Adverse experiences in early childhood and their longitudinal impact on later behavioral problems of children living in poverty

Early life adversity is associated with greater similarity in neural representations of ambiguous and threatening stimuli

Exposure to early life adversity (ELA) is hypothesized to sensitize threat-responsive neural circuitry. This may lead individuals to overestimate threat in the face of ambiguity, a cognitive-behavioral phenotype linked to poor mental health. The tendency to process ambiguity as threatening may stem from difficulty distinguishing between ambiguous and threatening stimuli. However, it is unknown how exposure to ELA relates to neural representations of ambiguous and threatening stimuli, or how processing of ambiguity following ELA relates to psychosocial functioning. The current fMRI study examined multivariate representations of threatening and ambiguous social cues in 41 emerging adults (aged 18 to 19 years). Using representational similarity analysis, we assessed neural representations of ambiguous and threatening images within affective neural circuitry and tested whether similarity in these representations varied by ELA exposure. Greater exposure to ELA was associated with greater similarity in neural representations of ambiguous and threatening images. Moreover, individual differences in processing ambiguity related to global functioning, an association that varied as a function of ELA. By evidencing reduced neural differentiation between ambiguous and threatening cues in ELA-exposed emerging adults and linking behavioral responses to ambiguity to psychosocial wellbeing, these findings have important implications for future intervention work in at-risk, ELA-exposed populations.

Neighborhood collective efficacy reduces child maltreatment through decreasing parenting stress: A longitudinal path model

BACKGROUND

Neighborhoods and families are crucial contexts for child maltreatment, yet research into mechanisms of neighborhood effects on child maltreatment remains limited.

OBJECTIVE

This study examined longitudinal associations between neighborhood collective efficacy, maternal parenting stress, and child maltreatment.

PARTICIPANTS AND SETTING

The study drew data from the Future of Families and Child Wellbeing Study (FFCWS). Participants included 2890 mothers who were interviewed when their children were born and at ages 3, 5, 9, and 15.

METHODS

A longitudinal path model was utilized to analyze direct and indirect effects of neighborhood collective efficacy on child maltreatment via parenting stress.

RESULTS

Neighborhood collective efficacy and parenting stress demonstrated temporal stability over time (ages 3 to 15). Child maltreatment had carry-over effects during childhood (ages 3 to 9) but not into adolescence (age 15). Higher parenting stress in earlier years was associated with increased child maltreatment in childhood (ages 3 to 9), but not in adolescence (age 15). Neighborhood collective efficacy was associated with reduced parenting stress over time. In early childhood (ages 3 to 9), neighborhood collective efficacy protected against child maltreatment through larger direct effects than indirect effects via reduced parenting stress. In later years (ages 5 to 15), however, neighborhood collective efficacy had neither direct nor indirect effects on childhood maltreatment.

CONCLUSIONS

Findings highlight early, targeted prevention and intervention strategies for child maltreatment. Programs aimed at reducing parenting stress, increasing community-based child protection practices, and strengthening neighborhood closeness could mitigate child maltreatment.

Prevalence and correlates of sexual violence against adolescents: Quantitative evidence from rural and urban communities in South-West Nigeria

Despite the recognized need to address the prevention of sexual violence against adolescents in Nigeria, significant research gaps persist in understanding the patterns, determinants, and impacts of such violence, particularly regarding regional variations and the specific developmental needs of adolescents across different stages. This study provides Nigerian regional prevalence estimates disaggregated by gender, rural/urban, and in/out-of-school populations, while also identifying socio-demographic and cultural determinants related to increased vulnerability. A cross-sectional survey was conducted in South-West Nigeria with a sample of 961 adolescents, targeting in- and out-of-school adolescents aged 13-17 years. Descriptive statistics and logistic regression analyses were performed.The prevalence of any form of SV since age 12 was 69.4%, with higher rates among out-of-school adolescents and boys. Non-contact abuse (63.2%), passive contact abuse (41.9%), and active contact abuse (28.7%) were the most common forms reported. Peers were the dominant perpetrators (77.1%), followed by other adults (27.9%). Being male (OR 2.033), older (OR 1.214 per year), involved in a romantic relationship (OR 2.731), and experiencing SV before age 12 (OR 4.622) were significant risk factors. Higher household wealth (OR 0.902 per asset) and emotional support from both parents (OR 0.413) were protective factors.This study highlights the high burden of SV against adolescents in Nigeria, with concerning patterns of male victimization and peer perpetration. The findings emphasize the need for comprehensive, evidence-based strategies addressing emotional support, social norms, power dynamics, and economic vulnerabilities to prevent and respond to this problem effectively.

The relationship between cumulative family risk and depression in left-behind children: a moderated mediation model

BACKGROUND

This study proposed a moderated mediation model to examine the mediating role of core self-evaluation in the relationship between cumulative family risk and depression among left-behind children, and whether this process was moderated by school climate.

METHODS

A total of 415 rural left-behind children from 35 townships in Anhui Province (54.46% males; mean age = 12.53, SD = 2.27) were randomly conducted in June 2023 using convenience sampling. Data were processed and analyzed using SPSS 25.0 and PROCESS 3.3.

RESULTS

After controlling for gender, age, grade, and left-behind type, cumulative family risk positively predicted depression in left-behind children (β = 0.18, p < 0.001). Core self-evaluation fully mediated the relationship between cumulative family risk and depression in left-behind children (indirect effect = 0.10, 95%CI = [0.06, 0.15]). Moreover, school climate moderated the relationship between cumulative family risk and core self-evaluation (the first half of the mediation pathway) (β =-0.13, p < 0.01). Specifically, as the school climate level increased, cumulative family risk became more predictive of core self-evaluation (Blow = - 0.001, p > 0.05; Bhigh = - 0.26, p < 0.001).

CONCLUSION

Creating a favourable family and school climate and improving core self-evaluation are beneficial to reduce depression in left behind children.

School connectedness as a protective factor between childhood adversity and adolescent mental health outcomes

School connectedness may offset mental health risks associated with childhood adversity. The present study examined the potential protective effects of school connectedness against childhood adversity when predicting adolescent mental health outcomes in 9,964 individuals (51% female, 81% white) from the Millennium Cohort Study. Structural equation models were fitted to examine the longitudinal relationships between childhood adversity, school connectedness, and adolescent mental health. Childhood adversity was a risk factor, predicting greater internalizing and externalizing problems and lower levels of positive mental health. School connectedness was a promotive factor as it predicted fewer mental health problems and greater positive mental health. Furthermore, school connectedness at age 11 was protective against childhood adversity when predicting internalizing and externalizing problems at age 14. That is, students with a history of adversity who felt more connected to school were less likely to exhibit internalizing and externalizing symptoms than those who felt less connected to school. Only school connectedness at age 11 was protective against childhood adversity, indicating that feeling connected to school at younger ages may disrupt processes linking childhood adversity to adolescent mental health. Schools should foster students' feelings of connectedness to protect vulnerable individuals and benefit all pupils' mental health.

