Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: Results from a cross-sectional survey

Associations between adverse childhood experiences, resilience, and health and educational outcomes using data from the 2022 National Survey of Children's Health

BACKGROUND

Exposure to adverse childhood experiences (ACEs) is associated with poor childhood health. There is increasing interest in understanding the influence of positive childhood experiences (PCEs) because of their potential protective role against ACEs.

OBJECTIVE

We sought to understand 1) whether PCEs are protective against developing learning disabilities and mental, emotional, developmental, and behavioral conditions (MEDBC); 2) whether this relationship varies by number of ACEs.

PARTICIPANTS AND SETTING

We analyzed the 2022 National Survey of Children's Health (NSCH).

METHODS

We constructed a variable for "high ACEs" (4+), and 6 PCEs were considered. Outcomes were MEDBC and learning disability. Logistic regression models were: 1) using high ACEs and each individual PCE as predictors; and 2) Model 1 + an interaction term for high ACEs x each PCE. Models were nationally weighted using survey-provided sampling weights and controlled for covariates with significance at p < 0.05.

RESULTS

The sample consisted of 53,133 children. In Model 1, each PCE except reading together (p = 0.795) and singing together (p = 0.551) was associated with a significantly lower odds of having MEDBC. Each PCE except reading together (p = 0.259), singing together (p = 0.583), and having meals together (p = 0.726) was associated with a significantly lower odds of having learning disabilities.

CONCLUSIONS

Regardless of number of ACEs, PCEs were associated with lower odds of having a MEDBC and a learning disability. As the enthusiasm for ACEs screening continues, clinicians should also consider PCE screening.

Adverse childhood experiences, positive childhood experiences, suicidal thoughts or behaviors and psychological distress among Kenyan youth-an exploratory analysis of the 2019 Kenya Violence Against Children and Youth Survey (VACS)

BACKGROUND

Early childhood experiences, whether positive or adverse, significantly impact health across the lifespan. Children and youth in low-resource settings face unique challenges that increase their vulnerability to poor mental health.

OBJECTIVE

To examine the relationship between adverse childhood experiences (ACEs) and suicidal thoughts or behaviors as well as psychological distress, and to explore the moderating role of parent-related positive childhood experiences (PPCEs) on this association.

PARTICIPANT AND SETTING

We used data from the 2019 Kenya Violence Against Children and Youth Survey.

METHODS

Analyses were restricted to youth ages 18-24. ACEs were dichotomized (into those who have experienced at least one ACEs and those who have not), and logistic regression was used to examine the relationship between ACEs, PPCEs, and suicidal thoughts or behaviors and psychological distress stratified by sex.

RESULTS

Significantly more males (75.8 %) than females (57.6 %) experienced at least 1 ACE in their lifetime (p = 0.0003). PPCEs are common; however, significantly more males (59.9 %) than females (41.2 %) had a strong father-child relationship (p = 0.0003). ACEs were positively associated with suicidal thoughts or behaviors and psychological distress, with notable sex-specific differences in the associations. Conversely, PPCEs were negatively associated with those outcomes, but there were also sex-specific differences in the associations. No significant interaction effect was observed between ACEs, PPCEs, and the mental health outcomes.

CONCLUSION

Suicidal thoughts or behaviors and psychological distress are pervasive problems that are common among youth in Kenya, and the associations with ACEs vary by sex. A multilevel approach and evidenced-based intervention strategies that consider the context of sociocultural norms are crucial to prevention and response efforts.

Development and validation of a brief questionnaire for the joint assessment of early maltreatment and early caring experiences

BACKGROUND

Early life experiences significantly impact mental health, yet tools assessing both early maltreatment experiences (EME) and early caring experiences (ECE) remain scarce.

OBJECTIVE

This study aimed to develop and validate the self-reported Early Maltreatment & Caring Experiences (EMCE) questionnaire, a concise tool for dual assessment of these experiences.

PARTICIPANTS AND SETTING

A clinical sample of 272 adults diagnosed with major depressive disorder was recruited from an outpatient clinic in Santiago, Chile.

METHODS

Confirmatory factor analyses (CFA), internal consistency, and test-retest reliability of the EMCE were assessed. Logistic regression with 1000 bootstrap replications evaluated predictive validity for complex and severe depression. Construct validity was assessed against the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and resilience was measured using the Brief Resilient Coping Scale (BRCS).

RESULTS

CFA refined the EMCE into a concise 6-item version (χ2(7) = 9.54, p = .216, RMSEA = 0.037, CFI = 0.995, TLI = 0.989) with strong psychometric properties, including good internal consistency (α = 0.73 for EME, α = 0.80 for ECE), excellent test-retest reliability (ICC = 0.86 and 0.79, respectively). Each EME point increased odds of complex depression (OR = 1.33, 95 % BC CI 1.18-1.52), while higher ECE scores reduced them (OR = 0.83, 95 % BC CI 0.74-0.94). Agreement analyses with the CTQ-SF supported construct validity.

CONCLUSIONS

The EMCE provides a reliable, concise tool for assessing early maltreatment and caregiving experiences, supporting clinicians and researchers in exploring vulnerabilities and protective factors. Its brevity ensures feasibility in clinical and research settings.

Network analysis of adverse and positive childhood experiences in a national sample of university students

BACKGROUND

Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) often co-occur and interact to exert long lasting impacts on health and other outcomes. However, current analytical approaches fall short in exploring the complex interplay between ACEs and PCEs, particularly within non-Western contexts.

OBJECTIVE

This study used network analysis to examine the complexity and interplay of ACEs and PCEs in a large sample of Chinese young adults.

METHODS

Leveraging data collected from 9468 Chinese university students through online surveys between August and November 2020, we examined ACE items (n = 6458), PCE items (n = 9249), and ACE x PCE items combined (n = 6365) for this study. ACEs were assessed using the Chinese version of the WHO ACE-International Questionnaire, while PCEs were measured using the Chinese Positive Childhood Experiences Scale. We first conducted zero-order tetrachoric correlation analysis, followed by network estimation using the Ising model with the eLasso method. We visualized the networks using the plot function from the IsingFit R package. Network communities were detected using the Walktrap algorithm, and network sensitivity and stability were assessed.

RESULTS

Network analysis revealed a high degree of connectivity within both ACEs and PCEs networks. Emotional abuse and household violence emerged as central nodes in the ACEs network, while family support and having a harmonious family environment were central in the PCEs network. The combined ACEs x PCEs network highlighted significant inverse associations between specific adverse and positive experiences, with emotional neglect closely linked with an inability to talk about feelings with family. The Walktrap algorithm identified distinct clusters within the networks, such as abuse and household dysfunction in the ACEs network, and family support and positive school experiences in the PCEs network.

CONCLUSIONS

Our findings confirm that ACEs and PCEs tend to co-occur and demonstrate that network analysis can elucidate their complex and intertwined nature. The findings suggest the need for culturally sensitive interventions that address both ACEs and PCEs to promote resilience and well-being in Chinese young adults.

Positive Childhood Experiences Support Cognition and Counteract Behavior and Emotion Problems During Early Adolescence

OBJECTIVE

This study aimed to identify the independent associations of positive childhood experiences (PCEs) on brain health (cognitive function, behavioral and emotional problems) among early adolescents.

