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Ntshalintshali T, Maepa MP. Relationship between childhood trauma and risk-taking and self-harm behaviors among Eswatini adolescents. Acta Psychol (Amst) 2025; 256:105045. [PMID: 40328102 DOI: 10.1016/j.actpsy.2025.105045] [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: 05/02/2024] [Revised: 04/15/2025] [Accepted: 04/25/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND There is a high number of child abuse and neglect cases globally that are associated with risk-taking and self-harm behaviors among adolescents in the Kingdom of Eswatini. PARTICIPANTS AND SETTING A sample of 470 adolescent boys and girls 16.57 years from selected high schools in Eswatini participated in the study. METHODS Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma and neglect. The Risk-taking and Self-harm Inventory for adolescents was utilized to measure adolescent risk-taking (RT) and self-harm (SH). A Pearson correlation coefficient and linear regression were used to test the association of childhood trauma with risk-taking and self-harm behaviors. RESULTS Results indicated an overall significant positive relationship between childhood trauma (emotional abuse (r(467) = 0.195, p < .001), physical abuse (r(470) = -0.245, p < .001), sexual abuse (r(469) = 0.205, p < .001), and risk-taking behavior and significant positive relationship between emotional abuse (r(288) = 0.347, p < .001), physical abuse (r(290) = 0.290, p < .001), sexual abuse (r(290) = 0.293, p < .001), and emotional neglect (r(290) = -0.193, p < .001), and physical neglect (r(290) = -0.121, p < .04) and self-harm behavior. CONCLUSIONS A significant correlation was found between childhood trauma and risk-taking and self-harm behaviors. Emotional, physical, and sexual abuse correlated with risk-taking behavior while all aspects of childhood trauma correlated with self-harm behavior.
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Affiliation(s)
- Thobile Ntshalintshali
- Department of Psychology, Faculty of Health Sciences, North-West University, Mafikeng, South Africa
| | - Mokoena Patronella Maepa
- Department of Clinical Psychology, School of Medicine, Sefako Makgatho Health Sciences University (SMU), Ga-Rankuwa, Pretoria, South Africa.
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Xu H, Cai J, Li M, Yuan Y, Qin H, Liu J, Wang W. Beyond Cumulative Scores: Distinct Patterns of Adverse Childhood Experiences and Their Differential Impact on Emotion, Borderline Personality Traits, and Executive Function. Stress Health 2025; 41:e3511. [PMID: 39621299 DOI: 10.1002/smi.3511] [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: 04/30/2024] [Revised: 10/09/2024] [Accepted: 11/12/2024] [Indexed: 03/05/2025]
Abstract
Adverse childhood experiences (ACEs) are associated with long-lasting and multifaceted consequences for mental health. Despite established dose-response effects of ACEs on mental health, the specificity of ACE pattern effects remains understudied, especially on executive function. This study aims to explore how specific patterns of ACEs, beyond just cumulative scores, differentially impact emotional symptoms, personality and cognitive function. This study recruited 2515 college students from several universities in northern China. Demographic characteristics, depression, anxiety, borderline personality traits, and executive function (Wisconsin Card Sort Test) were assessed. Latent class analysis was used to identify patterns of ACEs. Data were analysed using χ2-test, ANCOVA, and multivariate linear regression methods. Pattern-oriented and cumulative-oriented approaches were compared to predict the effects of ACEs. Three distinct patterns of ACEs were identified: low adversity (LA), multiple adversity (MA), and family environment adversity (FA). FA with the highest number of ACEs was uniquely linked to executive function impairments, while both MA and cumulative ACEs significantly predicted higher anxiety, depression, and borderline personality traits. The pattern-oriented method was more sensitive to capturing the diverse outcomes of executive function impairment than cumulative scores. Our findings highlight the importance of moving beyond cumulative scores and considering specific ACEs patterns to understand their differential impact on mental health. Identifying FA as a distinct pattern with specific consequences for executive function offers valuable insights into developing targeted prevention strategies tailored to specific risk profiles.
