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Almaradheef R, Alhalal E. Outcomes of adverse childhood experience during late adolescence: Evidence from college and community samples. Res Nurs Health 2024; 47:182-194. [PMID: 38217469 DOI: 10.1002/nur.22368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/31/2023] [Accepted: 12/23/2023] [Indexed: 01/15/2024]
Abstract
Scant studies have investigated adverse childhood experience (ACE) outcomes and mastery during adolescence in different cultural contexts. This cross-sectional study examines the impact of ACEs on subjective well-being, health complaints, and healthcare utilization during late adolescence, including the mediating role of the sense of mastery in the Saudi context. Adolescents (N = 396) aged 17-21 years were recruited via convenience sampling from colleges and local communities from two regions in Saudi Arabia. Data were collected using a paper-pencil anonymous survey and analyzed using path analysis. Of the sample, 85.5% experienced at least one ACE. ACEs had a direct effect on subjective well-being (p = 0.034), health complaints (p < 0.001), healthcare utilization (p < 0.001), and sense of mastery (p < 0.001). Sense of mastery had an effect on subjective well-being (p < 0.001) and health complaints (p < 0.001), but not on healthcare utilization (p = 0.436). Sense of mastery partially mediated the relationship between ACEs and subjective well-being (p = 0.034) and health complaints (p < 0.001), but not healthcare utilization (p = 0.438). ACEs have detrimental effects on adolescent health. Attention should be paid to primary prevention and early detection to avoid further harm, and interventions that address the role of the sense of mastery should be developed for adolescents.
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Affiliation(s)
| | - Eman Alhalal
- Community and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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Ashour R, Halstead EJ, Mangar S, Lin VKQ, Azhari A, Carollo A, Esposito G, Threadgold L, Dimitriou D. Childhood experiences and sleep problems: A cross-sectional study on the indirect relationship mediated by stress, resilience and anxiety. PLoS One 2024; 19:e0299057. [PMID: 38507345 PMCID: PMC10954170 DOI: 10.1371/journal.pone.0299057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/02/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact sleep quality in adult life, which in turn are modulated by the interplay of a variety of factors such as depression, anxiety, resilience and mental health problems. METHODS A cross-sectional observational study was conducted across the UK and the Middle Eastern countries during the COVID-pandemic on 405 participants. An online survey used a combination of questionnaires to assess ACE and BCEs. The following tools were then used to assess the contribution of resilience, stress, depression and anxiety respectively: Brief Resilience Scale (BRS), Perceived Stress Scale (PSS-10), Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) scale on childhood experiences. The extent of sleep disturbances experienced over a period of seven days was assessed using the PROMIS Sleep Disturbance Short-Form Tool. A serial-parallel mediation model was used to evaluate the impact of the mediators on childhood experiences and sleep quality. RESULTS Over 50% of the cohort were from Middle Eastern countries. Four or more BCEs were experienced by 94.3% of the cohort. In contrast, 67.9% of participants experienced at least one ACE before the age of 18 years, with moderate levels of stress, mild depression and anxiety were reported in 3.7%, 13% and 20% of participants respectively. Whilst 25.4% of participants reported having had four or more ACEs, with higher reports in the middle easter countries (32%). ACEs were found to correlate with sleep disturbance whilst BCEs showed an inverse correlation. The relationship between ACE and sleep disturbances was shown to be mediated by stress, and anxiety, but not by resilience or depression. Resilience and stress, and resilience and anxiety serially mediated the interaction between ACE and sleep disturbance. With regards to BCE, an inverse association with sleep disturbance was recorded with similar mediators of stress and anxiety observed. CONCLUSION This study confirms the negative effects of ACEs, and the positive effects of BCEs on sleep in adulthood which are both mediated predominantly by psychological resilience, anxiety and stress. Strategies aimed at improving psychological resilience as well as addressing stress and anxiety may help improve sleep quality.
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Affiliation(s)
- Rola Ashour
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Elizabeth J. Halstead
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Stephen Mangar
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
- Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - Vanessa Khoo Qi Lin
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Atiqah Azhari
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Laura Threadgold
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Psychology and Human Development, UCL-Institute of Education, London, United Kingdom
- Psychology and Human Development Department, UCL, IOE Faculty of Education and Society, London, United Kingdom
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Alnasser LA, Moro MF, Naseem MT, Bilal L, Akkad M, Almeghim R, Al-Habeeb A, Al-Subaie AS, Altwaijri YA. Social determinants of anxiety and mood disorders in a nationally-representative sample - Results from the Saudi National Mental Health Survey (SNMHS). Int J Soc Psychiatry 2024; 70:166-181. [PMID: 37740657 DOI: 10.1177/00207640231197944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
INTRODUCTION Social determinants of health (SDH) influence and modify the risk for mental health disorders. To our knowledge, no study has explored SDH in the context of mental health in Saudi Arabia (SA) using population-based data. This study investigated the association between several SDH and anxiety and mood disorders in SA. METHODS We utilized data from the nationally-representative Saudi National Mental Health Survey (SNMHS) conducted in 2014 to 2016. This study examined associations between personal-level, socioeconomic, physical health, and family environment characteristics and anxiety and mood disorders. Participants were classified as having anxiety-only disorders, mood-only disorders, or comorbidity of both disorders. Multinomial logistic regression models were employed to examine the associations between SDH and anxiety and/or mood disorders, comparing them to participants who had not experienced these disorders. RESULTS A total of 4,004 participants were included in this analysis; the lifetime prevalence of disorders was: anxiety only (18%), mood only (3.8%), and comorbidity of both (5.3%). Regression models indicated that females, young adults (26-35 years), individuals with a higher level of education, and those who were separated or widowed had higher odds of experiencing anxiety and/or mood disorders. Furthermore, there was a significant and direct association between having physical chronic conditions and all three categories of anxiety and mood disorders. Experiencing Adverse Childhood Events (ACEs) was also associated with a significant risk of developing anxiety and/or mood disorders, with the highest risk associated with physical or sexual abuse, followed by violence and neglect. CONCLUSION This study underscores the correlation between several personal-level, socioeconomic, and environmental SDH and anxiety and mood disorders in SA. These findings provide a foundation for future analyses examining the intricate interplay between upstream and downstream SDH in SA. Such research can enhance local scientific knowledge, aid in planning for social services, and inform policy decisions and treatment strategies.