METHODS

Data from the 2-year follow-up visit from the Adolescent Brain and Cognitive Development (ABCD) study were analyzed (N = 5449, mean age: 12.0 ± 0.7, age range = 10.6-13.4 years). Adverse childhood experiences (ACEs) were measured by parent report at baseline, and PCEs were measured by parent report at year two. Dependent variables included cognitive function domains (National Institutes of Health [NIH] Toolbox) and the child behavior checklist (CBCL) subscales at year two. Multivariate linear regression analyses were performed for each dependent variable, with the number of PCEs and ACEs as independent variables, adjusting for age, sex, race and ethnicity, puberty stage, and family income.

RESULTS

PCEs were associated with better cognitive function on tasks of picture vocabulary (b = 0.29, 95% CI 0.15-0.43), flanker (b = 0.14, 0.00-0.28), reading recognition (b = 0.19, CI 0.08-0.31), and picture sequence memory (b = 0.44, CI 0.21-0.67). The PCEs:ACEs interaction showed that greater PCEs predicted a weaker association of ACEs on the CBCL subscales: anxious-depressed (b = -0.06, -0.10 to -0.01), withdrawn (b = -0.06, -0.09 to -0.04), aggressive behavior (b = -0.11, -0.17 to -0.06), rule-breaking behaviors (b = -0.06, -0.09 to -0.04), social problems (b = -0.04, -0.07 to -0.01), somatic complaints (b = -0.03, -0.06 to 0.00), and total CBCL problems (b = -0.46, -0.69 to -0.23).

CONCLUSIONS

Exposure to PCEs supports cognition and is protective against psychopathology, even among children exposed to ACEs.

The mediating role of social support on the link between adverse childhood experiences and adult mental health

Adverse childhood experiences (ACEs) have been associated with adult mental health, especially anxiety and depression. We aimed to explain these relationships by investigating perceived social support as a mediating factor. In this model, it is proposed that individuals who experience more ACEs will have less perceived social support in adulthood, which in turn will increase reported anxiety and depression symptoms. Data were collected on ACEs, anxiety, depression, and perceived social support using an anonymous REDCap survey distributed through various social media outlets and relevant listservs. Respondents (N = 494) were caregivers who primarily resided in the United States and identified as White, well-educated, middle class, and female. ACEs were measured using the expanded ACE questionnaire extracted from the Health-Resiliency-Stress Questionnaire. Anxiety and depression were measured by the Generalized Anxiety Disorder 7-item scale and the Patient Health Questionnaire 9-item scale, respectively. Social support was measured with the Multidimensional Scale of Perceived Social Support. Results confirmed partial mediating effects of social support on the relation between (a) ACEs and anxiety and (b) ACEs and depression. Increased exposure to ACEs was associated with less social support in adulthood and, consequently, to greater mental health symptomatology. Implications of these findings highlight the potential role of social support as a preventative strategy and adult social support as a mitigating strategy.

The Impact of Positive Childhood Experiences: A Systematic Review Focused on Children and Adolescents

Childhood and adolescence are crucial stages of life, characterized by significant changes that profoundly influence overall development. While positive childhood experiences (PCEs) can help mitigate the effects of adverse events during these formative years, they have not been as thoroughly researched. Then, this systematic review aims to address this gap by organizing the existing literature on PCEs and examining their impact on both positive and negative outcomes in children and adolescents. A search through databases such as B-On, PsycINFO, PubMed, SCOPUS, and Scielo, as well as supplementary searches, identified 30 studies that met the inclusion criteria. The results indicate that most studies were published in the last 4 years, primarily in the USA, and focused on community populations with mixed samples. In addition, the results reveal that among children and adolescents, higher levels of PCEs were associated with better mental health outcomes (e.g., reduced depressive symptoms, anxiety, self-harm, substance use, and suicidal ideation), improved psychosocial outcomes (e.g., enhanced adult functioning and future orientation), better academic achievement (e.g., reduced absenteeism and fewer academic difficulties), and some improvements in physical health (e.g., reduced chronic pain). However, the relationship between PCEs and behavioral outcomes showed mixed results. Strengthening efforts to promote PCEs and resources that support child and adolescent resilience is crucial. Further research involving diverse samples is needed to gain a deeper understanding of the role of PCEs.

Adult Mental Health Associated with Adverse and Positive Childhood Experiences Among 1st and 2nd Generation Asian Americans

BACKGROUND

Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) impact adult health. However, differences in ACEs, PCEs, and mental health have not been extensively studied among Asian Americans.

OBJECTIVE

To examine the association between childhood experiences and adult mental health in first and second generation Asian Americans.

DESIGN

This study used data from the 2021-2022 California Health Interview Survey (CHIS), an address-based sampling of noninstitutionalized Californians conducted online or by phone.

PARTICIPANTS

Asian American respondents aged 18-65 years.

EXPOSURE

Fifteen different ACEs and seven different PCEs.

MAIN MEASURES

Adjusted prevalence ratios (aPR) of severe psychological distress for each generation. Survey weights were applied to all analyses for population-based representation.

KEY RESULTS

5,744 Asian Americans (48.0% male, 16.4% aged 18-25) were included in the current study. We found that second generation Asian Americans experienced a greater prevalence of ACEs (65.4% reported ≥1 ACE vs 47.5% in first generation Asian Americans) and lower prevalence of PCEs (32.1% reported ≤2 PCEs vs 22.6% in first generation Asian Americans). Second generation Asian Americans were more likely to report ≥4 ACEs (aPR, 1.46; 95% CI, 1.13 to 1.88) and ≤2 PCEs (aPR, 1.51; 95% CI, 1.29 to 1.78) relative to first generation Asian Americans. Second generation Asian Americans with ≥4 ACEs or ≤2 PCEs were more likely to report severe psychological distress (aPR, 2.54; 95% CI, 1.55 to 4.17 and aPR, 1.48; 95% CI, 1.03 to 2.13, respectively) relative to first generation Asian Americans. When examining ACEs and PCEs individually, domestic, physical, and verbal abuse; divorce; racism; and lacking support systems were significantly associated with severe psychological distress in second generation Asian Americans.

CONCLUSIONS

Second generation Asian Americans are more likely to experience more ACEs, fewer PCEs, and poorer mental health as a result. Our study indicates that physicians should screen for childhood experiences and leverage trauma-informed care among Asian American subpopulations.