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Affiliation(s)
- Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Jinping Cai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Man Li
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
| | - Yidan Yuan
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Hao Qin
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Weiwen Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Li R, Jia L, Zha J, Wang X, Huang Y, Tao X, Wan Y. Association of maternal and paternal adverse childhood experiences with emotional and behavioral problems among preschool children. Eur Child Adolesc Psychiatry 2025; 34:1111-1123. [PMID: 39126496 DOI: 10.1007/s00787-024-02542-3] [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: 10/25/2023] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
Although maternal adverse childhood experiences (ACEs) are known to be related to the emotional and behavioral problems (EBPs) of offspring, few studies have surveyed the intergenerational effects of paternal ACEs. In addition, no study has yet explored the combination and interaction effects of maternal and paternal ACEs on preschool children's EBPs in China, and the gender differences in these relationships also remain to be explored. A total of 3,575 preschool children from 12 preschools from Hefei city of Anhui province were included in this study. We used a binomial logistic regression to examine the relationship between maternal ACEs, paternal ACEs and children's EBPs. Logistic regression analysis indicated that maternal and paternal ACEs were significantly related to EBPs in children, respectively. The high maternal ACEs + high paternal ACEs group had the greatest association with children's EBPs. Interaction analysis results showed that, compared with the reference group (low maternal ACEs×low paternal ACEs), the other group (high maternal ACEs×high paternal ACEs ) were significantly related to children's EBPs (OR = 1.84, 95%CI: 1.55-2.19). We found that there were no gender differences in the combination and interaction effects (P>0.05). When fathers and mothers were jointly exposed to high levels of ACEs, children had a higher risk of developing EBPs than when they were exposed independently. Future studies should fully explore the intergenerational health effects of parental ACEs so that references for promoting the physical and mental health of preschool children can be developed.
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Affiliation(s)
- Ruoyu Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei, Anhui, China
| | - Liyuan Jia
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei, Anhui, China
| | - Jinhong Zha
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei, Anhui, China
| | - Xiaoyan Wang
- Hefei Women and Children Medical Care Center, Hefei, China
| | - Yongling Huang
- Anhui Women and Children Medical Care Center, Hefei, China
| | - Xingyong Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei, Anhui, China.
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Tao Y, Jin M, Zhang H, Ran M, Xu H, Zou S, Deng F, Huang L, Zhang H, Wang X, Wang Y, Hou H, Liang S, Ma X, Yin L. PRKCB methylation: a potential biomarker of MDD with childhood chronic stress, a cross-sectional study in drug-naive, first-episode adolescent MDD. Epigenetics 2024; 19:2408159. [PMID: 39342638 PMCID: PMC11444515 DOI: 10.1080/15592294.2024.2408159] [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: 06/10/2024] [Revised: 08/29/2024] [Accepted: 09/17/2024] [Indexed: 10/01/2024] Open
Abstract
The purpose of this study was to investigate the relationship between childhood chronic stress(CCS), Protein kinase C beta (PRKCB) methylation and adolescent major depressive disorder (MDD). After recruiting 100 adolescents with MDD and 50 healthy controls (HCs), we evaluated the severity of CCS. PRKCB methylation was assessed by pyrosequencing using whole blood-derived DNA. To explore the relationship between CCS, PRKCB and adolescent MDD, we conducted correlation analysis and regression analysis, and constructed multiplicative interaction models and generalized linear models. PRKCB methylation and CCS were both found to be associated with MDD, and CCS was associated with PRKCB methylation. No significant CCS-PRKCB methylation interactions were observed. However, we found the interaction of CCS and MDD on PRKCB methylation. Our results found that PRKCB methylation was influenced by CCS and the disease itself, and PRKCB methylation was significantly positively associated with MDD severity, suggesting that PRKCB methylation may be a potential biomarker for adolescent MDD. This study is a cross-sectional observational study, which cannot draw the conclusion of causality. Prospective cohort studies are needed to further examine the relationship between CCS, adolescent MDD, and PRKCB methylation.
