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Bhattarai A, King N, Dimitropoulos G, Cunningham S, Rivera D, Tough S, Bulloch AGM, Patten SB, Duffy A. Did childhood adversity increase the vulnerability of university students to the negative mental health impact of the COVID-19 pandemic? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38830179 DOI: 10.1080/07448481.2024.2360424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/19/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE To examine a potential synergistic effect of history of childhood adversity and COVID-19 pandemic exposure on the association with mental health concerns in undergraduate students. Participants: We used U-Flourish Survey data from 2019 (pre-pandemic) and 2020 (during-pandemic) first-year cohorts (n = 3,149) identified at entry to a major Canadian University. METHODS Interactions between childhood adversity (physical and sexual abuse, and peer bullying) and COVID-19 pandemic exposure regarding mental health concern (depressive and anxiety symptoms, suicidality, and non-suicidal self-harm) were examined on an additive scale. RESULTS We found a positive additive interaction between physical abuse and pandemic exposure in relation to suicidality (combined effect was greater than additive effect (risk difference 0.54 vs. 0.36)). Conversely, less than additive interactions between peer bullying and pandemic regarding depression and anxiety were observed. CONCLUSIONS Childhood adversities have diverse reactions to adult stressor depending on the nature of the childhood adversity and the mental health outcomes.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Gina Dimitropoulos
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Suzanne Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Research & Education, University of Calgary, Calgary, AB, Canada
| | - Anne Duffy
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
- Department of Psychiatry, University of Oxford, Oxford, UK
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Zhen-Duan J, Alvarez K, Zhang L, Cruz-Gonzalez M, Kuo J, Falgas-Bagué I, Bird H, Canino G, Duarte CS, Alegría M. Parental psychopathology and posttraumatic stress in Puerto Ricans: the role of childhood adversity and parenting practices. J Child Psychol Psychiatry 2024; 65:742-752. [PMID: 37850715 PMCID: PMC11024057 DOI: 10.1111/jcpp.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations. METHODS Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four-wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5-13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2-3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model. RESULTS Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2-3 (direct effect b = 1.72, 95% CI = [-0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent-child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology-PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent-child relationship quality scores. CONCLUSIONS Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family-based interventions focused on providing families with the tools to improve parent-child relationships may reduce the negative impact of childhood adversities on mental health across the life course.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kiara Alvarez
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lulu Zhang
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Josephine Kuo
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Irene Falgas-Bagué
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Hector Bird
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Glorisa Canino
- Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, PR, USA
| | - Cristiane S. Duarte
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Kazemian N, Zhou T, Chalasani N, Narayan A, Cedeño Laurent JG, Olvera Alvarez HA, Pakpour S. Long-Term Impact of Childhood Adversity on the Gut Microbiome of Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:68. [PMID: 38248533 PMCID: PMC10815413 DOI: 10.3390/ijerph21010068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Adverse childhood experiences (ACEs) encompass negative, stressful, and potentially traumatic events during childhood, impacting physical and mental health outcomes in adulthood. Limited studies suggest ACEs can have short-term effects on children's gut microbiomes and adult cognitive performance under stress. Nevertheless, the long-term effects of ACEs experienced during adulthood remain unexplored. Thus, this study aimed to assess the long-term effects of ACEs on the gut microbiota of adult nursing students. We employed a multidimensional approach, combining 16S rRNA sequencing, bioinformatics tools, and machine learning to predict functional capabilities. High-ACE individuals had an increased abundance of Butyricimonas spp. and Prevotella spp. and decreased levels of Clostridiales, and Lachnospira spp. Prevotella abundance correlated negatively with L-glutamate and L-glutamine biosynthesis, potentially impacting intestinal tissue integrity. While nursing students with high ACE reported increased depression, evidence for a direct gut microbiota-depression relationship was inconclusive. High-ACE individuals also experienced a higher prevalence of diarrhea. These findings highlight the long-lasting impact of ACEs on the gut microbiota and its functions in adulthood, particularly among nursing students. Further research is warranted to develop targeted interventions and strategies for healthcare professionals, optimizing overall health outcomes.
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Affiliation(s)
- Negin Kazemian
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| | - Tony Zhou
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Naveen Chalasani
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Apurva Narayan
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
- Department of Computer Science, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
- Department of Electrical and Computer Engineering, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
| | - Jose Guillermo Cedeño Laurent
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | | | - Sepideh Pakpour
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
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Watters ER, Aloe AM, Wojciak AS. Examining the Associations Between Childhood Trauma, Resilience, and Depression: A Multivariate Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:231-244. [PMID: 34313169 DOI: 10.1177/15248380211029397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
TOPIC OF REVIEW Childhood trauma has been associated with increased depression; however, resilience has been found to reduce this association. METHOD OF REVIEW Present analyses were based on multivariate meta-analytical techniques, an extension of univariate meta-analysis. All computations were performed using the metafor package and the metaRmat package from R. Bivariate associations (r) between trauma, resilience, and depression were utilized as the pooled effect sizes. CRITERIA FOR INCLUSION Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were coded based on the following inclusion criteria: (a) sample participants had a history of childhood trauma; (b) studies included one of the four instruments of trait resilience; (c) studies included measures of individual outcomes of depression; (d) studies were published in peer-reviewed journals, dissertations, book chapters since 2009, or provided by leading scholars who had yet to publish their data; (e) all manuscripts were written in English; and (f) studies included the Pearson Product Moment Correlation Coefficient (r) for the effect size. CRITERIA FOR REVIEW We systematically coded for the following items for each study: year of publication, type of report, peer-reviewed, funding, sampling strategy, sample size, gender, mean age, country of study, measure of resilience, measure depression, and measure of childhood trauma. MAJOR FINDINGS The pooled correlations indicate that trauma, resilience, and depression are significantly associated. There were no significant differences in symptoms of depression for high versus low reports of resilience for individuals with a history of trauma. Year of publication was a significant moderator for the associations between trauma, resilience, and depression. Resilience significantly mediated the association between trauma and depression.
