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Ning K, Gondek D, Pereira SMP, Lacey RE. Mediating mechanisms of the relationship between exposure to deprivation and threat during childhood and adolescent psychopathology: evidence from the Millennium Cohort Study. Eur Child Adolesc Psychiatry 2024; 33:1907-1920. [PMID: 37676493 PMCID: PMC11211201 DOI: 10.1007/s00787-023-02289-3] [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: 02/02/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
The key aim of our study was to examine pathways from exposure to childhood adversities (i.e., deprivation and threat) to adolescent psychopathology. The assessed mediating mechanisms included cognitive ability and emotion regulation, as proposed by the Dimensional Model of Adversity and Psychopathology (DMAP). The study comprised participants from the nationally representative Millennium Cohort Study. Latent scores for deprivation and threat were derived using confirmatory factor analysis from indicators collected when participants were at age of 9 months, 3 and 5 years. Cognitive ability was measured using the Verbal Similarities subscale of the British Ability Scales II at age 11, and emotion regulation was measured using emotion dysregulation subscale of the Child Social Behavioural Questionnaire at age 7. Psychopathology, defined as psychological distress, was assessed using the Kessler 6 scale at age 17. We conducted causal mediation analysis adjusting for multiple confounding factors. We did not find total effect of either exposure to deprivation or threat on psychological distress, but we did find significant indirect effects of exposure to deprivation on psychological distress via cognitive ability (- 0.11, 95% CI - 0.20 to - 0.05) and emotion regulation (0.03, 0.02 to 0.12), and exposure to threat on psychological distress via cognitive ability (- 0.04, - 0.07 to - 0.01) and emotion regulation (0.09, 0.03 to 0.15). The lack of associations between deprivation or threat and psychological distress may be due to reporting bias or developmental period of psychopathology. Results of mediation analysis partially support the DMAP but indicate limited benefits to reduce adolescent psychological distress by targeting cognitive ability or emotion regulation to those exposed to childhood adversities.
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Affiliation(s)
- Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Dawid Gondek
- Research Department of Epidemiology and Public Health, University College London, London, England
- Swiss Centre of Expertise in Life Course Research (LIVES), University of Lausanne, Lausanne, Switzerland
| | - Snehal M Pinto Pereira
- Division of Surgery and Interventional Science, University College London, London, England
| | - Rebecca E Lacey
- Research Department of Epidemiology and Public Health, University College London, London, England.
- Population Health Research Institute, St George's, University of London, London, England.
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2
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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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Chaudhary V, Walia GK, Devi NK, Shekhawat LS, Saraswathy KN. Adverse childhood experiences in mental health of young adults: An exploratory study from Delhi-NCR, India. Int J Soc Psychiatry 2024; 70:445-456. [PMID: 38063051 DOI: 10.1177/00207640231214986] [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: 05/03/2024]
Abstract
BACKGROUND Despite the growing realization regarding the importance of adverse childhood experiences (ACEs) in adult health outcomes, this area of research has received little scientific attention in low- and middle-income countries, including India. AIMS To understand the overall and domain-specific association of exposure to ACEs with current depression, anxiety, stress, and well-being among young adults of Delhi-NCR. METHODS This cross-sectional study was carried out among 1,812 young adults (aged 18-25 years) of both sexes (68.7% females). Fieldwork was conducted on the campuses of the University of Delhi, Delhi, and Amity University, Noida, India. ACEs, depression, anxiety, stress, and well-being were screened using the Adverse Childhood Experiences International Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory, Perceived Stress Scale, and WHO-5 Well-Being Index, respectively. RESULTS Exposure to ACEs was found to increase the odds of moderate/severe depression, moderate/severe anxiety, and high stress and decreased the odds of good well-being in a dose-response manner. Being bullied, followed by emotional abuse, was associated with the highest odds of current moderate/severe depression, moderate/severe anxiety, and high stress and the lowest odds of good well-being. Further, while several domains of household dysfunction showed poor association with studied mental health outcomes, domains of abuse and violence were more consistently associated. CONCLUSIONS The present study revealed the detrimental impact of ACEs on mental health outcomes among young adults of Delhi-NCR, India, and underscored the relevance of ACEs in the Indian context. Considering the lack of trauma awareness in Indian societies, there is an urgent need to create widespread awareness regarding ACEs and associated health implications.