Association Between Parental Adverse Childhood Experiences and Offspring's Risk of Suboptimal Health: A Systematic Review and Meta-Analysis

Previous reviews and meta-analysis have not adequately explored the impact of specific parental adverse childhood experiences (ACEs) subtypes on offspring's health. This updated systematic review and meta-analysis aimed to investigate the association between parental ACE subtypes and various offspring health outcomes. A comprehensive search was conducted in electronic databases including PubMed, Web of Science, the Cochrane Library, WANFANG, and China National Knowledge Infrastructure for studies published in English and Chinese from January 1, 1998, until July 18, 2023. Two independent reviewers screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. A random-effects model was applied to generate pooled odds ratios (ORs) and 95% confidence interval (95% CI). A total of 47 eligible studies were included in the final analysis. Overall, parental ACEs were significantly associated with several offspring's health outcomes, including preterm birth (PTB), low birth weight (LBW), total developmental delay, social-emotional problems, and behavioral problems (total, externalizing and internalizing behaviors), with ORs ranging from 1.06 to 3.02. Specific subtypes of parental ACEs, such as household dysfunction, sexual abuse, and physical abuse (but not emotional abuse) were significantly associated with PTB. Household dysfunction was notably linked to delayed cognition ability in offspring. Parental sexual abuse, physical abuse, emotional abuse, and emotional neglect were significantly correlated with social-emotion problems, with the expception of household dysfunction. Regarding total behavioral problems, parental household dysfunction, physical abuse, emotional abuse, physical neglect, and peer bullying were all significantly associated with children's behavioral issues, except for emotional neglect. There is a positive correlation between parental household dysfunction, sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect, peer bullying, and neighborhood-related adversity and their children's externalizing behavior problems. These findings underscore the significant impacts of parental ACEs on multiple adverse health outcomes in children, with specific parental ACEs subtypes exerting unique effects. This highlight the significance of comprehending the intergenerational effects of different ACE subtypes, and emphasizes the urgency of interventions to address these issues.

Patterns of adverse childhood experiences and their associations with depression, life satisfaction and short-form video addiction in Chinese college students

BACKGROUND

Adverse childhood experiences (ACEs) are widespread in East Asia, heightening the susceptibility to psychological and behavioral complications in adulthood.

OBJECTIVE

To identify polyvictimization patterns among Chinese college students and investigate the associations between diverse patterns and symptoms of depression, short-form video addiction (SVA), and life satisfaction.

PARTICIPANTS AND SETTING

This study encompassed 13,307 college students from four urban centers in China (Mage = 20.2; 46.4 % female).

METHODS

Latent class analysis (LCA) was employed to discern patterns of ACEs among college students. The three-step method (R3step) was utilized to explore the influence of demographic characteristics on the distribution of latent classes. Additionally, the automatic Bolck-Croon-Hagenaars (BCH) Method was deployed to investigate the latent classes effect on distal outcomes.

RESULTS

Left-behind experience was the most common ACE among Chinese college students. Four ACEs patterns were identified: 1) No/Very Low ACEs class (N = 8936, 67.2 %); 2) Parental Absence class (N = 430, 3.2 %); 3) Low/Moderate ACEs class (N = 3565, 26.8 %); and 4) High Violence and Left-behind class (N = 376, 2.8 %). The findings revealed a progressive escalation in healthy outcomes associated with the four ACEs patterns. Specifically, from the first class to the fourth, the severity of associated consequences (depression, life satisfaction and SVA) intensified.

CONCLUSIONS

Distinct ACEs patterns correlate with varying degrees of mental health issues. Compared to participants solely separated from parents, those exposed to abuse and neglect demonstrate more pronounced mental health challenges and addiction susceptibilities.

Resilience and hopelessness mediate the relationship between benevolent childhood experiences and life satisfaction: evidence from a cross-cultural study

BACKGROUND

A growing body of literature focuses on the role of benevolent childhood experiences (BCEs) in predicting adulthood well-being, in addition to adverse childhood experiences (ACEs). However, cross-cultural differences are generally ignored in this endeavor. Hence, this study aimed to explore the role of BCEs in predicting life satisfaction, resilience, and hopelessness. We also examined the potential of resilience and the role of hopelessness in mediating the relationship between BCE and life satisfaction.

METHODS

A total of 850 university students from Turkey (n = 371), Portugal (n = 248), and India (n = 231), aged 17 to 58 years (M = 22.12, SD = 4.41), participated in the study. Participants completed an online protocol consisting of measures to assess BCEs, life satisfaction, resilience, and hopelessness.

RESULTS

BCEs, hopelessness, and life satisfaction have significantly differed among the samples based on the country of residence. BCEs were positively correlated to resilience and life satisfaction and negatively to hopelessness. In the sequential mediation model, after controlling for country and sex, resilience and hopelessness sequentially mediated the relationship between BCEs and life satisfaction. BCEs were associated with life satisfaction, resilience, and hopelessness across countries and sexes. The model explains 42.8% of the variability.

CONCLUSION

Despite differences between countries, BCEs are important predictors of adult well-being in all three countries and should be monitored along with ACE. Further, resilience seems to have an important role in lowering the negative consequences of lower BCEs and feelings of hopelessness, pointing to the need to strengthen psychological resilience among adults.

Perceived control ameliorates the impact of adverse childhood experiences on downstream mental health

BACKGROUND

Previous scholarship has illustrated the pernicious role of adverse childhood experiences (ACEs) in self-reported mental health, namely depressive and anxiety-related symptoms. Given these insights, highlighting protective factors that may diminish the magnitude of this relationship is important. The present study explored the moderating role of perceived control on the relationship between ACEs and depressive and anxiety symptoms, respectively.

METHODS

Participants consisted of a US-based non-clinical sample of 567 undergraduate students who completed a battery of surveys related to psychological wellbeing and individual differences. A series of hierarchical linear regression analyses were utilized for hypothesis testing.

RESULTS

Consistent with our main hypotheses, perceived control moderated the relationship between ACEs and both anxiety and depressive symptoms, respectively. Namely, at low levels of perceived control, ACEs were associated with significantly greater levels of anxiety and depressive symptoms, respectively. However, for those reporting high levels of perceived control, we found no association between ACEs and self-reported symptoms.

CONCLUSION

We offer evidence that perceived control may serve as a protective factor for mental health and wellbeing against the influence of adverse childhood experiences.

Examining the relative impact of adverse and positive childhood experiences on adolescent mental health: A strengths-based perspective

BACKGROUND

It is well-documented that Adverse Childhood Experiences (ACEs) have a negative impact on mental health outcomes across the lifespan, while Positive Childhood Experiences (PCEs) act as a protective factor. Less is known about the relative impact of ACEs and PCEs on mental health outcome for adolescents.

OBJECTIVE

The present study sought to identify the relative impact of ACEs and PCEs on mental health outcomes for youth.

PARTICIPANTS AND SETTING

Data were drawn from a state-wide, cross-sectional health survey of 12-17 year-olds (n = 1169) conducted on a continuous basis throughout 2021, following the height of the COVID-19 pandemic.

METHODS

Adolescents completed ACEs and PCEs screeners and the Kessler 6-item Psychological Distress Scale to assess current mental health symptoms. A multiple regression analysis controlling for age, gender, and poverty level, was conducted to examine the relative impacts of ACEs and PCEs on mental health outcomes.

RESULTS

Male gender, younger age, lower family poverty level (e.g., more financial hardship), absence of ACEs, and experiencing more PCEs were significantly associated with better mental health outcomes for adolescents [F(5, 1163) = 104.48, p < .001]. Notably, ACEs were found to account for only 9 % of variance in mental health outcomes (ΔR2 = 0.09), while PCEs accounted for 18 % of variance (ΔR2 = 0.18).