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Affiliation(s)
- Elizabeth R Watters
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Ariel M Aloe
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Armeda S Wojciak
- Department of Family Social Sciences, University of Minnesota, MN, USA
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Brittain K, Zerbe A, Phillips TK, Gomba Y, Mellins CA, Myer L, Abrams EJ. Impact of adverse childhood experiences on women's psychosocial and HIV-related outcomes and early child development in their offspring. Glob Public Health 2022; 17:2779-2791. [PMID: 34613893 PMCID: PMC8983791 DOI: 10.1080/17441692.2021.1986735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
Adverse childhood experiences (ACEs) may have a critical influence on adult outcomes and subsequent offspring development, but few data have explored the effects of ACEs in low-resource settings where the burdens of childhood adversity and HIV are high. Among mothers living with HIV in Cape Town, we examined the effects of ACEs on maternal psychosocial and HIV-related outcomes, as well as early child development in their offspring aged 36-60 months. The World Health Organization's Adverse Childhood Experiences International Questionnaire was used to measure maternal reports of ACEs, and the Ages & Stages Questionnaire to screen for developmental delays in their offspring. Among 353 women (median age: 32 years), 84% reported ≥1 ACEs. Increased report of ACEs was strongly associated with depressive symptoms, hazardous alcohol use, intimate partner violence and self-reported suboptimal adherence to antiretroviral therapy. These associations were driven by more severe childhood experiences, including abuse, neglect and exposure to collective violence. Among 255 women who reported on their child's development, maternal ACEs were associated with poorer socioemotional development. These data suggest that childhood adversity has long-term effects on maternal outcomes as well as their children's socioemotional development and point to ACEs that might be targeted for screening and intervention.
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Affiliation(s)
- Kirsty Brittain
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Allison Zerbe
- ICAP at Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Tamsin K. Phillips
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Yolanda Gomba
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Elaine J. Abrams
- ICAP at Columbia University, Mailman School of Public Health, New York, NY, USA
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
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Physical activity mitigates the link between adverse childhood experiences and depression among U.S. adults. PLoS One 2022; 17:e0275185. [PMID: 36223342 PMCID: PMC9555628 DOI: 10.1371/journal.pone.0275185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) include potentially traumatic exposures to neglect, abuse, and household problems involving substance abuse, mental illness, divorce, incarceration, and death. Past study findings suggest ACEs contribute to depression, while physical activity alleviates depression. Little is known about the link between ACEs and physical activity as it relates to depression among U.S. adults. This research had a primary objective of determining the role of physical activity within the link between ACEs and depression. The significance of this study involves examining physical activity as a form of behavioral medicine. METHODS Data from the 2020 Behavioral Risk Factor Surveillance System were fit to Pearson chi-square and multivariable logistic regression models to examine the links between ACEs and depression, ACEs and physical activity, and physical activity and depression among U.S. adults ages 18-and-older (n = 117,204) from 21 states and the District of Columbia, while also determining whether physical activity attenuates the association between ACEs and depression. RESULTS Findings from chi-square analyses indicated that ACEs are related to physical activity (χ2 = 19.4, df = 1; p<0.01) and depression (χ2 = 6,841.6, df = 1; p<0.0001). Regression findings suggest ACEs were linked to depression (AOR = 1.050; 95% CI = 1.049, 1.051). ACEs and physical activity (AOR = 0.994; 95% CI = 0.992, 0.995) and physical activity and depression (AOR = 0.927; 95% CI = 0.922, 0.932) were both inversely related. Physical activity mitigated the link between ACEs and depression (AOR = 0.995; 95% CI = 0.993, 0.996). CONCLUSIONS This research addressed a critical knowledge gap concerning how ACEs and physical activity contribute to depression outcomes among U.S. adults. Findings suggest physical activity mitigates the effect of ACEs on depression. Future studies should apply physical activity interventions to alleviate depression among U.S. adults with high ACEs.
