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Ding K, Lei M. From the early scars to the vicissitudes of old age: A bibliometric analysis revealing childhood adversity and aging. Psychoneuroendocrinology 2024; 165:107038. [PMID: 38609808 DOI: 10.1016/j.psyneuen.2024.107038] [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: 01/09/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Adversity suffered in childhood may profoundly affect aging over the subsequent life cycle. The field of childhood adversity and aging has amassed a certain number of publications, but there are no bibliometric studies in this field. METHODS Publications in 10 years on childhood adversity and aging were searched in the Web of Science Core Collection. Bibliometric tools were used to analyze and visualize these publications by country, institution, journal, author, keyword, research area, and co-citation. RESULTS Four hundred thirty-five publications were retrieved from 2014 to September 21, 2023, with a 4.9% annual growth rate. The United States (251), University of California, San Francisco (59), Elissa S. Epel (11), and Psychoneuroendocrinology (29) were the countries, institutions, authors, and journals contributing the highest number of publications in this field, respectively. "Early-life stress" (87), "depression" (82), "childhood trauma" (69), and "aging" (60) were the keywords that appeared more frequently. CONCLUSIONS This is the first bibliometric study on childhood adversity and aging. The United States dominates the field regarding publication numbers, research institutions, and researchers. Publications in this field are interdisciplinary, covering several critical subject areas and having far-reaching impacts, with gerontology, neurosciences, psychology, and psychiatry at the core.
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Affiliation(s)
- Kaixi Ding
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Ming Lei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
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Ugarteche Pérez A, Berger E, Kelly-Irving M, Delpierre C, Capuron L, Castagné R. Early life stress in relation with risk of overweight, depression, and their comorbidity across adulthood: findings from a British birth cohort. Psychol Med 2024; 54:1853-1866. [PMID: 38197250 DOI: 10.1017/s0033291723003823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Multimorbidity, known as the co-occurrence of at least two chronic conditions, has become of increasing concern in the current context of ageing populations, though it affects all ages. Early life risk factors of multimorbidity include adverse childhood experiences (ACEs), particularly associated with psychological conditions and weight problems. Few studies have considered related mechanisms and focus on old age participants. We are interested in estimating, from young adulthood, the risk of overweight-depression comorbidity related to ACEs while adjusting for early life confounders and intermediate variables. METHODS We used data from the 1958 National Child Development Study, a prospective birth cohort study (N = 18 558). A four-category outcome (no condition, overweight only, depression only and, overweight-depression comorbidity) was constructed at 23, 33, and 42 years. Multinomial logistic regression models adjusting for intermediate variables co-occurring with this outcome were created. ACEs and sex interaction on comorbidity risk was tested. RESULTS In our study sample (N = 7762), we found that ACEs were associated with overweight-depression comorbidity risk throughout adulthood (RRR [95% CI] at 23y = 3.80 [2.10-6.88]) though less overtime. Comorbidity risk was larger than risk of separate conditions. Intermediate variables explained part of the association. After full-adjustment, an association remained (RRR [95% CI] at 23y = 2.00 [1.08-3.72]). Comorbidity risk related to ACEs differed by sex at 42. CONCLUSION Our study provides evidence on the link and potential mechanisms between ACEs and the co-occurrence of mental and physical diseases throughout the life-course. We suggest addressing ACEs in intervention strategies and public policies to go beyond single disease prevention.
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Affiliation(s)
| | - Eloïse Berger
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| | | | | | - Lucile Capuron
- University of Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France
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Aslam MV, Peterson C, Swedo E, Niolon PH, Bacon S, Florence C. Adults' exposure to adverse childhood experiences in the United States nationwide and in each state: modeled estimates from 2019-2020. Inj Prev 2024; 30:256-260. [PMID: 38238079 DOI: 10.1136/ip-2023-044935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Although preventable, adverse childhood experiences (ACEs) can result in lifelong health harms. Current surveillance data on adults' exposure to ACEs are either unavailable or incomplete for many U.S. states. METHODS Current estimates of the proportion of U.S. adults with past ACEs exposures were obtained by analysing individual-level data from 2019 to 2020 Behavioural Risk Factor Surveillance System-annual nationally representative survey of noninstitutionalized adults aged 18+years. Standardised questions measuring ACEs exposures (presence of household member with mental illness, substance abuse, or incarceration; parental separation; witnessing intimate partner violence; experiencing physical, emotional, or sexual abuse during childhood) were categorised into 0, 1, 2-3, or 4+ACEs and reported by sociodemographic group in each state. Missing ACEs responses (state did not offer ACEs questions or offered to only some respondents; respondent skipped questions) were modelled through multilevel mixed-effects logistic (MMEL) and jackknifed MMEL regressions. RESULTS In 2019-2020, an estimated 62.8% of U.S. adults had past exposure to 1+ACEs (range: 54.9% in Connecticut; 72.5% in Maine), including 22.4% of adults who were exposed to 4+ACEs (range: 11.9% in Connecticut; 32.8% in Nevada). At the national and state levels, exposure to 4+ACEs was highest among adults aged 18-34 years, those who did not graduate from high school, or adults who did not have a healthcare provider. Racial/ethnic distribution of adults exposed to 4+ACEs varied by age and state. CONCLUSIONS ACEs are common but not equally distributed. ACEs exposures estimated by state and sociodemographic group can help decisionmakers focus public health interventions on populations disproportionately impacted in their area.
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Affiliation(s)
- Maria V Aslam
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
| | - Cora Peterson
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
| | - Elizabeth Swedo
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
| | - Phyllis H Niolon
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
| | - Sarah Bacon
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
| | - Curtis Florence
- National Center for Injury Prevention and Control, CDC, Atlanta, Georgia, USA
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Hughes K, Bellis MA, Cresswell K, Hill R, Ford K, Hopkins JC. Examining relationships between adverse childhood experiences and coping during the cost-of-living crisis using a national cross-sectional survey in Wales, UK. BMJ Open 2024; 14:e081924. [PMID: 38692715 PMCID: PMC11086514 DOI: 10.1136/bmjopen-2023-081924] [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: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect individuals' resilience to stressors and their vulnerability to mental, physical and social harms. This study explored associations between ACEs, financial coping during the cost-of-living crisis and perceived impacts on health and well-being. DESIGN National cross-sectional face-to-face survey. Recruitment used a random quota sample of households stratified by health region and deprivation quintile. SETTING Households in Wales, UK. PARTICIPANTS 1880 Welsh residents aged ≥18 years. MEASURES Outcome variables were perceived inability to cope financially during the cost-of-living crisis; rising costs of living causing substantial distress and anxiety; and self-reported negative impact of rising costs of living on mental health, physical health, family relationships, local levels of antisocial behaviour and violence, and community support. Nine ACEs were measured retrospectively. Socioeconomic and demographic variables included low household income, economic inactivity, residential deprivation and activity limitation. RESULTS The prevalence of all outcomes increased strongly with ACE count. Perceived inability to cope financially during the cost-of-living crisis increased from 14.0% with 0 ACEs to 51.5% with 4+ ACEs. Relationships with ACEs remained after controlling for socioeconomic and demographic factors. Those with 4+ ACEs (vs 0 ACEs) were over three times more likely to perceive they would be unable to cope financially and, correspondingly, almost three times more likely to report substantial distress and anxiety and over three times more likely to report negative impacts on mental health, physical health and family relationships. CONCLUSIONS Socioeconomically deprived populations are recognised to be disproportionately impacted by rising costs of living. Our study identifies a history of ACEs as an additional vulnerability that can affect all socioeconomic groups. Definitions of vulnerability during crises and communications with services on who is most likely to be impacted should consider childhood adversity and history of trauma.
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Affiliation(s)
- Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Katie Cresswell
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Rebecca Hill
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
| | - Kat Ford
- School of Health Sciences, College of Medicine and Health Sciences, Bangor University, Wrexham, UK
| | - Joanne C Hopkins
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, UK
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Steger V, Stadelmann S, White L, Döhnert M. Child abuse and pubertal timing: what is the role of child sex and identity of the perpetrator? BMC Psychiatry 2024; 24:242. [PMID: 38561781 PMCID: PMC10983734 DOI: 10.1186/s12888-024-05683-6] [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: 08/25/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND This study investigated the association between child abuse [child neglect (CN), emotional (CEA) and physical abuse (CPA)] and early puberty with special regard to sex-specific effects concerning child and parental perpetrator. METHODS Data assessment took place within the framework of the LIFE Child Depression study, a longitudinal study on the development of depressive symptoms and disorders between child- and adulthood in Leipzig, Germany. A sample of 709 children (8-14 years) was recruited from the general population and via psychiatric hospitals. Data on pubertal status were assessed using an instrument for self-assessment of tanner stages (scales of physical pubertal development). Information on menarche was provided by parents. The Parent-Child Conflict Tactics Scales (CTS-PC) served for data on child abuse. RESULTS Regarding physical puberty markers, significant correlations were found, especially with child neglect (CN) and child emotional abuse (CEA). Regression analyses, controlling for Body-Mass-Index (BMI) and Socioeconomic Status (SES), revealed that children affected by child neglect perpetrated by mother (CNm) and child emotional abuse (CEA) parent-non-specifically enter puberty significantly earlier. Sex-specific analyses identified child neglect perpetrated by mother (CNm) to be associated with early puberty in girls and child emotional abuse perpetrated by father (CEAf) with early puberty in boys. Concerning the onset of menstruation, there was a significant positive correlation between early menarche and parent-specific and non-specific child neglect (CN), as well as between early menarche and child emotional abuse perpetrated by the mother (CEAm). In regression models that controlled for Body-Mass-Index (BMI) and Socioeconomic Status (SES) no significant associations were maintained. Child physical abuse (CPA) was not associated with early puberty. CONCLUSION Results outlined child neglect (CN) and child emotional abuse (CEA) to be sex- and perpetrator-specific risk factors for early pubertal development. Knowledge of sex- and perpetrator-specific effects could help clinicians to specify their diagnostic process and to define differential prevention and treatment goals for children with experiences of CN and CEA. Further research on the sex-specific impact of parental CN and CEA on girls' and boys' puberty is needed.
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Affiliation(s)
- V Steger
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany.
- , Bremen, Germany.
| | - S Stadelmann
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - L White
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - M Döhnert
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, St Elisabeth & St Barbara Hospital, Barbarastraße 4, 06110, Halle (Saale), Germany
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Lê-Scherban F, Wang A, Courts KA, Ettinger de Cuba S, Wade R, Chilton M. A Short Adverse Experiences Measure Among Mothers of Young Children. Pediatrics 2024; 153:e2023063882. [PMID: 38449423 DOI: 10.1542/peds.2023-063882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES Screening for parental adverse childhood experiences (ACEs) in pediatric settings can be burdensome because of the questionnaire's length and sensitive nature. Rapid screening tools may help address these challenges. We evaluated a 2-item short ACE measure developed for adults in a cross-sectional sample of mothers of young children in an urban pediatric emergency department. METHODS From January 2011 to March 2020, we administered the ACE questionnaire in English or Spanish to 3999 biological mothers of children aged <4 years in a pediatric emergency department in Philadelphia, Pennsylvania. We assessed sensitivity and specificity of a shortened 2-item ACE measure defined as report of childhood emotional abuse and/or household substance use, using 4+ ACEs on the full questionnaire as the standard. We assessed convergent validity by comparing associations of the 2-item and standard measures with maternal, household, and child outcomes using adjusted log-binomial regression. RESULTS Mothers were racially and ethnically diverse (54% Latina, 35% Black non-Latina); 94% of children were publicly insured. Thirteen percent of mothers reported childhood emotional abuse and 16% childhood household substance use; 23% reported at least 1 of these and 6% both. Compared with 4+ ACEs on the full questionnaire, the 2-item measure had sensitivity 88% and specificity 90%. In adjusted models, high adversity was associated with poor maternal, household, and child outcomes. CONCLUSIONS A 2-item ACE measure assessing childhood emotional abuse and household substance use may be useful in pediatric settings to identify mothers who may have experienced significant child adversity and inform development, testing, or provision of comprehensive family supports.