CONCLUSIONS

PCEs explained approximately double the variance in mental health outcomes for adolescents compared to ACEs. Results indicate promoting youths' exposure to PCEs in childhood and adolescence may offer a meaningful pathway for supporting adaptive mental health outcomes.

Intergenerational transmission of adverse and positive childhood experiences and associations with child well-being

BACKGROUND

Parental adverse childhood experiences (ACEs) contribute to offspring adversity and poor health outcomes, but little is known about whether and to what extent parental positive childhood experiences (PCEs) influence offspring positive experiences and well-being.

OBJECTIVE

To investigate the association between parent and child ACEs and PCEs and their impact on child well-being and psychopathology.

PARTICIPANTS AND SETTING

A national sample of n = 1016 US parents of 1-5-year-olds completed online surveys in September 2019.

METHODS

Mediation analysis in a path modeling framework was used with stratified probability weights for generalizability to the US population.

RESULTS

Each additional parent PCE equated to 0.32 (95 % CI: 0.20, 0.45) increase in child PCEs and each additional parent ACE equated to 0.18 (95 % CI: 0.06, 0.31) increase in child PCEs and 0.13 (95 % CI: 0.08, 0.18) increase in child ACEs. In turn, an increase in 1 child PCE was associated with 0.10-0.16 SD increase in well-being and 0.06-0.10 decrease in psychopathology, and each additional child ACE equated to 0.10-0.18 SD increase in psychopathology.

CONCLUSIONS

Results support the intergenerational transmission of PCEs and ACEs, advancing understanding of the role that parent PCEs play in promoting child PCEs and fostering child well-being. Findings underscore the importance of extending clinical surveillance of ACEs to include PCEs in pediatric and adult healthcare settings. Dual-generation programs that address the negative consequences of parental ACEs may be able to increase their impact by adding a parallel emphasis on PCEs and providing parents with tools to foster PCEs in their children.

Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents

OBJECTIVE

This study aimed to investigate the relationships between four types of perceived discrimination (based on race and ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth.

METHODS

This study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N = 10,915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0-5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs.

RESULTS

Weight discrimination was the most frequent exposure (n = 643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were non significant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range Child Behavior Checklist (CBCL) scores, even when accounting for other ACEs (aOR=1.47, 95% CI=1.2-1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR=0.82, 95% CI=0.72-0.93).

CONCLUSIONS

Results of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.

Adverse Childhood Events Significantly Impact Depression and Mental Distress in Adults with a History of Cancer

Objectives: Adverse childhood experiences (ACEs) are linked to a heightened risk of depression. We explored the relationship between ACEs and both depression and mental distress among cancer survivors. Methods: This was a cross-sectional analysis using the 2022 Behavioral Risk Factor Surveillance System database of cancer survivors aged ≥18 (n = 14,132). The primary outcome was self-reported history of depression, and the secondary outcome was mental distress. The exposure variable was the number of ACEs, classified as 0, 1-2, and ≥3. Weighted multivariable logistic regression models assessed the association between the number of ACEs and depression and mental distress while adjusting for covariates. Results: Approximately 22% of respondents reported experiencing ≥3 ACEs. The prevalence of depression was 21.8%, and mental distress was 15.4%. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 3.94; 95% CI, 3.04-5.10) or 1-2 (aOR = 1.85; 95% CI, 1.47-2.32) ACEs had a higher likelihood of reporting depression. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 0.67; 95% CI, 0.48-0.93) had a lower likelihood of reporting mental distress. Conclusions: This study highlights the impact of ACEs on depression in adulthood among cancer survivors.

The Impact of Positive and Adverse Experiences in Adolescence on Health and Wellbeing Outcomes in Early Adulthood

This study evaluated the associations between positive and adverse experiences and environments in adolescence and health, education and employment outcomes in early adulthood. Data were extracted from the Longitudinal Studies of Australian Youth cohort that commenced in 2003. The items were conceptually mapped to Positive and Adverse Youth Experiences and environments (PYEs and AYEs) at 15, 16 and 17 years old and outcomes at 25 years old. The associations between PYEs, AYEs and general health, mental health, education and employment were examined, including testing whether PYEs mitigated the association between AYEs and outcomes. A higher number of AYEs was associated with poorer health, education, and employment outcomes. Conversely, a higher number of PYEs was correlated with positive outcomes. The participants with higher PYEs had significantly greater odds of better general and mental health outcomes, even after accounting for AYEs. This relationship was not observed for employment or education outcomes. Adolescence and the transition to adulthood are critical developmental stages. Reducing adverse experiences and environments and increasing positive ones during adolescence could enhance adult wellbeing.

Association Between Adverse Childhood Experiences and Sleep Duration in US Children: Analysis of 2020-2021 National Survey of Children's Health

BACKGROUND

Adverse childhood experiences (ACEs) and suboptimal sleep both negatively associate with cardiovascular health. Although an association between ACEs and suboptimal sleep in youth has been reported, there has been no investigation for differential effects among ACE subdomains.

OBJECTIVE

We examined associations between total and subdomain ACEs and sleep duration, and age as a moderator.

METHODS

Using the 2020-2021 National Survey of Children's Health and the American Heart Association Life's Essential 8 scoring algorithm, we created 3 sleep subgroups: (1) optimal, (2) suboptimal (≥1 to <2 hours below or ≥1 hour above optimal), and (3) very suboptimal (≥2 hours below optimal). We assessed association between ACEs (total and subdomains) and sleep duration using multinomial logistic regression, controlling for sex, age, race/ethnicity, caregiver's education, household income, habitual bedtime, and physical activity. We tested the interactions between ACEs and child's age.

RESULTS

In children aged 6 to 17 years (N = 58 964), mean sleep duration score was 77.2 (95% confidence interval, 76.6-77.9). The mean number of ACEs was 0.89 (95% confidence interval, 0.87-0.91). Adjusting for covariates, each additional ACE increased the likelihood of falling into the suboptimal subgroup by 8% and the very suboptimal subgroup by 26%. There was an association between each subdomain of ACE and suboptimal sleep duration, with no significant interaction with age.

CONCLUSIONS

Our findings show a dose-response relationship between ACEs and suboptimal sleep duration-a new cardiovascular health indicator in Life's Essential 8. Healthcare providers should screen for ACEs and suboptimal sleep in children to reduce future cardiovascular disease risk.

Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences

BACKGROUND

Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored.

OBJECTIVE

To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample.

METHODS

A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire.

RESULTS

ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels.

CONCLUSIONS

This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.

Leveraging Public Health and Public School Partnerships for Local Surveillance of Positive Childhood Experiences

Childhood psychosocial experiences can have a lifelong effect on health. These experiences can be measured together as positive and adverse childhood experiences or individually as positive childhood experiences (PCEs) or adverse childhood experiences. Most research on PCEs has focused on how PCEs promote health outcomes. However, limited research has been conducted on the prevalence of PCEs among adolescents in local areas served by public health departments. The St. Joseph County Department of Health developed a study to test the feasibility of surveillance of PCEs through local public health departments and to establish a prevalence for PCE exposure among a population of urban public-school students in Indiana. We conducted a survey in spring 2022 that collected demographic information on students at 2 high schools and 1 middle school and assessed exposure to PCEs. We assessed prevalence of PCEs on a 5-point Likert scale (0 = never, 1 = rarely, 2 = sometimes, 3 = usually, 4 = always). PCE scores were grouped into low (0-2), medium (3-5), and high (6 or 7). The prevalence of individual PCE items ranged from 35.6% to 86.8%. Among 798 respondents, 189 (23.7%) reported low PCE scores, 396 (49.6%) reported medium scores, and 213 (26.7%) reported high scores. This research demonstrates the feasibility of school-based PCE surveillance and establishes a baseline prevalence of PCE exposure among a population of middle and high school students. These methods are applicable to different contexts and can provide both local health departments and school systems with a new tool to address adverse childhood experiences.