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Affiliation(s)
| | | | | | - Lokesh Singh Shekhawat
- Department of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, India
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Gondek D, Bernardi L, McElroy E, Comolli CL. Why do Middle-Aged Adults Report Worse Mental Health and Wellbeing than Younger Adults? An Exploratory Network Analysis of the Swiss Household Panel Data. APPLIED RESEARCH IN QUALITY OF LIFE 2024; 19:1459-1500. [PMID: 39211006 PMCID: PMC11349807 DOI: 10.1007/s11482-024-10274-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/09/2024] [Indexed: 09/04/2024]
Abstract
Despite the growing consensus that midlife appears to be a particularly vulnerable life phase for lower mental health and wellbeing, little is known about the potential reasons for this phenomenon or who the individuals at higher risk are. Our study used six waves (2013-2018) of the Swiss Household Panel (n = 5,315), to compare the distribution of mental health and wellbeing, as well as their key correlates, between midlife (40-55 years) and younger adults (25-39 years) in Switzerland. Moreover, using network analysis to investigate interrelationships across life domains, we describe the complex interrelations between multiple domain-specific correlates and indicators of both mental health and wellbeing across the two age groups. Middle-aged (age 40-55) individuals reported lower life satisfaction and joy, as well as higher anger, sadness, and worry than young adults (age 25-39), with the effect sizes reaching up to 0.20 Cohen's d. They also reported lower social support, relationships satisfaction, health satisfaction, and higher job demands and job insecurity. Relationships satisfaction and social support were the most consistent correlates across all three indicators of wellbeing in both age groups. Health satisfaction was more strongly, and directly, interrelated with energy and optimism in midlife compared with young adulthood (0.21 vs 0.12, p = 0.007). Job demands were more strongly linked with anger and sadness in midlife. The network model helped us to identify correlates or their clusters with direct and strong links to mental health and wellbeing. We hypothesised that health satisfaction, relationships satisfaction, social support, and job demands may help to explain worse mental health and wellbeing in midlife. Supplementary Information The online version contains supplementary material available at 10.1007/s11482-024-10274-4.
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Affiliation(s)
- Dawid Gondek
- Swiss Centre of Expertise in Life Course Research (LIVES), University of Lausanne, Bâtiment Géopolis, CH-1015 Lausanne, Switzerland
- FORS, Swiss Centre of Expertise in the Social Sciences, Lausanne, Switzerland
| | - Laura Bernardi
- Swiss Centre of Expertise in Life Course Research (LIVES), University of Lausanne, Bâtiment Géopolis, CH-1015 Lausanne, Switzerland
| | - Eoin McElroy
- School of Psychology, Ulster University, Coleraine, UK
| | - Chiara L. Comolli
- Department of Statistics “Paolo Fortunati”, University of Bologna, Bologna, Italy
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5
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Blanchflower DG, Bryson A. The adult consequences of being bullied in childhood. Soc Sci Med 2024; 345:116690. [PMID: 38367340 DOI: 10.1016/j.socscimed.2024.116690] [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: 11/30/2023] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 02/19/2024]
Abstract
Most studies examining the impact of bullying on wellbeing in adulthood rely on retrospective measures of bullying and concentrate primarily on psychological outcomes. Instead, we examine the effects of bullying at ages 7 and 11, collected prospectively by the child's mother, on subjective wellbeing, labour market prospects, and physical wellbeing over the life-course. We exploit 12 sweeps of interview data through to age 62 for a cohort born in a single week in Britain in 1958. Bullying negatively impacts subjective well-being between ages 16 and 62 and raises the probability of mortality before age 55. It also lowers the probability of having a job in adulthood. These effects are independent of other adverse childhood experiences.
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Affiliation(s)
- David G Blanchflower
- Department of Economics, Dartmouth College, Adam Smith Business School, University of Glasgow, GLO and NBER, UK.
| | - Alex Bryson
- Social Research Institute, University College London, NIESR and IZA, UK.
