LK, Boeker A, Schultebraucks K, Schulz A, Stenzel J, Spitzer C, Otte C. Are adverse childhood experiences and depression associated with impaired glucose tolerance in females? An experimental study. J Psychiatr Res 2017; 95:60-67. [PMID: 28783579 DOI: 10.1016/j.jpsychires.2017.07.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Received: 04/05/2017] [Revised: 06/20/2017] [Accepted: 07/31/2017] [Indexed: 01/01/2023]
Abstract
Adverse childhood experiences (ACE) enhance the risk for mental disorders, e.g. major depressive disorder (MDD). Increasing evidence suggests an association between ACE and impaired physical health, e.g. metabolic syndrome. The aim of this study was to assess several metabolic risk markers in healthy individuals with and without ACE and depressed patients with and without ACE. We examined glucose and insulin release in the oGTT in 33 women with MDD and ACE, 47 women with MDD without ACE, 21 women with ACE but no current or lifetime MDD and 36 healthy women without either MDD or ACE. Several metabolic markers such as triglycerides, cholesterol, LDL, HDL, HbA1c, BMI and waist to hip ratio were assessed. The four groups did neither differ in insulin release and glucose concentrations in the oGTT nor with respect to other metabolic variables. Depressed patients with and without psychotropic medication did not differ in any outcome variable, but there was a trend towards higher glucose concentrations in the oGTT in patients with current psychotropic medication. In this physically healthy sample neither ACE nor MDD were associated with metabolic risk factors. Thus, metabolic alterations might not directly be linked to ACE and depression.
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Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Linn K Kuehl
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Anita Boeker
- Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
| | - Katharina Schultebraucks
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Anne Schulz
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Julia Stenzel
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Christian Otte
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Begemann MJH, Stotijn E, Schutte MJL, Heringa SM, Sommer IEC. Letter to the Editor: Beyond childhood trauma - stressful events early and later in life in relation to psychotic experiences. Psychol Med 2017; 47:2731-2736. [PMID: 28414010 DOI: 10.1017/s0033291717000538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M J H Begemann
- Department of Psychiatry,University Medical Center Utrecht and Brain Center Rudolf Magnus,Heidelberglaan 100, 3485 CX Utrecht,The Netherlands
| | - E Stotijn
- Department of Psychiatry,University Medical Center Utrecht and Brain Center Rudolf Magnus,Heidelberglaan 100, 3485 CX Utrecht,The Netherlands
| | - M J L Schutte
- Department of Psychiatry,University Medical Center Utrecht and Brain Center Rudolf Magnus,Heidelberglaan 100, 3485 CX Utrecht,The Netherlands
| | - S M Heringa
- Department of Psychiatry,University Medical Center Utrecht and Brain Center Rudolf Magnus,Heidelberglaan 100, 3485 CX Utrecht,The Netherlands
| | - I E C Sommer
- Department of Psychiatry,University Medical Center Utrecht and Brain Center Rudolf Magnus,Heidelberglaan 100, 3485 CX Utrecht,The Netherlands
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Ma Z, Bayley MT, Perrier L, Dhir P, Dépatie L, Comper P, Ruttan L, Munce SE. The association between adverse childhood experiences and traumatic brain injury/concussion in adulthood: A scoping review protocol. BMJ Open 2017; 7:e018425. [PMID: 29025849 PMCID: PMC5652488 DOI: 10.1136/bmjopen-2017-018425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Exposure to adverse childhood experiences (ACEs) is a significant risk factor for physical and mental illnesses later in life. Concussion or traumatic brain injury is a challenging condition where preinjury factors may interact to affect recovery. The association between ACEs and traumatic brain injury/concussion is not well mapped in any previous reviews of the literature. Using a scoping review methodology, the research question that will be addressed is: what is known from the existing literature about the association between ACEs and traumatic brain injury/concussion in adults? METHODS AND ANALYSIS The methodological frameworks outlined by Arksey and O'Malley and Levac et al will be used. All original studies in English published since 2007 investigating ACEs and traumatic brain injury/concussion outcomes will be included with no limitations on study type. Literature search strategies will be developed using medical subject headings and text words related to ACEs and traumatic brain injury/concussions. Multiple electronic databases will be searched. Two independent reviewers will screen titles and abstracts for full-text review and full texts for final inclusion. Two independent reviewers will extract data on study characteristics for ACE exposure and traumatic brain injury/concussion outcomes. Extracted data will be summarised quantitatively using numerical counts and qualitatively using thematic analysis. DISSEMINATION This review will identify knowledge gaps on the associations between ACEs and traumatic brain injury/concussion and promote further research. Knowledge translation will occur throughout the review process with dissemination of project findings to stakeholders at the local, national and international levels.
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Affiliation(s)
- Zechen Ma
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Mark T Bayley
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Laure Perrier
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Priya Dhir
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lana Dépatie
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Comper
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Lesley Ruttan
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sarah Ep Munce
- Hull-Ellis Concussion Research Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Bandoli G, Campbell-Sills L, Kessler RC, Heeringa SG, Nock MK, Rosellini AJ, Sampson NA, Schoenbaum M, Ursano RJ, Stein MB. Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis. Psychol Med 2017; 47:2379-2392. [PMID: 28443533 PMCID: PMC5595661 DOI: 10.1017/s0033291717001064] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers. METHODS The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed. RESULTS Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment. CONCLUSIONS New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.