Two Sides of the Coin: The Roles of Adverse Childhood Experiences and Positive Childhood Experiences in College Students' Mental Health

Several studies have established a link between adverse childhood experiences (ACEs) and mental health issues in college students. However, less is known about how positive childhood experiences (PCEs) may promote mental health and well-being, and potentially act as a buffer in the relationship between risk exposure and poor outcomes. This study investigates how ACEs and PCEs relate to college students' mental health (N = 321), within the framework of Resiliency Theory with specific attention focus on the compensatory and the protective factors models. Three key hypotheses were examined using quantitative data collected by way of an online anonymous survey: (1) ACEs will predict poorer mental health outcomes; (2) PCEs will predict better mental health outcomes and will lessen the negative effects of ACEs on mental health outcomes (compensatory factor model), and (3) PCEs will moderate the association between ACEs and mental health outcomes so that the relationship will be weaker among participants with higher PCEs (protective factor model). Findings supported each of these hypotheses and are important for our understanding of the long-term mental health correlates of ACEs and PCEs among college students. Our study underscores the importance of promoting PCEs while also underscoring the necessity of proactively preventing ACEs. Practical implications are discussed in relation to improving assessments of student needs and providing targeted interventions for those at risk.

Examining childhood experiences and personality functioning as potential predictors for the speed of recovery during psychotherapy of patients with anxiety disorders

Background

Adverse childhood experiences were previously identified as relevant risk factors for the development of anxiety disorders. Furthermore, anxiety disorders were shown to be associated with impairments of personality functioning. The objective of this study was to investigate adverse and protective childhood experiences as well as personality functioning, as defined by the Operationalized Psychodynamic Diagnosis system, as potential predictors for the speed of recovery during psychotherapy for patients with anxiety disorders.

Methods

The sample consisted of n = 312 completed psychotherapies. The speed of recovery, defined as symptom abatement over time, was calculated using a two-stage hierarchical linear model. The effects of adverse and protective childhood experiences as well as personality functioning on the speed of recovery during psychotherapy were then examined using a structural equation model.

Results

The presence of adverse childhood experiences predicted a lower speed of recovery during psychotherapy. In addition, a higher number of adverse childhood experiences was associated with greater impairments in the abilities of perception and regulation as dimensions of personality functioning. A higher number of protective childhood experiences was associated with fewer impairments in the communication and attachment dimensions. Impairments in personality functioning in patients with anxiety disorders did not predict the speed of recovery during psychotherapy.

Conclusions

Among patients with anxiety disorders, adverse childhood experiences lead to a lower speed of recovery during psychotherapy. Therefore, childhood adversity should be routinely assessed before and thoroughly addressed during psychotherapy in patients with anxiety disorders.

Do childhood experiences influence associations between posttraumatic stress disorder symptoms and positive autobiographical memories among military veteran students? An exploratory study

BACKGROUND

Evidence links posttraumatic stress disorder (PTSD) symptoms and features of positive autobiographical memories (accessibility, vividness, coherence, sharing, emotional intensity, distancing). There is a knowledge gap on how adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) may influence these relationships.

OBJECTIVES

The current study explored whether the number ACEs or BCEs moderated associations between PTSD symptom severity and features of positive autobiographical memories.

DESIGN AND METHODS

The sample included 124 student military veterans who had experienced a trauma (Mage = 33.90; 77.4% male; 75.0% White).

RESULTS

Path analyses showed more PTSD symptom severity was significantly associated with less positive autobiographical memory vividness (β = -0.26, p = .019, R2 = 0.06). Further, the number of ACEs moderated the relationship between PTSD symptom severity and positive autobiographical memory accessibility (β = -0.25, p = .023, R2 = 0.10) and vividness (β = -0.20, p = .024, R2 = 0.10). Among individuals with more ACEs (1 SD above the mean) compared to those with fewer ACEs (1 SD below the mean), less accessibility and vividness of positive autobiographical memories was associated with greater PTSD symptom severity. The number of BCEs was not a significant moderator.

CONCLUSIONS

Positive memory-based interventions may be particularly useful to address PTSD symptoms among military veterans with a history of childhood adversity.

Service-seeking behaviors among male victims of violence in five African countries: The effects of positive and adverse childhood experiences

BACKGROUND

Violence against boys and men is widely under-reported. Boys and men face unique and gendered barriers to accessing services following experiences of violence.

PARTICIPANTS AND SETTING

The study is a secondary data analysis of five nationally representative population-based Violence Against Children and Youth Surveys (VACS) conducted in Kenya (2019), Côte d'Ivoire (2018), Lesotho (2018), Mozambique (2019), and Namibia (2019). Analysis was limited to males between 18 and 24 years who experienced lifetime physical or sexual violence.

OBJECTIVE AND METHODS

We analyzed the association between positive and adverse childhood experiences (PCEs and ACEs), and seeking post-violence services among males using bivariate chi-squared tests and multivariable logistic regression.

RESULTS

8.02 % (5.55-10.50 %) of male victims between the ages of 18 and 24 sought services for any lifetime physical or sexual violence. Witnessing interparental violence and experiencing death of one or both parents were each associated with increased odds of having sought post-violence services (aOR 2.43; 95 % CI: 1.25-4.79; aOR 2.27; 95 % CI: 1.14-4.50), controlling for education, violence frequency, and violence type. High parental monitoring was associated with increased odds of service seeking (aOR 1.79; 95 % CI: 1.02-3.16), while strong father-child relationship was associated with lower odds (aOR 0.45; 95 % CI: 0.23-0.89).

CONCLUSION

These findings contribute to limited research on service-seeking behaviors among men and boys. While some parent-youth relationship factors were associated with higher odds of service-seeking, the outcome remained rare. Age and gender-related barriers should be addressed where post-violence care services are offered.

Positive childhood experiences as predictors of anxiety and depression in a large sample from Turkey

BACKGROUND

Positive childhood experiences positively influence one's adult life, while the absence of such positive experiences can potentially yield mental health problems throughout the lifespan.

OBJECTIVE

This study aimed to investigate the role of positive childhood experiences on depression and anxiety levels.

PARTICIPANTS AND SETTING

3090 (2059 women) young adults participated in this research. They ranged in age between 18 and 68 years (M = 28.78, SD = 9.44) and completed the self-report measures including the Positive Childhood Experiences Scale, Beck Depression and Anxiety Scales and Personal Information Forms.

METHOD

A cross-sectional research design was used to collect the data through social media platforms. We conducted a regression analysis to examine how positive childhood experiences contribute to depression and anxiety.