What do we mean when we talk about socioeconomic status? Implications for measurement, mechanisms and interventions from a critical review on adolescent mental health

Low socioeconomic status (SES) is a well-established risk factor for general and mental health problems. However, there is no widely accepted definition or operationalisation for SES, leading to varied interpretations in research. In a critical review of the child and adolescent mental health literature, we map how SES is defined and measured. We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES. Our analysis revealed fundamental problems such as the lack of clear definitions, insufficient detail on variables used and limited measures directly reported by adolescents. We discuss issues related to measurement techniques and their impact on reproducibility, policy development and intervention design. Based on our findings, we recommend using SES measures that directly assess the socioeconomic position of children and adolescents. Additionally, we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection. The wide range of distinct measures used to represent SES, coupled with insufficient reporting, likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships. This, in turn, makes the path to effective health interventions more challenging.

Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.

Longitudinal associations between the quality of family interactions and school-age children's narrative abilities in the context of financial insecurity

This longitudinal study investigates whether the quality of family interactions at 3-5 years of age predicts narrative abilities in 7-9-year-old children from socioeconomically disadvantaged families. The sample consists of 67 children and their parents receiving social welfare. Family interactions were filmed during mealtime at home and coded using the Mealtime Interaction Coding System. Children's narrative abilities were measured based on their capacity to coherently elaborate and resolve stories from the Attachment Story Completion Task. Results revealed that children exposed to family interactions of higher quality make their narratives more accessible and understandable and include more appropriate expression of affects in their stories 4 years later, even after accounting for maternal education and verbal abilities. The results of this study highlight the importance of considering family interactions in the context of financial insecurity when studying socioemotional competence in childhood.

Do Ethnic Identity, Familial, and Community Contexts Impact the Association Between Adverse Childhood Experiences and Psychopathology Among Latinx Adolescents?

OBJECTIVE

Few studies have explored the interplay of how individual identity, parental, familial, and contextual factors impact associations between Latinx adolescent adversities and psychopathology. This study aimed to examine whether these factors mediate the relationship between adversities and psychopathology in Latinx youth.

METHOD

Latinx youth (n = 2,411) data from the Adolescent Brain Cognitive Development (ABCD) Study were used to examine path models with adverse childhood experiences (ACEs) as the predictor and either youth- or caregiver-rated internalizing/externalizing scores over 4 timepoints as the outcome (ages 9-13 years). Models examined 3 potential mediators: (1) ethnic identity, (2) familial context (comprising parental monitoring, family conflict, and caregiver acceptance), and (3) community cohesion. Models were conducted separately for internalizing and externalizing symptoms.

RESULTS

Greater adversity was associated with greater youth- and caregiver-rated internalizing/externalizing psychopathology over time. Greater adversity was associated with lower family functioning and lower ethnic identity, and greater family functioning was associated with lower psychopathology. Family functioning mediated associations between adversity and psychopathology over time (youth-reported internalizing: 95% CI = 0.012-0.019; youth-reported externalizing: 95% CI = 0.020-0.028). In contrast, there was not strong evidence for ethnic identity and community cohesion mediating associations between adversities and psychopathology over time.

CONCLUSION

Unlike previous studies, ethnic identity did not influence the relationship between ACEs and psychopathology over time. Additional research is needed to identify whether possible tensions rise as Latinx youth acculturate into US culture and achieve optimal levels of ethnic identity formation. Providers need to assess specific Latinx parental and familial contexts that may interfere with youth identity formation.

The Association between Adverse Childhood Experiences and Frailty: A Systematic Review

OBJECTIVE

Based on life-course theory, adverse childhood experiences (ACEs) have emerged as risk factors for health in later life. This study aimed to explore the association between ACEs and frailty.

DESIGN

Systematic review.

SETTING AND PARTICIPANTS

Frail older adults who have experienced ACEs.

METHODS

We searched 7 databases: PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO, and China National Knowledge Infrastructure (CNKI). The last searched date was October 27, 2023. Included studies should have investigated the association between exposure to at least 1 ACE and frailty. Two researchers independently assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale (NOS) and an adapted version of the NOS scale and also extracted relevant characteristics and outcomes of the included studies.

RESULTS

A total of 14 studies were finally included. Consistent associations with increased risk of frailty were only shown in studies that assessed family members with mental illness, low neighborhood quality, emotional abuse, sexual abuse, and combinations of ACEs. In addition, women exposed to ACEs were more likely to be at risk for frailty than men, and greater numbers or types of exposure to ACEs were associated with higher odds of frailty. The results of the quality assessment showed a moderate risk of bias in half of the studies.

CONCLUSIONS AND IMPLICATIONS

This study summarizes for the first time the evidence for an association between ACEs and frailty. Considered collectively, increased attention to ACEs may be one way to prevent frailty, and unhealthy lifestyles resulting from ACEs may serve as a breakthrough in developing interventions.

Implementing culturally responsive and trauma-informed practices with checklists and goal setting

We discuss the use of two empirically validated behavior-change methods-checklists and goal setting-and designed a checklist to assist behavior analysts in improving their behavioral services to be more culturally responsive and trauma informed. We also present pilot data evaluating the use of the checklist and goal setting on the inclusion of culturally responsive and trauma-informed practices in behavior support plans designed for students in a public school. The training package was effective for both participants, and the participants' weekly goals corresponded to the observed changes in their behavior plans. Moreover, both participants strongly agreed that the checklist was valuable and easy to use and reported increases in their perceived abilities to implement culturally responsive and trauma-informed practices posttraining.

Childhood adversities and memory function in later life: the mediating role of activity participation

BACKGROUND

Childhood adversities may lead to decreased activity participation in later life, impacting memory health in ageing adults. Childhood adversities related to deprivation and threat, as conceptualized by the Dimensional Model of Adversity, can exhibit distinct impacts on cognitive and emotional outcomes in children and younger adults. This study examined the potential influence of childhood deprivation and threat on memory function in later life and the mediating role of activity participation in these relationships.

METHODS

This study used data from the first wave of Panel Study of Active Ageing and Society (PAAS), a representative survey of Hong Kong residents aged 50 or above (N = 1,005). Key variables included late-life memory function measured by delayed recall test, deprivation- and threat-related childhood adversities, and the frequency of participation in informal and formal types of activities. Mediation tests were used for analysis.

RESULTS

Childhood deprivation was associated with a lower late-life memory function, whereas threat was not. The negative effects of childhood deprivation and its subdomain, economic hardship, on memory function were mediated by activity participation. Total participation scores presented the strongest mediating effect (17.3-20.6%), with formal activities playing a more substantial mediating role than informal activities in mitigating the effect of childhood deprivation.

CONCLUSIONS

These findings expand the applicability of the Dimensional Model of Adversity to ageing populations, highlighting the influence of deprivation on life-long cognitive development. Furthermore, this study revealed an indirect mechanism by which childhood deprivation affects memory health in old age through diverse activity participation.

Retrospective ACEs predict complex PTSD symptoms in a large sample of Chinese young adults longitudinally: the moderating role of self-compassion

This longitudinal study in Mainland China (2021-2022) explored the impact of adverse childhood experiences (ACEs) on complex posttraumatic stress disorder (CPTSD) symptoms, with a focus on the role of self-compassion. Among 18,933 surveyed university students, 21.2% reported experiencing at least one ACE. Results revealed a clear relationship between ACEs and CPTSD symptoms. Furthermore, self-compassion, particularly the dimensions of self-judgment and isolation, moderated the association between retrospective ACEs and posttraumatic stress disorder (PTSD) and disturbance in self-organization (DSO) symptoms. These findings highlight the enduring impact of ACEs on CPTSD symptoms and emphasize the importance of early identification and targeted interventions, especially addressing self-judgment and isolation, to mitigate CPTSD risk among young Chinese adults.