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Affiliation(s)
- Yuanmei Tao
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
| | - Meijiang Jin
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
| | - Hang Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
| | - Maojia Ran
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
| | - Hanmei Xu
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shoukang Zou
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Fang Deng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Lijuan Huang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hong Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaolan Wang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yanping Wang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huijin Hou
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shufang Liang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaohong Ma
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
| | - Li Yin
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Psychiatry, Sichuan Clinical Medical Research Center for Mental Disorder, Chengdu, Sichuan, China
- Institute for Systematic Genetics, Frontiers Science Center for Disease-Related Molecular Network, Chengdu, Sichuan, China
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Xue J, Huang H, Zhou C, Feng W, Ge Y, Hu Y. Patterns of adverse childhood experiences and their associations with depression, life satisfaction and short-form video addiction in Chinese college students. CHILD ABUSE & NEGLECT 2024; 158:107091. [PMID: 39454405 DOI: 10.1016/j.chiabu.2024.107091] [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: 04/02/2024] [Revised: 09/09/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are widespread in East Asia, heightening the susceptibility to psychological and behavioral complications in adulthood. OBJECTIVE To identify polyvictimization patterns among Chinese college students and investigate the associations between diverse patterns and symptoms of depression, short-form video addiction (SVA), and life satisfaction. PARTICIPANTS AND SETTING This study encompassed 13,307 college students from four urban centers in China (Mage = 20.2; 46.4 % female). METHODS Latent class analysis (LCA) was employed to discern patterns of ACEs among college students. The three-step method (R3step) was utilized to explore the influence of demographic characteristics on the distribution of latent classes. Additionally, the automatic Bolck-Croon-Hagenaars (BCH) Method was deployed to investigate the latent classes effect on distal outcomes. RESULTS Left-behind experience was the most common ACE among Chinese college students. Four ACEs patterns were identified: 1) No/Very Low ACEs class (N = 8936, 67.2 %); 2) Parental Absence class (N = 430, 3.2 %); 3) Low/Moderate ACEs class (N = 3565, 26.8 %); and 4) High Violence and Left-behind class (N = 376, 2.8 %). The findings revealed a progressive escalation in healthy outcomes associated with the four ACEs patterns. Specifically, from the first class to the fourth, the severity of associated consequences (depression, life satisfaction and SVA) intensified. CONCLUSIONS Distinct ACEs patterns correlate with varying degrees of mental health issues. Compared to participants solely separated from parents, those exposed to abuse and neglect demonstrate more pronounced mental health challenges and addiction susceptibilities.
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Affiliation(s)
- Jiao Xue
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Hai Huang
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China.
| | - Chunyan Zhou
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Wenting Feng
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Yanwei Ge
- Mental Health Education Center, China Jiliang University, Hang Zhou, China
| | - Yue Hu
- Student Mental Health and Counseling Center, Sichuan International Studies University, Chongqing, China
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Migeot J, Panesso C, Duran-Aniotz C, Ávila-Rincón C, Ochoa C, Huepe D, Santamaría-García H, Miranda JJ, Escobar MJ, Pina-Escudero S, Romero-Ortuno R, Lawlor B, Ibáñez A, Lipina S. Allostasis, health, and development in Latin America. Neurosci Biobehav Rev 2024; 162:105697. [PMID: 38710422 PMCID: PMC11162912 DOI: 10.1016/j.neubiorev.2024.105697] [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: 10/24/2023] [Revised: 03/05/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.
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Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Carolina Panesso
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Cristian Ávila-Rincón
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia
| | - Carolina Ochoa
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Hernando Santamaría-García
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Josefina Escobar
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Stefanie Pina-Escudero
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, USA
| | - Roman Romero-Ortuno
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
| | - Sebastián Lipina
- Unidad de Neurobiología Aplicada (UNA, CEMIC-CONICET), Buenos Aires, Argentina.