RESULTS

The results of correlation analysis indicated that positive childhood experiences were significantly negatively related to depression and anxiety. Regression analysis revealed that positive childhood experiences explained a significant amount of variance in the prediction of depression (10 %) and anxiety (8 %) after controlling for demographic factors.

CONCLUSIONS

The results suggest that the frequency of positive experiences lived during childhood might significantly reduce anxiety and depression, and positive childhood experiences might positively affect them.

Association between adverse childhood experiences and sleep quality, emotional and behavioral problems and academic achievement of children and adolescents

The impact of adverse childhood experiences (ACEs) on adult health has been extensively examined, but the association between ACEs and sleep, emotion, behavior and academic outcomes of children and adolescents is not well known. A total of 6363 primary and middle school students were included to examine the effect of ACEs on sleep quality, emotional and behavioral problems and academic achievement and further explore the mediation role of sleep quality and emotional and behavioral problems. Children and adolescents with ACE exposure had 1.37 times risk of poor sleep quality (adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI]: 1.21-1.55), 1.91 times risk of emotional and behavioral problems (adjusted OR = 1.91, 95%CI: 1.69-2.15) and 1.21 times risk of self-reported lower academic achievement (adjusted OR = 1.21, 95%CI: 1.08-1.36). Most types of ACEs were significantly associated with poor sleep quality, emotional and behavioral problems and lower academic achievement. There were dose-response relationships between cumulative ACE exposure and risk of poor sleep quality, emotional and behavioral problems, and lower academic achievement. Sleep quality and emotional and behavioral performance mediated 45.9% of the effect of ACEs exposure on math scores and 15.2% of the effect of ACEs exposure on English scores. Early detection and prevention of ACEs among children and adolescents are urgent and essential, and targeted interventions for sleep and emotional and behavioral performance as well as early educational interventions are recommended for children with ACEs exposure.

Positive childhood experiences serve as protective factors for mental health in pandemic-era youth with adverse childhood experiences

BACKGROUND

While adverse childhood experiences (ACEs) predict poorer mental health across the life course, positive childhood experiences (PCEs) predict better mental health. It is unclear whether PCEs protect against poor mental health outcomes and promote mental well-being in pandemic-era adolescents with ACEs.

METHODS

We examined the individual and joint contributions of ACEs and PCEs to mental health and well-being (MHW) in eleventh-grade British Columbian adolescents (N = 8864) during the fifth wave of COVID-19. We used a novel measure of ACEs that included community- and societal-level ACEs in addition to ACEs experienced at home to investigate the role of social and structural determinants of mental health in supporting the MHW of pandemic-era adolescents. A series of two-way ANCOVAs were conducted comparing MHW outcomes between adolescents with and without ACEs. Interaction effects were examined to investigate whether PCEs moderated the association between ACEs and MHW.

RESULTS

Adolescents with no ACEs had significantly better MHW than those with one or more ACE. Having six or more PCEs was associated with better MHW in adolescents with and without ACEs. PCEs significantly moderated the association between ACEs and depression. Effect sizes were larger for PCEs than ACEs in relation to depression, mental well-being, and life satisfaction.

CONCLUSIONS

PCEs may protect against depression among adolescents with ACEs and promote MHW among all pandemic-era adolescents. These findings emphasize the importance of addressing social determinants of mental health to mitigate the impact of ACEs and promote PCEs as part of a public health approach to MHW.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND

Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood.

METHODS

A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted.

RESULTS

Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE.

CONCLUSIONS

PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.

A preliminary examination of the effects of childhood abuse and resilience on pain and physical functioning in patients with knee osteoarthritis

OBJECTIVES

We examined associations of a self-reported history of childhood abuse with pain and physical functioning in patients with knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA). We also explored the potential moderating effects of positive childhood experiences (PCEs), an index of resilience, on these associations.

METHODS

Prior to TKA, participants with KOA awaiting surgery (N = 239) completed self-report measures of adverse childhood experiences (ACEs), PCEs, pain, and physical functioning. We evaluated associations of pain and physical functioning (Brief Pain Inventory [BPI] and Western Ontario and McMaster University of Osteoarthritis Index [WOMAC]) based on the experience of ACEs (childhood abuse), with PCEs (childhood happiness and supportive parental care) as potential moderators.

RESULTS

Greater exposure to childhood abuse was positively correlated with BPI pain interference as well as WOMAC pain and functioning scores. Additionally, childhood happiness and supportive parental care moderated the positive associations of childhood abuse with pain and physical functioning; though, surprisingly, the adverse effects of childhood abuse on these outcomes were more pronounced among participants with high levels of childhood happiness and supportive parental care.

CONCLUSION

Overall, results show an association between a self-reported history of childhood abuse and pain and functioning in patients with KOA awaiting TKA. However, PCEs did not protect against the negative consequences of childhood abuse in our cohort. Further research is needed to validate these associations and gain a more comprehensive understanding of the complex interplay between childhood abuse and PCEs and their potential influences on pain experiences in adults with chronic pain conditions, including KOA.

A Developmental Psychopathology Perspective on Adverse Childhood Experiences (ACEs): Introduction to the Special Issue

Adverse childhood experiences (ACEs), including child maltreatment and other adversities in the home context and beyond (e.g., witnessing domestic violence; parental mental illness; parental separation; living in a disadvantaged neighborhood) are prevalent in the population and often covary together. Research based on the construct of ACEs has transformed the field of adult mental health, yet child and adolescent mental health has often been overlooked in this work. This special issue of Research on Child and Adolescent Psychopathology focuses on the developmental science of ACEs and child psychopathology. The research presented here draws on the extensive evidence base that now exists regarding the co-occurrence of common childhood adversities, while informing the integration of theory and research on ACEs with that of developmental psychopathology at large. This Introduction provides an overview of ACEs and child mental health from a developmental psychopathology perspective, with an emphasis on key concepts and recent progress spanning the prenatal period through to adolescence and intergenerational pathways. Models of ACEs that emphasize the multi-dimensional nature of adversity and the importance of developmental timing to risk and protective pathways, have played a driving role in this progress. Methodological innovations in this work are highlighted, along with implications for prevention and intervention.

Enhancing the Focus: How Does Parental Incarceration Fit into the Overall Picture of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs)?

Despite the five million children in the U.S. with an incarcerated parent, there is limited research on risk and protective factors for this population. We analyzed data from the National Survey for Children's Health (2018) to: (1) examine associations among parental incarceration and other adverse childhood experiences (ACEs), (2) characterize the association between parental incarceration and youth mental health outcomes, (3) examine differences in positive childhood experiences (PCEs; collective socialization, community engagement, neighborhood amenities, and family problem solving) by parental incarceration status, (4) examine whether PCEs were protective against mental health problems and if there was an interaction with parental incarceration status, and (5) examine the interaction between PCEs, parental incarceration, and ACEs on mental health problems. Results revealed that children with incarcerated parents had higher odds of experiencing other ACEs, higher odds of having mental health problems, and experienced fewer PCEs compared to children without incarcerated parents. Further, although PCEs were associated with a lower odds of mental health problems for both children with and without incarcerated parents, they did not mitigate the negative impact of parental incarceration on mental health outcomes. While PCEs attenuated the association between ACEs and mental health, parental incarceration status did not significantly moderate the interaction. These results highlight vulnerabilities and potential protective factors for children with incarcerated parents and have important implications for the development of multilevel intervention strategies that seek to promote resilience and reduce risk for this population.