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Khanijahani A, Sualp K. Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6-17 years old US Children: Evidence from a Population-Based Study. Community Ment Health J 2022; 58:166-178. [PMID: 33709281 DOI: 10.1007/s10597-021-00808-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 02/23/2021] [Indexed: 11/24/2022]
Abstract
We pooled data from four years (2016-2019) of the National Survey of Children's Health (NSCH) and included a nationally representative sample of 6 to 17 years old US children (N = 94,369; Mean age = 11.53 years, Standard Deviation [SD] = 3.53). Among 6-17-year-old US children, about 48% had a lifelong exposure to at least one of nine Adverse Childhood Experiences (ACEs), and 18.7% had a current diagnosis of at least one of four mental disorders. We examined the association between ACEs, neighborhood support, and mental disorders using several logistic regression models. More types of lifelong ACEs and lower neighborhood support were associated with a higher diagnosis of internalizing (anxiety/depression) and externalizing (ADHD/behavior problems) mental disorders (odds ratio [OR] > 1, and p < .001 for all relationships). After controlling for neighborhood support in the models, the odds ratios for ACEs attenuated but remained significant in all models regardless of mental disorder type or age group. However, the odds ratios for neighborhood support were larger for the association with ADHD/behavior problems than anxiety/depression. Moreover, odds ratios for neighborhood support levels were higher for older children (12-17 years old) compared to younger (6-11 years old) children. Higher neighborhood support appears to mitigate the adverse effects of ACEs on mental disorders, especially externalizing mental disorders (anxiety/depression) among adolescents (12-17 years old).
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Affiliation(s)
- Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Kenan Sualp
- Department of Public Affairs, University of Central Florida, Orlando, FL, USA
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Patterns of adverse childhood experiences and depressive symptoms: self-esteem as a mediating mechanism. Soc Psychiatry Psychiatr Epidemiol 2022; 57:331-341. [PMID: 34191037 PMCID: PMC8243305 DOI: 10.1007/s00127-021-02129-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE There is a growing interest in the co-occurring natures of adverse childhood experiences (ACEs) and unmeasured types of adversity. The current body of knowledge may also lack plausible mechanisms linking ACEs to mental health in young adulthood. This study aims to identify early adversity patterns using expanded ACEs items and investigate the pathway of ACEs and self-esteem to depressive symptoms in young adulthood. METHODS Data were obtained from the National Longitudinal Study of Adolescent and Adult Health, including a nationally representative sample in the U.S. (N = 10,702). We identified the ACEs patterns and estimated the direct and indirect associations between ACEs and depressive symptoms through self-esteem, using a latent class analysis with a distal outcome. RESULTS This study identified four distinct groups of ACEs that include Child Maltreatment, Household Dysfunction, Violence, and Low Adversity. The Child Maltreatment class showed a significantly higher risk of depressive symptoms compared to other ACEs groups. Self-esteem mediated the negative association of child maltreatment with depressive symptoms. The Violence class presented a significantly higher risk of depressive symptoms than Low Adversity, but no mediation of self-esteem was found. CONCLUSION The study highlights the profound consequence of child abuse/neglect and identifies self-esteem as a plausible mediating mechanism. Researchers and practitioners should increase collaboration efforts to prevent early adversity exposures and detrimental effects on mental health.
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What Do Adults Think About Their Adverse Childhood Experiences (ACEs), and Does It Matter? Community Ment Health J 2020; 56:1255-1261. [PMID: 32065317 DOI: 10.1007/s10597-020-00580-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
We examined the self-reported adulthood impact of adverse childhood experiences (ACE's), including both the amount (magnitude) and type (valence positive or negative) of impact reported, in order to characterize variability in impact ratings, as well as to quantify their predictive ability with respect to health outcomes. We descriptively characterized impact by type of event and analyzed associations between impact ratings and demographic characteristics of respondents to explore resilience. We also analyzed the relationships between impact ratings and health outcomes. We found that, while there was wide variability in impact ratings, emotional abuse was rated as the most impactful in magnitude, and sexual and emotional abuse were rated as the most negatively impactful in terms of valence. We further found that impact ratings are predictive of adult health outcomes above and beyond the experience of the events alone. We conclude that perceived impact is a potentially important variable to include when self-reported ACEs are assessed.
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Kelifa MO, Yang Y, Herbert C, He Q, Wang P. Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea. CHILD ABUSE & NEGLECT 2020; 106:104480. [PMID: 32470689 DOI: 10.1016/j.chiabu.2020.104480] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/10/2020] [Accepted: 03/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are well recognized remote risks for adulthood depression. However, proximal processes for this relationship is still an ongoing research endeavor, particularly among college students living in resource-limited settings. The mechanism of the impact of ACEs on depression may be attributed to mediators such as psychological resilience and current stressful events (CSEs). METHODS Data was obtained using a cross-sectional study from a national representative sample of college undergraduates in Eritrea (N = 507). To explain the mediated effect of ACEs on depression, a mediation analysis using structural equation modeling (SEM) was performed. RESULTS ACEs were found to have both direct (β = 0.102, p = 0.023) and indirect (β = 0.216, p < 0.001) effects on depression. The indirect effect was negatively mediated by psychological resilience and positively by CSEs. Respondents with higher levels of psychological resilience reported lower depressive symptoms and lower ACEs scores, while those with higher scores of either CSEs or ACEs reported more depressive symptoms. CONCLUSIONS The impact of ACEs on depression may be reduced by managing current stressors and building students' psychological resilience.