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Affiliation(s)
- Félice Lê-Scherban
- Department of Epidemiology and Biostatistics
- Drexel Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Anqi Wang
- Department of Epidemiology and Biostatistics
| | - Kelly A Courts
- Department of Epidemiology and Biostatistics
- St Christopher's Hospital for Children, Philadelphia, Pennsylvania
| | - Stephanie Ettinger de Cuba
- Boston University School of Public Health and Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Roy Wade
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Pediatrics at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mariana Chilton
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Barreca J, Swiggum M. Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here. Pediatr Phys Ther 2024; 36:278-284. [PMID: 38568276 DOI: 10.1097/pep.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.
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Affiliation(s)
- Jessica Barreca
- Center for Interprofessional Education and Research (Dr Barreca), Saint Louis University, Saint Louis, Missouri; Doctor of Physical Therapy Program (Dr Swiggum), Wingate University, Wingate, North Carolina
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Seya MKS, Matthews S, Zhu L, Brown C, Lefevre A, Agathis N, Chiang LF, Annor FB, McOwen J, Augusto A, Manuel P, Kamagate MF, Nobah MT, Coomer R, Kambona C, Low A. Parenting-related positive childhood experiences, adverse childhood experiences, and mental health-Four sub-Saharan African countries. CHILD ABUSE & NEGLECT 2024; 150:106493. [PMID: 37839988 DOI: 10.1016/j.chiabu.2023.106493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with poor mental health outcomes and risk-taking behaviors. Positive childhood experiences (PCEs) may mitigate these negative impacts. OBJECTIVE This study 1) assessed the associations between ACEs and negative health outcomes and risk-taking behaviors among young adults, and 2) evaluated whether - and which - PCEs moderate the association between ACEs and these outcomes in sub-Saharan Africa. METHODS This multi-country analysis combined cross-sectional representative survey data from young adults, ages 18-24 years, from the 2019 Kenya, 2018 Lesotho, 2019 Mozambique, and 2019 Namibia Violence Against Children and Youth Surveys. The association between experiencing any ACEs and each health outcome was assessed using Wald's chi-square tests. Multivariable logistic regression analyses assessed the association between each PCE and each outcome of interest. RESULTS Females who experienced any ACEs had higher odds of experiencing moderate to severe mental distress (aOR = 2.7, 95%CI: 1.9, 3.9). Males who experienced any ACEs had higher odds of experiencing suicidal/self-harm behaviors (aOR = 6.7, 95%CI: 2.8, 16.0) and substance use (aOR = 2.5, 95%CI: 1.4, 4.2). In females, strong mother-child relationship was protective against moderate to severe mental distress (aOR = 0.7, 95%CI: 0.6, 0.9), suicidal/self-harm behaviors (aOR = 0.6, 95%CI: 0.4, 0.9), and substance use (aOR = 0.6, 95%CI: 0.4, 0.9). For males, a strong mother-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.5, 95%CI: 0.2, 0.9), and a strong father-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.4, 95%CI: 0.2, 0.7) and substance use (aOR = 0.6, 95%CI: 0.4, 0.8). CONCLUSIONS Strong parenting programs may likely play an important role in improving the psychosocial health of young adults.
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Affiliation(s)
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Adrienne Lefevre
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Nickolas Agathis
- Division of Global HIV and Tuberculosis, Center for Global Health Centers for Disease Control and Prevention, GA, USA
| | - Laura F Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Marie-Therese Nobah
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
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Rollman JE, Thomas M, Mercer Kollar LM, Ports KA, Clelland C, Satter DE, David-Ferdon C. American Indian and Alaska Native violence prevention efforts: a systematic review, 1980 to 2018. Inj Epidemiol 2024; 8:72. [PMID: 38504377 PMCID: PMC10949553 DOI: 10.1186/s40621-024-00488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Violence is a serious public health concern disproportionately experienced by American Indian and Alaska Native (AIAN) people. While the burden and impact of violence may be explained by the presence of risk factors among this group, AIAN communities benefit from unique protective factors and universal strategies which may be tailored with tribal adaptations. We sought to identify and explore violence prevention strategies specific to AIAN populations. METHODS A review was conducted to systematically identify violence prevention programs, policies, and practices implemented in AIAN communities. We searched nine electronic databases and relevant gray literature released between January 1980 and June 2018. We included intervention-focused records targeting at least one violence topic area (child abuse/neglect, elder abuse, intimate partner violence, sexual violence, youth violence, and suicide) in a majority (> 50%) AIAN population. RESULTS A total of 5220 non-duplicate records were screened, yielding 318 full-text records. After applying exclusion criteria, 57 records describing 60 program, policy, or practice implementations of 43 unique interventions were identified. All six violence types were represented, although more than half (58%; n = 25/43) focused on suicide prevention. Among suicide prevention programs, the most common strategies were identifying and supporting people at risk (80%; n = 20), teaching coping and problem-solving skills (56%; n = 14), and promoting connectedness (48%; n = 12). Two-thirds of the implementations (67%; n = 40/60) were in fully (100%) AIAN communities. Programs were implemented across many settings, though schools were the most common (35%, n = 21/60) setting. Of the 60 total implementations, a majority (80%; n = 48) were new approaches developed by and for AIAN communities, while the remainder were AIAN adaptations of programs previously created for non-AIAN populations. Most implementations (60%; n = 36/60) provided some evaluation data although less than half (45%; n = 27/60) reported evaluation results. CONCLUSIONS This review identified many violence prevention strategies specific to AIAN populations. While programs developed in one tribe may not be completely generalizable to others, shared tribal risk and protective factors suggest programs could be successful across diverse communities. Findings indicate there is a need to develop and evaluate violence prevention programs, policies and practices for AIAN populations.
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Affiliation(s)
- Jeffrey E Rollman
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - M Thomas
- Independent Researcher, Gulf Breeze, FL, 32563, USA
| | - Laura M Mercer Kollar
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA.
| | - Katie A Ports
- American Institutes for Research, 10 South Riverside Plaza, 6th Floor, Chicago, IL, 60606, USA
| | - Carmen Clelland
- Indian Health Service, 5600 Fishers Lane, Rockville, MD, 20857, USA
- Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, 1825 Century Boulevard, Atlanta, GA, 30345, USA
| | - Delight E Satter
- Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, 1825 Century Boulevard, Atlanta, GA, 30345, USA
| | - Corinne David-Ferdon
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 4770 Buford Highway, Atlanta, GA, 30341, USA
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10
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Collins ME, Hall M, Chung PJ, Bettenhausen JL, Keys JR, Bard D, Puls HT. Spending on public benefit programs and exposure to adverse childhood experiences. CHILD ABUSE & NEGLECT 2024:106717. [PMID: 38433038 DOI: 10.1016/j.chiabu.2024.106717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/11/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Adverse childhood experiences are associated with poverty, and public benefit programs are increasingly used as primary prevention for negative child outcomes. OBJECTIVE To estimate the association between spending on benefit programs and cumulative exposure to ACEs among children. PARTICIPANTS AND SETTING Children aged 0-17 years in the United States during 2016-17 as reported in National Survey of Children's Health. METHODS We examined the sum of state and federal spending on 5 categories of public benefit programs at the state-level. The primary exposure was mean annual spending per person living below the Federal poverty limit across 2010-2017 Federal fiscal years. The primary outcome was children <18 years old having ever been exposed to ≥ 4 ACEs. RESULTS Nationally, 5.7 % (95 % confidence interval [CI] 5.3 % - 6.0 %) of children had exposure to ≥ 4 ACEs. After adjustment for children's race and ethnicity, total spending on benefit programs was associated with lower exposure to ≥ 4 ACEs (odds 0.96 [95 % CI: 0.95, 0.97]; p < 0.001). Increased spending in each individual benefit category was also associated with decreased cumulative ACEs exposure (all p < 0.05). Inverse associations were largely consistent when children were stratified by race and ethnicity and income strata. CONCLUSIONS Investments in public benefit programs may not only decrease poverty but also have broad positive effects on near- and long-term child well-being beyond the programs' stated objectives. Findings support federal and state efforts to prioritize families' economic stability as part of a public health model to prevent ACEs.
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Affiliation(s)
- Megan E Collins
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, United States.
| | - Matthew Hall
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; Children's Hospital Association, 16011 College Boulevard #250, Lenexa, Kansas 66219, United States.
| | - Paul J Chung
- Department of Health Systems Science, Kaiser Permanente School of Medicine, 98 South Los Robles Avenue, Pasadena, California 91101, United States; Departments of Pediatrics and Health Policy & Management, UCLA, 10833 Le Conte Avenue, Los Angeles, California 90095, United States.
| | - Jessica L Bettenhausen
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, United States.
| | - Jordan R Keys
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, United States.
| | - David Bard
- Department of Pediatrics, College of Medicine, The University of Oklahoma, 940 Stanton L Young Boulevard #357, Norman, OK 73104, United States.
| | - Henry T Puls
- Department of Pediatrics, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, United States.
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King WM, Fleischer NL, Operario D, Chatters LM, Gamarel KE. Inequities in the distribution of adverse childhood experiences and their association with health among transgender people of color. CHILD ABUSE & NEGLECT 2024; 149:106654. [PMID: 38350400 DOI: 10.1016/j.chiabu.2024.106654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Racism and cisgenderism expose transgender people of color to adversity across the life course. However, little is known about the prevalence of adverse childhood experiences (ACEs) in this population or their association with health in comparison to other groups. OBJECTIVE Guided by the structural trauma framework, we examined race/ethnicity/gender group differences in the prevalence of ACEs and their association with adult mental and physical health. PARTICIPANTS AND SETTING 2019-2021 Behavioral Risk Factor Surveillance Survey. METHODS Transgender participants (n = 551) were matched with two cisgender men (n = 1102) and two cisgender women (n = 1102) on key covariates. We compared age-adjusted predicted probabilities of nine ACEs by race/ethnicity/gender group. We then fit adjusted logistic regression models predicting poor mental and physical health by each ACE and compared marginal effects between groups. RESULTS Transgender people of color had higher age-adjusted probabilities of six ACEs than at least one other group; for example, household incarceration was 0.16 (95 % CI: 0.11-0.22) compared to 0.09 (95 % CI: 0.06-0.13) for cisgender men of color (p = 0.032). The relationship between five ACEs and poor mental health was greater for transgender people of color than at least one other group. For instance, the marginal effect of household alcoholism on poor mental health was 0.28 (95 % CI: 0.11-0.45) compared to 0.07 (0.01-0.14) for White cisgender men (p = 0.031). There were no statistically significant differences regarding effects on poor physical health. CONCLUSIONS ACEs inequitably impact transgender people of color, reflecting the need to restructure the interlocking systems that drive adversity among transgender children of color and exacerbate ACEs' health effects among adults.
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Affiliation(s)
- Wesley M King
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1525 Clifton Road, Atlanta, GA 30329, United States of America.
| | - Linda M Chatters
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America; University of Michigan School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, United States of America.
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
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Baker NS, VanHook C, Ziminski D, Semenza D, Lassiter T, Garmon J, Bonne S. What's missing? Violently injured Black men's narratives around Adverse Childhood Experiences (ACEs). CHILD ABUSE & NEGLECT 2024; 149:106644. [PMID: 38237241 DOI: 10.1016/j.chiabu.2024.106644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Adverse childhood experiences have been associated with future outcomes; however, Felitti's 1998 ACEs questionnaire fails to capture the experiences of Black populations living in disinvested neighborhoods making it necessary to expand the ACEs questionnaire to examine the life experiences of violently injured Black men. OBJECTIVE The aim of the study was to advance the understanding of ACEs among Black male firearm violence survivors using the ACEs questionnaire and semi-structured interviews. PARTICIPANTS AND SETTING Ten Black male firearm violence survivors were recruited from an urban HVIP. Case managers conducted recruitment using the HVIP's REDcap database; active and previous HVIP participants were eligible for the study. METHODS A qualitative study design was used to understand the childhood experiences of Black male firearm violence survivors using Felitti's ACEs questionnaire and a semi-structured interview examining perceptions of their childhood experiences. Due to the COVID-19 pandemic, recruitment and interviews were conducted over the phone. RESULTS All participants experienced at least one ACE. Three themes arose from the interviews: youth incarceration, family separation and loss, and housing transition. Men at risk for violent injury experience ACEs beyond those measured in the current instrument.