The lived experience of Omani adolescents and young adults with mental illness: A qualitative study

There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13-22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems.

Food insecurity is inversely associated with positive childhood experiences among a nationally representative sample of children aged 0-17 years in the USA

OBJECTIVE

We examined the association between food insecurity and positive childhood experiences (PCE).

DESIGN

Outcome measure was number of PCE and seven PCE constructs. Food insecurity was assessed with a three-category measure that ascertained whether the respondent could afford and choose to eat nutritious food. We then used bivariate and multivariable Poisson and logistic regressions to analyse the relationship between food insecurity and the outcome measures. The analyses were further stratified by age (≤ 5, 6-11 and 12-17 years).

SETTING

The National Survey of Children's Health (NSCH) from 2017 to 2020, a nationally representative sample of children and adolescents in the USA.

PARTICIPANTS

Parents/caregivers who reported on their children's experiences of PCE and food insecurity from the 2017-2020 NSCH (n 114 709).

RESULTS

Descriptively, 22·13 % of respondents reported mild food insecurity, while 3·45 % of respondents reported moderate to severe food insecurity. On multivariable Poisson regression analyses, there was a lower rate of PCE among children who experienced mild (incidence rate ratio (IRR) = 0·93; 95 % CI 0·92, 0·94) or moderate/severe food insecurity (IRR = 0·84; 95 % CI 0·83, 0·86) compared with those who were food secure. We found an inverse relationship between food insecurity and rate of PCE across all age categories.

CONCLUSIONS

Our study finding lends evidence to support that interventions, public health programmes, as well as public health policies that reduce food insecurity among children and adolescents may be associated with an increase in PCE. Longitudinal and intervention research are needed to examine the mechanistic relationship between food insecurity and PCE across the life course.

Adverse childhood experiences: impacts on adult mental health and social withdrawal

Background

Adverse childhood experiences (ACEs) have been found to negatively impact adult mental health outcomes. Numerous studies have highlighted on ACEs in family and community settings. However, few have examined the impact of ACEs in school settings, despite the potential influence on social participation. Hikikomori, characterized by severe social withdrawal, was first studied in Japan and has gained recognition in recent years. The present study aims to present the concept of ACEs specific to schools and investigate the impact of both school ACEs and traditional ACEs on adult mental health and Hikikomori.

Methods

A total of 4,000 Japanese adults, aged 20-34, were recruited through an Internet survey form. All data were obtained in October 2021. Participants answered questions regarding their ACEs in the family (10 items), school ACEs (five teacher-related items and two bullying-related items), depressive/anxiety symptoms, and Hikikomori (remaining at home for more than 6 months).

Results

A significant association with depressive/anxiety symptoms was shown in both ACEs and school ACEs. An increase of one point in the ACE scores was associated with a 24% increase in the risk of depressive/anxiety symptoms. School ACE scores also demonstrated a significant association with depressive/anxiety symptoms, with an increase of one point associated with a 44% increase in the risk of these symptoms. As for Hikikomori, a significant association was shown in the school ACEs only: a 29% increased risk of Hikikomori for every one-point increase in school ACE scores. Both school ACE scores for teacher-related and bullying-related factors revealed a significant association with Hikikomori; the rates of increased risk were 23 and 37%, respectively.

Conclusion

These results suggest that school ACEs, rather than ACEs in the family, are associated with the risk of Hikikomori. School ACEs are important for social adaptation, and reducing traumatic experiences in school settings may have the potential to prevent problems in later life, specifically in terms of social participation.

Positive Childhood Experiences and Chronic Pain Among Children and Adolescents in the United States

Positive childhood experiences (PCEs) are associated with better mental and physical health outcomes and moderate the negative effects of adverse childhood experiences (ACEs). However, knowledge of the associations between PCEs and childhood chronic pain is limited. We conducted a cross-sectional analysis of 2019 to 2020 National Survey of Children's Health (NSCH) to evaluate associations between PCEs and childhood chronic pain. Parents of 47,514 children ages 6 to 17 years old reported on their child's exposure to 7 PCEs and 9 ACEs. Associations between PCEs and chronic pain were evaluated using weighted, multivariate logistic regression analyses adjusted for sociodemographic factors. We found that PCEs had dose-dependent associations with pediatric chronic pain; children exposed to higher numbers of PCEs (5-7 PCEs) had the lowest reported rate of chronic pain (7.1%), while children exposed to 2 or fewer PCEs had the highest rate of chronic pain (14.7%). The adjusted analysis confirmed that children experiencing 5 to 7 PCEs had significantly lower odds of chronic pain relative to children experiencing 0 to 2 PCEs (adjusted odds ratio (aOR): .47, 95% confidence interval (CI): .39-.61, P < .0001). PCEs moderated associations between ACEs and chronic pain: among children reporting 2 or more ACEs, those reporting 5 to 7 PCEs were significantly less likely to report chronic pain as compared to children only reporting 0 to 2 PCEs (aOR: .64, 95%CI: .45-.89, P = .009). In conclusion, children with greater PCEs exposure had lower prevalence rates of chronic pain. Furthermore, PCEs was associated with reduced prevalence of chronic pain among children exposed to ACEs. PERSPECTIVE: This article estimates associations between survey-measured PCEs and pediatric chronic pain among children in the United States. Promoting PCEs could improve pediatric pain outcomes.

The influence of adverse and positive childhood experiences on young people's mental health and experiences of self-harm and suicidal ideation

BACKGROUND

Few studies have examined the interaction of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) with mental health outcomes in nationally representative European populations.

OBJECTIVE

The primary objective was to test models of resilience through investigating associations between ACEs and PCEs and young people's risk of common mood and anxiety disorders, self-harm and suicidal ideation.

PARTICIPANTS AND SETTING

Data were from the Northern Ireland Youth Wellbeing Survey (NIYWS), a stratified random probability household survey conducted between June 2019 and March 2020. Analysis is based on data from adolescents aged 11-19 years (n = 1299).

METHOD

Logistic regression was used to test the direct effects of ACEs and PCEs on mental health outcomes and the moderating effect of PCEs at different levels of ACE exposure.

RESULTS

Prevalence rates of mental health outcomes were: common mood and anxiety disorders (16 %); self-harm (10 %); suicidal ideation (12 %). ACEs and PCEs both independently predicted common mood and anxiety disorders, self-harm and suicidal ideation. Every additional ACE increased the likelihood of a common mood and anxiety disorder (81 %), self-harm (88 %) and suicidal ideation (88 %). Every additional PCE reduced common mood and anxiety disorders (14 %), self-harm (13 %) and suicidal ideation (7 %). There was no moderating effect of PCEs on ACEs and mental health outcomes.

CONCLUSION

The findings suggest that PCEs act largely independently of ACEs and that initiatives to increase PCEs can assist in the prevention of mental health problems.