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Affiliation(s)
- Gretchen Bandoli
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | | | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Steven G. Heeringa
- University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
| | - Matthew K. Nock
- Department of Psychology, Harvard College, Cambridge, MA, USA
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
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49
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King E, Steenson C, Shannon C, Mulholland C. Prevalence rates of childhood trauma in medical students: a systematic review. BMC Med Educ 2017; 17:159. [PMID: 28899378 PMCID: PMC5594709 DOI: 10.1186/s12909-017-0992-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 10/31/2016] [Accepted: 08/28/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND It is known that medical students suffer from high rates of mental health difficulties. In recent years there has been an increasing focus on the need to improve support and treatment services for those in difficulty. In order to meet these needs it is important to clarify the relevant aetiological factors. There is robust evidence from general population studies that a history of childhood trauma (including physical and sexual abuse and emotional neglect) predisposes to the subsequent development of mental health difficulties in adult life. It has previously been speculated that students with a history of such trauma might preferentially apply to study medicine. METHODS This systematic review seeks to examine the existing evidence base with regard to rates of childhood trauma in medical student populations. Articles were identified through a literature search of psychINFO, web of science, Embase and medline. RESULTS This search generated 11 articles which were deemed to meet criteria for inclusion in this review. There is a wide range of results given for rates of childhood trauma in these studies. CONCLUSIONS The published research which examines rates of childhood trauma affecting medical students is limited and difficult to generalise from, or to use to draw firm conclusions. Given the possible negative outcomes of a history of childhood trauma in medical students, including that such a history may be associated with difficulties in a student progressing in their undergraduate and postgraduate examinations, well-organised prospective studies are required.
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Affiliation(s)
- Eimear King
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Claire Steenson
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Ciaran Shannon
- School of Psychology, Queen’s University of Belfast, Belfast, Northern Ireland UK
| | - Ciaran Mulholland
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
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Rey R, D'Amato T, Boyer L, Brunel L, Aouizerate B, Berna F, Capdevielle D, Chereau I, Chesnoy-Servanin G, Denizot H, Dorey JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Lancon C, Mallet J, Misdrahi D, Passerieux C, Schandrin A, Schürhoff F, Urbach M, Vidailhet P, Llorca PM, Fond G. Nicotine dependence is associated with depression and childhood trauma in smokers with schizophrenia: results from the FACE-SZ dataset. Eur Arch Psychiatry Clin Neurosci 2017; 267:567-577. [PMID: 28389889 DOI: 10.1007/s00406-017-0779-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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] [Received: 06/20/2016] [Accepted: 03/06/2017] [Indexed: 12/27/2022]
Abstract
In a perspective of personalized care for smoking cessation, a better clinical characterization of smokers with schizophrenia (SZ) is needed. The objective of this study was to determine the clinical characteristics of SZ smokers with severe nicotine (NIC) dependence. 240 stabilized community-dwelling SZ smokers (mean age = 31.9 years, 80.4% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and assessed with validated scales. Severe NIC dependence was defined by a Fagerstrom questionnaire score ≥ 7. Depression was defined by a Calgary score ≥ 6. Childhood trauma was self-reported by the Childhood Trauma Questionnaire score (CTQ). Ongoing psychotropic treatment was recorded. Severe NIC dependence was identified in 83 subjects (34.6%), depression in 60 (26.3%). 44 (22.3%) subjects were treated by antidepressants. In a multivariate model, severe NIC dependence remained associated with depression (OR = 3.2, p = 0.006), male gender (OR = 4.5, p = 0.009) and more slightly with childhood trauma (OR = 1.03, p = 0.044), independently of socio-demographic characteristics, psychotic symptoms severity, psychotropic treatments and alcohol disorder. NIC dependence was independently and strongly associated with, respectively, depression and male gender in schizophrenia, and only slightly with history of childhood trauma. Based on these results, the care of both nicotine dependence and depression should be evaluated for an effective smoking cessation intervention in schizophrenia.
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Affiliation(s)
- Romain Rey
- Fondation FondaMental, Créteil, France.
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France.
| | - Thierry D'Amato
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Laurent Boyer
- Fondation FondaMental, Créteil, France
- Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274, Marseille cedex 09, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France
- INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France, Université de Bordeaux, Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000, Bordeaux, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Gabrielle Chesnoy-Servanin
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Hélène Denizot
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Créteil, France
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France
- Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Catherine Faget
- Fondation FondaMental, Créteil, France
- Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Franck Gabayet
- Fondation FondaMental, Créteil, France
- Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Christophe Lancon
- Fondation FondaMental, Créteil, France
- Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France, Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France
- Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Aurélie Schandrin
- Fondation FondaMental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France
- INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France
- Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Pierre Vidailhet
- Fondation FondaMental, Créteil, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France
- Clinique Jeanne D'Arc-Hôpital Privé Parisien, Saint Mandé, F94000, France, CHU Carémeau, Nîmes, F30000, France
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