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Affiliation(s)
- Nazsa S Baker
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States.
| | - Cortney VanHook
- University of Illinois- Urbana-Champaign, School of Social Work, 1010 W Nevada St, Urbana, IL 61801, United States
| | - Devon Ziminski
- Rutgers University-New Brunswick, School of Social Work, 120 Albany St, New Brunswick, NJ 08901, United States
| | - Daniel Semenza
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States; Rutgers University-Camden, Department of Sociology, Anthropology, and Criminal Justice, 405-7 Cooper Street, Camden, NJ 08102, United States
| | - Teri Lassiter
- Rutgers University-Newark, School of Public Health, 1 Riverfront Plaza, Newark, NJ 07102, United States
| | - Jeannie Garmon
- Rutgers University-Camden, 303 Cooper St, Camden, NJ 08102, United States
| | - Stephanie Bonne
- Hackensack University Medical Center, Department of Surgery, 30 Prospect Ave, Hackensack, NJ 07601, United States
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Khanam SJ, Khan MN. Examining the influence of child nutritional disorders on early childhood development in Bangladesh: insights from the multiple indicator cluster survey. Public Health Nutr 2024; 27:e76. [PMID: 38384260 DOI: 10.1017/s1368980024000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The objective of this study was to explore the relationship between various forms of child nutritional disorders and early childhood development in Bangladesh. DESIGN We analysed data from the nationally representative cross-sectional 2019 Multiple Indicator Cluster Survey. Early childhood development was evaluated using the Early Childhood Development Index (ECDI), which comprised 10 yes-or-no questions across four domains: literacy-numeracy, physical well-being, socio-emotional development, and learning abilities. Nutritional disorders (e.g. stunting, wasting, and underweight) were measured based on the World Health Organization's height and weight guidelines. To investigate the relationships between child development and nutritional disorders, we used multilevel logistic regression models. SETTING Bangladesh. PARTICIPANTS Data of 9,455 children aged 3 and 4 years. RESULTS Approximately 38 % of the children analysed experienced a nutritional disorder, with stunting being the most prevalent at 28·15 %. Overall, 25·27 % did not meet expected developmental progress measured by the ECDI. Stunted children were more likely to be off track developmentally, while those without any nutritional disorder were more likely to be on track. Socio-demographic factors, including age, sex, attendance in early childhood education programme, maternal education, maternal functional difficulties, region, and income, were identified as determinants of ECDI. CONCLUSIONS Childhood nutrition and socio-demographic factors significantly affect multiple developmental domains and overall ECDI among children aged 3-4 years. Prioritising policies and programmes that improve nutrition and address these determinants are crucial for fostering optimal development in children.
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Affiliation(s)
- Shimlin Jahan Khanam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
- Centre for Women's Health Research, Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
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14
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Aslam MV, Swedo E, Niolon PH, Peterson C, Bacon S, Florence C. Adverse Childhood Experiences Among U.S. Adults: National and State Estimates by Adversity Type, 2019-2020. Am J Prev Med 2024:S0749-3797(24)00064-3. [PMID: 38369270 DOI: 10.1016/j.amepre.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Although adverse childhood experiences (ACEs) are associated with lifelong health harms, current surveillance data on exposures to childhood adversity among adults are either unavailable or incomplete for many states. In this study, recent data from a nationally representative survey were used to obtain the current and complete estimates of ACEs at the national and state levels. METHODS Current, complete, by-state estimates of adverse childhood experiences were obtained by applying small area estimation technique to individual-level data on adults aged ≥18 years from 2019-2020 Behavioral Risk Factor Surveillance System survey. The standardized questions about childhood adversity included in the 2019-2020 survey allowed for obtaining estimates of ACE consistent across states. All missing responses to childhood adversity questions (states did not offer such questions or offered them to only some respondents; respondents skipped questions) were predicted through multilevel mixed-effects logistic small area estimation regressions. The analyses were conducted between October 2022 and May 2023. RESULTS An estimated 62.8% of U.S. adults had past exposure to ACEs (range: 54.9% in Connecticut; 72.5% in Maine). Emotional abuse (34.5%) was the most common; household member incarceration (10.6%) was the least common. Sexual abuse varied markedly between females (22.2%) and males (5.4%). Exposure to most types of adverse childhood experiences was lowest for adults who were non-Hispanic White, had the highest level of education (college degree) or income (annual income ≥$50,000), or had access to a personal healthcare provider. CONCLUSIONS Current complete estimates of ACEs demonstrate high countrywide exposures and stark sociodemographic inequalities in the burden, highlighting opportunities to prevent adverse childhood experiences by focusing social, educational, medical, and public health interventions on populations disproportionately impacted.
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Affiliation(s)
- Maria V Aslam
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Elizabeth Swedo
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Phyllis H Niolon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Bacon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Curtis Florence
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Harper CR, Tan-Schriner C, Royster J, Morgan KL, Burnett V, Treves-Kagan S, Bradford J, Ettman L, Espinosa O, Marziale E. Increasing support for the prevention of adverse childhood experiences and substance use: Implementation of narrative change strategies in local health departments. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 38356403 DOI: 10.1002/ajcp.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
Adverse childhood experiences (ACEs) are potentially traumatic but preventable experiences that occur before the ages of 18, including child abuse, witnessing violence, and parental substance use. ACEs have been linked with increased risk for substance use, along with a variety of other negative health outcomes. However, there is limited evidence of community-level strategies that link ACEs and substance to increase awareness of prevention efforts. This article reports on a $2.9 million program to promote health equity and inform narratives for the prevention of ACEs and substance use within three Midwestern communities. Program partners sought to create new transformational narratives that linked ACEs and substance use, while underscoring the importance of addressing social determinants of health (SDOH) that lead to disparities in ACEs and substance use. A mixed-methods evaluation design included document review, in-depth interviews with program staff (N = 8) and community liaisons (N = 2), and site reports from program staff (N = 8) and their community partners (N = 17). Analyses showed that successful implementation efforts had early leadership buy-in and support, set clear and manageable expectations at the outset of implementation, and developed strong relationships with organizations that engage in health equity work. Training and technical assistance were critical to helping community partners build trust, recognize each other's perspectives, broaden and reframe their world view, and better understand narrative efforts for the primary prevention of ACEs and substance use.
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Affiliation(s)
- Christopher R Harper
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia, USA
| | | | | | | | | | - Sarah Treves-Kagan
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia, USA
| | - Joivita Bradford
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia, USA
| | - Leah Ettman
- National Network of Public Health Institutes, Washington DC, USA
| | - Oscar Espinosa
- National Network of Public Health Institutes, Washington DC, USA
| | - Erin Marziale
- National Network of Public Health Institutes, Washington DC, USA
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Wen S, Zhu J, Han X, Li Y, Liu H, Yang H, Hou C, Xu S, Wang J, Hu Y, Qu Y, Liu D, Aspelund T, Fang F, Valdimarsdóttir UA, Song H. Childhood maltreatment and risk of endocrine diseases: an exploration of mediating pathways using sequential mediation analysis. BMC Med 2024; 22:59. [PMID: 38331807 PMCID: PMC10854183 DOI: 10.1186/s12916-024-03271-9] [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: 04/18/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), including childhood maltreatment, have been linked with increased risk of diabetes and obesity during adulthood. A comprehensive assessment on the associations between childhood maltreatment and all major endocrine diseases, as well as the relative importance of different proposed mechanistic pathways on these associations, is currently lacking. METHODS Based on the UK Biobank, we constructed a cohort including 151,659 participants with self-reported data on childhood maltreatment who were 30 years of age or older on/after January 1, 1985. All participants were followed from the index date (i.e., January 1, 1985, or their 30th birthday, whichever came later) until the first diagnosis of any or specific (12 individual diagnoses and 9 subtypes) endocrine diseases, death, or the end of follow-up (December 31, 2019), whichever occurred first. We used Cox models to examine the association of childhood maltreatment, treated as continuous (i.e., the cumulative number of experienced childhood maltreatment), ordinal (i.e., 0, 1 and ≥ 2), or binary (< 2 and ≥ 2) variable, with any and specific endocrine diseases, adjusted for multiple covariates. We further examined the risk of having multiple endocrine diseases using Linear or Logistic Regression models. Then, sequential mediation analyses were performed to assess the contribution of four possible mechanisms (i.e., suboptimal socioeconomic status (SES), psychological adversities, unfavorable lifestyle, and biological alterations) on the observed associations. RESULTS During an average follow-up of 30.8 years, 20,885 participants received a diagnosis of endocrine diseases. We observed an association between the cumulative number of experienced childhood maltreatment and increased risk of being diagnosed with any endocrine disease (adjusted hazard ratio (HR) = 1.10, 95% confidence interval 1.09-1.12). The HR was 1.26 (1.22-1.30) when comparing individuals ≥ 2 with those with < 2 experienced childhood maltreatment. We further noted the most pronounced associations for type 2 diabetes (1.40 (1.33-1.48)) and hypothalamic-pituitary-adrenal (HPA)-axis-related endocrine diseases (1.38 (1.17-1.62)), and the association was stronger for having multiple endocrine diseases, compared to having one (odds ratio (95% CI) = 1.24 (1.19-1.30), 1.35 (1.27-1.44), and 1.52 (1.52-1.53) for 1, 2, and ≥ 3, respectively). Sequential mediation analyses showed that the association between childhood maltreatment and endocrine diseases was consistently and most distinctly mediated by psychological adversities (15.38 ~ 44.97%), while unfavorable lifestyle (10.86 ~ 25.32%) was additionally noted for type 2 diabetes whereas suboptimal SES (14.42 ~ 39.33%) for HPA-axis-related endocrine diseases. CONCLUSIONS Our study demonstrates that adverse psychological sequel of childhood maltreatment constitutes the main pathway to multiple endocrine diseases, particularly type 2 diabetes and HPA-axis-related endocrine diseases. Therefore, increased access to evidence-based mental health services may also be pivotal in reducing the risk of endocrine diseases among childhood maltreatment-exposed individuals.
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Affiliation(s)
- Shu Wen
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jianwei Zhu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Han
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Haowen Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Can Hou
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Shishi Xu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Division of Endocrinology & Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Junren Wang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Di Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Sichuan University - Pittsburgh Institute, Sichuan University, Chengdu, China
| | - Thor Aspelund
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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Kuhlman KR. Pitfalls and potential: Translating the two-hit model of early life stress from pre-clinical non-human experiments to human samples. Brain Behav Immun Health 2024; 35:100711. [PMID: 38169793 PMCID: PMC10758720 DOI: 10.1016/j.bbih.2023.100711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/08/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Exposure to early life stress (ELS) has been linked to at least double the risk of psychopathology as well as higher morbidity and earlier mortality across the lifespan. For this reason, the field of developmental psychopathology has spent decades identifying factors that explain which individuals are at risk for negative health outcomes. Preclinical experiments in this field commonly test the "two-hit hypothesis", which explores how ELS potentiates vulnerability to pathogenic physiological and behavioral outcomes when an individual is exposed to a stressor later in development. Yet, translation of the two-hit hypothesis to humans is conceptually and practically challenging, thus impeding progress in the field. This review summarizes the two-hit hypothesis used in preclinical experiments as it pertains to two putative pathways linking ELS to psychopathology: the innate immune and neuroendocrine systems. This review also identifies important considerations when translating this model to humans and provides several recommendations. Specifically, attention to the "biological salience" of different forms of ELA and the concordance of that salience with later probes of the system are needed. Further, the consequences of ELS may be context-specific rather than ubiquitous, at least among young people. Within this conceptualization, "second hits" may be best operationalized using standardized acute challenges to the innate immune and neuroendocrine systems (e.g., psychosocial stress). Third, more explicit reporting of sex differences in the human literature is needed. Finally, preclinical experimental designs that more accurately reflect the natural occurrence of ELS in community samples will more effectively advance the understanding of developmental mechanisms that occur as a consequence of ELS.