Type and dose-response effect of adverse childhood experiences in predicting depression: A systematic review and meta-analysis

BACKGROUND

Researchers have documented that adverse childhood experiences (ACEs) are associated with adverse long-term consequences for mental health, including increased risk for depression. However, the type and dose-response effects of ACE on depression risk need further exploration.

OBJECTIVE

We aimed to synthesize the evidence on the relationship between ACEs measured by ACE International Questionnaire (ACE-IQ) and depression in type and quantity.

PARTICIPANTS AND SETTING

Individuals with ACEs.

METHODS

A systematic search was carried out of all published articles, up to November 2022, in eight electronic databases. Fixed- and random-effect models and dose-response were used.

RESULTS

Exposure to ACEs, including household dysfunction, was associated with a higher risk of depression (ORs ranged from 1.34 to 3.17). The numbers of ACE acted as a nonlinear predictor of depression.

CONCLUSIONS

These analyses provided important evidence that ACEs, regardless of type or quantity, may be a risk factor for depression development. Prevention of ACEs and interventions for supporting those affected by ACEs are necessary.

Association between Childhood Maltreatment and Depressive and Anxiety Symptoms among Men Who Have Sex with Men in Los Angeles

Adverse childhood experiences (ACEs) have been associated with poor mental health outcomes in adulthood. Childhood maltreatment is related to both depressive and anxiety symptoms. Our objective was to investigate these associations among low-income, mostly Black and Latino men who have sex with men (MSM), as these may be a particularly vulnerable population group. Data come from a longitudinal study of MSM with varied substance use behaviors (n = 321) collected between August 2014 and April 2022. Cumulative, childhood maltreatment ACEs, and the single ACE of childhood sexual abuse were investigated as potential predictors of self-reported depressive and anxiety symptoms in mixed-effects logistic and ordinal regression models. There was no evidence of a dose-response relationship between the number of ACEs and the predicted probability of depressive and anxiety symptoms. Compared to MSM reporting fewer than five ACEs, those with five or more ACEs had approximately double the odds ratio of reporting depressive (OR = 1.93; 95% CI: 1.04-3.60) and anxiety symptoms (OR = 2.21; 95% CI: 1.05-4.68). The dimension of childhood maltreatment had a more robust prediction of depressive symptoms than the dimension of household dysfunction across all models. The association between childhood sexual abuse history and depressive symptoms remained after adjustment for the other nine ACEs (OR = 2.27; 95% CI: 1.11-4.68). The ordinal logistic model suggested that cumulative ACEs more than triple the odds of being in a higher anxiety category (OR = 3.12; 95% CI: 1.58-6.14), with associations reported for childhood maltreatment ACEs (OR = 1.31; 95% CI: 1.06-1.66) and childhood sexual abuse (OR = 1.93; 95% CI: 0.89-4.21). Childhood maltreatment ACEs, particularly childhood sexual abuse, are salient predictors of depressive and anxiety symptoms among adult urban MSM. Mitigating the impact of childhood maltreatment requires understanding the additional burden of social distress often faced by MSM throughout the life course.

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

PURPOSE

Adolescents exposed to adverse childhood experiences (ACEs) are at increased risk for health-compromising behaviors. However, few studies have investigated how ACEs correlate with patterns of health risk behaviors (HRBs) during adolescence, a crucial developmental period. The aim was to extend the current knowledge about the relationship between ACEs and HRB patterns among adolescents, and to explore gender differences.

METHODS

A multi-centered population-based survey was conducted in 24 middle schools in three provinces across China between 2020 and 2021. A total of 16,853 adolescents effectively completed anonymous questionnaires covering exposure to eight ACE categories and 11 HRBs. Clusters were identified using latent class analysis. Logistic regression models were utilized to test the association between them.

RESULTS

There were four classes of HRB patterns: "Low all" (58.35%), "Unhealthy lifestyle" (18.23%), "Self-harm" (18.42%), and "High all" (5.0%). There were significant differences between HRB patterns in terms of the different numbers and types of ACEs in three logistic regression models. Specifically, compared to "Low all," different types of ACEs were positively associated with the three other HRB patterns, and there were significant trends toward increase in the three latent classes of HRBs with higher ACEs. In general, females with ACEs had a higher risk of "High all" except sexual abuse than males.

CONCLUSION

Our study comprehensively considers the association between ACEs and aggregation categories of HRBs. The results support efforts to improve clinical healthcare, and future work may explore protective factors based on individual, family, and peer education to mitigate the negative trajectory of ACEs.

Interpersonal and Environmental Protective Factors and Their Associations With Children's Weight Status

Both external structure (ie, participating in extracurricular activities) and family factors (ie, parental emotional support) have separately been linked with children's physical health and well-being, however, their combined effects are less well known. The current study examined the longitudinal associations between participating in structured out-of-school activities and parent reports of warmth/emotional support with children's weight status (ie, zBMI) over time. Utilizing longitudinal data from the United States-based Early Childhood Longitudinal Study, Kindergarten Class of 2010 to 2011 (ECLS-K:2011), we employed a confirmatory factor analysis (CFA) and a latent variable cross-lagged path analysis to examine if emotional supportiveness and participation in structured activities predicted lower zBMI over the course of 1 year. The final sample included 18 135 participants. Mean age of the participants was 8.12 years (±0.38 years), and 51% of children were male. Mean zBMI was 0.54 (±1.12). Structure at baseline predicted increased zBMI in year 2 (β = .03, P = .02) but did not predict parent emotional supportiveness at year 2 (β = -.05, P = .09). Parent emotional supportiveness at baseline predicted greater zBMI at year 2 (β = .02, P = <.01) but did not predict structure at year 2 (β = .02, P = .39). zBMI at baseline did not predict structure (β = .02, P = .25) or parent emotional supportiveness at year 2 (β = -.01, P = .55). Our findings were inconsistent with our hypothesis with regard to directionality. Continued refinement about the role of internal structure (ie, family, and parenting practices) may inform public health prevention strategies to support the well-being of children and families.

Positive Childhood Experiences Associate with Adult Flourishing Amidst Adversity: A Cross Sectional Survey Study with a National Sample of Young Adults

The purpose of this study was to examine the prevalence of PCEs among young adults in Mainland China and the extent to which the cumulative number of PCEs moderates the associations between ACEs and flourishing in adulthood. Between August and November 2020, we used convenience and snowball sampling to recruit 9468 young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China to participate in a survey, which included measures on flourishing, exposure to ACEs and PCEs, and demographic characteristics. Approximately 92% of participants reported experiencing seven to nine PCEs, with harmonious family relationships (96.9%), feeling supported by friends (96.8%) and being treated fairly at school (96.3%) being the most common PCEs reported. Results of the multiple regression indicated that the cumulative number of PCEs statistically significantly moderated the relation between the cumulative number of ACEs and flourishing (interaction term b = -0.060 [-0.071, -0.049], p < 0.001, adjusted R² = 0.183); as the number of ACEs increased up through eight ACEs, decreases in flourishing were smaller among those with higher numbers of PCEs. PCEs are common among young adults from Mainland China and serve a potential buffering effect against exposure to ACEs.