The mediating role of trait emotional intelligence in the relationship between parental neglect and cognitive emotion regulation strategies

BACKGROUND

Examining children's abilities to recognize and regulate their emotions in the context of parental neglect is of significant importance in order to comprehend the dynamics of and to support the development of emotional skills of children, particularly those at risk of neglect. From this point of view, the aim of the study was to examine the mediating role of trait emotional intelligence (trait EI) in the relationship between parental neglect and cognitive emotion regulation strategies (CERS) in children.

METHOD

The study group consisted of 265 children (135 girls and 130 boys) who were attending two separate primary schools in the city center of Antalya, Turkey. The mean age of the children was 10.27 ± 0.45. As the data gathering instruments, an "Individual Information Form" was administered to assess the socio-demographic information of the children, while the "Multidimensional Neglectful Behavior Scale-Child Report was administered to examine the level of neglect of children by the parents, the "Trait Emotional Intelligence Questionnaire-Child Form" was administered to assess the trait emotional intelligence level, and the "Cognitive Emotion Regulation Strategies for Children Scale" was administered to assess the CERS of the children.

RESULT

It was found that trait EI played a full mediator role in the relationship between CERS and both maternal and paternal neglect (p < .05), except for the relationship between paternal neglect and maladaptive CERS (p > .05).

CONCLUSIONS

The results may suggest that neglected children use all emotion regulation skills, including both adaptive and maladaptive, to cope with their negative emotional experience, but may use adaptive CERS more if their trait EI is higher.

Conceptualizing adverse childhood experiences as a latent factor: Tests of measurement invariance across five racial and ethnic groups

Adverse childhood experiences (ACEs) are conventionally measured using a cumulative-risk index without consideration of distinct measurement properties across racial and ethnic groups. Drawing from the 2018-2020 National Survey of Children's Health (N = 93,759; 48% female; average age: 9.52 years), we assess the measurement invariance of a latent-factor ACE model across five groups: Hispanic children (14%) and non-Hispanic White (73%), Black (7%), Asian/Pacific Islander (5%), and American Indian/Alaskan Native (1%) children. Results support configural and full metric invariance across groups. However, several ACE item thresholds differed across groups. Findings highlight the potential utility of a latent factor approach and underscore the need to assess differences across racial and ethnic groups in terms of the optimal conceptualization and measurement of ACEs.

Investigating the Poverty-Reducing Effects of SNAP on Non-nutritional Family Outcomes: A Scoping Review

INTRODUCTION/PURPOSE

Poverty-reduction efforts that seek to support households with children and enable healthy family functioning are vital to produce positive economic, health, developmental, and upward mobility outcomes. The Supplemental Nutrition Assistance Program (SNAP) is an effective poverty-reduction policy for individuals and families. This study investigated the non-nutritional effects that families experience when receiving SNAP benefits.

METHODS

We conducted a scoping review using the PRISMA Guidelines and strategic search terms across seven databases from 01 January 2008 to 01 February 2023 (n=2456). Data extraction involved two researchers performing title-abstract reviews. Full-text articles were assessed for eligibility (n=103). Forty articles were included for data retrieval.

RESULTS

SNAP positively impacts family health across the five categories of the Family Stress Model (Healthcare utilization for children and parents, Familial allocation of resources, Impact on child development and behavior, Mental health, and Abuse or neglect).

DISCUSSION/CONCLUSION

SNAP is a highly effective program with growing evidence that it positively impacts family health and alleviates poverty. Four priority policy actions are discussed to overcome the unintentional barriers for SNAP: distributing benefits more than once a month; increasing SNAP benefits for recipients; softening the abrupt end of benefits when wages increase; and coordinating SNAP eligibility and enrollment with other programs.

A qualitative exploration of the drivers for the transfer of foster children in Gauteng, South Africa

BACKGROUND

Many children in South Africa are orphaned or subjected to maltreatment, leaving them in need of care and protection. Foster care is one form of alternative care for such children. Retention of foster parents, or foster care placement stability, is one of the many challenges related to foster care, globally and in South Africa. This instability can have an adverse impact on children, and although some research speaks to the problem, the experiences of South African role players regarding this problem have not been documented, to date. To improve foster care retention in South Africa, local, contextualized studies exploring the drivers of foster care placement instability are required.

AIM

The aim of this qualitative study was thus to explore designated social workers' (DSWs) and foster parents' experiences about the reasons prompting foster care transfers.

PARTICIPANTS AND SETTING

A purposively selected sample of ten foster parents and ten DSWs in the Gauteng province of South Africa took part in the study.

METHODS

A descriptive qualitative study was adopted as basis for this study, which entailed thematic analysis of 20 semi-structured interviews.

RESULTS

It was found that children's behavioural problems, a shortage of resources, a lack of parenting skills, problematic relationships between foster parents and foster children, and previous traumatic events, led to most foster care transfers. A key finding from this study, which appears not to be evident in previous studies, centres on the critical role played by money, or rather its absence, in contributing to foster care placement instability.

CONCLUSIONS

When considered in conjunction with findings emerging from previous studies, our findings underscore the importance of obtaining a contextualized understanding of local, cultural factors at play in foster care delivery. To improve foster care retention in South Africa, which is fraught with challenges not yet reported elsewhere, it is recommended that screening procedures for foster parents be revised, and that allocation of resources to DSWs be prioritized.

Sibling Experiences of Adverse Childhood Experiences: A Scoping Review

Adverse childhood experiences (ACEs) are traumatic events during childhood known to affect health and well-being across the life span. The detrimental impact ACEs have on children and young people is well-established. It is also known that 85 to 90% of children have at least one sibling. Using this as the foundation for our inquiry, the purpose of this scoping review was to understand what we currently know about the experiences of siblings living with ACEs. Sibling relationships are unique, and for some the most enduring of experiences. These relationships can be thought of as bonds held together by love and warmth; however, they can also provide scope for undesirable outcomes, such as escalation of conflicts and animosities. This scoping review was conducted following Arksey and O'Malley's (2005) methodological framework, complemented by the PAGER framework (Bradbury-Jones et al. 2021), offering a structured approach to the review's analysis and reporting through presenting the Patterns, Advances, Gaps, and Evidence for practice and Research. In June 2020, we searched 12 databases, with 11,469 results. Articles were screened for eligibility by the review team leaving a total of 148 articles meeting the inclusion criteria. Included articles highlighted overwhelming evidence of older siblings shielding younger siblings, and the likelihood that when one sibling experiences adversity, other siblings will be experiencing it themselves or vicariously. The implications of this in practice are that support services and statutory bodies need to ensure considerations are given to all siblings when one has presented with experiencing childhood adversity, especially to older siblings who may take far more burden as regards care-giving and protection of younger siblings. Given that more than half of the included articles did not offer any theoretical understanding to sibling experiences of ACEs, this area is of importance for future research. Greater attention is also needed for research exploring different types of sibling relationships (full, step, half), and whether these influence the impact that ACEs have on children and young people.

The relationship between cumulative family risk and athlete burnout among Chinese college athletes: the mediating role of negative affect

Introduction

Burnout of college athletes affects the sports performance of college athletes, etc., and plays an important role in the career development of college athletes. China attaches great importance to the mental health development of college athletes, but the influence mechanism of college athlete burnout has not received attention. This study explored the relationship between cumulative family risk, negative affect, and athlete burnout in college athletes.