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Affiliation(s)
- Kate Ryan Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California Irvine, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA
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Cooper ZW, Wolfer TA. Conceptualizing the Biopsychosocial-Spiritual Health Influences of Adverse Childhood Experiences and the Application of Primary Care Behavioral Health for Their Treatment. JOURNAL OF RELIGION AND HEALTH 2024; 63:619-639. [PMID: 37831309 DOI: 10.1007/s10943-023-01928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/14/2023]
Abstract
Adverse Childhood Experiences (ACEs) are common and affect the overall functioning of adults, but there is a need to understand how to better address the health impact of ACEs on adults in primary healthcare settings. A narrative review was utilized to extract data from seminal articles to (1) operationalize the influence of ACEs on health outcomes, (2) assess the primary care behavioral health (PCBH) model as a mechanism to address the influence of ACEs, and (3) identify mechanisms to expand the PCBH model to explicitly address spiritual determinants of health. The extracted data revealed that ACEs influence the biological, psychological, social, and spiritual health of patients providing a rationale for integrating psychosocial and spiritual treatment within primary healthcare settings. Simultaneously, the PCBH model integrates psychosocial interventions into existing primary care services but does not explicitly address spiritual determinants. Recommendations for expansion include (1) training for clinicians on evidence-based interventions to address spirituality, (2) spiritual screening tools in PCBH settings, and (3) consultation with chaplains as needed.
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Affiliation(s)
- Zachary W Cooper
- School of Social Work, University of Georgia, 279 Williams St, Athens, GA, 30602, USA.
| | - Terry A Wolfer
- College of Social Work, University of South Carolina, Columbia, SC, USA
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Virtanen P, Nummi T, Janlert U, Hammarström A. Psychosocial conditions during school-age as determinants of long-term labour market attachment: a study of the Northern Swedish Cohort from the 1980s to the 2020s. BMC Public Health 2024; 24:191. [PMID: 38229043 PMCID: PMC10790433 DOI: 10.1186/s12889-023-17611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND This study, conducted on a Swedish population cohort, explores how internalized (depressive and functional somatic) and externalized (smoking, drinking, truancy, vandalism, delinquency) mental health symptoms, as well as close interpersonal relations (family climate and school connectedness) reported during adolescence, influence the work-life course up to late midlife. METHODS We examined repeated measurements of labour market status from age 16 to 56 using sequence analyses. We identified five different labour market attachment (LMA16-56) trajectories, namely 'strong,' 'early intermediate,' 'early weak,' 'late weak,' and 'constantly weak.' Multinomial logistic regressions were employed to relate each of the nine determinants to the identified trajectories. RESULTS When compared to the risk of 'strong' LMA16-56, adversity in all conditions, except for vandalism, entailed a higher risk of the 'constantly weak' trajectory. Moreover, all conditions, except for functional somatic symptoms, entailed a higher risk of the 'late weak' LMA16-56. The risk of the 'early intermediate' LMA16-56 was non-significant across all the conditions. CONCLUSIONS This study contributes to existing knowledge through its novel exploration of labour market attachment and the revelation of the significance of proximal interpersonal relationships in attachment outcomes. Additionally, the study reaffirms the importance of externalizing behaviour, while suggesting that internalized symptoms in adolescence might have a less influential, though not negligible, role. These results underscore the importance of addressing acting out behaviour and nurturing human relationships during compulsory basic education, when the entire age group is still within reach. This approach aims not only to reduce frictions in the school-to-work transition but also to prevent midlife labour market attachment problems that may arise with delayed intervention.
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Affiliation(s)
| | | | | | - Anne Hammarström
- Umeå University, Umeå, Sweden
- Karolinska Institutet, Stockholm, Sweden
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Elsenburg LK, Rieckmann A, Bengtsson J, Jensen AK, Rod NH. Application of life course trajectory methods to public health data: A comparison of sequence analysis and group-based multi-trajectory modeling for modelling childhood adversity trajectories. Soc Sci Med 2024; 340:116449. [PMID: 38091856 DOI: 10.1016/j.socscimed.2023.116449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 01/23/2024]
Abstract
There is increasing awareness of the importance of modelling life course trajectories to unravel how social, economic and health factors relate to health over time. Different methods have been developed and applied in public health to classify individuals into groups based on characteristics of their life course. However, the application and results of different methods are rarely compared. We compared the application and results of two methods to classify life course trajectories of individuals, i.e. sequence analysis and group-based multi-trajectory modeling (GBTM), using public health data. We used high-resolution Danish nationwide register data on 926,160 individuals born between 1987 and 2001, including information on the yearly occurrence of 7 childhood adversities in 2 dimensions (i.e. family poverty and family dynamics). We constructed childhood adversity trajectories from 0 to 15 years by applying (1) sequence analysis using optimal matching and cluster analysis using Ward's method and (2) GBTM using logistic and zero-inflated Poisson regressions. We identified 2 to 8 cluster solutions using both methods and determined the optimal solution for both methods. Both methods generated a low adversity, a poverty, and a consistent or high adversity cluster. The 5-cluster solution using sequence analysis additionally included a household psychiatric illness and a late adversity cluster. The 4-group solution using GBTM additionally included a moderate adversity cluster. Compared with the solution obtained through sequence analysis, the solution obtained through GBTM contained fewer individuals in the low adversity cluster and more in the other clusters. We find that the two methods generate qualitatively similar solutions, but the quantitative distributions of children over the groups are different. The method of choice depends on the type of data available and the research question of interest. We provide a comprehensive overview of important considerations and benefits and drawbacks of both methods.
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Affiliation(s)
- Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Fortson K, Rajbhandari-Thapa J, Ingels J, Thapa K, Dube SR. Adverse childhood experiences, risk of opioid misuse and its pathway among students at a public university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2859-2868. [PMID: 34788586 DOI: 10.1080/07448481.2021.2002336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with ≥4 ACEs and 0-3 ACEs were 2.93 (95% CI: 1.95, 4.39; p < 0.001) and 1.96 (95% CI: 1.46, 2.65; p < 0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals.
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Affiliation(s)
- Kennicia Fortson
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Justin Ingels
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Kiran Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Shanta R Dube
- Department of Population Health Sciences, School of Public Health, Georgia State University, Athens, Georgia, USA
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Harms MB, Garrett-Ruffin SD. Disrupting links between poverty, chronic stress, and educational inequality. NPJ SCIENCE OF LEARNING 2023; 8:50. [PMID: 37985671 PMCID: PMC10662171 DOI: 10.1038/s41539-023-00199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
The income-achievement gap is a significant and stubborn problem in the United States, which has been exacerbated by the Covid-19 pandemic. In this article, we link two emerging literatures that have historically been disparate: the neurobiology of poverty as a form of early life stress, and research on educational policies with the potential to reduce SES-based disparities in academic achievement. In doing so, we (1) integrate the literature on poverty-related mechanisms that contribute to early life stress, alter neurobiology, and lead to educational inequities, and (2) based on this research, highlight policies and practices at the school/classroom level and broader structural level that have the potential to address the problem of inequity in our educational systems. We emphasize that educational inequity is a systemic issue, and its resolution will require coordination of local, state, and national policies.
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Affiliation(s)
- Madeline B Harms
- Department of Psychology, University of Minnesota Duluth, Duluth, USA.
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Blackburn NA, Ramos S, Dorsainvil M, Wooten C, Ridenour TA, Yaros A, Johnson-Lawrence V, Fields-Johnson D, Khalid N, Graham P. Resilience-Informed Community Violence Prevention and Community Organizing Strategies for Implementation: Protocol for a Hybrid Type 1 Implementation-Effectiveness Trial. JMIR Res Protoc 2023; 12:e50444. [PMID: 37934578 PMCID: PMC10664006 DOI: 10.2196/50444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Community violence is a persistent and challenging public health problem. Community violence not only physically affects individuals, but also its effects reverberate to the well-being of families and entire communities. Being exposed to and experiencing violence are adverse community experiences that affect the well-being and health trajectories of both children and adults. In the United States, community violence has historically been addressed through a lens of law enforcement and policing; the impact of this approach on communities has been detrimental and often ignores the strengths and experiences of community members. As such, community-centered approaches to address violence are needed, yet the process to design, implement, and evaluate these approaches is complex. Alternatives to policing responses are increasingly being implemented. However, evidence and implementation guidance for community-level public health approaches remain limited. This study protocol seeks to address community violence through a resilience framework-Adverse Community Experiences and Resilience (ACE|R)-being implemented in a major US city and leveraging a strategy of community organizing to advance community violence prevention. OBJECTIVE The objective of this research is to understand the impact of community-level violence prevention interventions. Furthermore, we aim to describe the strategies of implementation and identify barriers to and facilitators of the approach. METHODS This study uses a hybrid type 1 effectiveness-implementation design. Part 1 of the study will assess the effectiveness of the ACE|R framework plus community organizing by measuring impacts on violence- and health-related outcomes. To do so, we plan to collect quantitative data on homicides, fatal and nonfatal shootings, hospital visits due to nonaccidental injuries, calls for service, and other violence-related data. In Part 2 of the study, to assess the implementation of ACE|R plus community organizing, we will collect process data on community engagement events, deliver community trainings on community leadership and organizing, and conduct focus groups with key partners about violence and violence prevention programs in Milwaukee. RESULTS This project received funding on September 1, 2020. Prospective study data collection began in the fall of 2021 and will continue through the end of 2023. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2024. CONCLUSIONS Community violence is a public health problem in need of community-centered solutions. Interventions that center community and leverage community organizing show promise in decreasing violence and increasing the well-being of community members. Methods to identify the impact of community-level interventions continue to evolve. Analysis of outcomes beyond violence-specific outcomes, including norms and community beliefs, may help better inform the short-term and proximal impacts of these community-driven approaches. Furthermore, hybrid implementation-effectiveness trials allow for the inevitable contextualization required to disseminate community interventions where communities drive the adaptations and decision-making. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50444.
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Affiliation(s)
| | - Stefany Ramos
- RTI International, Research Triangle Park, NC, United States
| | | | - Camara Wooten
- RTI International, Research Triangle Park, NC, United States
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Ty A Ridenour
- RTI International, Research Triangle Park, NC, United States
- University of Pittsburgh, Pittsburgh, PA, United States
- University of North Carolina, Chapel Hill, NC, United States
| | - Anna Yaros
- RTI International, Research Triangle Park, NC, United States
| | | | | | | | - Phillip Graham
- RTI International, Research Triangle Park, NC, United States
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Ochoa MK, Constantin K. Impacts of child sexual abuse: The mediating role of future orientation on academic outcomes. CHILD ABUSE & NEGLECT 2023; 145:106437. [PMID: 37659153 DOI: 10.1016/j.chiabu.2023.106437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/03/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Child Sexual Abuse (CSA) has significant impacts on an individual's physical and mental well-being including substance use, depression, anxiety, post-traumatic stress disorder, relationship issues, as well as sexual revictimization in adulthood. Positive future orientation is associated with higher educational outcomes and successful goal attainment, but CSA survivors have lower educational attainment and less employment opportunities leading to less financial security in adulthood. OBJECTIVE Our study seeks to examine whether future orientation mediates the relationship between CSA and academic outcomes using data from the Kaplan Longitudinal and Multigenerational Study (KLAMS). PARTICIPANTS & SETTING KLAMS is a U.S. based panel study which captures information about the mental health, relationships, academic outcomes, and deviant behavior of two generations of family members at multiple points in time. In the present study, we use data from two separate interviews with the children (N = 2084) of the original respondents. METHODS We estimated a series of regressions using generalized structural equation modeling to examine the relationship between child sexual abuse, future orientation, and three different types of academic outcomes. RESULTS Youth who experienced sexual abuse had lower grades in school, were more likely to drop out, and had lower levels of education than children with no history of sexual abuse. Negative future orientation mediated the relationship between child sexual abuse and all three outcomes. CONCLUSIONS In support of existing research, we found child sexual abuse has a negative impact on positive future orientation, and positive future orientation contributes to better academic outcomes.
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Affiliation(s)
- Melissa K Ochoa
- Department of Women's and Gender Studies, Saint Louis University, 3750 Lindell Blvd., St. Louis, MO 63108, United States of America.
| | - Katie Constantin
- Department of Sociology, Oklahoma State University, 467 Social Sciences & Humanities, Stillwater, OK 74078, United States of America.