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Moodley L, Ntlantsana V, Tomita A, Paruk S. The missed pandemic: Intimate partner violence in female mental-health-care-users during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:3064-3075. [PMID: 37122135 DOI: 10.1080/13548506.2023.2206143] [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: 01/06/2022] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
Adverse childhood experiences (ACEs) and interpersonal violence (IPV) in mentally ill women are often neglected and need to be reviewed in light of the suggested increase in IPV during the COVID-19 pandemic.We investigated the prevalence of ACEs and IPV in women living with severe mental illness (SMI) attending an outpatient psychiatry service at a public hospital in KwaZulu-Natal, South Africa, during the COVID-19 pandemic. We also described the association of ACEs with later IPV.A written survey comprising socio-demographic and clinical questionnaire, WHO Adverse Childhood Experiences International Questionnaire (ACE-IQ) for ACEs and the Women abuse screening tool (WAST) for IPV, was completed by the 154 women with SMI.141 (91.6%) participants scored positive for ACEs and 104 (67.5%) had experienced three or more ACEs. The most prevalent forms of ACEs were emotional neglect 72 (46.8%), one or no parents, parental separation, or divorce 104 (67.5%), contact sexual abuse 67 (43.5%) and witnessing a household member treated violently 67 (43.5%). Sixty-one (46.6%) participants reported IPV with scores 13 (indicative of abuse). On logistic regression, experience of three or more ACEs was significantly associated with IPV in adulthood (aOR 3.3, 95% CI: 1.2-9.6).The high prevalence of IPV and association of IPV with cumulative ACEs reflect firstly the hidden epidemic of domestic violence and secondly the vulnerability of those with ACEs to become victims of abuse later which is often missed in the care of women with SMI.
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Affiliation(s)
- Lynette Moodley
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Vuyokazi Ntlantsana
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Bellis MA, Hughes K, Ford K, Lowey H. Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey. BMC Public Health 2023; 23:1618. [PMID: 37620866 PMCID: PMC10463476 DOI: 10.1186/s12889-023-16549-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: 09/26/2022] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals' levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends. METHODS A cross-sectional household telephone survey in England (a North West local authority) and Wales (nationally) using landline and mobile numbers stratified by health areas, deprivation quintile and age group and supplemented by an online survey. Data were collected from 4,673 English and Welsh residents aged ≥ 18 years during national COVID-19 restrictions (December 2020 to March 2021). Measures included nine types of ACE; self-reported mental health, physical health and sleep quality at time of survey (in pandemic) and one-year earlier (pre-pandemic); numbers of trusted family members and friends, knowledge of community help; and COVID-19 infection. RESULTS ACEs were strongly related to moving into poorer mental health, physical health, and sleep categories during the pandemic, with likelihoods more than doubling in those with ≥ 4 ACEs (vs. 0). ACEs were also associated with increased likelihood of moving out of poorer health and sleep categories although this was for a much smaller proportion of individuals. Individuals with more trusted family members were less likely to move into poorer health categories regardless of ACE counts. CONCLUSIONS ACEs are experienced by large proportions of populations and are associated with poorer health even in non-pandemic situations. However, they also appear associated with greater vulnerability to developing poorer health and well-being in pandemic situations. There is a minority of those with ACEs who may have benefited from the changes in lifestyles associated with pandemic restrictions. Connectedness especially with family, appears an important factor in maintaining health during pandemic restrictions.
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Affiliation(s)
- Mark A Bellis
- Faculty of Health, Liverpool John Moores University, Liverpool, L2 2ER, UK.
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Policy and International Health, Public Health Wales, Wrexham, LL13 7YP, UK.
- Public Health Collaborating Unit, School of Medical and Health Sciences, College of Human Sciences, Bangor University, Wrexham, LL13 7YP, UK.
| | - Karen Hughes
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Policy and International Health, Public Health Wales, Wrexham, LL13 7YP, UK
- Public Health Collaborating Unit, School of Medical and Health Sciences, College of Human Sciences, Bangor University, Wrexham, LL13 7YP, UK
| | - Kat Ford
- Public Health Collaborating Unit, School of Medical and Health Sciences, College of Human Sciences, Bangor University, Wrexham, LL13 7YP, UK
| | - Helen Lowey
- Helen Lowey Consultancy Ltd, Lathom, L40 4BQ, UK
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Bhui K, Butcher I. The trouble with trauma and triggering. Lancet Psychiatry 2023; 10:478-479. [PMID: 37080220 DOI: 10.1016/s2215-0366(23)00112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Kamaldeep Bhui
- CHIMES Research Group, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX3 7JX, UK; Wadham College, University of Oxford, Oxford OX3 7JX, UK.
