Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study

"Support for my dad would have benefited me because I was the one looking after him": A qualitative analysis of the support needs of young people exposed to Adverse Childhood Experiences

BACKGROUND

Adverse childhood experiences (ACEs) are associated with negative health and wellbeing outcomes. Ensuring young people receive timely and appropriate support after experiencing ACEs could improve these outcomes.

OBJECTIVE

This study aimed to explore what works to support young people living with ACEs; what support do they receive, and what are the characteristics of valuable help?

PARTICIPANTS AND SETTING

Young people living in Wales aged 16-18 years (n = 559) completed an online survey about their ACEs and the help they did or did not receive with these experiences.

METHODS

Free text responses were analysed using reflexive thematic analysis. Public involvement workshops with young people were utilised to guide the analytic process.

RESULTS

Few participants reported accessing enough support. Five themes were developed: "Help me by helping my family", "Talking to a trusted adult is helpful… until it's not", "Being informed: 'I was kept in the loop'", "Schools and colleges as sites of support" and "Loneliness and peer support".

CONCLUSIONS

More support is needed for young people with ACEs. Young people find it helpful when their whole family is supported in times of adversity, not blamed. People who provide support should be empathic and non-judgmental. Young people would rather be spoken to about ACEs and 'kept in the loop' than have them treated as a taboo or sensitive subject. Experiencing ACEs can be lonely in the absence of peer support. Schools and colleges are acceptable sites of support and may be well placed to provide opportunities for peer support.

Positive childhood experiences in mental health of young adults across adverse childhood experiences levels: A study from Delhi-NCR, India

BACKGROUND

While the impact of adverse childhood experiences (ACEs) on adult health outcomes has received substantial scientific attention, the role of positive childhood experiences (PCEs) has far less widely been explored, especially in low- and middle-income countries.

OBJECTIVE

The present study aimed to understand the association of exposure to cumulative and individual PCEs with current depression, anxiety, stress, and well-being among young adults in Delhi-NCR, India, independently and across ACE exposure levels.

PARTICIPANTS AND SETTING

This cross-sectional study involved 1553 young adults (aged 18-25) of both sexes (70.3 % females) residing in Delhi-NCR.

METHODS

PCEs and ACEs were measured using the Benevolent Childhood Experiences scale and ACE- International Questionnaire, respectively. Depression, anxiety, stress, and well-being were screened using validated tools.

RESULTS

In the overall analysis, exposure to PCEs was negatively associated with depression, anxiety, and stress and positively associated with well-being, even after accounting for ACEs. Feeling comfortable with oneself emerged as the most important PCE item with respect to studied mental health conditions. The stratified analysis showed that while the PCE score was associated only with depression (negatively) in the no ACE category, it was associated with all the studied outcome variables in higher ACE categories.

CONCLUSIONS

The study found PCEs to be associated with better mental health outcomes across varying ACE levels, with the protective effect being particularly pronounced in high ACE contexts. Promoting PCEs can help improve mental health outcomes and well-being despite adversities.

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

BACKGROUND

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

OBJECTIVE

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

PARTICIPANTS AND SETTING

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Workplace trauma and professional quality of Life in clinical and forensic psychiatry: the CRITIC study

Background

Frontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL).

Method

The Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling.

Discussion

The CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals.

Trial registration

The CRITIC study has been approved by the Medical Ethical Committee of the Erasmus Medical Centre, under trial registration number NL73417.078.20.