Methods

Data on 824 college athletes from more than 40 universities in China were collected through convenient sampling, using questionnaires including Cumulative Family Risk Scale, Athlete Burnout Questionnaire, and Negative Affect Scale.

Results

The results of the structural equation model show that cumulative family risk has a significant positive effect on college athlete burnout. Cumulative family risk has a significant positive effect on the negative affect of college athletes. Negative affect also plays a significant mediating role in the relationship between cumulative family risk and college athlete burnout.

Discussion

These results suggest that cumulative family risk directly or indirectly affects collegiate athlete burnout.

Socioeconomic and Racial/Ethnic Disparities in Recovery from Childhood Behavioral or Conduct Problems: Evidence from a Nationally Representative Sample of 3-17 Years Old US Children

Our study provides nationally-generalizable evidence on the racial/ethnic and socioeconomic disparities in diagnosis and recovery from childhood behavioral or conduct problems. We pooled data from 4 years (2016-2019) of the National Survey of Children's Health (NSCH) for 3 to 17 years old US children (N = 114,476). We performed several logistic regression models using complex survey data analysis statistical methodologies to estimate nationally representative and generalizable results in the Stata MP 16 program. About 20.1% of 3-17 years old US children previously diagnosed with behavioral or conduct problems no longer had the current diagnosis (were recovered). Hispanic children [Odds ratio (OR) 0.77, 95% Confidence Interval (CI) 0.65-0-95], immigrant children or children of immigrant parents (first or second generation immigrant children), and children from high-income families [200-399% Federal Poverty Level (FPL)] were about 23%, 38%, and 21% less likely than non-Hispanic White children, children of US native parents, and children with a family income of below 100% FPL to be currently diagnosed with behavioral or conduct problems, respectively. Conversely, Non-Hispanic Black and Hispanic children were about 50% and 40% more likely than non-Hispanic White children to recover from a past diagnosis. Moreover, children from higher-income families (at or above 300% of FPL) were between 1.59 to 1.79 times more likely than those from low-income families (below 100% FPL) to recover from a past diagnosis. Racial/ethnic and socioeconomic disparities in diagnosing appear to persist in recovering from behavioral or conduct problems.

[Family stressors on young children's emotional development]

BACKGROUND

Adverse childhood experiences (ACE) have been pointed out as risk factors for physical and mental health, with consequences extending from childhood into adulthood. Based on research regarding the effects of selected ACE as well as the accumulation of ACE, this article investigates how different types of family stressors are linked to children's negative emotionality in infancy and early childhood.

METHODS

Data are from the KiD 0-3 study (N = 5583) and the follow-up of a subsample after 2 years (n = 681). Based on 14 stress factors, we distinguish families with no/little stressors, socioeconomic stressors, parenting stressors, and multiple stressors.

RESULTS

Children in multiply stressed families have the highest risk of high negative emotionality (compared to unstressed families: Odds Ratios [OR] ranging from 13.00 to 6.81), controlling for demographic characteristics, child-related stress factors (e.g., excessive crying), and caregiver childhood stress. Children in families primarily characterized by parenting stress also showed a significantly increased risk of high negative emotionality (OR ranging from 8.31 to 6.95), whereas this did not hold for children from socioeconomically stressed families (without parenting stress) compared to those from unstressed families. Longitudinal analyses of the follow-up subsample showed that changes in the number of stressors were also associated with parallel changes in children's negative emotionality.

DISCUSSION

These results confirm findings from international research on ACE in Germany and for early childhood. They underline the importance of a well-developed early intervention system.

Evaluation of Midlife Educational Attainment Among Attendees of a Comprehensive Early Childhood Education Program in the Context of Early Adverse Childhood Experiences

Importance

Educational attainment is a key social determinant of health and can be particularly consequential for racial and ethnic minority populations. Although the consequences of adverse childhood experiences (ACEs) are well established, there is little research on protective factors and policy-relevant strategies to mitigate ACE-related inequities.

Objective

To examine associations between early ACEs, comprehensive early intervention, and midlife educational attainment in a cohort of predominantly Black participants.

Design, Setting, and Participants

The Chicago Longitudinal Study is a prospective cohort study of Black and Latinx children from Chicago, Illinois. The intervention group included 989 children entering the Child-Parent Center (CPC) preschool Early Childhood Education (ECE) program in the 1980s. The comparison group comprised 550 children participating in usual early childhood services. All participants were followed up for 30 years after the end of the intervention. Analyses were conducted from July 1 to September 1, 2022.

Intervention

Attendance at the CPC preschool ECE program.

Main Outcomes and Measures

A standard battery of early childhood ACEs (conventional ACEs), a set of early childhood ACEs more commonly associated with high-poverty contexts (expanded ACEs), and educational attainment at 35 years of age were measured from self-report and administrative records.

Results

The original Chicago Longitudinal Study sample comprised 1539 participants (1430 Black participants [92.9%]; 774 female participants [50.3%]). Data on educational attainment and ACEs were available for 1083 of 1467 living participants (73.8%). Participants in the present study (1013 Black participants [93.5%]; 594 female participants [54.9%]) were a mean (SD) age of 35.1 (0.3) years at completion of the midlife survey. For the comparison group but not the CPC intervention group, having 1 or more conventional or expanded ACEs in early childhood was associated with fewer years of education (β = -0.64; 95% CI, -1.02 to -0.26), reduced likelihood of attaining a bachelor's degree or higher (odds ratio, 0.26; 95% CI, 0.09-0.70), and reduced likelihood of attaining an associate's degree or higher (odds ratio, 0.26; 95% CI, 0.11-0.62) after adjusting for covariates. Moderation analyses indicated that CPC participants with either conventional or expanded ACEs in early childhood attained a bachelor's degree or higher and an associate's degree or higher at rates similar to CPC participants without early ACEs (15.4% vs 13.6% for bachelor's degree or higher; 22.4% vs 19.9% for associate's degree or higher). Conversely, comparison group participants with early ACEs had significantly lower rates of educational attainment than their counterparts without ACEs (3.7% vs 12.1% for bachelor's degree or higher; 5.6% vs 17.1% for associate's degree or higher).

Conclusions

This cohort study suggests that early ACEs were associated with reduced educational attainment for the comparison group but not for the group participating in the CPC comprehensive early intervention. These results build on research suggesting that youths at higher risk can benefit most from intervention and support ECE as a tool for reducing ACE-related disparities.

Associations between early childhood adversity and behavioral, substance use, and academic outcomes in childhood through adolescence in a U.S. longitudinal cohort

BACKGROUND

Childhood adversity is strongly associated with adolescent substance use, but few epidemiologic studies have investigated early childhood adversity (ECA) before age 5. This study investigated pathways by which ECA is associated with adolescent alcohol and cannabis use and high school completion through childhood behavioral and academic mediators and their reciprocal effects.

METHODS

Data were from the National Longitudinal Survey of Youth 1979-Child/Young Adult Cohort which surveyed children born 1984-1999 and followed through 2016 (n = 5521). Outcomes included alcohol and cannabis use frequency at ages 15-18, and high school completion by age 19. ECA at ages 0-4 was a cumulative score of maternal heavy drinking/drug use, low emotional support, low cognitive stimulation, and household poverty. Multilevel path models were conducted with ECA, childhood mediators (behavioral (externalizing and internalizing problems) and academics (reading and math scores), accounting for demographics and confounders.