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Elsenburg LK, Rieckmann A, Bengtsson J, Lange T, Baker JL, Sørensen TIA, Rod NH. Early childhood adversity and body mass index in childhood and adolescence: linking registry data on adversities with school health records of 53,401 children from Copenhagen. Int J Obes (Lond) 2023; 47:1057-1064. [PMID: 37626127 PMCID: PMC10599995 DOI: 10.1038/s41366-023-01355-9] [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: 11/14/2022] [Revised: 06/26/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE We examined whether childhood adversity experienced in early childhood (0-5 years) is related to body mass index (BMI) in childhood (6-7 years) and adolescence (12-15 years). METHODS This study combined data from the nationwide register-based DANLIFE study on childhood adversities with data on height and weight of school children in Copenhagen. Data were available for 53,401 children born in Denmark between 1980 and 1996. Children were divided into groups of early childhood adversity by applying group-based multi-trajectory modelling using their yearly count of childhood adversity in three dimensions (i.e., material deprivation, loss or threat of loss, and family dynamics) from 0-5 years. Direct and total associations between the early childhood adversity groups and BMI z-scores in childhood and adolescence were estimated using sex-stratified structural equation models. RESULTS Five exclusive and exhaustive groups of early childhood adversity were identified, which were characterized by low adversity (51%), moderate material deprivation (30%), high material deprivation (14%), loss or threat of loss (3%) and high adversity (2%). Boys and girls exposed to moderate or high material deprivation and loss or threat of loss had a slightly higher BMI z-score, especially in adolescence, compared with those in the low adversity group, with the strongest association found for girls in the loss or threat of loss group (b (95% CI) = 0.18 (0.10, 0.26)). Additionally, boys in the high adversity group had a slightly lower BMI z-score in childhood than boys in the low adversity group (b (95% CI) = -0.12 (-0.22, -0.02)). CONCLUSIONS Whereas associations with BMI were found for children and adolescents exposed to material deprivation, loss or threat of loss, and high adversity, the effect sizes were generally small. Contrary to prevailing hypotheses, weight changes in childhood is probably not a major explanatory mechanism linking early childhood adversity with later-life morbidity.
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Affiliation(s)
- Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Andreas Rieckmann
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Bengtsson
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer L Baker
- Section of Epidemiology, Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Section on Genomic Physiology and Translation, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Treves-Kagan S, Kennedy K, Carrington M. Examining narratives around adverse childhood experiences and social determinants of health in media coverage of substance use in two mid-western cities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023:10.1002/ajcp.12707. [PMID: 37853845 PMCID: PMC11026294 DOI: 10.1002/ajcp.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 10/20/2023]
Abstract
Local media narratives play an important role in how people interpret and propose solutions for health issues in their community. This research characterized narratives about adverse childhood experiences (ACEs), and/or social determinants of health (SDOH) in media coverage of substance use. Scans covered articles published in the Detroit Free Press and the Cincinnati Enquirer from March 1, 2019 to June 1, 2019 and March 1, 2021 to June 1, 2021. Scans used search terms for opioids and substance use. Included articles were coded and analyzed for narratives about why people use substances, how to prevent substance use, and how ACEs or SDOH relate to substance use. While half of the included articles reported on the overdose epidemic, the most common type of media coverage reported on criminal justice milestones. Other common narratives identified addiction as an illness that should be treated; and over-prescription of painkillers or the strength of the drugs as causes of substance use disorders. Narratives about SDOH and the primary prevention of ACEs and substance use were limited. Transformational narrative change work can increase support for addressing the root causes of ACEs and substance use. Results suggest this strategy remains largely untapped in the formal media.
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Affiliation(s)
- Sarah Treves-Kagan
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| | - Katrina Kennedy
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Makala Carrington
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
- Association for Schools and Programs in Public Health, Washington, DC, USA
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Bhattarai A, Dimitropoulos G, Bulloch AGM, Tough SC, Patten SB. Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study. BMC Public Health 2023; 23:2036. [PMID: 37853382 PMCID: PMC10585893 DOI: 10.1186/s12889-023-16935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. METHODS The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994-2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). RESULTS During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. CONCLUSION The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.
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Affiliation(s)
- Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada.
| | - Gina Dimitropoulos
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
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Parenteau AM, Boyer CJ, Campos LJ, Carranza AF, Deer LK, Hartman DT, Bidwell JT, Hostinar CE. A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience. Dev Psychopathol 2023; 35:1821-1842. [PMID: 36097815 PMCID: PMC10008755 DOI: 10.1017/s0954579422000499] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Social and economic inequality are chronic stressors that continually erode the mental and physical health of marginalized groups, undermining overall societal resilience. In this comprehensive review, we synthesize evidence of greater increases in mental health symptoms during the COVID-19 pandemic among socially or economically marginalized groups in the United States, including (a) people who are low income or experiencing homelessness, (b) racial and ethnic minorities, (c) women and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) communities, (d) immigrants and migrants, (e) children and people with a history of childhood adversity, and (f) the socially isolated and lonely. Based on this evidence, we propose that reducing social and economic inequality would promote population mental health and societal resilience to future crises. Specifically, we propose concrete, actionable recommendations for policy, intervention, and practice that would bolster five "pillars" of societal resilience: (1) economic safety and equity, (2) accessible healthcare, including mental health services, (3) combating racial injustice and promoting respect for diversity, equity, and inclusion, (4) child and family protection services, and (5) social cohesion. Although the recent pandemic exposed and accentuated steep inequalities within our society, efforts to rebuild offer the opportunity to re-envision societal resilience and policy to reduce multiple forms of inequality for our collective benefit.
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Affiliation(s)
- Anna M. Parenteau
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | - Chase J. Boyer
- Department of Human Ecology, University of California-Davis
| | | | | | - LillyBelle K. Deer
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | | | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, University of California-Davis
| | - Camelia E. Hostinar
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
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Kyei JJ. As the Twig is Bent so the Tree is Inclined? Exploring the Associations of Adverse Childhood Experiences and Adult Relational Impairments in Ghana. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11272-11289. [PMID: 37427577 DOI: 10.1177/08862605231179722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Studies on adverse childhood experiences (ACEs), which have been conducted predominantly with samples from Western cultures have found ACEs to be associated with poor health outcomes and relational impairments in adulthood. This study sought to contribute to the ACEs literature by investigating the long-term consequences of ACEs on the interpersonal functioning of adult survivors in Ghana, a non-Western culture. In the current study, the associations of five ACEs (high parental conflict, physical abuse, sexual abuse, emotional abuse, and neglect) with four types of relational impairments (alienation, insecure attachment, egocentricity, and social incompetence) were examined using a community sample of 403 adults who retrospectively provided self-reports of ACEs. The most frequently reported ACE in this sample was high parental conflict, while sexual abuse was the least frequently reported ACE. Participants with ACE histories had significantly more relational impairments than those with no ACE histories, however multiple regression analyses revealed no significant relational impairments in adulthood following any ACE experience, whether alone or in any combination, suggesting that cultural values such as collectivism and religiosity may play a protective role against ACEs negative effects in the interpersonal domain. The study's limitations, and the implications of these findings for the Ghanaian and other similar contexts are discussed.
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Affiliation(s)
- J Joana Kyei
- Ghana Institute of Management and Public Administration, Achimota-Accra, Ghana
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30
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Sasaki N, Tabuchi T, Fujiwara T, Nishi D. Adverse childhood experiences and living in the socially deprived areas in adulthood: a cross-sectional study of the nationwide data in Japan. BMC Public Health 2023; 23:1616. [PMID: 37620789 PMCID: PMC10463887 DOI: 10.1186/s12889-023-16557-z] [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: 05/08/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood. METHODS The cross-sectional study was conducted by using nation-wide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4 + was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis. RESULTS The total of 27,916 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 38.2%, 26.5%, 20.8%, respectively. 75% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p = 0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4 + was non-significant after controlling the individual-level factors. CONCLUSION People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those with ACEs.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan.
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Luo S, Chen D, Li C, Lin L, Chen W, Ren Y, Zhang Y, Xing F, Guo VY. Maternal adverse childhood experiences and behavioral problems in preschool offspring: the mediation role of parenting styles. Child Adolesc Psychiatry Ment Health 2023; 17:95. [PMID: 37563663 PMCID: PMC10416370 DOI: 10.1186/s13034-023-00646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Maternal history of adverse childhood experiences (ACEs) has been found to be associated with children's health outcomes. However, the underlying mechanisms were unclear. This study aimed to examine the association between maternal ACEs and behavioral problems in their preschool offspring and to explore the potential mediating role of maternal parenting styles in the association. METHODS A cross-sectional study was conducted involving 4243 mother-child dyads in Chengdu, China. Mothers completed the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) to assess their history of ACEs (i.e., physical abuse, emotional abuse, physical neglect, emotional neglect, witnessing domestic violence, household substance abuse, household mental illness, incarcerated household member, parental separation or divorce, parental death, bullying, and community violence), the short Egna Minnen Beträffande Uppfostran Parent Form (S-EMBU-P) to evaluate their parenting styles (i.e., emotional warmth, rejection, and overprotection), and the 48-item Conners' Parent Rating Scale (CPRS-48) to measure behavioral problems in their children. Logistic regression models were established to examine the association between cumulative number of maternal ACEs and children's behavioral problems. The mediating role of parenting styles in this association was explored by generalized structural equation models (GSEM). RESULTS Of the participating mothers, 85.8% (n = 3641) reported having experienced at least one type of ACE. Children of mothers with ≥2 ACEs showed a significantly increased risk of behavioral problems across all dimensions, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and hyperactivity index, in both crude and adjusted models (all p-values < 0.05). Dose-response patterns were also observed between the cumulative number of maternal ACEs and children's behavioral problems. In addition, maternal parenting styles of rejection emerged as a significant mediator, accounting for approximately 8.4-15.0% of the associations. CONCLUSIONS Our findings indicated an intergenerational association of maternal ACEs with behavioral problems in preschool offspring, which was mediated by maternal parenting styles of rejection. Early screening and targeted intervention strategies are critical to mitigate the downstream consequences of maternal ACEs on young children's outcomes. Providing support and resources to improve parenting skills may prove beneficial.
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Affiliation(s)
- Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Dezhong Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunrong Li
- School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Chengdu Jintang County Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yan Ren
- School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yuchi Zhang
- Chengdu Jintang County Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Fenglin Xing
- Chengdu Qingyang District Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Watt TT, Hartfield K, Kim S, Ceballos N. Adverse childhood experiences contribute to race/ethnic differences in post-secondary academic performance among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1845-1853. [PMID: 34242134 DOI: 10.1080/07448481.2021.1947838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/12/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study explores how adverse childhood experiences (ACEs) relate to race/ethnicity and academic achievement among a sample of college students. PARTICIPANTS Participants were students attending a large public university in the Southwest (n = 404). Methods: Online surveys captured ACE scores, demographics, and self-reported GPA. RESULTS Students of Color had higher ACE scores and lower GPAs than White students. Regression analyses also revealed that an ACE score of 4 or higher is associated with lower GPAs, but only for Students of Color (Black and Hispanic students), not for White students. CONCLUSIONS There are race/ethnic differences in the incidence and impact of adverse childhood experiences on post-secondary academic achievement. Thus, it is important for colleges and universities to create a trauma-informed campus culture and holistic mental health support system, particularly for Students of Color, who may not have had access to high quality care before attending college.
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Affiliation(s)
- Toni Terling Watt
- Department of Sociology, Texas State University, San Marcos, Texas, USA
| | | | - Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos, Texas, USA
| | - Natalie Ceballos
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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Swedo EA, Aslam MV, Dahlberg LL, Niolon PH, Guinn AS, Simon TR, Mercy JA. Prevalence of Adverse Childhood Experiences Among U.S. Adults - Behavioral Risk Factor Surveillance System, 2011-2020. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:707-715. [PMID: 37384554 DOI: 10.15585/mmwr.mm7226a2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Adverse childhood experiences (ACEs) are defined as preventable, potentially traumatic events that occur among persons aged <18 years and are associated with numerous negative outcomes; data from 25 states indicate that ACEs are common among U.S. adults (1). Disparities in ACEs are often attributable to social and economic environments in which some families live (2,3). Understanding the prevalence of ACEs, stratified by sociodemographic characteristics, is essential to addressing and preventing ACEs and eliminating disparities, but population-level ACEs data collection has been sporadic (1). Using 2011-2020 Behavioral Risk Factor Surveillance System (BRFSS) data, CDC provides estimates of ACEs prevalence among U.S. adults in all 50 states and the District of Columbia, and by key sociodemographic characteristics. Overall, 63.9% of U.S. adults reported at least one ACE; 17.3% reported four or more ACEs. Experiencing four or more ACEs was most common among females (19.2%), adults aged 25-34 years (25.2%), non-Hispanic American Indian or Alaska Native (AI/AN) adults (32.4%), non-Hispanic multiracial adults (31.5%), adults with less than a high school education (20.5%), and those who were unemployed (25.8%) or unable to work (28.8%). Prevalence of experiencing four or more ACEs varied substantially across jurisdictions, from 11.9% (New Jersey) to 22.7% (Oregon). Patterns in prevalence of individual and total number of ACEs varied by jurisdiction and sociodemographic characteristics, reinforcing the importance of jurisdiction and local collection of ACEs data to guide targeted prevention and decrease inequities. CDC has released prevention resources, including Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence, to help provide jurisdictions and communities with the best available strategies to prevent violence and other ACEs, including guidance on how to implement those strategies for maximum impact (4-6).