| | - Isabelle Butcher
- CHIMES Research Group, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
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Gondek D, Feder G, Howe LD, Gilbert R, Howarth E, Deighton J, Lacey RE. Factors mitigating the harmful effects of intimate partner violence on adolescents' depressive symptoms-A longitudinal birth cohort study. JCPP ADVANCES 2023; 3:e12134. [PMID: 37431316 PMCID: PMC10241470 DOI: 10.1002/jcv2.12134] [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: 05/13/2022] [Accepted: 12/02/2022] [Indexed: 09/20/2024] Open
Abstract
Background Preventing parental intimate partner violence (IPV) or mitigating its negative effects early in the lifecourse is likely to improve population mental health. However, prevention of IPV is highly challenging and we know very little about how the mental health of children exposed to IPV can be improved. This study assessed the extent to which positive experiences were associated with depressive symptoms among children with and without experience of IPV. Method This study used data from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort. After excluding those without information on depressive symptoms at age 18, the final sample comprised 4490 participants. Parental intimate partner violence (physical or emotional cruelty reported by mother or partner) when the cohort child was aged 2-9 years. Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 18 years. Results Each additional report of parental intimate partner violence (over six reports) was associated with 0.047 (95% CI 0.027-0.066), or 4.7%, higher SMFQ score. Conversely, each additional positive experience (over 11 domains) was linked with -0.042 (95% CI -0.060 to -0.025) or 4.1%, lower SMFQ score. Among those with parental intimate partner violence (19.6% of participants), relationship with peers (effect size = 3.5%), school enjoyment (effect size = 1.2%), neighbourhood safety and cohesion (effect size = 1.8%) were associated with lower levels of depressive symptoms. Conclusions Most positive experiences were linked with lower levels of depressive symptoms regardless of parental intimate partner violence exposure. However, among those with parental IPV, this association was found only for relationships with peers, school enjoyment, neighbourhood safety and cohesion on depressive symptoms. If our findings are assumed to be causal, nurturing these factors may mitigate the harmful effects of parental intimate partner violence on depressive symptoms in adolescence.
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Affiliation(s)
- Dawid Gondek
- UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Gene Feder
- Department of Population Health SciencesUniversity of BristolBristolUK
- Centre for Academic Primary CareUniversity of BristolBristolUK
| | - Laura D. Howe
- Department of Population Health SciencesUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Ruth Gilbert
- UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Emma Howarth
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
- School of PsychologyUniversity of East LondonLondonUK
| | - Jessica Deighton
- Evidence Based Practice UnitUniversity College LondonAnna Freud National Centre for Children and FamiliesClinical, Educational and Health PsychologyLondonUK
| | - Rebecca E. Lacey
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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Grummitt L, Barrett E, Kelly E, Newton N. An Umbrella Review of the Links Between Adverse Childhood Experiences and Substance Misuse: What, Why, and Where Do We Go from Here? Subst Abuse Rehabil 2022; 13:83-100. [PMID: 36411791 PMCID: PMC9675346 DOI: 10.2147/sar.s341818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/09/2022] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A wealth of research has identified adverse childhood experiences (ACEs; abuse, neglect, violence or disorder in the home) as a strong risk factor for substance misuse. Synthesis of the existing evidence is critical to shape policy and inform directions for future research. Existing reviews have focused on specific substances or substance use outcomes (eg, disorder), and do not include discussion of the mechanisms that operate between ACEs and substance misuse. The current umbrella review aims to synthesize reviews on the relationship between ACEs and substance misuse, review the evidence on the mechanisms linking these, identify existing gaps in our knowledge, and discuss critical directions for future research, practice, and public policy. METHODS Two electronic databases (PsycINFO and Medline) were searched for reviews published between 1998 and 2022 on the link between ACEs and substance misuse. Twenty articles met eligibility criteria and were qualitatively synthesized. RESULTS Results overwhelmingly demonstrated an elevated risk of substance misuse or disorder, among adolescents and adults exposed to ACEs. Research on the mechanisms that explain this link highlights a multitude of potential intervention targets, with childhood stress propelling a cascade of effects across neurobiological, endocrine, immune, metabolic, and nervous systems, impacting psychosocial and cognitive functioning. Nonetheless, the literature is subject to limitations surrounding potential unmeasured cofounders and causality, as well as decontextualizing childhood adversity from broader structural issues that influence the link between ACEs and substance misuse. Research, policy, and practice that seek to holistically understand and address the relationship between ACEs and substance misuse within the broader social determinants of health is crucial.
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Affiliation(s)
- Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
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Ceccarelli C, Prina E, Muneghina O, Jordans M, Barker E, Miller K, Singh R, Acarturk C, Sorsdhal K, Cuijpers P, Lund C, Barbui C, Purgato M. Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders. Epidemiol Psychiatr Sci 2022; 31:e75. [PMID: 36245402 PMCID: PMC9583628 DOI: 10.1017/s2045796022000580] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/09/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022] Open
Abstract
Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low- and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs).In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.