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Gao Y, Liu J, Liu X, Wang Y, Qiu S. Dimensions of family stress and repetitive nonsuicidal self-injury in adolescence: Examining the interactive effects of impulsivity and emotion dysregulation. CHILD ABUSE & NEGLECT 2024; 152:106804. [PMID: 38636157 DOI: 10.1016/j.chiabu.2024.106804] [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: 04/24/2023] [Revised: 10/16/2023] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Repetitive non-suicidal self-injury (R-NSSI) in adolescence represents a significant risk factor for suicide. Although exposure to family stress is robustly associated with the risk of non-suicidal self-injury (NSSI), studies have not examined the potential mechanisms linking different forms of family stress and R-NSSI. OBJECTIVE This study examined how unique dimensions of family stress (threat and deprivation) relate to R-NSSI via interactions between impulsivity and emotion dysregulation. PARTICIPANTS AND SETTING The current sample included 3801 middle-school adolescents (42.2 % girls, Mage = 13.21 years). METHODS We conducted a two-wave study with 6-month intervals. Participants completed self-report measures assessing family stress, impulsivity, emotion dysregulation, and NSSI. RESULTS Moderate mediation analyses showed that threat was indirectly associated with NSSI frequency through the interaction of impulsivity and emotion dysregulation in the R-NSSI group and indirectly through impulsivity in the occasional NSSI (O-NSSI) group. Deprivation did not predict subsequent NSSI frequency in either group. CONCLUSIONS These findings lend empirical support to dimensional models of adversity and suggest that adolescents who experience threat-related family stress may have greater impulsivity and are more likely to report R-NSSI in the context of emotion dysregulation.
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Affiliation(s)
- Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
| | - Yumeng Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shaojie Qiu
- Faculty of Psychology, Beijing Normal University, Beijing, China
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Barger SD, Oláis JA. Partitioning the Composition of Adverse Childhood Experiences From Accumulated Adversity: Cross-Sectional Evidence From 2 U.S. Samples. AJPM FOCUS 2024; 3:100192. [PMID: 38419615 PMCID: PMC10899063 DOI: 10.1016/j.focus.2024.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Introduction Adverse childhood experiences are linked to adult morbidity and mortality. However, it is unknown whether the patterning of adverse childhood experiences, individually and in combination, confer health risk distinct from that of a cumulative adversity score. This study evaluates whether individual and comorbid adverse childhood experience exposures within a cumulative risk score are equally associated with current smoking and lifetime history of depression. Methods Cross-sectional analysis of adverse childhood experience assessments in the Behavioral Risk Factor Surveillance System from 21 states in 2019 (n=115,183) and 23 states in 2020 (n=120,416) was performed. We modeled cumulative adverse childhood experience scores and the 5 most common distinct adverse childhood experience components that compose a given adverse childhood experience score, up to a cumulative score of 4. We compared adverse childhood experience components, adjusting for covariates. Results Across both samples, 23% and 57%-58% of persons reported 1 adverse childhood experience and 2 or more adverse childhood experiences, respectively. In 2019 smoking prevalence was 10.4% for persons reporting zero adverse childhood experiences and 14.2% for persons reporting 1 adverse childhood experience. When the single adverse childhood experience was experiencing parental divorce, smoking was higher (16.6%) than when the single adverse childhood experience was verbal abuse (11.8%) or living with a mentally ill household member (9.5%). Lifetime depression prevalence was 9.6% and 14.1% across zero and 1 adverse childhood experience, respectively, whereas it was 26.6% if the single adverse childhood experience was living with a mentally ill household member and 11.0% when the adverse childhood experience was experiencing parental divorce. This heterogeneity was replicated in 2020 data. Additional heterogeneity was observed for higher cumulative adverse childhood experience scores. Conclusions Cumulative adverse childhood experience scores mask substantial health risk heterogeneity, which can be delineated by examining distinct components of cumulative adverse childhood experience scores.
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Affiliation(s)
- Steven D Barger
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
- the Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - Jose A Oláis
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
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