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Nyandwi A, Munyanshongore C, Nyirazinyoye L, Ndola P, Perren-Klingler G. Correlates of emotional violence against children in Rwanda: Findings from a cross-sectional national survey. PLoS One 2023; 18:e0286788. [PMID: 37310951 DOI: 10.1371/journal.pone.0286788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/06/2023] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION National data on children affected by violence are critical in preventing violence against children. Rwanda conducted its first cross-sectional national survey on violence against children in 2015. This study used data from the Rwanda Survey to describe the profile of children affected by emotional violence (EV) and to assess factors associated with it in Rwanda. METHODS A sample of 1,110 children (618 boys and 492 girls) aged 13-17 from the Rwanda Survey was analysed. Weighted descriptive statistics were applied to describe the prevalence of EV and the profile of children affected by it. In addition, factors associated with EV were investigated using logistic regression. RESULTS Male children were more likely to experience EV than female children. Nine percent (8.87%, 95% CI [6.95-11.25]) of male children versus five percent (5.17%, 95% CI [3.79-7.03]) of female children reported having experienced EV in their lifetime. Seven percent (6.77%, 95% CI [5.15-8.84]) of male children versus four percent of female children (3.97%, 95% CI [2.83-5.54]) reported having experienced EV in the last twelve months before the survey. Fathers and mothers were the top two perpetrators of EV against children. Seventeen percent of male children (17.09%, 95% CI [11.06-25.47]) and 12 percent of female children (11.89%, 95% CI [6.97,19.55]) reported EV by their fathers. Mothers were responsible for nineteen percent (19.25%, 95% CI [12.94-27.65]) of EV reported by male children and eleven percent (10.78%, 95% CI [5.77-19.25]) of EV reported by female children. Female children (OR = 0.48, 95% CI [0.31-0.76]) and children with some trust in people from their communities (OR = 0.47, 95% CI [0.23-0.93]) were less likely to report EV. Factors associated with risk for EV were not attending school (OR = 1.80, 95% CI [1.10-2.92]), living with father only (OR = 2.96, 95% CI [1.21-7.85]), not feeling close to biological parents (OR = 7.18, 95% CI [2.12-24.37]), living in a larger household (OR = 1.81, 95% CI [1.03-3.19]), not having a friend (OR = 2.08, 95% CI [1.02-4.11]), and not feeling safe in the community (OR = 2.56, 95% CI [1.03-6.38]). CONCLUSION EV against children was pervasive in Rwanda, with parents topping the list of its perpetrators. Children from unsupportive socioeconomic family environments, i.e., children without a close relationship with biological parents, children not attending school, children living with their fathers only, children from larger households of five people and more, children without a friend, and children who reported not feeling safe in their communities, were identified as groups of children vulnerable to emotional violence in Rwanda. A family-centred approach, focusing on positive parenting and protecting vulnerable children, is needed to reduce emotional violence against children and the risk factors associated with it in Rwanda.
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Affiliation(s)
| | | | | | - Prata Ndola
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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Kim K, Yaffe K, Rehkopf DH, Zheng Y, Nannini DR, Perak AM, Nagata JM, Miller GE, Zhang K, Lloyd-Jones DM, Joyce BT, Hou L. Association of Adverse Childhood Experiences With Accelerated Epigenetic Aging in Midlife. JAMA Netw Open 2023; 6:e2317987. [PMID: 37306997 PMCID: PMC10261996 DOI: 10.1001/jamanetworkopen.2023.17987] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/05/2023] [Indexed: 06/13/2023] Open
Abstract
Importance Adverse childhood experiences (ACEs) are associated with the risk of poorer health, and identifying molecular mechanisms may lay the foundation for health promotion in people with ACEs. Objective To investigate the associations of ACEs with changes in epigenetic age acceleration (EAA), a biomarker associated with various health outcomes in middle-aged adults, in a population with balanced race and sex demographics. Design, Setting, and Participants Data for this cohort study were from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants in CARDIA underwent 8 follow-up exams from baseline (year 0 [Y0]; 1985-1986) to Y30 (2015-2016), and participant blood DNA methylation information was obtained at Y15 (2000-2001) and Y20 (2005-2006). Individuals from Y15 and Y20 with available DNA methylation data and complete variables for ACEs and covariates were included. Data were analyzed from September 2021 to August 2022. Exposures Participant ACEs (general negligence, emotional negligence, physical violence, physical negligence, household substance abuse, verbal and emotional abuse, and household dysfunction) were obtained at Y15. Main Outcomes and Measures The primary outcome consisted of results from 5 DNA methylation-based EAA measurements known to be associated with biological aging and long-term health: intrinsic EAA (IEAA), extrinsic EAA (EEAA), PhenoAge acceleration (PhenoAA), GrimAge acceleration (GrimAA), and Dunedin Pace of Aging Calculated From the Epigenome (DunedinPACE), measured at Y15 and Y20. Linear regression and generalized estimating equations were used to assess associations of the burden of ACEs (≥4 vs <4 ACEs) with EAA adjusting for demographics, health-related behaviors, and early life and adult socioeconomic status. Results A total of 895 participants for Y15 (mean [SD] age, 40.4 [3.5] years; 450 males [50.3%] and 445 females [49.7%]; 319 Black [35.6%] and 576 White [64.4%]) and 867 participants for Y20 (mean [SD] age, 45.4 [3.5] years; 432 males [49.8%] and 435 females [50.2%]; 306 Black [35.3%] and 561 White [64.7%]) were included after excluding participants with missing data. There were 185 participants with (20.7%) vs 710 participants without (79.3%) 4 or more ACEs at Y15 and 179 participants with (20.6%) vs 688 participants without (79.4%) 4 or more ACEs at Y20. Having 4 or more ACEs was positively associated with EAA in years at Y15 (EEAA: β = 0.60 years; 95% CI, 0.18-1.02 years; PhenoAA: β = 0.62 years; 95% CI = 0.13-1.11 years; GrimAA: β = 0.71 years; 95% CI, 0.42-1.00 years; DunedinPACE: β = 0.01; 95% CI, 0.01-0.02) and Y20 (IEAA: β = 0.41 years; 95% CI, 0.05-0.77 years; EEAA: β = 1.05 years; 95% CI, 0.66-1.44 years; PhenoAA: β = 0.57 years; 95% CI, 0.08-1.05 years; GrimAA: β = 0.57 years; 95% CI, 0.28-0.87 years; DunedinPACE: β = 0.01; 95% CI, 0.01-0.02) after adjusting for demographics, health-related behaviors, and socioeconomic status. Conclusions and Relevance In this cohort study, ACEs were associated with EAA among middle-aged adults after controlling for demographics, behavior, and socioeconomic status. These findings of the associations between early life experience and the biological aging process in midlife may contribute to health promotion in a life course perspective.
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Affiliation(s)
- Kyeezu Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - David H. Rehkopf
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Drew R. Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amanda M. Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco
| | - Greg E. Miller
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer
| | - Donald M. Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Potocsnak Longevity Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brian T. Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Potocsnak Longevity Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Cumming C, Bell MF, Segal L, Spittal MJ, Kinner SA, Dennison S, Dawe S, Preen DB. Maternal incarceration increases the risk of self-harm but not suicide: a matched cohort study. Epidemiol Psychiatr Sci 2023; 32:e33. [PMID: 37161898 DOI: 10.1017/s2045796023000264] [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] [Indexed: 05/11/2023] Open
Abstract
AIMS Children of incarcerated mothers are at increased risk of experiencing multiple adversity such as poverty, mental illness and contact with child protection services (CPS), including being taken into out of home care (OOHC). However, little is known about whether these children are at increased risk of suicide or self-harm compared to children not exposed to maternal incarceration or about the factors that may contribute to this. We aimed to investigate differences in the risk of suicide and self-harm between children exposed to maternal incarceration and those not exposed and examine how socio-demographic factors, maternal mental illness and CPS contact (with or without OOHC) may affect these outcomes. METHODS We used a retrospective matched cohort study design, comparing 7674 children exposed to maternal incarceration with 7674 non-exposed children. We used multivariable Cox proportional hazards regression to compare the risk of suicide and self-harm between exposed and non-exposed groups, controlling for geographical remoteness, CPS contact and maternal mental illness. RESULTS There was no significant difference in the rate of suicide (rate ratio [RR] = 1.49; 95% confidence interval [CI]: 0.78, 2.87) or risk of suicide (adjusted hazard ratio [aHR] = 0.92; 95% CI: 0.43, 1.96) between the two groups. However, the exposed group had a significantly higher rate of self-harm (RR = 2.83; 95% CI: 2.50, 3.21) and a significantly higher risk of self-harm (aHR = 1.74; 95% CI: 1.45, 2.09) compared to those non-exposed. CPS contact with or without OOHC was independently associated with an increased risk of self-harm for both groups. CONCLUSION Children exposed to maternal incarceration are at an increased risk of self-harm and should be prioritized to receive targeted, multimodal support that continues after the mother's release from prison. The association between CPS contact and self-harm warrants further research.
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Affiliation(s)
- Craig Cumming
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Megan F Bell
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Leonie Segal
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Population Health, Curtin University, Perth, Australia
| | - Susan Dennison
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, Australia
- The Hopkins Centre, Griffith University, Brisbane, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
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Dosanjh LH, Hinds JT, Cubbin C. The impacts of adverse childhood experiences on socioeconomic disadvantage by sexual and gender identity in the U.S. CHILD ABUSE & NEGLECT 2023; 141:106227. [PMID: 37163969 DOI: 10.1016/j.chiabu.2023.106227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/13/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) predict low education and low income, but this has scarcely been examined by sexual orientation and gender identity. OBJECTIVE We investigated prevalence and associations between ACEs, low income, and low education in sexual and gender diverse (SGD) and cisgender heterosexual (CGH) sub-groups. PARTICIPANTS AND SETTING Data came from 14 states in the 2019 Behavioral Risk Factor Surveillance System survey (n = 79,303). METHODS Chi-square, logistic regression, and moderation analyses were implemented to examine the prevalence and associations between ACEs, low income, and low education. Sample stratification was used to examine differences between SGD and CGH sub-groups. RESULTS SGD participants reported higher prevalence of ACEs, low income, and low education compared to CGH participants (p < 0.0001) with the highest proportions in transgender and queer/something else groups. ACEs were associated with low income (AOR 1.084, CI 1.067-1.102) and low education (AOR 1.056, CI 1.041-1.071) in the entire sample. Transgender and queer/something else groups had higher odds of low income (AOR 3.345, CI 1.975-5.665; AOR 1.702, CI 1.096-2.643) and low education (AOR 1.702, CI 1.096-2.643; AOR 3.552, CI 2.842-4.440) and gay/lesbian identity had reduced odds of low education (AOR 0.586, CI 0.457-0.751) compared to CGH males. The strength of associations between ACEs and low income and low education were weaker among SGD compared to CGH sub-groups. CONCLUSION These findings highlight the importance of including categories of sexual identity cross-classified by gender identity in population-based analyses in order to facilitate a comprehensive characterization of the life course outcomes of SGD populations.