RESULTS

ECA was indirectly associated with adolescent cannabis frequency through mediators of externalizing/internalizing problems, low academics, and early cannabis onset before age 14. ECA was also indirectly associated with alcohol frequency via the same mediators, but not early alcohol onset. Greater behavioral problems elevated substance use risk; whereas, low academics reduced risk. Reciprocal effects were evident between childhood behavioral problems and cannabis frequency to high school completion.

CONCLUSION

Adversity from birth to age 4 is associated with childhood behavioral problems and lower academics, which increased adolescent alcohol and cannabis use and lowered high school completion. Early childhood interventions with parents and preschools/daycare may reduce early onset and adolescent substance use.

Impacts on children's health of adverse childhood experiences of their mothers: A gender-specific mediation analysis using data from the China Health and Retirement Longitudinal Study

BACKGROUND

Numerous people have suffered adverse childhood experiences (ACEs) that can have lasting negative consequences. However, few studies have focused on maternal ACEs' effect on their children's health. This study aimed to evaluate the impact on children's health of ACEs that their mothers experienced.

METHODS

Data from the China Health and Retirement Longitudinal Study (CHARLS) 2018 combined with the CHARLS 2014 Life History Survey were analyzed. The logistic regression was used to investigate maternal ACEs' impact on their children's health. Based on the stepwise regression model and bias-corrected bootstrap, we estimated the mediating effects.

RESULTS

Maternal ACEs could result in harm to the health of children (P < 0.05). If the types of maternal ACEs increased by one unit, the odds ratio of their children's poor health would rise by 9.6 %. Moreover, if the types of maternal ACEs increased by one unit, the odds ratio of daughters' and sons' poor health would increase by 8.3 % and 10.2 %, respectively. Three mediating mechanisms of mothers' education, physical health, and mental health were confirmed by empirical tests.

LIMITATIONS

We could not employ objective indicators to measure children's health. Meanwhile, maternal ACEs were all self-reported from the mothers' recollection, which might descend the accuracy due to memory bias.

CONCLUSION

Maternal ACEs harmed the health of both their sons and daughters. The children's health would deteriorate as the maternal ACEs increased. Mother's education, physical health, and mental health mediated the relationships between maternal ACEs and children's health.

Sex Differences in the Relationship Between Early Adverse Childhood Experiences, Delinquency, and Substance Use Initiation in High-Risk Adolescents

Adverse childhood experiences (ACEs) have been linked to a host of subsequent negative health and behavioral problems. However, the role of sex in the ramifications of early ACEs remains unclear, particularly for delinquency and substance use initiation in adolescence. A small body of research has produced mixed findings on sex differences in the relationship between ACEs and antisocial outcomes in adolescence, resulting in uncertainty about whether and how ACEs may operate differently for boys and girls. The current study drew on a high-risk group of adolescents (N=2455; M_age=15.4; 48% female; 50% Black, 23% Hispanic) from the Fragile Families and Child Wellbeing Study to examine the associations between accumulated ACEs across early childhood, and delinquency and substance use initiation of alcohol, cigarette, and cannabis in adolescence. We utilized mother and father reports on the exposure to seven different types of ACEs (i.e., physical abuse, psychological abuse, neglect, parental substance misuse, parental mental illness, parental intimate partner violence, and parental criminal behavior) when adolescents were ages 1, 3, and 5. Total ACEs scores and their relationships with delinquency, and lifetime use of alcohol, cigarettes, and cannabis were assessed separately for girls and boys. Results suggested that accumulated ACEs during early childhood may be implicated in boys' delinquency, while ACEs were not significantly associated with girls' self-reported delinquency or for boys' and girls' substance use initiation. Findings suggest that the enduring consequences of ACEs may be sex-specific, and have implications for the development of policies to mitigate ACEs and their harms.

The conditioning effects of positive experiences on the ACEs-offending relationship in adolescence

BACKGROUND

Research shows that adverse childhood experiences (ACEs) are problematic and may impact delinquency and arrest in adolescence. However, resiliency theories suggest the association between ACEs and delinquency/arrest may be mitigated by positive childhood experiences (PCEs).

OBJECTIVE

This study tests the hypothesis that an accumulation of PCEs ameliorates the relationship between ACEs and delinquency and arrest during adolescence.

PARTICIPANTS AND SETTING

Prospective data were collected from approximately 800 participants in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN).

METHODS

Self-report data from 16-year-old participants were used to measure the two dependent variables: the number of delinquent acts committed and having at least one arrest in the past year. Count measures reflected the number of ACEs and PCEs, with the former based on reports from child protective services, caregivers, and youth collected from ages 4-12, and the latter based on self-reports at age 12. Negative binomial models analyzed delinquency outcomes, logistic regression models examined arrest, and interaction terms assessed moderating effects.

RESULTS

ACEs were associated with significantly more delinquent acts but not arrest, and PCEs were associated with significantly fewer delinquent acts but not arrest. PCEs significantly reduced the relationship between ACEs and delinquency but only for youth with moderate levels of ACEs.

CONCLUSIONS

Findings indicate a need for additional research measuring the moderating effects of a variety of PCEs and to the need to enhance positive experiences for youth to prevent delinquency.

Exploring the Relationship Between Modifiable Protective Factors and Mental Health Issues Among Children Experiencing Adverse Childhood Experiences Using a Resilience Framework

The purpose of this study was to examine whether the National Scientific Council on the Developing Child (NSCDC) resilience framework statistically predicted whether a child with 4 or more adverse childhood experiences (ACEs) ever had a mental health issue. The study also explored which NSCDC modifiable resilience factors had the strongest relationship with mental health issues among children with 4 or more ACEs. Utilizing the 2019 National Survey of Children's Health, secondary data analysis was conducted using a sample of 1,225 children between 6 and 17 years old that had experienced 4 or more ACEs. Logistic regression examined whether the NSCDC framework was associated with a lower likelihood of mental health issues in school-aged children. Analysis found that the NSCDC framework predicted whether children with 4 or more ACEs ever had a mental health issue. Self-regulation had the strongest relationship with whether a child with 4 or more ACEs ever had a mental health issue. A supportive parent/caregiver relationship was also associated with a lower likelihood of ever having a mental health issue. The results demonstrate the promise of the NSCDC framework and modifiable protective factors to mitigate the impact of ACEs on mental health outcomes. Interventions that teach children skill-based self-regulation and parent/caregiver co-regulation while providing safe and supportive environments can build self-regulation to overcome ACEs. Promoting resilience-building parent-child relationships also have the potential to build resilience to mitigate ACEs.