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Affiliation(s)
- Mohammedhamid Osman Kelifa
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China; Orotta College of Medicine and Health Sciences, Asmara, Meakel, Eritrea
| | - Yinmei Yang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Carly Herbert
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Qiqiang He
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
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Riedl D, Lampe A, Exenberger S, Nolte T, Trawöger I, Beck T. Prevalence of adverse childhood experiences (ACEs) and associated physical and mental health problems amongst hospital patients: Results from a cross-sectional study. Gen Hosp Psychiatry 2020; 64:80-86. [PMID: 32304934 DOI: 10.1016/j.genhosppsych.2020.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can have severe detrimental effects on physical and mental health. This study aimed to present prevalence rates of ACEs amongst a mixed sample of hospital patients. METHODS In- and outpatients at seven departments of the University Hospital of Innsbruck (Austria) participated in the study. They completed questionnaires regarding retrospective assessments of ACEs, physical and mental health and experience of domestic violence. The impact of ACEs on patients' health was evaluated by calculation of odds ratios (OR) in binary logistic regressions. RESULTS A total of n = 2392 (74.3% of all approached patients) were included in the analyses. The results showed that 36.1% of them reported at least one form of ACEs, and 6.3% were polyvictimized (i.e. they reported ≥4 forms of ACEs). Most frequent forms of ACE were emotional abuse (18.3%), peer abuse (14.2%), and neglect (12.3%). ACEs were significantly associated with increased ORs for various physical diseases, mental health problems and domestic violence. CONCLUSION Retrospectively assessed ACEs are highly prevalent amongst hospital patients and exposure to high numbers of ACEs is associated with decreased physical and mental health. The identification of patients with symptoms following ACEs and referral to appropriate treatment is a crucial challenge for health-care professionals.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Silvia Exenberger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Tobias Nolte
- Wellcome Department of Imaging Neuroscience, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Iris Trawöger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Beck
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
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Hargreaves MK, Mouton CP, Liu J, Zhou YE, Blot WJ. Adverse Childhood Experiences and Health Care Utilization in a Low-Income Population. J Health Care Poor Underserved 2020; 30:749-767. [PMID: 31130549 DOI: 10.1353/hpu.2019.0054] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine associations of adverse childhood experiences (ACE) with adult health care utilization in an underserved, low-income population. METHODS Questionnaires on ACE were completed by 38,200 adults (mean age 54), two-thirds African American, recruited from community health centers (CHCs) across 12 Southeastern states. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were computed. RESULTS The percentages reporting emergency room visits and doctor's office visits, with high chronic disease index scores, rose monotonically (ptrend<.001) with rising ACE score. Odds ratios (CIs) for those with four or more vs. zero ACEs were 1.37 (95% CI 1.27-1.47) for 1-10 times and 1.80 (95% CI 1.29-2.52) for more than 10 times ER visits, 1.37 (95% CI 1.18-1.59) for over 10 doctor's visits, and 2.29 (95% CI 2.06-2.54) for three or more chronic diseases. CONCLUSIONS High ACE levels were associated with greater chronic disease burden and greater health care utilization in adulthood. Long-lasting effects from ACE on the health care of underserved populations are indicated. There is an urgent need to train health care providers, patients, and their families on ACE effects and treatments for better health care outcomes.
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Suglia SF, Crookes DM, Kaplan R, Sotres-Alvarez D, Llabre MM, Van Horn L, Carnethon MR, Isasi CR. Intergenerational Transmission of Childhood Adversity in Parents and their Children's BMI in the Hispanic Community Children's Health Study/Study of Latino Youth (HCHS/SOL Youth). J Psychosom Res 2020; 131:109956. [PMID: 32044520 PMCID: PMC7415479 DOI: 10.1016/j.jpsychores.2020.109956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/17/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.
| | - Danielle M Crookes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States of America; Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, FL, United States of America
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States of America
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. Childhood maltreatment, vulnerability characteristics and adult incident common mental disorders: 3-year longitudinal data among >10,000 adults in the general population. J Psychiatr Res 2019; 113:199-207. [PMID: 30986694 DOI: 10.1016/j.jpsychires.2019.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 01/07/2023]
Abstract
Childhood maltreatment (CM) is a strong predictor of incident (first-onset and recurrent) mental disorders in adulthood. However, less is known about underlying mechanisms and moderators of these associations. This study examines to what extent vulnerability characteristics (low social support, negative life events, parental psychopathology, neuroticism, history and comorbidity of mental and physical health) contribute to the impact of CM on adult psychopathology. Data from two general population cohorts - the first and second Netherlands Mental Health Survey and Incidence Studies - were combined into one dataset (N = 10,065). CM (emotional, psychological, physical or sexual abuse before the age of 16) and vulnerability characteristics were assessed with a structured face-to-face interview. First-onset and recurrent mental (mood, anxiety, substance use) disorders were assessed using the Composite International Diagnostic Interview. CM doubled the risk of developing a first-onset or recurrent mental disorder at three-year follow-up (OR = 2.08). CM was not only directly connected to incident mental disorders, but also indirectly through vulnerability characteristics. Several vulnerabilities, in particular low social support, parental psychopathology, prior mental disorders and neuroticism, moderated the relationship between CM and adult mental disorders, indicating that these vulnerability factors had a greater effect on incident mental disorders among people with childhood abuse. As not all adults with a history of CM develop mental disorders, these mediating and moderating risk factors might help identify adults with a history of maltreatment who could benefit from preventive interventions.
