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Wang X, Jiang L, Barry L, Zhang X, Vasilenko SA, Heath RD. A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges. TRAUMA, VIOLENCE & ABUSE 2024; 25:1695-1708. [PMID: 37594222 DOI: 10.1177/15248380231192922] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.
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Sigrist C, Ottaviani C, Baumeister-Lingens L, Bussone S, Pesca C, Kaess M, Carola V, Koenig J. A sex-specific pathway linking early life maltreatment, vagal activity, and depressive symptoms. Eur J Psychotraumatol 2024; 15:2325247. [PMID: 38512074 PMCID: PMC10962311 DOI: 10.1080/20008066.2024.2325247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/08/2023] [Indexed: 03/22/2024] Open
Abstract
Background: Experiences of early life maltreatment (ELM) are alarmingly common and represent a risk factor for the development of psychopathology, particularly depression. Research has focused on alterations in autonomic nervous system (ANS) functioning as a mediator of negative mental health outcomes associated with ELM. Early alterations in autonomic vagal activity (vmHRV) may moderate the relationship between ELM and depression, particularly when considering forms of emotional maltreatment. Recent evidence suggests that the relationships of both ELM and vmHRV with depression may be non-linear, particularly considering females.Objective: Building on and extending theoretical considerations and previous work, the present work aims to further the current understanding of the complex relationships between ELM exposure, vmHRV, and depression.Methods: This study uses an adaptive modelling approach, combining exploratory network-based analyses with linear and quadratic moderation analyses, drawing on a large sample of males and females across adolescence (total N = 213; outpatient at-risk sample and healthy controls) and adulthood (total N = 85; community-based convenience sample).Results: Exploratory network-based analyses reveal that exposure to emotional abuse is particularly central within a network of ELM subtypes, depressive symptoms, and concurrent vmHRV in both adolescents and adults. In adults, emotional neglect shows strong associations with both emotional abuse and vmHRV and is highly central as a network node, which is not observed in adolescents. Moderator analyses reveal significant interactions between emotional maltreatment and vmHRV predicting depressive symptoms in adult females. Significant quadratic relationships of emotional maltreatment and vmHRV with depression are observed in both adolescent and adult females.Conclusions: The present findings contribute to the understanding of the psychological and physiological mechanisms by which ELM acts as a risk factor for the development of depression. Ultimately, this will contribute to the development of targeted and effective intervention strategies to mitigate the detrimental effects of early adversity.
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Affiliation(s)
- Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Cristina Ottaviani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Luise Baumeister-Lingens
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Silvia Bussone
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Pesca
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Valeria Carola
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Pollmann A, Fritz J, Barker E, Fuhrmann D. Networks of Adversity in Childhood and Adolescence and Their Relationship to Adult Mental Health. Res Child Adolesc Psychopathol 2023; 51:1769-1784. [PMID: 36331717 PMCID: PMC10661796 DOI: 10.1007/s10802-022-00976-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Adverse experiences before the age of eighteen are common and include diverse events ranging from sexual abuse to parental divorce. These stressful experiences have been linked to physical and mental health issues. Previous research has focused mainly on childhood adversity, such as experiences in the family environment. Little consideration has been given to adversities that may be particularly harmful in adolescence. To understand adolescents' adverse experiences, this project used data from the Avon Longitudinal Study of Parents and Children (ALSPAC, total N = 14,901, N ≈ 1,200 - 10,000 per measure). We modelled interrelations of adversities in childhood (1-11 years) and adolescence (11-23 years) and examined adversity clusters using network analysis. We found two similar clusters in the childhood and adolescence networks: (1) direct abuse and (2) adverse family factors. We identified a third cluster of (3) educational and social adversities for adolescence. For both age groups, emotional abuse in the family environment was closely linked to mental health in early adulthood and most adversities were linked with depression in early adulthood. In adolescence, housing and academic issues and abuse by a romantic partner were particularly central to the network of adversities. Thus, we found commonalities and differences in the relevance of adverse experiences at different developmental stages. These findings highlight the need to develop age-dependent frameworks for adversity research and policymaking.
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Affiliation(s)
- Ayla Pollmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK.
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Edward Barker
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, Henry Wellcome Building for Psychology, Denmark Hill Campus, SE5 8AF, London, UK
| | - Delia Fuhrmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK
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Ng AE, Tkach N, Alcalá HE. A window of opportunity: Adverse childhood experiences and time alone with a provider in the United States. Prev Med 2023; 175:107675. [PMID: 37633601 DOI: 10.1016/j.ypmed.2023.107675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND To date, there is limited literature on the relationship between Adverse Childhood Experiences (ACEs) and the quality of health care provider encounters. This is key, as people with a history of ACEs have a greater burden of illness. METHODS This study uses data from the 2020-2021 National Survey of Children's Health to examine relationships between ACEs and (1) spending less than ten minutes with a health care provider, and (2) spending time alone with a health care provider. RESULTS In general, our results suggested most ACEs were associated with higher odds of a provider spending <10 min with a child during their last preventative care visit, while ACEs were inconsistently related to spending time alone with a provider. Each additional ACE was found to be associated with higher odds of both outcomes. CONCLUSIONS This work emphasizes the importance of ACEs screening in a health care setting and may set the groundwork for future research investigating mechanisms within these associations. Given the established link between health care quality and patient-provider trust, and health outcomes, intervention work is needed to develop healthcare practices that may encourage the length and quality of health care provider visits.
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Affiliation(s)
- Amanda E Ng
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, United States of America
| | - Nicholas Tkach
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, United States of America
| | - Héctor E Alcalá
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States of America; Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, United States of America.
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Hughes PM, Graaf G, deJong NA, Thomas KC. Emotional Support Among Parents of Children With Adverse Childhood Experiences. J Pediatr Health Care 2023; 37:557-565. [PMID: 37245128 PMCID: PMC10524602 DOI: 10.1016/j.pedhc.2023.05.003] [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] [Received: 04/05/2023] [Accepted: 05/10/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION We assess the association between a child's exposure to adverse childhood experiences (ACEs) and the parent's current experiences of emotional support. METHOD This study used pooled cross-sectional data from the National Survey of Children's Health (N = 129,988). Emotional support for the parent was classified by the presence (any emotional support, no emotional support) and type (any formal support or only informal support). All models were adjusted for relevant predisposing, enabling, and need factors. RESULTS Having two or more ACEs was associated with a higher probability of any emotional support (average marginal effect = 0.017; 95% confidence interval = 0.002-0.032) and a higher probability of formal support (average marginal effect = 0.049; 95% confidence interval = 0.028-0.069). Several individual ACEs were associated with the presence and type of emotional support. DISCUSSION Parents of children with higher ACEs are likelier to have emotional support, especially formal support.
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Affiliation(s)
- Phillip M. Hughes
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy
- Division of Research, UNC Health Sciences at MAHEC, Asheville, NC
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
| | - Genevive Graaf
- School of Social Work, University of Texas at Arlington, Arlington, TX
| | - Neal A. deJong
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Kathleen C. Thomas
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
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Alcalá HE, Ng AE, Tkach N, Salam Z. Adverse Childhood Experiences and Utilization and forgoing of Health Care among Children: A Nationally Representative Study in the United States. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2108812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Héctor E. Alcalá
- Health Science Tower, Stony Brook University, Stony Brook, NY, USA
| | - Amanda E. Ng
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, College Park, MD, USA
| | | | - Zoha Salam
- Department of Global Health, McMaster University, Hamilton, Ontario, Canada
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