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Affiliation(s)
- Lubna A Alnasser
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Mohammad Talal Naseem
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marya Akkad
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reema Almeghim
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Prevention, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah S Al-Subaie
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Yasmin A Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Elrefaay SMM, Elyzal AS. Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation. J Psychosoc Nurs Ment Health Serv 2024; 62:45-54. [PMID: 37527517 DOI: 10.3928/02793695-20230726-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].
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Oei A, Li D, Chu CM, Ng I, Hoo E, Ruby K. Disruptive behaviors, antisocial attitudes, and aggression in young offenders: Comparison of Adverse Childhood Experience (ACE) typologies. CHILD ABUSE & NEGLECT 2023; 141:106191. [PMID: 37084615 DOI: 10.1016/j.chiabu.2023.106191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young offenders' antisocial attitudes, disruptive behaviors and aggression, risk factors for delinquency and reoffending. OBJECTIVE This study examined ACE patterns and their association with the above factors in young offenders. PARTICIPANTS AND SETTING 1130 youth offenders (964 males; Mage = 17.57 years), provided self-reports on ACEs, antisocial attitudes, disruptive behavior ratings and aggression. METHOD Latent Class Analysis was performed on 12 self-reported ACEs, followed by Analyses of Covariance on each of the measures. RESULTS Four classes - Low ACE, Indirect Victims, Abusive Environment, and Polyvictimized - were identified. Polyvictimized youths had the highest levels of conduct problems (M = 70.35, ps < .05) and proactive aggression (M = 0.45, ps < .05) but did not differ from youths in Abusive Environment in reactive aggression (M = 1.02, p = .69), oppositional problems (M = 65.15, p = .18), and antisocial attitudes (M = 26.95, p = .21). Indirect Victims had lower levels of conduct problems (M = 64.80, p < .05) and antisocial attitudes (M = 24.35, p < .05) than Polyvictimized youths but higher levels of these outcomes than the Low ACE group. CONCLUSIONS Our findings showed that ACEs patterns vary in their effects on antisociality and disruptive behaviors. The novel finding was that childhood victimization does not have to be direct, as indirect victimization significantly impacted factors important to delinquency and reoffending.
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Affiliation(s)
- Adam Oei
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore.
| | - Dongdong Li
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore
| | - Chi Meng Chu
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Policy Research Office, Ministry of Social and Family Development, 512 Thomson Road, MSF Building, #07-00, 298136, Singapore
| | - Irene Ng
- Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore
| | - Eric Hoo
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore
| | - Kala Ruby
- Probation and Community Rehabilitation Services, Ministry of Social and Family Development, 1 Kay Siang Road, #01-10, 248922, Singapore
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Adverse Childhood Experience as a Risk Factor for Developing Type 2 Diabetes among the Jazan Population: A Cross-Sectional Study. CHILDREN 2023; 10:children10030499. [PMID: 36980057 PMCID: PMC10047776 DOI: 10.3390/children10030499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/19/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
Background: Adverse Childhood Experiences (ACEs), such as childhood abuse, neglect, and family dysfunction, prevent appropriate emotional, behavioral, and physical development. They are also a major public health issue, and have been debatably linked to chronic diseases, including type 2 diabetes mellitus (T2DM). T2DM is highly prevalent in Saudi Arabia, and various theories have been raised to explain the epidemiology of diabetes. However, few studies have discussed the relationship between ACEs and T2DM. Thus, we aimed to evaluate the association between ACEs and T2DM in Jazan Province, Saudi Arabia. Methods: This observational, cross-sectional study was conducted using a validated questionnaire distributed among patients with T2DM in a diabetes center. The t-test and Chi-Square test were used for comparison, and the p-value was set at <0.05 for significance. Results: A total of 579 participants were involved in this study, and 303 (52.33%) were female. Among the included participants, 45.25% were diagnosed with T2DM. About 28.71% of participants with diabetes experienced verbal abuse, 16.09% experienced physical abuse, and 30.91% reported that parents beat them. Additionally, 1.58% of participants with diabetes reported living with a family member who abused substances, 8.83% believed that no one would take them to the doctor even if essential, 12.62% of participants with diabetes felt that no one would protect them, and 23.03% reported that they felt no one in their family loved them. All reported ACEs were significantly associated with a high risk of T2DM (p < 0.05), and the more frequent the ACEs, the more the risk of T2DM (p = 0.0001). Conclusions: This study indicated that ACEs are significantly associated with the development of T2DM, and the risk increases with the frequency of ACEs, which aligns with other studies. Further national studies are required to understand how ACEs could contribute to T2DM, and preventive interventions in childhood must be considered to reduce the burden of T2DM.
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