Patterns of adverse childhood experiences among Chinese preschool parents and the intergenerational transmission of risk to offspring behavioural problems: moderating by coparenting quality

Background: Although intergenerational transmission of ACEs among parents and their offspring have been extensively studied in the West, few studies have been conducted in China on preschool children and their parents, and explore the protective fact for the intergeneration transmission. Objective: Using latent class analysis and moderation model, this study examined the associations between patterns of adverse childhood experiences of Chinese preschool parents and behavioural problems in their children and whether coparenting quality plays a protective role in this relationship. Method: A retrospective study was conducted on 3091 parent-child dyads from 11 kindergartens in the northern, central, and southern Anhui provinces in China. Online questionnaires were used to collect the data. Parents reported adverse childhood experiences (ACEs) and provided information on their children's behavioural problems and perceived coparenting quality. Latent class analysis and a moderating model were used to examine the associations between patterns of adverse childhood experiences of Chinese preschool parents and behavioural problems in their children, and the moderating role of coparenting quality. Results: Four classes were identified: a high ACEs group, a violent victimisation group, a child abuse and physical neglect group, and a low ACEs group. Increasing levels of co-parenting quality were associated with reduced parent-reported child behaviour problems for all classes, and that potentially buffering effect was significantly stronger for the low ACEs class than for children whose parents in high ACEs class. Conclusions: Exposure to high ACEs increases the risk of developing behavioural problems in offspring, and coparenting quality may serve as a protective mechanism for intergenerational transmission. Future research should develop and implement interventions to support disadvantaged, at-risk parents and promote coparenting quality.

Character Strength and Mental Health Problems among Children from Low-Income Families in South Korea

This study was conducted to understand the association between character strength and mental health problems among children in early adolescence from low-income families in South Korea. This study used a cross-sectional and descriptive study design with 214 fifth- and sixth-grade elementary school children from low-income families enrolled in 20 community centers and receiving government financial assistance. A bivariate probit model was used to examine the association between character strength and mental health problems in the children. We found that character strength lowers the likelihood of developing hyperactivity-inattention and emotional symptoms among children from low-income families. Additionally, adverse life events were associated with increased mental health problems, whereas adverse life events were not significantly correlated with character strength in the current study. Specific interventions should be developed to cultivate character strength among children in early adolescence from low-income families who are at a high risk of mental health problems under cumulative adverse life events.

Adverse childhood experiences and adolescent mental health: Understanding the roles of gender and teenage risk and protective factors

Adverse Childhood Experiences (ACEs) have been linked to a host of negative outcomes in adolescence. However, research on the impact of ACEs on adolescent mental health has produced mixed results, leaving it unclear how ACEs may relate to depression and anxiety during adolescence. Moreover, this body of work has neglected how gender, risk and protective factors may influence these relationships, despite research demonstrating gender differences in both responses to adversity and in the impact of risk and protective factors on maladaptive outcomes in adolescence. Drawing on a sample of at-risk youth from the Fragile Families and Child Wellbeing Study (N = 2455; age 14-18; 48 % female, 50 % Black, 23 % Hispanic), the current study examines the association between ACEs during early childhood (i.e., ages 1 to 5) and anxious and depressive tendencies reported during adolescence. Models are stratified by gender and incorporate six types of teenage risk and protective factors (peer bullying, delinquent peers, low self-control, parental attachment, collective efficacy, and school connectedness). Results showed support for gender differences in the associations between ACEs and boys' and girls' mental health symptoms. Initially, ACEs were associated with an increased risk of both depressive and anxious tendencies in boys, but the total ACEs score was only significantly associated with an increased risk for depressive symptoms in girls. After accounting for teenage protective factors, ACEs were related to a decreased risk of depressive and anxious symptoms among girls only. Findings have important implications for refining intervention and prevention strategies focusing on mitigating the harms of ACEs.

How Influential are Adverse Childhood Experiences (ACEs) on Youths?: Analyzing the Immediate and Lagged Effect of ACEs on Deviant Behaviors

Although the effect of adverse childhood experiences (ACEs) on antisocial behaviors is well established in the literature, limited research, if any, has analyzed the effect that ACEs have on behaviors at two different times. Limited research also has analyzed the effect that specific ACEs have on deviant behaviors after statistically controlling for respondents' protective factors. This study expands the literature in this area by analyzing in a sample of 555 adolescents the immediate and lagged effect that individual ACEs, and exposure to a number of ACEs, have on three deviant behaviors after controlling for respondents' protective factors not previously examined in ACEs studies. Results obtained from multivariate logistic regression models revealed that stealing things was predicted by being hit hard, being sexually molested, and having lived with a depressed or suicidal individual; and receiving threats over the internet predicted physical fights. Only being hit hard and living with an alcoholic had a lagged effect on smoking marijuana. Results also showed that the protective factors of school connection, anger management skills, and parental supervision reduced the effect of ACEs on the behaviors analyzed. Research, theory, and policy implications are discussed.

Adolescent Mental Health and Family Economic Hardships: The Roles of Adverse Childhood Experiences and Family Conflict

Rising and economically disproportionate rates of adverse mental health outcomes among children and youth warrant research investigating the complex pathways stemming from socioeconomic status. While adverse childhood experiences (ACEs) have been considered a possible mechanism linking socioeconomic status (SES) and child and youth psychopathology in previous studies, less is understood about how family environments might condition these pathways. Using data from a longitudinal, multiple-wave study, the present study addresses this gap by examining the direct relationships between family economic status and youth internalizing and externalizing symptoms, if ACEs mediate these relationships, and if conflictual family environments moderate these direct and indirect relationships. The data were obtained from 5510 youth participants [mean age at baseline = 9.52 (SD = 0.50), 47.7% female, 2.1% Asian, 10.3% Black, 17.6% Hispanic, 9.8% Multiracial/Multiethnic, 60.2% White] and their caretakers from the baseline, 1-year, and 2-year follow up waves. Conditional process analysis assessed the direct, indirect, and moderated relationships in separate, equivalent models based on youth- versus caregiver-raters of ACEs and youth psychopathology to capture potential differences based on the rater. The results of both the youth- and caregiver-rated models indicated that lower family economic status directly predicted higher levels of externalizing symptoms, and ACEs indirectly accounted for higher levels of internalizing and externalizing symptoms. Additionally, family conflict moderated some, but not all, of these relationships. The study's findings highlight that lower family economic status and ACEs, directly and indirectly, contribute to early adolescent psychopathology, and conflictual family environments can further intensify these relationships. Implementing empirically supported policies and interventions that target ACEs and family environments may disrupt deleterious pathways between SES and youth psychopathology.

Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment

Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.

Childhood Trauma and College Sexual Harassment: Coping and Resilience as Moderators

Childhood trauma has been identified as a risk factor for future revictimization, especially in young adulthood. There is an established link between childhood victimization and later sexual assault, but it is unclear if childhood trauma is associated with sexual harassment. Related research has examined coping and resilience as buffers, or moderators, against negative outcomes associated with childhood victimization and sexual assault, so the buffering effect of these variables will be explored for sexual harassment as well. In a sample of 583 young adults age 18-25, self-report measures of childhood trauma, sexual harassment, coping, and resilience, were collected via an online survey tool. Results of a path analysis suggest that, in general, childhood trauma places young adults at a risk for sexual harassment. Resiliency did not moderate the association between childhood trauma and sexual harassment in young adulthood, but coping did moderate this association. Specifically, when coping was high, trauma and sexual harassment were negatively related, but when coping was low to moderate, trauma and sexual harassment were positively related.