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Affiliation(s)
- Laura H Dosanjh
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America.
| | - Josephine T Hinds
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
| | - Catherine Cubbin
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
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Mayne GV, Namazi M. Social Determinants of Health: Implications for Voice Disorders and Their Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1050-1064. [PMID: 37059074 DOI: 10.1044/2023_ajslp-21-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE Adverse childhood experiences (ACEs) and related conditions, such as discrimination, are social determinants of health (SDOHs). Critical race theory (CRT) is a lens through which to understand SDOHs in a way that may impact our clinical care. When prolonged or chronic, SDOHs might cause toxic stress and trauma, which, in turn, adversely affect health and are shown to be relevant for some voice disorders. The goals of this tutorial are to (a) review the literature on SDOHs that potentially contribute to disparities; (b) discuss explanatory models and theories that describe how psychosocial factors influence health; (c) relate the foregoing information to voice disorders, highlighting functional voice disorders (FVDs) as a particular case in point; and (d) describe how trauma-informed care can improve patient outcomes and advance health equity for vulnerable populations. CONCLUSIONS This tutorial concludes with a call for heightened awareness of the role that SDOHs such as structural and individual discrimination may play in voice disorders, and a call for research into SDOHs, traumatic stress, and health disparities in this patient population. A call is also made for more universal practice of trauma-informed care in the clinical voice domain.
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Affiliation(s)
- Geneva V Mayne
- School of Communication Disorders and Deafness, Kean University, Union, NJ
| | - Mahchid Namazi
- School of Communication Disorders and Deafness, Kean University, Union, NJ
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Wallace N, Parente A, McGrath RE. Character Strengths as Moderators of the Relationship Between Adverse Childhood Experiences and Negative Health Outcomes. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023; 8:1-24. [PMID: 37361626 PMCID: PMC10113722 DOI: 10.1007/s41042-023-00097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 06/28/2023]
Abstract
Adverse childhood experiences (ACEs) refer to negative events of childhood. Research has demonstrated relationships between ACEs and adult mental and physical difficulties. Fewer studies have examined potential moderators of these relationships. This study assessed the role of character strengths in the relationship between ACEs and negative physical and mental health outcomes in adulthood. An online sample of 1,491 adults completed questionnaires measuring character strengths, exposure to ACEs, and aspects of physical/mental health. Results replicated previous findings that ACEs and character strengths are each meaningfully related to health outcomes. Gratitude and self-regulation were generally indicative of better health outcomes, kindness and appreciation of beauty of poorer outcomes. Character strengths remained meaningful correlates of adult behavioral and emotional health even when controlling for ACEs. Character strengths did not moderate the relationship between ACEs and health, suggesting that character strengths do not mitigate the effects of ACEs, but do make an independent contribution to physical and mental health. Supplementary Information The online version contains supplementary material available at 10.1007/s41042-023-00097-3.
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Affiliation(s)
- Norah Wallace
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ 07666 USA
| | - Allison Parente
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ 07666 USA
| | - Robert E. McGrath
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ 07666 USA
- VIA Institute on Character, Cincinnati, Ohio, USA
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Komanchuk J, Letourneau N, Duffett-Leger L, Cameron JL. History of "Serve and Return" and a Synthesis of the Literature on its Impacts on Children's Health and Development. Issues Ment Health Nurs 2023; 44:406-417. [PMID: 37015096 DOI: 10.1080/01612840.2023.2192794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Parent/caregiver sensitivity and responsiveness are important for children's health and development. The "serve and return" metaphor was created to help providers and caregivers understand the importance of sensitive and responsive early caregiving. In this review, we explain the concept of "serve and return", outline historical and theoretical principles that culminated in this metaphor, highlight parent and child constructs associated with "serve and return" interactions, and synthesize literature on sensitive and responsive caregiving and children's health and developmental outcomes. Nurses and other healthcare professionals in public policy, clinical, community, education, and research roles need knowledge of "serve and return" interactions.
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Affiliation(s)
- Jelena Komanchuk
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Judy L Cameron
- Faculty of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Collins S, Orth T, Brunton R, Dryer R. Child abuse and wellbeing: Examining the roles of self-compassion and fear of self. CHILD ABUSE & NEGLECT 2023; 138:106089. [PMID: 36764171 DOI: 10.1016/j.chiabu.2023.106089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and sequelae of abuse supporting gender-specific analyses. To assist in circumventing poor outcomes associated with child abuse, this study examined fear of self (FoS) and self-compassion (SC) as risk and protective factors between child abuse and well-being. METHOD Australian women (N = 1302, Mage = 47.28 [13.63]) completed an online assessment of childhood abuse, psychological distress, perceived quality of life, SC, FoS. Moderated-moderation examined the different abuses as predictors of psychological distress and quality of life (QoL) and FoS and SC as primary and secondary moderators, respectively. RESULTS Physical abuse did not predict psychological distress or QoL. FoS and SC were independent predictors of distress and QoL. Similarly, childhood sexual abuse was not found to predict distress or QoL. FoS and SC were independent predictors of distress and QoL. There was also an interaction between childhood sexual abuse and SC in predicting QoL. A moderated-moderation was found for the relationship between child sexual abuse and distress. Psychological abuse predicted distress and QoL, and FoS and SC both moderated this relationship. Moreover, a moderated-moderation was observed for the relationship between psychological abuse and QoL. CONCLUSIONS Greater FoS is associated with poorer outcomes for child abuse survivors; SC may mitigate this impact. Psychological abuse was the strongest predictor of well-being. Interventions that increase SC and raise awareness of psychological abuse and its impacts are needed.
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Swedo EA, D'Angelo DV, Fasula AM, Clayton HB, Ports KA. Associations of Adverse Childhood Experiences With Pregnancy and Infant Health. Am J Prev Med 2023; 64:512-524. [PMID: 36697281 PMCID: PMC10033436 DOI: 10.1016/j.amepre.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Adverse childhood experiences are associated with a host of negative outcomes; however, few have studied cumulative adverse childhood experiences in the context of pregnancy and infant health. This study examines state-level prevalence of adverse childhood experiences and associations with pregnancy- and infant health‒related indicators. METHODS The study used 2016-2018 Pregnancy Risk Assessment Monitoring System population-based data from 5 states. Analyses were conducted for individual states and grouped states using similar adverse childhood experience items. Thirteen adverse childhood experience measures were included across 3 domains: abuse, neglect, and household challenges. Adverse childhood experience scores were calculated for the number of adverse childhood experiences experienced (0, 1, 2, ≥3) on the basis of available state measures. Fourteen pregnancy- and infant health‒related indicators were examined, including unwanted pregnancy, adequate prenatal care, experiences during pregnancy (e.g., smoking, abuse, depression), gestational diabetes, hypertensive disorders of pregnancy, birth outcomes (e.g., preterm birth), and breastfeeding. Adjusting for demographics, parity, health insurance status, and educational attainment, prevalence ratios and 95% CIs were calculated to examine the associations between pregnancy- and infant health‒related indicators and adverse childhood experience scores. RESULTS Over 50% of respondents reported at least 1 adverse childhood experience and 13%-31% reported ≥3 adverse childhood experiences, depending on the state. Significant associations were identified in all adjusted models between adverse childhood experiences and unwanted pregnancy, smoking, physical abuse, and depression during pregnancy. CONCLUSIONS Adverse childhood experiences are associated with risk factors that impact pregnancy and infant health. Preventing and mitigating adverse childhood experiences is an important strategy to improve pregnancy- and infant health‒related indicators.
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Affiliation(s)
- Elizabeth A Swedo
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Denise V D'Angelo
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy M Fasula
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heather B Clayton
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katie A Ports
- and the Health Equity Research Applied, Albuquerque, New Mexico
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de Vries TR, Arends I, Oldehinkel AJ, Bültmann U. Associations between type of childhood adversities and labour market participation and employment conditions in young adults. J Epidemiol Community Health 2023; 77:230-236. [PMID: 36805940 PMCID: PMC10086506 DOI: 10.1136/jech-2022-219574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Cumulative exposure to childhood adversity is associated with a variety of labour market outcomes in young adulthood. It remains largely unclear whether the type of adversity matters in this association. This prospective study examined the differences in exposure to 14 adverse experiences among groups of young adults aged 22 characterised by distinct labour market participation states and employment conditions. METHODS We used data from the TRacking Adolescents' Individual Lives Survey, a Dutch prospective cohort study with 15 years of follow-up (N=1524). We included 14 adverse experiences (ages 0-16) across five domains: peer influences, loss or threat of loss, material deprivation, family dynamics and maltreatment. Labour market participation states and employment conditions were assessed at age 22. We used latent class analysis to derive labour market outcome groups, which we subsequently compared on exposure to adverse experiences using pairwise comparisons. RESULTS Inactive individuals (n=85, 5.6%), often neither in education (77.4%) nor employment (98.6%) and on benefits (94.4%), were more likely to be exposed to many distinct types of adverse experiences (eg, parental addiction, bullying victimisation) as compared with all other groups. Early workers (n=413, 27.1%), often on temporary contracts and low monthly incomes, were more likely to be exposed to parental divorce (22.7%) compared with students with side jobs (12.9%). CONCLUSIONS Different adverse experiences are not equally associated with labour market outcomes. Researchers and stakeholders in policy and practice should be aware of the differences between adverse experiences in their importance for labour market outcomes in young adults.
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Affiliation(s)
- Tjeerd Rudmer de Vries
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Iris Arends
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Arbo Unie BV, Utrecht, The Netherlands
| | - Albertine J Oldehinkel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Sosnowski DW, Ellison-Barnes A, Kaufman J, Hoyo C, Murphy SK, Hernandez RG, Marchesoni J, Klein LM, Johnson SB. Financial stress as a mediator of the association between maternal childhood adversity and infant birth weight, gestational age, and NICU admission. BMC Public Health 2023; 23:606. [PMID: 36997868 PMCID: PMC10064571 DOI: 10.1186/s12889-023-15495-0] [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: 09/02/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND To examine whether financial stress during pregnancy mediates the association between maternal exposure to adverse childhood experiences (ACEs) and three birth outcomes (i.e., gestational age, birth weight, and admission to the neonatal intensive care unit [NICU]). METHODS Data were obtained from a prospective cohort study of pregnant women and their infants in Florida and North Carolina. Mothers (n = 531; Mage at delivery = 29.8 years; 38% Black; 22% Hispanic) self-reported their exposure to childhood adversity and financial stress during pregnancy. Data on infant gestational age at birth, birth weight, and admission to the NICU were obtained from medical records within 7 days of delivery. Mediation analysis was used to test study hypotheses, adjusting for study cohort, maternal race, ethnicity, body mass index, and tobacco use during pregnancy. RESULTS There was evidence of an indirect association between maternal exposure to childhood adversity and infant gestational age at birth (b = -0.03, 95% CI = -0.06 - -0.01) and infant birth weight (b = -8.85, 95% CI = -18.60 - -1.28) such that higher maternal ACE score was associated with earlier gestational age and lower infant birth weight through increases in financial distress during pregnancy. There was no evidence of an indirect association between maternal exposure to childhood adversity and infant NICU admission (b = 0.01, 95% CI = -0.02-0.08). CONCLUSIONS Findings demonstrate one pathway linking maternal childhood adversity to a potentially preterm birth or shorter gestational age, in addition to low birth weight at delivery, and present an opportunity for targeted intervention to support expecting mothers who face financial stress.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | | | - Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, USA
- Department of Psychiatric and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - Cathrine Hoyo
- Department of Biological Sciences and Center for Human Health, North Carolina State University, Raleigh, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, USA
| | - Raquel G Hernandez
- Johns Hopkins All Children's Hospital, Baltimore, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Joddy Marchesoni
- Department of Biological Sciences and Center for Human Health, North Carolina State University, Raleigh, USA
| | - Lauren M Klein
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Sara B Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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45
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Storrie CL, Kitissou K, Messina A. The Effects of Severe Childhood Physical and Sexual Abuse on Adult Socioeconomic Prosperity. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:55-68. [PMID: 36776634 PMCID: PMC9908797 DOI: 10.1007/s40653-022-00499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 06/18/2023]
Abstract
Our study utilizes Adverse Childhood Experience (ACE) scores to estimate the relationship between forced sexual intercourse and physical abuse on socioeconomic outcomes in adulthood. ACEs have been shown to have long-term negative impacts on health, mental health, and cognition. We expand upon the literature that analyzes the effects of ACEs on human capital investment and adult socioeconomic outcomes by focusing on the ACE scores pertaining to repeated physical and forced sexual abuse in childhood. Specifically, we estimate probit models using data from the Behavioral Risk Factor Surveillance System to measure the marginal effects of childhood sexual abuse (CSA) and physical abuse on the probability of high school completion, unemployment, and the likelihood of living in poverty in adulthood. We find adults who suffered physical abuse in childhood are more likely to live in poverty. Adult survivors of CSA are less likely to finish high school and more likely to live in poverty. The likelihood of high school noncompletion increases when the individual suffered both forms of abuse. We also find that only those who suffered both forms of abuse in childhood had a greater likelihood of being unemployed and high school noncompletion. We find the negative socioeconomic impact in adulthood is larger for women than for men, implying gender heterogeneity in outcomes of CSA and physical abuse. Researchers should control for the correlation between sexual abuse and physical abuse in childhood, particularly in women, when estimating their effects on socioeconomic outcomes.