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Affiliation(s)
- Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | | | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands; Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
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Riedl D, Beck T, Exenberger S, Daniels J, Dejaco D, Unterberger I, Lampe A. Violence from childhood to adulthood: The influence of child victimization and domestic violence on physical health in later life. J Psychosom Res 2019; 116:68-74. [PMID: 30654997 DOI: 10.1016/j.jpsychores.2018.11.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Previous research has shown a detrimental effect of child victimization (CV) on physical disease and mortality. Additionally, individuals with adverse experiences in childhood frequently face domestic violence (DV) in later life. As DV has also been observed to harm physical health, a potential cumulative effect has been proposed. Currently, however, only limited data on such a cumulative effect and its impact on patients' physical health are available. METHODS A cross-sectional observational study at the University Hospital of Innsbruck was conducted. Data on CV, DV and physical health were collected using self-report questionnaires. To evaluate the impact of CV and DV on patients' health, odds ratios (OR) were calculated using binary logistic regression. RESULTS A total of 1480 patients from various departments participated in the study. CV was found for 38% and DV for 16% of participants. A significantly higher occurrence of physical disease was observed in patients with poly-victimization (4+ CVs). When accounting for the cumulative effect of CV and DV, the occurrence was further increased for musculoskeletal disorders (OR:5.1), chronic pain (OR:5.0), gastrointestinal diseases (OR:3.0), metabolic diseases (OR:2.8) and respiratory diseases (OR:2.4). CONCLUSION CV and DV were found to be prevalent and highly correlated in patients treated in a primary care hospital. CV and DV - individually, combined and cumulatively - may thus present risks for physical health. Screening patients for the risk of DV as well as assessing CV may aid in early identification and initiation of psychosocial interventions to avoid further aggravation of physical and psychological problems.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Beck
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Exenberger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Daniel Dejaco
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Iris Unterberger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
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16
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Hoppen TH, Chalder T. Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clin Psychol Rev 2018; 65:81-151. [PMID: 30189342 DOI: 10.1016/j.cpr.2018.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 02/09/2023]
Affiliation(s)
| | - Trudie Chalder
- Academic Department of Psychological Medicine, King's College London, UK
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17
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Poor mental health among low-income women in the U.S.: The roles of adverse childhood and adult experiences. Soc Sci Med 2018; 206:14-21. [PMID: 29679816 DOI: 10.1016/j.socscimed.2018.03.043] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 02/26/2018] [Accepted: 03/11/2018] [Indexed: 01/20/2023]
Abstract
RATIONALE It is well established that exposure to a greater number of adverse childhood experiences (ACEs) increases the risk of poor physical and mental health outcomes. Given the predictive validity of ACE scores and other cumulative risk metrics, a similar measurement approach may advance the study of risk in adulthood. OBJECTIVE We examined the prevalence and interrelations of 10 adverse adult experiences, including household events such as intimate partner violence and extrafamilial events such as crime victimization. We also tested the relation between cumulative adult adversity and later mental health problems, and we examined whether adult adversity mediates the link between childhood adversity and mental health. METHODS Data were collected from 501 women in the Families and Children Thriving Study, a longitudinal investigation of low-income families that received home visiting services in Wisconsin. We conducted correlation analyses to assess interrelations among study measures along with multivariate analyses to test the effects of childhood and adult adversity on three outcomes: depression, anxiety, and posttraumatic stress disorder (PTSD). We then fit a structural equation model to test whether the effects of childhood adversity on mental health are mediated by adult adversity. RESULTS Over 80% of participants endorsed at least one adverse adult experience. Adult adversities correlated with each other and with the mental health outcomes. Controlling for ACEs and model covariates, adult adversity scores were positively associated with depression, anxiety, and PTSD scores. Path analyses revealed that the ACE-mental health connection was mediated by adult adversity. CONCLUSION Our findings indicate that mental health problems may be better understood by accounting for processes through which early adversity leads to later adversity. Pending replication, this line of research has the potential to improve the identification of populations that are at risk of poor health outcomes.