Mechanisms of Inequity: The Impact of Instrumental Biases in the Child Protection System

The structural risk perspective conceptualizes the causes of inequities in child protection system contact as unequal exposure to the structural causes of child abuse risk, combined with biases in the responses of child welfare workers and reporters. This conceptual article proposes a third mechanism of inequity: instrumental biases. It is proposed that instrumental biases operate as a third group of mechanisms that inequitably increase the involvement of some groups and not others. Instrumental biases operate through institutional structures, interpretive concepts and risk proxies that affect how risk is coded and becomes attached to particular people. Against the background of the notify-investigate model that creates poor conditions for decision making, and shapes institutional structures, instrumental biases include the miscalibration of the demand and supply of services (an institutional cause); family-specific surveillance bias and a reliance on prior case histories (a risk proxy cause); widening legal definitions of serious harm (an interpretive concept cause); and complex responses to intimate partner violence that minimize theories of IPV and the social context it occurs within (concept and risk proxy causes). It is argued that within the decision-making context of the child protection system, how services are structured and risk becomes codified has disproportionate impacts on some communities compared to others. Examples from Aotearoa New Zealand, with reference to Māori and people living in high-deprivation areas, are used to illustrate these concepts.

The Potential for Teacher-Student Relationships and the Whole School, Whole Community, Whole Child Model to Mitigate Adverse Childhood Experiences

BACKGROUND

Adverse childhood experiences (ACEs) are associated with poorer health and educational outcomes. With over 20% of children experiencing multiple ACEs, interventions must target protective factors to improve outcomes among these students. Teacher-student relationships (TSRs) integrated with the Whole School, Whole Community, Whole Child (WSCC) are one promising approach to building resilience to overcome ACEs.

METHODS

A narrative literature review was conducted on ACEs, resilience, TSRs, and the WSCC model to explore the evidence and potential of TSR interventions integrated within the WSCC model to build resilience in students experiencing ACEs.

RESULTS

Supportive adult relationships are one of the strongest protective factors against ACEs. TSR interventions have improved student and relationship outcomes. Few studies have explored the relationship between TSRs and ACEs or TSR ACEs interventions. The WSCC model provides opportunities to integrate TSRs and other protective factors into a schoolwide health model to build resilience.

CONCLUSIONS

TSRs and the WSCC model are promising approaches to target protective factors to mitigate ACEs. Research is needed to further establish TSRs as a protective factor, explore TSR ACEs interventions, and determine best practices for integrating TSRs and resilience in the WSCC model.

Impact of Poverty on Parent-Child Relationships, Parental Stress, and Parenting Practices

OBJECTIVES

To explore the impact of poverty on parent-child relationships, parental stress and parenting practices.

DESIGN

A mixed methods study.

SAMPLE

Four hundred and eighty five Hong Kong Chinese parents who had children aged 3-6 years, and who were from low-income families. Eleven of these parents were randomly selected for individual semi-structured interviews.

MEASUREMENTS

A sociodemographic questionnaire, the parent-child relationship score, the Parental Stress Scale and the Perceived Parental Aggression Scale.

RESULTS

The parents were found to have an impaired relationship with their children. The findings indicated that employment status, parental stress and harsh parenting were significantly associated with parent-child relationships. The qualitative findings revealed that parents from low-income families encountered a wide range of difficulties, which made these parents more likely to experience parental stress, thereby increasing their tendency to adopt harsh parenting practices that undermined parent-child relationships.

CONCLUSION

This study sheds light on the associations between parent-child relationships, parental stress and parenting practices in low-income families. These findings will enhance nurses' understanding of the impact of poverty on parent-child relationships, and highlight the need for nurses to ensure that underprivileged parents and their children receive adequate primary care to prevent the development of psychological problems in this vulnerable group.

Prevalence and Impact of Adverse Childhood Experiences in an Interdisciplinary, School-Based Pediatric Clinic

INTRODUCTION

This study's purpose was to ascertain the prevalence of adverse childhood experiences (ACEs) in a pediatric population and their connection to other health history information.

METHOD

Using health history data, a retrospective, descriptive study was undertaken with 1,028 children seen at a school-based, interprofessional clinic over 1 academic year.

RESULTS

Nearly 58% of children had at least one ACE, and 9.5% had four or more, similar to the prevalence of ACEs in adults reported in the original study by Felitti et al. (1998). With increasing ACEs, children had higher rates of intrauterine drug exposure, intensive care on delivery, homelessness, substance abuse, behavioral problems, mental illness, learning difficulties, and weight issues.

DISCUSSION

Because ACEs are prevalent among children, pediatric providers should use trauma-informed care principles and teach and model a loving and supportive adult presence in children's lives.

Roles of participation in social activities in the association between adverse childhood experiences and health among older Japanese adults

Adverse childhood experiences (ACEs) have shown strong associations with later-life health such as depression and subjective health. Social participation is also associated with later-life health but it is unclear to what extent this could contribute to alleviating harmful impacts of ACEs, nor is it clear whether ACEs are themselves associated with later-life social participation. Thus, this study aims to understand: (1) the influence of ACEs on social participation in later life and (2) whether social participation can alleviate the harmful influences of ACEs on depression and subjective health among Japanese older adults. Data were from 5,671 Japanese older adults (aged 65+) in surveys in 2013 and 2016 as part of the Japan Gerontological Evaluation Study (JAGES). Logistic regression analyses were conducted to estimate the relations between ACEs and later-life social participation, adjusting for potential confounders and mediators. Inverse probability weighting was used to estimate average effects of ACEs on later-depression and subjective health, adjusting for potential confounders, and these were compared against controlled direct effect (CDE) estimates from marginal structural models based on all respondents experiencing weekly social participation. We found that ACEs were associated with reduced later-life social participation (OR for >1 ACEs = 0.88, 95% CI = 0.79, 0.99). The estimated effect of ACEs on depression ( adjusted total effect estimates: OR = 1.23, 95% CI = 1.05, 1.45) was marginally alleviated in estimates assuming weekly social participation for everyone (CDE = 1.18, 95% CI = 0.98, 1.43). A similar tendency was seen for poor subjective heath. Negative impacts of ACEs on depression may be marginally mitigated through social participation, but mitigating effects were moderate. Further investigation on other potential later-life mitigating factors is needed.

The Longitudinal Associations Between Paternal Incarceration and Family Well-Being: Implications for Ethnic/Racial Disparities in Health

OBJECTIVE

Ethnic/racial minority children in the United States are more likely to experience father loss to incarceration than White children, and limited research has examined the health implications of these ethnic/racial disparities. Telomere length is a biomarker of chronic stress that is predictive of adverse health outcomes. This study examined whether paternal incarceration predicted telomere length shortening among offspring from childhood to adolescence, whether maternal depression mediated the link, and whether ethnicity/race moderated results.

METHOD

Research participants included 2,395 families in the Fragile Families and Child Wellbeing study, a national and longitudinal cohort study of primarily low-income families from 20 large cities in the United States. Key constructs were measured when children were on average ages 9 (2007-2010) and 15 (2014-2017).

RESULTS

Children who experienced paternal incarceration exhibited shorter telomere lengths between ages 9 and 15, and changes in maternal depression mediated this finding. Specifically, mothers who experienced a partner's incarceration were more likely to have depression between children's ages 9 and 15. In turn, increases in maternal depression between children's ages 9 and 15 predicted more accelerated telomere length shortening among children during this period. Paternal incarceration was more prevalent and frequent for ethnic/racial minority youth than for White youth.

CONCLUSION

Paternal incarceration is associated with a biomarker of chronic stress among children in low-income families. Rates of paternal incarceration were more prevalent and frequent among Black American and multiethnic/multiracial families than among White Americans. As a result, the mass incarceration crisis of the criminal justice system is likely shaping intergenerational ethnic/racial health disparities.