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Affiliation(s)
- Christine L. Storrie
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
| | - Kpoti Kitissou
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
| | - Anthony Messina
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
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Levey EJ, Chang AR, Sanchez MLJ, Harrison AM, Rodriguez AEM, Gelaye B, Rondon MB. Manifestations of Intergenerational Trauma During the Perinatal Period Among Adolescent Mothers in Lima, Peru: A Qualitative Analysis. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:21-30. [PMID: 36776635 PMCID: PMC9908777 DOI: 10.1007/s40653-022-00477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 06/18/2023]
Abstract
Adverse childhood experiences have a lasting impact on health across the life course. The perinatal period offers a unique opportunity to rework problematic dynamics in families experiencing intergenerational trauma. This study explores the family dynamics that are activated during the perinatal period and considers the potential for intervention with adolescent parents and their families in Lima, Peru. This narrative analysis was part of a broader study that included focus groups and in-depth interviews. Of the ten adolescent mothers interviewed, four narratives were selected for presentation in this manuscript. These particular narratives were selected to illustrate the diversity of the experiences among this group and for the exceptional level of detail provided about their life experiences and family relationships. Narrative excerpts were analyzed in the context of the entire interview and the aggregate content of other interviews in order to explore both explicit and implicit meanings. This study identified critical relational shifts among adolescent parents and their families during the perinatal period. In one instance, adolescent parenthood created an opportunity for the family to come together. In the other cases, conflict escalated, relations grew distant, or both. These narrative data demonstrate that intergenerational trauma can interfere with family relationships in the context of adolescent pregnancy and prevent adolescent parents from accessing needed support from their families. Intervention with families could address the impact of trauma and improve communication and collaboration.
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Affiliation(s)
- Elizabeth J. Levey
- The Chester M. Pierce, Division of Global Psychiatry, Massachusetts General Hospital, Boston, 02114 USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115 USA
| | - Andrew R. Chang
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115 USA
| | | | - Alexandra M. Harrison
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115 USA
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA 02139 USA
| | | | - Bizu Gelaye
- The Chester M. Pierce, Division of Global Psychiatry, Massachusetts General Hospital, Boston, 02114 USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115 USA
- Department of Epidemiology, Harvard University T. H. Chan School of Public Health, Boston, MA 02115 USA
| | - Marta B. Rondon
- Asociación Civil Proyectos en Salud, Lima, Peru
- Instituto Nacional Materno Perinatal, Lima, Peru
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Bouchard S, Langevin R, Vergunst F, Commisso M, Domond P, Hébert M, Ouellet-Morin I, Vitaro F, Tremblay RE, Côté SM, Orri M, Geoffroy MC. Child Sexual Abuse and Employment Earnings in Adulthood: A Prospective Canadian Cohort Study. Am J Prev Med 2023:S0749-3797(23)00054-5. [PMID: 36849276 DOI: 10.1016/j.amepre.2023.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/27/2023]
Abstract
INTRODUCTION Child sexual abuse remains a worldwide concern with devastating consequences on an individual's life. This longitudinal study investigates the associations between child sexual abuse (official reports versus retrospective self-reports) and subgroups by perpetrator identity (intrafamilial and extrafamilial), severity (penetration/attempted penetration, fondling/touching, noncontact), and chronicity (single, multiple episodes) and employment earnings in adulthood in a cohort followed for over 30 years. METHODS The Quebec Longitudinal Study of Kindergarten Children database was linked to child protection services (official reports of sexual abuse) and to Canadian government tax returns (earned income). The sample included 3,020 individuals in Quebec French-language school kindergartens in 1986/1988, followed until 2017, and assessed with retrospective self-reports at age 22 years. Tobit regressions were used for associations with earnings (ages 33-37 years), adjusting for sex and family socioeconomic characteristics in 2021-2022. RESULTS Individuals who experienced child sexual abuse had lower annual earnings. Those with retrospective self-reported sexual abuse (n=340) earned $4,031 (95% CI= -7,134, -931) less annually at ages 33-37 years than nonabused individuals (n=1,320), with pronounced differences for those with official reports (n=20), earning $16,042 (95% CI= -27,465, -4,618) less. Individuals self-reporting intrafamilial sexual abuse earned $4,696 (95% CI= -9,316, -75) less than those who experienced extrafamilial sexual abuse, whereas those self-reporting penetration/attempted penetration earned $6,188 (95% CI= -12,248, -129) less than those who experienced noncontact sexual abuse. CONCLUSIONS Earnings gaps were highest for severest child sexual abuse (official reports, intrafamilial, penetrative). Future studies should investigate the underlying mechanisms. Improving support for victims of child sexual abuse could yield socioeconomic returns.
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Affiliation(s)
- Samantha Bouchard
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Rachel Langevin
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Francis Vergunst
- CHU Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montreal, Quebec, Canada; Deparment of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Oslo, Norway
| | - Melissa Commisso
- Department of Psychology, Faculty of Arts and Sciences, Concordia University, Montreal, Quebec, Canada
| | - Pascale Domond
- CHU Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montreal, Quebec, Canada
| | - Martine Hébert
- Department of Sexology, University of Quebec at Montreal, Montreal, Quebec, Canada
| | | | - Frank Vitaro
- School of Psycho-Education, University of Montréal, Montreal, Quebec, Canada
| | - Richard E Tremblay
- Department of Pediatrics, Psychology, and Psychiatry, University of Montréal, Montreal, Quebec, Canada
| | - Sylvana M Côté
- CHU Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montreal, Quebec, Canada
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Marie-Claude Geoffroy
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Arowolo T, Animasahun A, Baptiste-Roberts K, Bronner Y. Effect of COVID-19 Pandemic Response and Parental Adverse Childhood Experiences on Child Health and Well-Being. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 17:1-10. [PMID: 36818743 PMCID: PMC9924853 DOI: 10.1007/s40653-023-00517-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Family responses to crises such as COVID-19 are driven by parents' experiences. Parental history of adverse childhood experiences (ACEs) might play an important role in predicting resilience, coping capacity, and parenting practices during the COVID-19 pandemic response. The purpose of this review is to examine the impact of COVID-19 pandemic disruption on child health and well-being as influenced by the previous history of ACEs in the parents. Scopus, Google Scholar, PubMed, and PsychInfo were searched for peer-reviewed articles using the keywords "COVID-19", "Parents or Maternal Adverse Childhood Experiences", and "child health" or "child well-being". Data were extracted using a literature review matrix template. Title, abstract, and full article-level reviews were conducted by two reviewers. The association between COVID-19 disruption, negative parenting, and child behavioral and emotional problems was stronger for parents with younger children with a history of high ACE scores. Parents with high ACE scores were more likely to cope poorly with childcare duties and engage in child neglect, verbal abuse, and reduced feeding frequency, specifically during the COVID-19 pandemic. The review findings support the framework of inadequate resilience and coping skills of adults with a history of ACEs during periods of stress and unpredictability such as the COVID-19 pandemic. The negative effects of these parental stressors on a child's health and well-being are modifiable and could be mitigated by targeted interventions. Trauma-informed care should be adopted to contribute to optimum child health.
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Affiliation(s)
- Tolu Arowolo
- Department of Public Health, School of Community Health & Policy, Morgan State University, 4530 Portage Ave Campus, Ste 211 1700 E Cold Spring Lane, 21251 Baltimore, MD USA
| | - Adeola Animasahun
- Department of Public Health, School of Community Health & Policy, Morgan State University, 4530 Portage Ave Campus, Ste 211 1700 E Cold Spring Lane, 21251 Baltimore, MD USA
| | - Kesha Baptiste-Roberts
- Department of Public Health, School of Community Health & Policy, Morgan State University, 4530 Portage Ave Campus, Ste 211 1700 E Cold Spring Lane, 21251 Baltimore, MD USA
| | - Yvonne Bronner
- Department of Public Health, School of Community Health & Policy, Morgan State University, 4530 Portage Ave Campus, Ste 211 1700 E Cold Spring Lane, 21251 Baltimore, MD USA
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Fields K, Shreffler KM, Ciciolla L, Baraldi AN, Anderson M. Maternal childhood adversity and prenatal depression: the protective role of father support. Arch Womens Ment Health 2023; 26:89-97. [PMID: 36401128 DOI: 10.1007/s00737-022-01278-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
Depression during pregnancy is common, and previous research suggests childhood adversity may increase the risk for prenatal depression. Support during pregnancy can buffer these risks, and paternal support is associated with improved maternal well-being during pregnancy. There is evidence to suggest that increased support from fathers may be particularly helpful in combatting depressive symptoms for mothers with adverse childhood experiences. The study aims to explore the role of biological father support as a protective factor against the risks associated with childhood adversity for maternal prenatal depression. Sample included 133 pregnant women recruited from two university-affiliated OB-GYN clinics serving diverse and low-income patients. Participants completed measures on childhood adversity, prenatal depressive symptoms, and father support. Results showed a significant moderating effect of father support on the relation between maternal ACEs and prenatal depressive symptoms, suggesting that higher levels of father support are protective against prenatal depressive symptoms, specifically in mothers with low-to-moderate ACEs. These results highlight the positive impact of paternal support for maternal well-being during pregnancy. Although mothers with low-to-moderate ACEs experience a buffering effect of father support, mothers with high levels of childhood adversity remain at elevated risk for prenatal depressive symptoms even with high father support. As such, screening mothers for ACEs in addition to father support may help identify those at higher risk of prenatal depression.
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Affiliation(s)
- Kristin Fields
- Department of Psychology, Oklahoma State University, 116 The Psychology Building, Stillwater, OK, 74078, USA.
| | - Karina M Shreffler
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, 1100 N. Stonewall Ave., Oklahoma City, OK, 73117, USA
| | - Lucia Ciciolla
- Department of Psychology, Oklahoma State University, 116 The Psychology Building, Stillwater, OK, 74078, USA
| | - Amanda N Baraldi
- Department of Psychology, Oklahoma State University, 116 The Psychology Building, Stillwater, OK, 74078, USA
| | - Machele Anderson
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, 85004, USA
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Adverse Childhood Experiences Are Associated With History of Overdose Among Patients Presenting for Outpatient Addiction Care. J Addict Med 2023:01271255-990000000-00139. [PMID: 36728084 DOI: 10.1097/adm.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are associated with mental health issues and substance use. Having a substance use disorder increases the risk of overdose (OD). Research on ACEs and risk of OD is limited. This study examined the relationship between ACE scores and a self-reported history of OD among patients in an addiction and mental health outpatient setting. METHODS This single-center, cross-sectional design included adults in a dual-diagnosis addiction and mental health outpatient recovery and treatment program from November 2017 to August 2020. Patients (N = 115) were assessed with self-report questionnaires, which included ACEs and history of OD. Bivariate and multivariable logistic regression was used to determine factors associated with self-reported OD history. We assessed the reliability and validity of the ACEs scale. RESULTS Of the 115 participants, 26 (22.6%) reported a past OD at intake. The mean ACE score for participants with an OD history, as compared with those with no history of OD, was 4.0 (standard deviation, 2.7) vs 2.3 (standard deviation, 2.2). In the multivariable regression, a higher ACE score was associated with history of OD (adjusted odds ratio, 1.23; 95% confidence interval, 1.00-1.50; P = 0.0456). CONCLUSIONS Given the observed association between OD and higher ACE scores, patients presenting for treatment in outpatient dual-diagnosis clinics should be screened for ACEs and OD history, providing the opportunity for treatment with trauma-informed care and/or referral to appropriate services.
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