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Adverse Childhood Experiences and Postpartum Depression in Home Visiting Programs: Prevalence, Association, and Mediating Mechanisms. Matern Child Health J 2018; 22:1051-1058. [DOI: 10.1007/s10995-018-2488-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Lueger-Schuster B, Knefel M, Glück TM, Jagsch R, Kantor V, Weindl D. Child abuse and neglect in institutional settings, cumulative lifetime traumatization, and psychopathological long-term correlates in adult survivors: The Vienna Institutional Abuse Study. CHILD ABUSE & NEGLECT 2018; 76:488-501. [PMID: 29276971 DOI: 10.1016/j.chiabu.2017.12.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/05/2017] [Accepted: 12/08/2017] [Indexed: 06/07/2023]
Abstract
Child maltreatment (CM) in foster care settings (i.e., institutional abuse, IA) is known to have negative effects on adult survivor's mental health. This study examines and compares the extent of CM (physical, emotional, and sexual abuse; physical and emotional neglect) and lifetime traumatization with regard to current adult mental health in a group of survivors of IA and a comparison group from the community. Participants in the foster care group (n = 220) were adult survivors of IA in Viennese foster care institutions, the comparison group (n = 234) consisted of persons from the Viennese population. The comparison group included persons who were exposed to CM within their families. Participants completed the Childhood Trauma Questionnaire, the Life Events Checklist for DSM-5, the PTSD Checklist for DSM-5, the International Trauma Questionnaire for ICD-11, and the Brief Symptom Inventory-18 and completed a structured clinical interview. Participants in the foster care group showed higher scores in all types of CM than the comparison group and 57.7% reported exposure to all types of CM. The foster care group had significantly higher prevalence rates in almost all mental disorders including personality disorders and suffered from higher symptom distress in all dimensional measures of psychopathology including depression, anxiety, somatization, dissociation, and the symptom dimensions of PTSD. In both groups, adult life events and some but not all forms of CM predicted PTSD and adult life events partly mediated the association of PTSD and CM. Explanations for the severe consequences of CM and IA are discussed.
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Affiliation(s)
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
| | - Tobias M Glück
- Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
| | - Reinhold Jagsch
- Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
| | - Viktoria Kantor
- Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
| | - Dina Weindl
- Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria.
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20
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Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2017; 2:e356-e366. [PMID: 29253477 DOI: 10.1016/s2468-2667(17)30118-4] [Citation(s) in RCA: 2126] [Impact Index Per Article: 303.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. METHODS In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. FINDINGS Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I2 of >75%) between estimates for almost half of the outcomes. INTERPRETATION To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. FUNDING Public Health Wales.
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Affiliation(s)
- Karen Hughes
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Mark A Bellis
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK.
| | - Katherine A Hardcastle
- Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Dinesh Sethi
- World Health Organization Regional Office for Europe, Division of NonCommunicable Diseases and Promoting Health through the Life-Course, Copenhagen, Denmark
| | - Alexander Butchart
- World Health Organization, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, Geneva, Switzerland
| | - Christopher Mikton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Lisa Jones
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
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21
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Kim YH. Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students. CHILD ABUSE & NEGLECT 2017; 67:338-348. [PMID: 28351730 DOI: 10.1016/j.chiabu.2017.03.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 03/12/2017] [Accepted: 03/14/2017] [Indexed: 05/12/2023]
Abstract
This study investigated adverse childhood experiences of Korean college students and the impact such experiences have on students' depression and alcohol abuse. Using an online questionnaire, 939 college students were surveyed regarding their adverse childhood experiences, depressive symptoms and alcohol use habits. About half of the participants claimed to have experienced at least one adversity in their childhood. Eight percent of participants reported experiencing four or more categories of adversity. The correlations between adverse childhood experiences and depressive symptoms, alcohol abusive behaviors, and the comorbid condition of the two outcomes were significant when students' gender, geographical regions, maternal and paternal education, and family incomes were adjusted. Graded associations of cumulated adverse childhood experiences with the outcome variables were evident. These findings strengthen the link between child maltreatment and adult public health issues carrying socioeconomic burdens, two matters that have not been extensively studied in Korean contexts.
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Affiliation(s)
- Yeon Ha Kim
- Department of Child & Family Studies, College of Human Ecology, Kyung Hee University 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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22
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Wise PH. Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging. Acad Pediatr 2016; 16:S37-45. [PMID: 27044700 DOI: 10.1016/j.acap.2016.01.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 02/07/2023]
Abstract
The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies. Strong and varied evidence base documents the effect of child poverty and related early life experiences and exposures on the major threats to adult health and healthy aging. Studies using a variety of methodologies, including longitudinal and cross-sectional strategies, have reported significant findings regarding cardiovascular disorders, obesity and diabetes, certain cancers, mental health conditions, osteoporosis and fractures, and possibly dementia. These relationships can operate through alterations in fetal and infant development, stress reactivity and inflammation, the development of adverse health behaviors, the conveyance of child chronic illness into adulthood, and inadequate access to effective interventions in childhood. Although the reviewed studies document meaningful relationships between child poverty and adult outcomes, they also reveal that poverty, experiences, and behaviors in adulthood make important contributions to adult health and aging. There is strong evidence that poverty in childhood contributes significantly to adult health. Changes in the content, financing, and advocacy of current child health programs will be required to address the childhood influences on adult health and disease. Policy reforms that reduce child poverty and mitigate its developmental effects must be integrated into broader initiatives and advocacy that also attend to the health and well-being of adults.
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Affiliation(s)
- Paul H Wise
- March of Dimes Center for Prematurity Research, the Division of Neonatology, Department of Pediatrics, School of Medicine, and the Centers for Health Policy/Primary Care and Outcomes Research, Stanford University, Calif.