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Affiliation(s)
- C. Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - E. Prina
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - O. Muneghina
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | - M. Jordans
- War Child, Amsterdam, the Netherlands
- University of Amsterdam, Amsterdam, the Netherlands
| | - E. Barker
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - K. Miller
- Faculty of Education, University of British Columbia, Vancouver, Canada
| | - R. Singh
- Research Department, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - C. Acarturk
- Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Turkey
| | - K. Sorsdhal
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - P. Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
- Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - C. Lund
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
- Health Service and Population Research Department, King's Global Health Institute, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - C. Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - M. Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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Grummitt LR, Keyes KM, Rajan S, Kelly EV, Barrett EL, Newton NC. Clusters of Adversity Types Among U.S. Youth: Associations With Mental Health. Am J Prev Med 2022; 63:331-340. [PMID: 35523697 DOI: 10.1016/j.amepre.2022.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Childhood adversities are risk factors for subsequent mental health problems. Research commonly focuses on adverse childhood experiences, despite evidence that other exposures, such as neighborhood violence or peer victimization, co-occur with adverse childhood experiences and are associated with similar mental health outcomes. This study explored the clustering of these exposures and examined the associations with mental health. METHODS Data were a nationally representative sample of U.S. children aged 10-17 years (N=1,959), collected in 2013-2014. Latent class analysis was conducted on 22 types of childhood adversity. Regression models examined associations with mental health and substance use. These secondary analyses were conducted in 2021. RESULTS A total of 5 classes were identified: Low all (59% of the sample), Abuse (29%), High multiple adversities (5%), Peer adversity (4%), and Neighborhood violence (4%). All classes had poorer mental health and a higher prevalence of substance use than Low all, with particularly harmful levels in High multiple adversities. Neighborhood violence was not significantly different from High multiple adversities on mental health symptoms and showed a greater proportion of past-year substance use than all other classes except High multiple adversities. Peer adversity and Abuse classes did not differ significantly in any outcomes. CONCLUSIONS Findings highlight the particularly deleterious impact of neighborhood violence and highly co-occurring adversity types on mental health and substance use. It is important to extend our conceptualization of adverse childhood experiences to include peer adversity and neighborhood violence and shift from a siloed approach to examining all these exposures.
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Affiliation(s)
- Lucinda R Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sonali Rajan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Teachers College, A Graduate School of Education & Psychology, Columbia University, New York, New York
| | - Erin V Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Personality as a Possible Intervention Target to Prevent Traumatic Events in Adolescence. Behav Sci (Basel) 2022; 12:bs12040090. [PMID: 35447662 PMCID: PMC9031006 DOI: 10.3390/bs12040090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Traumatic events (severe injury, violence, threatened death) are commonly experienced by children. Such events are associated with a dose-response increasing risk of subsequent substance use, mental illness, chronic disease, and premature mortality. Preventing the accumulation of traumatic events is thus an urgent public health priority. Substance use risk personality profiles (impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) may be an important target for preventing trauma exposure, given associations between these personality traits and risky behaviour, substance misuse, and injuries across adolescence. The current study aimed to investigate associations between personality at age 13 and the number of traumatic events experienced by age 18. It also examined associations between traumas before age 13 and personality at age 13. Participants were the control group of a cluster-randomised controlled trial examining prevention of adolescent alcohol misuse. Baseline data were collected at ages 12–13 (2012). Participants were followed-up at ages 18–19 (2017–2018). Personality profiles of hopelessness, anxiety sensitivity, impulsivity, and sensation seeking were measured at baseline using the Substance Use Risk Profile Scale. Traumatic events and age of exposure were measured at age 18–19 using the Life Events Checklist for DSM-5. Mixed-effect regression was conducted on 287 participants in Stata 17, controlling for sex. High scores on hopelessness, impulsivity, and sensation seeking at age 13 were associated with a greater number of traumatic events by age 18. Impulsivity and sensation seeking predicted the number of new traumatic events from age 13 to 18. Prior trauma exposure was associated with high hopelessness at age 13. Adolescents exhibiting high impulsivity or sensation seeking may be at greater risk of experiencing traumatic events. Additionally, early trauma exposure may contribute to the development of a hopelessness personality trait.
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