Racial/ethnic differences in clusters of adverse childhood experiences and associations with adolescent mental health

Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure “classes” and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the ‘Low Adversity’ class. Conversely, most Black and Hispanic adolescents were classified in the ‘High Socioeconomic Adversity and Paternal Incarceration’ class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the ‘High Global Adversity’ class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.

•

In a U.S. sample of low-income children, 93% experienced at least one ACE in past year.

•

ACEs cluster differently for White, Black, and Hispanic adolescents.

•

Most White adolescents are in a low adversity class.

•

Most Black and Hispanic adolescents are in a high SES adversity and parental incarceration class.

•

There are race differences in relationships between ACE classes and mental health.

Cingulo-opercular and Cingulo-parietal Brain Networks Functional Connectivity in Pre-adolescents: Multiplicative Effects of Race, Ethnicity, and Parental Education

Introduction

A growing body of research has shown a diminished association between socioeconomic status (SES) indicators and a wide range of neuroimaging indicators for racial and ethnic minorities compared to majority groups. However, less is known about these effects for resting-state functional connectivity between various brain networks.

Purpose

This study investigated racial and ethnic variation in the correlation between parental education and resting-state functional connectivity between the cingulo-opercular (CO) and cingulo-parietal (CP) networks in children.

Methods

This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study; we analyzed the resting-state functional Magnetic Resonance Imaging (rsfMRI) data of 8,464 American pre-adolescents between the ages of 9 and 10. The main outcome measured was resting-state functional connectivity between the CO and CP networks calculated using rsfMRI. The independent variable was parental education, which was treated as a nominal variable. Age, sex, and family marital status were the study covariates. Race and ethnicity were the moderators. Mixed-effects regression models were used for data analysis, with and without interaction terms between parental education and race and ethnicity.

Results

Higher parental education was associated with higher resting-state functional connectivity between the CO and CP networks. Race and ethnicity both showed statistically significant interactions with parental education on children's resting-state functional connectivity between CO and CP networks, suggesting that the correlation between parental education and the resting-state functional connectivity was significantly weaker for Black and Hispanic pre-adolescents compared to White and non-Hispanic pre-adolescents.

Conclusions

In line with the Minorities' Diminished Returns theory, the association between parental education and pre-adolescents resting-state functional connectivity between CO and CP networks may be weaker in Black and Hispanic children than in White and non-Hispanic children. The weaker link between parental education and brain functional connectivity for Blacks and Hispanics than for Whites and non-Hispanics may reflect racism, racialization, and social stratification that collectively minimize the returns of SES indicators, such as parental education for non-Whites, who become others in the US.

Adverse childhood experiences and behavior problems among poor Black children: Nonresident father involvement and single mothers' parenting stress

BACKGROUND

Adverse childhood experiences (ACEs) in early childhood and developmental outcomes during the middle childhood and adolescent years have been understudied among low-income Black families.

OBJECTIVE

To test a model linking economic hardship, single mothers' parenting stress, ACEs, and nonresident fathers' involvement in early childhood to behavior problems in middle childhood and adolescence.

PARTICIPANTS AND SETTING

We used six waves of longitudinal data from a subsample of 800 unmarried Black mothers, nonresident fathers, and their children (at child birth and ages 1, 3, 5, 9, and 15) from the Fragile Families and Child Wellbeing Study, a nationally representative data set.

METHOD

Structural equation models with latent variables that incorporate path analysis and confirmatory factor analysis were tested.

RESULTS

Mothers' economic hardship was associated directly with parenting stress (beta = 0.27, p < .001) and related both directly (beta = 0.22, p < .001) and indirectly (through parenting stress) to the children's increased likelihood of exposure to ACEs (indirect effect = 0.05, p < .001). Nonresident fathers' involvement early on (child's age 1 to 5) was associated directly with reductions in the mothers' economic hardship (beta = -0.18, p < .001), children's reduced exposure to ACEs (beta = -0.15, p < .001), and fewer behavior problems in middle childhood and adolescence (beta = -0.10, p < .001).

CONCLUSION

Nonresident Black fathers' involvement in single-mother families may buffer the adverse consequences over time for economically and socially disadvantaged Black children of exposure to ACEs in early childhood. Interventions that encourage sustained involvement by nonresident Black fathers with young children and their single mothers are recommended.

The longitudinal influences of adverse childhood experiences and positive childhood experiences at family, school, and neighborhood on adolescent depression and anxiety

BACKGROUND

Adolescent depression and anxiety are major mental health concerns. Adverse childhood experiences (ACEs) are risk factors for depression and anxiety in adolescence and positive childhood experiences at home, school, and neighborhood are protective factors. Few studies, however, have compared the longitudinal effects of these two sets of contextual risk and protective factors on depression and anxiety among adolescents by framing them together.

METHODS

This study used data on a subsample of 3426 socioeconomically disadvantaged adolescents collected at their birth, ages one, three, five, nine, and fifteen. Logistic regression was used to examine the longitudinal effects of ACEs, focusing on childhood maltreatment and family dysfunctions, and positive childhood experiences with family, school, and neighborhood on the risks of depression and anxiety. Adolescents' characteristics and their families' socioeconomic status were adjusted.

RESULTS

In the two ACEs subcategories, childhood maltreatment exposures increased the risks only for later anxiety; family dysfunction increased the risks for both later depression and anxiety. In the three contexts, positive childhood experiences at family and school protected at-risk adolescents against both mental health concerns, whereas neighborhood collective efficacy protected adolescents only against depression.

LIMITATIONS

Resilience was examined as an outcome only; it can also be examined as a process. Neither teachers' nor grandparents' supports were included.

CONCLUSIONS

ACEs maltreatment and family dysfunction are two different risk dimensions for adolescent depression and anxiety. Positive childhood experiences at family are the strongest protective factors for children exposed to ACEs, followed by these in school and neighborhood. Early interventions building positive relationships may benefit adolescent mental health.

Neighborhood Environment and Child Health in Immigrant Families: Using Nationally Representative Individual, Family, and Community Datasets

PURPOSE

This study aimed to examine neighborhood effects on the physical and socioemotional health of children from immigrant families, after controlling for parents' demographic characteristics, socioeconomic status, acculturation, and health care issues.

DESIGN

Pooled cross-sectional data were merged with community profiles.

SETTING

The United States in 2013, 2014, and 2015.

PARTICIPANTS

10,399 children from immigrant families in the 2013-2015 National Health Interview Surveys and the U.S. Census Data.

MEASURES

Both objective and subjective measures of neighborhood environments were assessed, including neighborhood physical disorder, socioeconomic status, demographic composition, community resources, and social trust.

ANALYSIS

Descriptive statistics, logistic regression models.

RESULTS

About half of the sampled children were male (51%); 68% were white; 56% were of Hispanic; and 34% were school-aged. Three neighborhood factors-neighborhood trust, area-level poverty rate, and the presence of primary care physician-were identified as significant predictors for child health outcomes. Foreign-born population, green space, and food desert were not significant. At the individual level, parents' racial and ethnic minority status, non-marital status, and healthcare issues were found to be risk factors. Families' financial resources and parental education were identified as protective factors of socioemotional health.

CONCLUSION

Intervention approaches to build on neighborhood trust may have broad potential to improve child outcomes. Programs focusing on immigrant families with children in high poverty neighborhoods should be a high priority.

Physical health and emotional and behavioral problems in maltreated children according to family economic status: Health problems of maltreated children in Korea

Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.Cross-sectional nationwide studyData from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.