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23
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Mouton CP, Hargreaves MK, Liu J, Fadeyi S, Blot WJ. Adult Cancer Risk Behaviors Associated with Adverse Childhood Experiences in a Low Income Population in the Southeastern United States. J Health Care Poor Underserved 2016; 27:68-83. [PMID: 27168716 PMCID: PMC4860265 DOI: 10.1353/hpu.2016.0027] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Adverse childhood experiences (ACE) can affect health in adulthood. We investigate the relationship between childhood experiences and adult cancer risk and screening behaviors in a racially diverse, low income population. METHODS Nearly 22,000 adults 40 years and older in the Southern Community Cohort Study were administered the ACE questionnaire. We estimated odds ratios (OR) for the prevalence of smoking, alcohol consumption, BMI and five cancer screening methods in relation to the ACE score. RESULTS Over half reported at least one ACE, with percentages higher for women (61%) than men (53%). Higher ACE scores were related to increased prevalence of smoking (ORs 1.25 (1.05-1.50) to 2.33 (1.96-2.77). Little association was seen between rising ACE score and alcohol consumption or BMI, except for a modest trend in morbid obesity (BMI ≥ 40 kg/m2). Mammography and cervical cancer screening decreased with rising ACE scores, but no trends were seen with prostate or colorectal cancer screening. CONCLUSIONS Adverse childhood experiences are strong predictors of adult cancer risk behaviors, particularly increased likelihood of smoking, and among women, lower mammography and Pap screening rates.
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Stumbo SP, Yarborough BJH, Paulson RI, Green CA. The impact of adverse child and adult experiences on recovery from serious mental illness. Psychiatr Rehabil J 2015; 38:320-7. [PMID: 26053533 PMCID: PMC4673039 DOI: 10.1037/prj0000141] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this study was to compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. METHODS As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a 2-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia, or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. RESULTS Child and adult exposures to adverse experiences were high, at 91% and 82%, respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning and social functioning and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone.
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Affiliation(s)
- Scott P Stumbo
- Kaiser Permanente Northwest, Science Programs Division, Center for Health Research
| | | | - Robert I Paulson
- Louis de la Parte Florida Mental Health Institute, University of South Florida
| | - Carla A Green
- Kaiser Permanente Northwest, Science Programs Division, Center for Health Research
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25
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PINTO VCP, ALVES JFC, MAIA ÂC. Adversidade na infância prediz sintomas depressivos e tentativas de suicídio em mulheres adultas portuguesas. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2015. [DOI: 10.1590/0103-166x2015000400005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo examinou a prevalência de 10 categorias de experiências adversas na infância autorrelatadas em mulheres adultas portuguesas, e avaliou se essas experiências eram preditoras do índice de sintomatologia depressiva e de tentativas de suicídio. Um total de 225 mulheres completou o Adverse Childhood Experiences Study Questionnairee a subescala de depressão do Inventário de Sintomas Psicopatológicos. Quase 96,0% das mulheres relatou ter sido exposta a pelo menos uma experiência adversa na infância e adolescência. Os resultados da regressão linear indicam que a adversidade total explica 6,6% da variância dos sintomas de depressão, enquanto a regressão logística mostra que o incremento de um ponto na adversidade total aumenta o risco de tentativas de suicídio em 1,818 vezes. Os resultados deste estudo mostram que a exposição a experiências adversas na infância é frequente e o seu grau é preditor de sintomatologia depressiva e tentativas de suicídio.
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26
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Lin CC. The Effect of Higher-Order Gratitude on Mental Well-Being: Beyond Personality and Unifactoral Gratitude. CURRENT PSYCHOLOGY 2015. [DOI: 10.1007/s12144-015-9392-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Helitzer D, Graeber D, LaNoue M, Newbill S. Don't Step on the Tiger's Tail: A Mixed Methods Study of the Relationship Between Adult Impact of Childhood Adversity and Use of Coping Strategies. Community Ment Health J 2015; 51:768-74. [PMID: 25536941 PMCID: PMC4480186 DOI: 10.1007/s10597-014-9815-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 12/10/2014] [Indexed: 10/24/2022]
Abstract
A mixed methods study examined the relationship between childhood adversity (ACE) and coping among individuals grouped by perceived impact of ACE in adulthood. Groups did not differ on mean total ACE scores and total ACE score was not associated with any coping strategy. Differences between groups were found in 6 of 14 coping strategies. Planning and active coping were endorsed the most by both groups, despite their being used in significantly different amounts and in different ways. How individuals with ACE rate its impact in their current lives is a significant factor in the use and meaning of coping strategies.
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Affiliation(s)
- Deborah Helitzer
- Department of Family and Community Medicine, School of Medicine, MSC 09-5040, University of New Mexico, Albuquerque, NM, 87121-0001, USA.
| | - David Graeber
- Department of Psychiatry, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Marnie LaNoue
- Department of Family and Community Medicine, Jefferson Medical College, Philadelphia, PA, USA
| | - Sharon Newbill
- Department of Family and Community Medicine, School of Medicine, MSC 09-5040, University of New Mexico, Albuquerque, NM, 87121-0001, USA
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Mandelli L, Petrelli C, Serretti A. The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression. Eur Psychiatry 2015; 30:665-80. [PMID: 26078093 DOI: 10.1016/j.eurpsy.2015.04.007] [Citation(s) in RCA: 310] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/29/2015] [Accepted: 04/29/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A large literature has long focused on the role of trauma in childhood and risk for psychological disorders in adulthood. Despite several studies performed, to date, it is not clear which weight have different childhood stressors specifically on the risk for depression in adult life. In the present study, we performed a meta-analysis of the literature in order to assess the effective role of childhood traumas as risk factor in the onset of depressive disorders in adults. METHODS Previously published papers investigating the exposure to childhood trauma and their association with depression in adult subjects were retrieved in literature through common databases. Meta-analysis was conducted by the RevMan software. The quality of studies was evaluated by an adapted version of the New-Ottawa Quality Assessment Scale; bias publication was evaluated by the Egger's test. Meta-regression analysis was employed to detect potential confounders and/or moderating variables. Finally, a sensitivity analysis was post-hoc performed to control for potential confounders. RESULTS Emotional abuse showed the strongest association with depression (OR=2.78) followed by neglect (OR=2.75) and sexual abuse (OR=2.42). Significant associations were also found for domestic violence (OR=2.06) and physical abuse (OR=1.98). Nevertheless, in post-hoc analysis, emotional abuse and neglect showed the strongest associations with depression as compared to other kinds of child trauma. CONCLUSIONS These findings support the role of neglect and emotional abuse as significantly associated to depression. Sexual/physical abuse or violence in family may be unspecific risk factors for mental disturbance. Other kind of trauma may play a less relevant role in risk of adult depression, though they should be not underestimated.
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Affiliation(s)
- L Mandelli
- Institute of Psychiatry, Department of Biomedical and Neuromotor Sciences, University of Bologna, V.le C. Pepoli 5, 40123 Bologna, Italy.
| | - C Petrelli
- Department of Biomedical Sciences, Metabolism and Neuroscience, University of Modena and Reggio Emilia, Italy
| | - A Serretti
- Institute of Psychiatry, Department of Biomedical and Neuromotor Sciences, University of Bologna, V.le C. Pepoli 5, 40123 Bologna, Italy
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The scars of childhood adversity: minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients. PLoS One 2014; 9:e111711. [PMID: 25393812 PMCID: PMC4230942 DOI: 10.1371/journal.pone.0111711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/28/2014] [Indexed: 01/20/2023] Open
Abstract
Background Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily) stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients. Method Daily stress was assessed in recurrently depressed adult patients, enrolled into two randomized trials while remitted. The reported intensity and frequency of dependent and independent daily stress was assessed at baseline. Independent stress is externally generated, for example an accident happening to a friend, while dependent stress is internally generated, for example getting into a fight with a neighbor. Hierarchical regression analyses were performed with childhood adversity, independent and dependent daily stress as predictor variables of prospectively measured depressive symptoms after three months of follow-up (n = 138). Results We found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress. The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at follow-up (unadjusted models respectively: B = 0.47, t = 2.05, p = 0.041, 95% CI = 0.02–0.92; B = 0.29, t = 2.20, p = 0.028, 95% CI = 0.03–0.55). No associations were found between childhood adversity and depressive symptoms at follow-up. Conclusion No evidence was found supporting stress sensitization due to the experience of childhood adversity in this recurrently depressed but remitted patient group. Nevertheless, our research indicates that daily stress might be a target for preventive treatment. Trial Registration Trial A: Nederlands Trial Register NTR1907 Trial B: Nederlands Trial Register NTR2503
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30
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LaNoue M, Graeber DA, Helitzer DL, Fawcett J. Negative affect predicts adults' ratings of the current, but not childhood, impact of adverse childhood events. Community Ment Health J 2013; 49:560-6. [PMID: 22460928 DOI: 10.1007/s10597-012-9511-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 03/11/2012] [Indexed: 10/28/2022]
Abstract
Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed.
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Affiliation(s)
- Marianna LaNoue
- Department of Family and Community Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
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31
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Association between adverse childhood experiences and diagnosis of cancer. PLoS One 2013; 8:e65524. [PMID: 23776494 PMCID: PMC3679131 DOI: 10.1371/journal.pone.0065524] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/21/2013] [Indexed: 11/20/2022] Open
Abstract
Objective Adverse childhood experiences (ACEs) are linked to multiple adverse health outcomes. This study examined the association between ACEs and cancer diagnosis. Methods Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey were used. The BRFSS is the largest ongoing telephone health survey, conducted in all US states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands, and provides data on a variety of health issues among the non-institutionalized adult population. Principal component analysis (PCA) was used to derive components for ACEs. Multivariable logistic regression models were used to provide adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between ACE components and overall, childhood and adulthood cancer, adjusting for confounders such as age, gender, race/ethnicity, income, educational status, marital status, and insurance status. Results Approximately 62% of respondents reported being exposed to ACEs and about one in ten respondents reported ever having been diagnosed with cancer. Component 1, which had the sexual abuse variables with the highest weights, was significantly associated with adulthood cancer (adjusted OR: 1.21; 95% CI: 1.03–1.43). Conclusion The association between ACEs and adulthood cancer may be attributable to disease progression through association of ACEs with risk factors for other chronic diseases. More research should focus on the impact of sexual abuse ACEs and adverse health outcomes.
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